National Health Investors (NHI) 10-Q 7 May 19 2019 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2019	May 03, 2019
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Entity Registrant Name	NATIONAL HEALTH INVESTORS INC
Entity Central Index Key	0000877860
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		43,199,318
Entity Small Business	false
Entity Emerging Growth Company	false

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Assets
Land	$ 207,380	$ 202,196
Buildings and improvements	2,676,127	2,599,526
Construction in progress	19,810	16,643
Real estate properties, gross	2,903,317	2,818,365
Less accumulated depreciation	(468,562)	(451,483)
Real estate properties, net	2,434,755	2,366,882
Mortgage and other notes receivable, net	257,481	246,111
Cash and cash equivalents	5,177	4,659
Straight-line rent receivable	75,123	105,620
Assets held for sale, net	3,745	0
Other assets	29,987	27,298
Total Assets	2,806,268	2,750,570
Liabilities and Equity
Debt	1,287,205	1,281,675
Accounts payable and accrued expenses	22,532	19,890
Dividends Payable	45,359	42,700
Lease deposit liabilities	10,638	10,638
Deferred income	24,550	5,954
Total Liabilities	1,390,284	1,360,857
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	432	427
Capital in excess of par value	1,406,822	1,369,919
Cumulative net income in excess of dividends	8,388	18,068
Accumulated other comprehensive income	342	1,299
Total Stockholders' Equity	1,415,984	1,389,713
Total Liabilities and Equity	$ 2,806,268	$ 2,750,570

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2019	Dec. 31, 2018
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	43,199,318	42,700,411
Common stock, shares outstanding	43,199,318	42,700,411

Consolidated Statements Of Inco

Consolidated Statements Of Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenues:
Rental income	$ 70,953	$ 69,253
Interest income	5,154	3,493
Revenues	76,107	72,746
Expenses:
Depreciation	18,491	17,335
Interest, including amortization of debt discount and issuance costs	13,518	11,614
Legal	270	111
Franchise, excise and other taxes	545	346
General and administrative	4,014	4,170
Property costs paid from tenant escrow	1,090	0
Loan and realty losses	2,500	0
Total operating expenses	40,428	33,576
Income before investment and other gains	35,679	39,170
Loss on convertible note retirement	0	(738)
Net income	$ 35,679	$ 38,432
Weighted average common shares outstanding:
Basic	42,825,824	41,532,154
Diluted	43,125,032	41,576,876
Basic:
Net income per common share attributable to common stockholders	$ 0.83	$ 0.93
Diluted:
Net income per common share attributable to common stockholders	$ 0.83	$ 0.92

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement of Comprehensive Income [Abstract]
Net income	$ 35,679	$ 38,432
Other comprehensive income (loss):
Increase (decrease) in fair value of cash flow hedge	665	(1,646)
Less: reclassification adjustment for amounts recognized in net income	(292)	276
Total other comprehensive income (loss)	(957)	1,922
Comprehensive income	$ 34,722	$ 40,354

Consolidated Statements Of Cash

Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net income	$ 35,679	$ 38,432
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	18,491	17,335
Amortization	1,263	1,069
Amortization of commitment fees	(119)	(552)
Amortization of lease incentives	168	63
Straight-line rental income	(5,228)	(5,962)
Non-cash interest income on construction loan	(548)	(436)
Loss on modification and extinguishment of debt	0	738
Loan and realty losses	2,500	0
Payment of lease incentives	(1,250)	0
Share-based compensation	2,001	1,425
Change in operating assets and liabilities:
Other assets	2,961	(3,876)
Accounts payable and accrued expenses	1,597	585
Deferred income	16,322	56
Net cash provided by operating activities	73,837	48,877
Cash flows from investing activities:
Investment in mortgage and other notes receivable	(11,002)	(5,905)
Collection of mortgage and other notes receivable	300	2,535
Investment in real estate	(50,122)	(14,404)
Investment in renovations of existing real estate	(4,215)	(1,812)
Net cash used in investing activities	(65,039)	(19,586)
Cash flows from financing activities:
Proceeds from revolving credit facilities	95,000	56,000
Payments on revolving credit facilities	(90,000)	(15,000)
Payments on term loans	(296)	(285)
Debt issuance costs	(67)	0
Value of shares withheld from options exercised for employee tax withholding	(1,006)	0
Proceeds from issuance of common shares, net	35,913	(56)
Consideration provided in convertible bond repurchase	0	(29,958)
Dividends paid to stockholders	(42,700)	(39,456)
Net cash provided by (used in) financing activities	(3,156)	(28,755)
Increase in cash and cash equivalents and restricted cash	5,642	536
Cash and cash equivalents, beginning of year	4,659
Cash and cash equivalents, end of year	5,177
Supplemental disclosure of cash flow information:
Interest Paid, Including Capitalized Interest, Operating and Investing Activities	11,901	9,904
Supplemental schedule of non-cash investing and financing activities:
Change in accounts payable related to investments in real estate construction	(1,048)	290
Change in accounts payable related to investments in real estate acquisition	1,178	0
Change in straight-line rent receivable related to investments in real estate	38,000	0
Change in other assets related to investments in real estate	176	0
Tenant investment in leased asset	0	1,275
Cash and cash equivalents and restricted cash, beginning of period	$ 15,554	$ 8,611

Consolidated Statement Of Equit

Consolidated Statement Of Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Cumulative Dividends In Excess Of Net Income [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Parent [Member]
Balance, shares at Dec. 31, 2017		41,532,154
Balance, value at Dec. 31, 2017		$ 415	$ 1,289,919	$ 32,605	$ (822)	$ 1,322,117
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	$ 38,432			38,432	1,922	40,354
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	$ 40,354
Payments of Stock Issuance Costs			(56)			(56)
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt, Subsequent Adjustments			(2,427)			(2,427)
Stock Issued During Period, Value, New Issues						1,425
Share-based compensation			1,425
Dividends declared, $1.54 per share				(41,532)		(41,532)
Balance, value at Mar. 31, 2018		$ 415	$ 1,288,861	29,270	1,335	$ 1,319,881
Balance, shares at Mar. 31, 2018		41,532,154
Balance, shares at Dec. 31, 2018	42,700,411
Balance, value at Dec. 31, 2018	$ 1,389,713
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	35,679
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	34,722
Balance, value at Mar. 31, 2019	$ 1,415,984
Balance, shares at Mar. 31, 2019	43,199,318
New Accounting Pronouncement or Change in Accounting Principle, Cumulative Effect of Change on Equity or Net Assets				$ (235)	$ 235

Consolidated Statement Of Equ_2

Consolidated Statement Of Equity Consolidated Statement of Equity (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement of Stockholders' Equity [Abstract]
Common Stock, Dividends, Per Share, Declared	$ 1.05	$ 1

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2019
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, 2018 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, 2018 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, notes 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, 2018 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, 2018 , which are included in our 2018 Annual Report on Form 10-K filed with the U.S. Securities and Exchange Commission (the “SEC”), 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. 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 would consolidate 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. If the Company has determined that an entity is not a VIE, the Company assesses the need for consolidation under all other provisions of Accounting Standards Codification (“ASC”) Topic 810 Consolidation . These provisions provide for consolidation of majority-owned entities where a majority voting interest held by the Company demonstrates control of such entities in the absence of any legal constraints. At March 31, 2019 , we held an interest in six 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 Senior Living Various 1 $ 59,943,000 $ 80,228,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 46,678,000 $ 58,921,000 Notes 2, 3 2015 Timber Ridge, LCS affiliate Notes receivable $ 58,765,000 $ 59,790,000 Note 3 2016 Senior Living Management Notes and straight-line receivable $ 26,632,000 $ 26,632,000 Note 3 2017 Evolve Senior Living Note receivable $ 9,933,000 $ 9,933,000 — 2018 Sagewood, LCS affiliate Notes receivable $ 91,013,000 $ 178,283,000 Note 3 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 to a new tenant. 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 and unamortized lease incentives. For VIE relationships listed above without a note reference, refer to our financial statements included in our most recent Annual Report on Form 10-K for the year ended December 31, 2018 . Cash and Cash Equivalents and Restricted Cash - Cash equivalents consist of all highly liquid investments with an original maturity of three months or less. Restricted cash includes amounts required to be held on deposit in accordance with agency agreements governing our Fannie Mae and HUD mortgages. The following table sets forth our cash, cash equivalents and restricted cash reported within the Company’s Condensed Consolidated Statements of Cash Flows (in thousands) : March 31, March 31, Cash and cash equivalents $ 5,177 $ 3,230 Restricted cash 10,377 5,381 $ 15,554 $ 8,611 Leases - We record our operating leases under the guidance of ASC Topic 842, Leases . Our leases generally have an initial leasehold term of 10 to 15 years followed by one or more 5 -year tenant renewal options. The leases are “triple net leases” under which the tenant is responsible for the payment of all taxes, utilities, insurance premiums, repairs and other charges relating to the operation of the properties, including required levels of capital expenditures each year. The tenant is obligated at its expense to keep all improvements, fixtures and other components of the properties covered by “all risk” insurance in an amount equal to at least the full replacement cost thereof, and to maintain specified minimal personal injury and property damage insurance, protecting us as well as the tenant. The leases also require the tenant to indemnify and hold us harmless from all claims resulting from the use, occupancy and related activities of each property by the tenant, and to indemnify us against all costs related to any release, discovery, clean-up and removal of hazardous substances or materials, or other environmental responsibility with respect to each facility. These provisions, along with a growing senior demographic and the historical propensity for real estate to hold its value, collectively constitute much of the means by which the risk associated with the residual value of our properties is mitigated. Additionally, in monitoring the performance of our properties, we are positioned to respond appropriately to declines in physical plant or tenant performance. While we do not incorporate residual value guarantees, the above lease provisions and considerations inform our expectation of realizable value from our properties upon the expiration of their lease terms. The residual value of our real estate under lease is still subject to various market, asset, and tenant-specific risks and characteristics. As the classification of our leases is dependent on the fair value of estimated cash flows at lease commencement, residual values represent significant assumptions in our accounting for operating leases. Similarly, the exercise of options is also subject to these same risks, making a tenant’s lease term another significant variable in a lease’s cash flows. Most of our existing leases contain annual fixed escalators in rent payments, and, for financial statement purposes, rental income is recognized on a straight-line basis over the term of the lease. Other operators lease from us under leases that provide for variable escalation in lease payments based on contingent factors not determinable in advance. Principally, variable revenue from two operators constitutes 21% of our total revenue and derives from either an index applied to the measured level of operations or the consumer price index. Additionally, we derive variable payments from those operators discussed under the sub-heading “Tenant Transition” for which variable payments are determined as discussed later in Note 2. Our variable revenue from these operators is recognized when received. A summary of future minimum lease payments as of March 31, 2019, can be found in Note 2. 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 10.

Real Estate

Real Estate	3 Months Ended
	Mar. 31, 2019
Real Estate [Abstract]
Real Estate Disclosure [Text Block]	REAL ESTATE As of March 31, 2019 , we owned 220 health care real estate properties located in 33 states and consisting of 143 senior housing communities (“SHO”), 72 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 $2,471,000 ) consisted of properties with an original cost of approximately $2,900,846,000 rented under triple-net leases to 30 lessees. During the three months ended March 31, 2019 , we made the following real estate investments and commitments as described below ($ in thousands) : Operator Date Properties Asset Class Amount Wingate Healthcare January 2019 1 SHO $ 52,200 Holiday Retirement January 2019 1 SHO 38,000 $ 90,200 Wingate On January 15, 2019, we acquired a 267 -unit senior living campus in Massachusetts for a purchase price of $50,300,000 , including closing costs of $300,000 . The facility is being leased to Wingate Healthcare, Inc. (“Wingate”) for a term of 10 years , with three five -year renewal options, at an initial lease rate of 7.5% plus annual fixed escalators. We have committed to the additional funding of up to $1,900,000 in capital improvements, and the lease provides for incentive payments up to $5,000,000 to become available beginning in 2020 upon the attainment of certain operating metrics. NHI will have a right of first offer on two additional Wingate-operated facilities. We accounted for the transaction as an asset purchase. Major Tenants Holiday In November 2018, we entered into a lease amendment and guaranty release (“the Agreement”) with an affiliate of Holiday Retirement (“Holiday”). Among other provisions, the Agreement decreased base rent beginning in 2019 from $39,000,000 to $31,500,000 , extended the term of the original lease through 2035, and increased required minimum capital expenditure per unit. As consideration for amending provisions included in the original 2013 lease, Holiday agreed to pay NHI $55,125,000 in cash or real estate and forfeit $10,637,000 of their original $21,275,000 security deposit. On January 31, 2019, we acquired a senior housing facility in Vero Beach, Florida from Holiday consisting of 157 independent living and 71 assisted living units in exchange for $38,000,000 toward the $55,125,000 receivable arising from the lease amendment, discussed above. The property was added to the master lease at a 6.71% lease rate. Under the restructured master lease, annual lease escalators ranging from 2% to 3% , based on portfolio revenue growth, will go into effect on November 1, 2020. Holiday settled the remaining commitment to NHI with cash of $17,125,000 at closing. Acquisition of the property and collection of residual cash flowed through our accounts as adjustments to lease receivables and resulted in the change of our straight-line receivable from Holiday at the beginning of the year into a straight-line payable, which is included in the accompanying Condensed Consolidated Balance Sheets as “deferred income” at March 31, 2019. As of March 31, 2019 , we leased 26 independent living facilities to Holiday. Of our total revenues, $9,930,000 ( 13% ) and $10,954,000 ( 15% ) were derived from Holiday for the three months ended March 31, 2019 and 2018 , respectively, including $1,630,000 and $1,530,000 in straight-line rent income, respectively. Our tenant operates the facilities pursuant to a management agreement with a Holiday-affiliated manager. Bickford As of March 31, 2019 , our Bickford Senior Living (“Bickford”) lease portfolio consists of the following ($ in thousands) : Lease Expiration June 2023 September 2027 May 2031 April 2033 Total Number of Properties 13 4 28 5 50 2019 Contractual Rent $ 11,468 $ 1,576 $ 30,765 $ 4,826 $ 48,635 2019 Straight Line Rent 358 195 3,937 843 5,333 $ 11,826 $ 1,771 $ 34,702 $ 5,669 $ 53,968 Of our total revenues, $13,244,000 ( 17% ) and $11,445,000 ( 16% ) were recognized as rental income from Bickford for the three months ended March 31, 2019 and 2018 , including $1,371,000 and $1,169,000 in straight-line rent income, respectively. Senior Living Communities As of March 31, 2019 , we leased 11 retirement communities totaling 2,216 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 3% effective January 1, 2019. Of our total revenues, $11,532,000 ( 15% ) and $11,449,000 ( 16% ) in rental income were derived from Senior Living for the three months ended March 31, 2019 and 2018 , respectively, including $1,058,000 and $1,359,000 in straight-line rent income, respectively. NHC As of March 31, 2019 , we leased 42 facilities under two master leases to National HealthCare Corporation (“NHC”), a publicly-held company. 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 legacy properties and a master lease agreement dated August 30, 2013 (“the 2013 lease”) which includes 7 skilled nursing facilities acquired in 2013. The 1991 lease expiration is December 31, 2026. There are two additional 5 -year renewal options, each at fair rental value 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, 2019 2018 Current year $ 877 $ 853 Prior year final certification 1 334 285 Total percentage rent income $ 1,211 $ 1,138 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, $9,748,000 ( 13% ) and $9,674,000 ( 13% ) in rental income were derived from NHC for the three months ended March 31, 2019 and 2018 , respectively. The chairman of our board of directors is also a director on NHC’s board of directors. As of March 31, 2019 , NHC owned 1,630,462 shares of our common stock. Purchase Options Certain of our operators hold purchase options allowing them to acquire properties they currently lease from NHI. For options open or coming open in the near future, we are engaged in preliminary negotiations to continue as lessor or in some other capacity. A summary of these tenant options is presented below ( $ in thousands ): Asset Number of Lease 1st Option Option Contractual Type Properties Expiration Open Year Basis Rent MOB 1 February 2025 Open i $ 302 SHO 4 September 2027 Open iv $ 1,560 HOSP 1 September 2027 2020 ii $ 2,673 SHO 8 December 2024 2020 ii $ 6,027 HOSP 1 March 2025 2020 iv $ 1,900 SHO 2 May 2031 2021 iv $ 4,892 HOSP 1 June 2022 2022 i $ 3,460 SNF 7 August 2028 2025 iii $ 3,732 SNF 1 September 2028 2028 iii $ 463 Tenant purchase options generally give the lessee an option to purchase the underlying property for consideration determined by i) greater of fixed base price or fair market value; ii) a fixed base price plus a specified share in any appreciation; iii) fixed base price; or iv) a fixed capitalization rate on lease revenue. Other Portfolio Activity Tenant Transition As of March 31, 2019, we continued to transition three lease portfolios to new operators as a result of non-compliance with our lease terms. The properties consist of three former Regency buildings, five former LaSalle Autumn Leaves properties and a property formerly leased to Landmark. To expedite stabilization of the facilities, NHI has committed to specified income-generating capital expenditures for the re-branding and refurbishment of certain of these properties. While the transition is now underway, during the first quarter of 2019, some agreements concerning the transition were informal in nature. Background of the tenant relationships is described in the financial statements included in Form 10-K for the year ended December 31, 2018. In June 2018, East Lake Capital Management LLC (“East Lake”) and certain related entities, including SH Regency Leasing, LLC (for three assisted living facilities in Tennessee, Indiana and North Carolina referred to as “Regency”), filed suit against NHI in Texas seeking injunctive and declaratory relief and unspecified monetary damages. We countered with motions calling for the immediate appointment of a receiver and for pre-judgment possession. Resulting from these claims and counterclaims, on December 6, 2018, the plaintiff parties entered into an agreement resulting in Regency vacating the facilities in December 2018. NHI arranged with experienced third-party operators to operate the three buildings. Until operations become stabilized or more formal long-term lease agreements are entered into, NHI is to receive 95% of operating cash flow, after management fees, generated by the Tennessee facility, and 100% of operating cash flow from a similar arrangement for the Indiana facility. The Charlotte facility remains closed while undergoing significant upgrades which are expected to be completed in June 2019. NHI has committed $3,100,000 toward these upgrades as well as anticipated facility operating losses. Another of our tenants, The LaSalle Group (“LaSalle”), has been in default on its rent payments since November 2018. With no rent payment forthcoming in the first quarter of 2019, we began the process to transition to a new tenant, and on April 16, 2019, we placed the five buildings with a new tenant with NHI to receive 100% of operating cash flow, after management fees, generated by the facilities pending stabilization of the operations of the facility. We also commenced litigation for the recovery of certain funds owed under the lease and against the principal executive personally under the guaranty agreement At December 31, 2018, we had a single-property lease in Wisconsin with Landmark Senior Living (”Landmark”) that was non-performing. For the three months ended March 31, 2019, we recorded $625,000 in lease income for amounts collected during the period. In February 2019, we transitioned the lease to BAKA Enterprises, (“BAKA”), temporarily acting under a management agreement with Landmark. Under terms of the new lease, after regulatory approval, NHI will receive 95% of operating cash flow, after management fees, as generated by the facilities. Upon the establishment of an operational baseline, beginning in year two, the agreement calls for a rent reset to fair value. The agreement provides for a term of 8 years , subject to renewal. As we seek to stabilize the operations of these facilities, if our resulting tenants or operating partners do not have adequate liquidity to accept the risks and rewards of a tenant-lessee, NHI might be deemed the primary beneficiary of the operations and might be required to consolidate those statements of financial position and results of operations of the managers or operating partners into our consolidated financial statements. Of our total revenue, $702,000 ( 1% ) and $3,172,000 ( 4% ) in lease revenues were derived from the above properties for the three months ended March 31, 2019 and 2018 , respectively. Assets Held For Sale During the three months ended March 31, 2019, we identified two assisted living properties for disposal and began active marketing of the properties. The buildings are smaller than are typical of our portfolio and are no longer considered to be an appropriate investment for NHI. In January we ceased recording depreciation on the properties, and we booked an adjustment to lease revenues to write off the associated $124,000 in straight-line receivables. We recognized an impairment loss of $2,500,000 to write down the properties to their estimated net realizable value of $3,745,000 and have classified the assets as available for sale on the Condensed Consolidated Balance Sheet at March 31, 2019. Future Minimum Lease Payments With the adoption of Accounting Standards Codification (“ASC”) Topic 842, Leases , as discussed in Note 10, our minimum lease payments are now determined under guidance different from that required as of December 31, 2018, when we were subject to ASC Topic 840 Leases . Presented in the following table are future minimum lease payments, as of March 31, 2019 , to be received by us under our operating leases, as determined under ASC 842 ( in thousands ): March 31, 2019 $ 192,261 2020 256,991 2021 257,610 2022 259,674 2023 253,653 Thereafter 1,719,019 $ 2,939,208 We assess the collectibility of our lease receivables, including deferred rents receivable, based on several factors, including payment history, the financial strength of the tenant and any guarantors, historical operations and operating trends of the property, and current economic conditions. If our evaluation of these factors indicates it is not probable that we will be to recover substantially all of the receivable, we de-recognize the deferred rent receivable asset and record as a reduction in rental revenue.

Mortgage And Other Notes Receiv

Mortgage And Other Notes Receivable	3 Months Ended
	Mar. 31, 2019
Financing Receivable, Net [Abstract]
Mortgage Notes Receivable	MORTGAGE AND OTHER NOTES RECEIVABLE At March 31, 2019 , we had net investments in mortgage notes receivable with a carrying value of $213,563,000 , secured by real estate and UCC liens on the personal property of 12 facilities, and other notes receivable with a carrying value of $43,918,000 , guaranteed by significant parties to the notes or by cross-collateralization of properties with the same owner. All our notes receivable were on full accrual basis and no allowance for doubtful accounts was considered necessary at March 31, 2019 or December 31, 2018 . Bickford At March 31, 2019 , our construction loans to Bickford are summarized as follows: Commencement Rate Maturity Commitment Drawn Location July 2016 9% 5 years $ 14,000,000 $ (13,047,000 ) Illinois January 2017 9% 5 years 14,000,000 (13,191,000 ) Michigan January 2018 9% 5 years 14,000,000 (6,134,000 ) Virginia July 2018 9% 5 years 14,700,000 (4,042,000 ) Michigan $ 56,700,000 $ (36,414,000 ) The construction loans 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 property. Usual and customary covenants extend to the agreements, including the borrower’s obligation for payment of insurance and taxes. NHI has a fair market value purchase option on the properties at stabilization of the underlying operations. On these development projects, Bickford as borrower is entitled to up to $2,000,000 per project in incentive loan draws based on the achievement of predetermined operational milestones and, if funded, will increase the principal amount and NHI's future purchase price and eventual NHI lease payment. Our loans to Bickford represent a variable interest. Bickford is structured to limit liability for potential claims for damages, is capitalized to achieve that purpose and is considered a VIE within the definition set forth in Note 1. Life Care Services - Sagewood On December 21, 2018 we entered into an agreement to lend LCS-Westminster Partnership IV LLP (“LCS-WP IV”), an affiliate of Life Care Services (“LCS”), the manager of the facility, up to $180,000,000 . The loan agreement conveys a mortgage interest and will facilitate the construction of Phase II of Sagewood, a Type-A Continuing Care Retirement Community in Scottsdale, AZ. As an affiliate of a larger company, LCS-WP IV is structured to limit liability for potential damage claims, is capitalized to achieve that purpose and is considered a VIE within the definition set forth in Note 1. The loan takes the form of two notes under a master credit agreement. The senior note (“Note A”) totals $118,800,000 at a 7.25% interest rate with 10 basis-point annual escalators after year three and has a term of 10 years . We have funded $77,118,000 of Note A as of March 31, 2019 . Note A is interest-only and is locked to prepayment until January 2021. After 2020, the prepayment penalty starts at 2% and declines to 1% in 2022. The second note (“Note B”) is a construction loan for up to $61,200,000 at an annual interest rate of 8.5% and carries a five -year maturity. The total amount funded on Note B was $15,612,000 as of March 31, 2019 . Life Care Services - Timber Ridge In February 2015 , we entered into an agreement with LCS-Westminster Partnership III LLP (“LCS-WP III”), an affiliate of LCS, the manager of the facility, to lend up to $154,500,000 . 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, Washington. Our loan to LCS-WP III represents a variable interest. As an affiliate of a larger company, LCS-WP III is structured to limit liability for potential damage claims, is capitalized to achieve that purpose and is considered a VIE within the definition set forth in Note 1. The loan took the form of two notes under a master credit agreement. The senior note (“Note A”) totals $60,000,000 at an initial rate of 6.75% (currently 6.95% ) with 10 basis-point escalators after year three and has a term of 10 years . We have funded $58,975,000 of Note A as of March 31, 2019 . Note A is interest-only and is locked to prepayment for three years . Beginning in February 2018, the prepayment penalty started at 5% and will decline 1% annually for five years . Note B was a construction loan for up to $94,500,000 , with the remaining outstanding balance being fully repaid during the first quarter of 2018. NHI has an option to purchase the entire Timber Ridge property for the greater of a mutually agreed-upon fair market value or $115,000,000 during a window of 120 days that opened in February 2019. Senior Living Communities In connection with the acquisition in December 2014 of 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, $2,758,000 at March 31, 2019 , bear interest at an annual rate equal to the prevailing 10 -year U.S. Treasury rate, 2.41% at March 31, 2019 , plus 6% . NHI has two mezzanine loans of up to $12,000,000 and $2,000,000 , respectively, 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, which opened in April 2018. The loans bear interest payable monthly at a 10% annual rate and mature in March 2021 . The loans were fully drawn at March 31, 2019 , and provide NHI with a purchase option on the development upon its meeting certain operational metrics. 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. Senior Living is structured to limit liability for potential claims for damages, is appropriately capitalized for that purpose and is considered a VIE. Senior Living Management In August 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, 2019 . Our loans to SLM represent a variable interest. 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, 2019
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 $ 2,864 $ 6,381 Regulatory escrows 8,208 8,208 Unamortized lease incentive payments 8,538 7,456 Restricted cash 10,377 5,253 $ 29,987 $ 27,298 Restricted cash consists of reserves for replacement, insurance and tax escrows 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, 2019
Debt Instruments [Abstract]
Debt Disclosure	DEBT Debt consists of the following ( in thousands ): March 31, December 31, Revolving credit facility - unsecured $ 89,000 $ 84,000 Bank term loans - unsecured 550,000 550,000 Private placement term loans - unsecured 400,000 400,000 HUD mortgage loans (net of discount of $1,299 and $1,320) 42,717 42,906 Fannie Mae term loans - secured, non-recourse 95,958 96,044 Convertible senior notes - unsecured (net of discount of $1,199 and $1,391) 118,802 118,609 Unamortized loan costs (9,272 ) (9,884 ) $ 1,287,205 $ 1,281,675 Aggregate principal maturities of debt as of March 31, 2019 , and for each of the next five years and thereafter are as follows ( in thousands ): Twelve months ended March 31, 2020 $ 1,196 2021 1,244 2022 121,291 2023 465,340 2024 351,390 Thereafter 358,513 1,298,974 Less: discount (2,497 ) Less: unamortized loan costs (9,272 ) $ 1,287,205 Revolving credit facility and bank term loans - unsecured Our unsecured bank credit facility consists of $250,000,000 and $300,000,000 term loans and a $550,000,000 revolving credit facility. The $250,000,000 term loan and $550,000,000 revolving facility mature in August 2022 , and the $300,000,000 term loan matures in September 2023 . On March 22, 2019, we entered into swap agreements to fix the interest rates on $200,000,000 of the $300,000,000 term loans through December 2021, when LIBOR is scheduled to cease automatic recalculation. The revolving facility fee is currently 20 basis points per annum, and based on our current leverage ratios, the facility presently provides for floating interest on the revolver and the term loans at 30-day LIBOR plus 115 and a blended 127 bps, respectively. At March 31, 2019 and December 2018 , 30-day LIBOR was 249 and 250 bps, respectively. Within the facility, the employment of interest rate swaps for a portion of our fixed term debt leaves only our revolving credit facility and $100,000,000 of our term loans exposed to interest rate risk through April 2019, when our $40,000,000 swap expires. 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, 2019 , we had $461,000,000 available to draw on the revolving portion of our credit facility, subject to usual and customary covenants. Among other stipulations, the unsecured credit facility agreement requires that we maintain certain financial ratios within limits set by our creditors. At March 31, 2019 , we were in compliance with these ratios. 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. Private placement term loans - unsecured Our unsecured private placement term loans, payable interest-only, are 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 Except for specific debt-coverage ratios, covenants pertaining to the private placement term loans are generally conformed with those governing our credit facility. HUD mortgage loans Our HUD mortgage loans are secured by ten properties leased to Bickford and having a net book value of $50,437,000 at March 31, 2019 . 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, at a discount, requires monthly payments of principal and interest of 2.9% (inclusive of mortgage insurance premium) and matures in October 2047. The loan has an outstanding principal balance of $8,652,000 and a carrying value of $7,353,000 , which approximates fair value. Fannie Mae term loans - secured, non-recourse 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. In a December 2017 acquisition, we assumed additional Fannie Mae debt that amortizes through 2025 when a balloon payment will be due, is subject to prepayment penalties until 2024, bears interest at a nominal rate of 4.60% , and has remaining balance of $17,874,000 at March 31, 2019 . All together, these notes are secured by facilities having a net book value of $137,416,000 at March 31, 2019 . Convertible senior notes - unsecured 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 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. As of March 31, 2019 , our senior unsecured convertible notes were convertible at a rate of 14.47 shares of common stock per $1,000 principal amount, representing a conversion price of approximately $69.11 per share for a total of 1,736,340 remaining underlying shares. For the three months ended March 31, 2019 , dilution resulting from the conversion option within our convertible debt is 223,513 shares. If NHI’s current share price increases above the adjusted $69.11 conversion price, further dilution will be attributable to the conversion feature. On March 31, 2019 , the value of the convertible debt, computed as if the debt were immediately eligible for conversion, exceeded its face amount by $16,390,000 . Interest Rate Swap Agreements Our existing interest rate swap agreements will collectively continue through December 2021 to hedge against fluctuations in variable interest rates applicable to $450,000,000 of our bank term loans. During the next year, approximately $881,000 of gains, which are included in accumulated other comprehensive income (loss), are projected to be reclassified into earnings. As of March 31, 2019 , we employ the following interest rate swap contracts to mitigate our interest rate risk on our bank term loans described above ( dollars in thousands ): Date Entered Maturity Date Fixed Rate Rate Index Notional Amount Fair Value May 2012 April 2019 2.84% 1-month LIBOR $ 40,000,000 $ 31 June 2013 June 2020 3.41% 1-month LIBOR $ 80,000,000 $ 230 March 2014 June 2020 3.46% 1-month LIBOR $ 130,000,000 $ 298 March 2019 December 2021 3.46% 1-month LIBOR $ 100,000,000 $ (92 ) March 2019 December 2021 3.47% 1-month LIBOR $ 100,000,000 $ (127 ) 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 9 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, 2019 and December 31, 2018 were $339,000 and $1,297,000 , respectively. The following table summarizes interest expense ( in thousands ): Three Months Ended March 31, 2019 2018 Interest expense on debt at contractual rates $ 13,074 $ 10,527 Losses reclassified from accumulated other comprehensive income (loss) into interest expense (292 ) 276 Capitalized interest (157 ) (24 ) Amortization of debt issuance costs and debt discount 893 835 Total interest expense $ 13,518 $ 11,614

Commitments And Contingencies

Commitments And Contingencies	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments And Contingencies	COMMITMENTS AND CONTINGENCIES In the normal course of business, we enter into a variety of commitments, typically 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 as of March 31, 2019 according to the nature of their impact on our leasehold or loan portfolios. Asset Class Type Total Funded Remaining Loan Commitments: LCS Sagewood Note A SHO Construction $ 118,800,000 $ (77,118,000 ) $ 41,682,000 LCS Sagewood Note B SHO Construction 61,200,000 (15,612,000 ) 45,588,000 LCS Timber Ridge Note A SHO Construction 60,000,000 (58,975,000 ) 1,025,000 Bickford Senior Living SHO Construction 56,700,000 (36,415,000 ) 20,285,000 Senior Living Communities SHO Revolving Credit 15,000,000 (2,758,000 ) 12,242,000 $ 311,700,000 $ (190,878,000 ) $ 120,822,000 See Note 3 to our condensed consolidated financial statements for full details of our loan commitments. As provided above, loans funded do not include the effects of discounts or commitment fees. Asset Class Type Total Funded Remaining Development Commitments: Ignite Medical Resorts SNF Construction $ 25,350,000 $ (6,621,000 ) $ 18,729,000 Woodland Village SHO Renovation 7,450,000 (7,268,000 ) 182,000 Senior Living Communities SHO Renovation 6,830,000 (5,808,000 ) 1,022,000 Senior Living Communities SHO Renovation 3,100,000 — 3,100,000 Bickford Senior Living SHO Renovation 1,750,000 (1,750,000 ) — Navion Senior Solutions SHO Construction 650,000 — 650,000 Discovery Senior Living SHO Renovation 500,000 (302,000 ) 198,000 $ 45,630,000 $ (21,749,000 ) $ 23,881,000 Asset Class Type Total Funded Remaining Contingencies: Bickford Senior Living SHO Lease Inducement $ 10,000,000 $ (8,750,000 ) $ 1,250,000 Bickford Senior Living SHO Incentive Loan Draws 8,000,000 (250,000 ) 7,750,000 Wingate Healthcare SHO Lease Inducement 5,000,000 — 5,000,000 Navion Senior Solutions SHO Lease Inducement 4,850,000 — 4,850,000 Ignite Medical Resorts SNF Lease Inducement 2,000,000 — 2,000,000 $ 29,850,000 $ (9,000,000 ) $ 20,850,000 Contingent lease inducement payments of $10,000,000 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. Upon funding, these payments are added to the lease base and amortized against rental income. Litigation See Note 2 for a discussion of our litigation involving our former tenants East Lake Capital Management LLC, SH Regency Leasing LLC and The LaSalle Group, including our transition of properties to other operators. 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.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2019
Deferred Compensation Arrangements [Abstract]
Stock-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. All restricted stock granted (if any) is recognized 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 may 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, 2019 , there were 319,669 shares available for future grants under the 2012 Plan. On May 3, 2019, our stockholders approved the 2019 Stock Incentive Plan (“the 2019 Plan”) pursuant to which 3,000,000 shares of our common stock were made available to grant as stock-based payments to employees, officers, directors or consultants. The individual option grant awards may vest over periods up to five years . The term of the options under the 2019 Plan is up to ten years from the date of grant. Compensation expense is only recognized for the awards that ultimately vest. Accordingly, pre-vesting forfeitures that were not expected will result in the reversal of previously recorded compensation expense. Non-cash compensation expense reported for the three months ended March 31, 2019 and 2018 was $2,001,000 and $1,425,000 , respectively and is included in general and administrative expense in the Condensed Consolidated Statements of Income. At March 31, 2019 , we had, net of expected forfeitures, $2,298,000 of unrecognized compensation cost related to unvested stock options which is expected to be expensed over the following periods: 2019 - $1,430,000 , 2020 - $776,000 and 2021 - $92,000 . The weighted average fair value per share of options granted during the three months ended March 31, 2019 and 2018 was $6.17 and $4.49 , 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: 2019 2018 Dividend yield 5.5% 6.5% Expected volatility 18.6% 19.4% Expected lives 2.9 years 2.9 years Risk-free interest rate 2.50% 2.39% The following table summarizes our outstanding stock options: Three Months Ended March 31, 2019 2018 Options outstanding January 1, 920,346 859,182 Options granted under 2012 Plan 602,000 560,000 Options exercised under 2012 Plan (352,830 ) — Options forfeited under 2012 Plan — (15,000 ) Options outstanding, December 31, 1,169,516 1,404,182 Exercisable at December 31, 678,997 949,160

Earnings and Dividends Per Shar

Earnings and Dividends Per Share	3 Months Ended
	Mar. 31, 2019
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, 2019 2018 Net income $ 35,679 $ 38,432 BASIC: Weighted average common shares outstanding 42,825,824 41,532,154 DILUTED: Weighted average common shares outstanding 42,825,824 41,532,154 Stock options 75,695 44,722 Convertible subordinated debentures 223,513 — Weighted average dilutive common shares outstanding 43,125,032 41,576,876 Net income per common share - basic $ .83 $ .93 Net income per common share - diluted $ .83 $ .92 Incremental anti-dilutive shares excluded: Net share effect of stock options with an exercise price in excess of the average market price for our common shares 17,415 118,639 Regular dividends declared per common share $ 1.05 $ 1.00

Fair Value Of Financial Instrum

Fair Value Of Financial Instruments	3 Months Ended
	Mar. 31, 2019
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 asset acquisitions. 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. 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 $ 559 $ 1,297 Interest rate swap liability Accounts payable and accrued expenses $ (219 ) $ — Carrying amounts and fair values of financial instruments that are not carried at fair value at March 31, 2019 and December 31, 2018 in the Condensed Consolidated Balance Sheets are as follows ( in thousands ): Carrying Amount Fair Value Measurement 2019 2018 2019 2018 Level 2 Variable rate debt $ 633,401 $ 628,010 $ 639,000 $ 634,000 Fixed rate debt $ 653,804 $ 653,665 $ 653,455 $ 644,745 Level 3 Mortgage and other notes receivable $ 257,481 $ 246,111 $ 260,119 $ 244,206 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, 2019 and December 31, 2018 , 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, 2019
Recent Accounting Pronouncements [Abstract]
New Accounting Pronouncements and Changes in Accounting Principles [Text Block]	RECENT ACCOUNTING PRONOUNCEMENTS In February 2016 the FASB issued Accounting Standards Update (“ASU”) 2016-02, Leases , which has been codified under ASC Topic 842. In July and December 2018 the FASB updated the pending Topic 842 with ASU 2018-11, Leases - Targeted Improvements, and ASU 2018-20, Narrow-Scope Improvements for Lessors, respectively. ASU 2018-11 provides a simplified transition method under which we applied the new leases standard as of the adoption date and recognized a cumulative-effect adjustment, as appropriate, to the opening balance of retained earnings in the period of adoption. Consequently, our reporting for the comparative periods presented in the financial statements in which we adopted the new leases standard will continue to be in accordance with prior GAAP (Topic 840, Leases). ASU 2018-20 was issued to address implementation issues related to Topic 842. We adopted Topic 842 on January 1, 2019 (the “application date”), and, effective with our adoption, we elected the package of practical expedients allowing, among other provisions, for transition with no reassessment of the lease classification for any expired or existing leases. Further, we elected the available practical expedient under ASU 2018-11 that allows us to make an accounting policy election and assess whether a contract is predominantly lease or service-based and recognize the entire contract under the relevant accounting guidance. No cumulative effect adjustment to retained earnings was necessary, based on our analysis. The Narrow-Scope Improvements for Lessors under ASU 2018-20 requires NHI to exclude from variable payments, and therefore revenue, our costs paid by our tenants directly to third parties. Some of our leases require property tax and insurance costs be covered by our tenants through escrow reimbursement. We serve as the administrative agent for these escrow transactions and ASU 2018-20 requires the associated revenue and expense to be included in our consolidated financial statements. We have included $1,090,000 reimbursement as both a revenue and expense item in our condensed consolidated income statement for the three months ended March 31, 2019, under the captions “Rental income“ and “Property taxes and insurance on leased properties,” respectively. 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, changes 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 and unlike prior GAAP, a buyer-lessor in a sale-leaseback transaction will be required to apply the sale and leaseback guidance to determine whether the transaction qualifies as a sale. Topic 842 includes provisions which generally conform with Topic 606, and the presence of a seller-lessee repurchase option on real estate in a sale and leaseback transaction will result in recording the transaction as a financing that would otherwise meet the lease accounting requirements for buyer-lessors under previous guidance. Going forward under Topic 842, for us as lessor, existing sale-leaseback or other leases that undergo modifications may trigger reconsideration of continued accounting for the lease. NHI has largely ceased inclusion of purchase options in new sale-leaseback transactions, and there were no material effects from the change in sale-leaseback guidance as it relates to repurchase options. In April 2018, we entered into a ground lease as lessee in connection with our acquisition of certain real estate assets. In accordance with transition elections allowed under Topic 842, discussed above, we have continued to account for the lease as an operating lease. Upon adoption of the standard, as lessee we recognized a right-of-use asset and a lease liability at the adoption date. No cumulative effect adjustment to retained earnings was required to effect a net balance sheet adjustment resulting in an additional operating lease liability and right-of-use asset approximating $1,176,000 , as a result of our adoption of Topic 842, which were included in the accompanying Condensed Consolidated Balance Sheet as of March 31, 2019 among “Accounts payable and accrued expenses” and “Real estate assets,” respectively. Consistent with present standards, upon the adoption of Topic 842, NHI continues to account for lease revenue on a straight-line basis for most leases. Under Topic 842 only initial direct costs that are incremental to the lessor are capitalized, a standard consistent with NHI’s current practice. Under provisions of ASU 2018-20, discussed above, we continue to exclude from variable payments lessor costs paid by our lessees directly to third parties, as consistent with our prior practice. 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. Currently, 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. ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments-Credit Losses, aligns the transition requirements and clarifies that operating lease receivables are excluded from the scope of ASU 2016-13. Instead, impairment of operating lease receivables is to be accounted for under ASC 842. Because we are likely to continue to invest in loans and generate related notes receivable, adoption of ASU 2016-13 in 2020 will have some effect on our accounting for our loan 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 that adopting the provisions of ASU 2016-13 in 2020 will have on NHI.

Subsequent Events Subsequent Ev

Subsequent Events Subsequent Events	3 Months Ended
	Mar. 31, 2019
Subsequent Events [Abstract]
Subsequent Events [Text Block]	NOTE 11. SUBSEQUENT EVENT Comfort Care On April 30, 2019, we acquired a newly-constructed 60 unit assisted living facility in Michigan which has 14 memory care units under construction with an expected summer 2019 opening. The purchase price was $10,800,000 , inclusive of closing costs. We leased the property to Comfort Care Senior Living (“Comfort Care”), providing for an initial 7.75% lease rate, with annual fixed escalators beginning in year three over the term of 10 years plus two five -year renewal options. The lease includes a $3,000,000 earnout incentive which will be added to the lease base when funded. We accounted for the acquisition as an asset purchase.

Significant Accounting Polici_2

Significant Accounting Policies (Policy)	3 Months Ended
	Mar. 31, 2019
Policy Text Block [Abstract]
Cash and Cash Equivalents, Restricted Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents and Restricted Cash - Cash equivalents consist of all highly liquid investments with an original maturity of three months or less. Restricted cash includes amounts required to be held on deposit in accordance with agency agreements governing our Fannie Mae and HUD mortgages. The following table sets forth our cash, cash equivalents and restricted cash reported within the Company’s Condensed Consolidated Statements of Cash Flows (in thousands) : March 31, March 31, Cash and cash equivalents $ 5,177 $ 3,230 Restricted cash 10,377 5,381 $ 15,554 $ 8,611
Lessor, Leases [Policy Text Block]	Leases - We record our operating leases under the guidance of ASC Topic 842, Leases . Our leases generally have an initial leasehold term of 10 to 15 years followed by one or more 5 -year tenant renewal options. The leases are “triple net leases” under which the tenant is responsible for the payment of all taxes, utilities, insurance premiums, repairs and other charges relating to the operation of the properties, including required levels of capital expenditures each year. The tenant is obligated at its expense to keep all improvements, fixtures and other components of the properties covered by “all risk” insurance in an amount equal to at least the full replacement cost thereof, and to maintain specified minimal personal injury and property damage insurance, protecting us as well as the tenant. The leases also require the tenant to indemnify and hold us harmless from all claims resulting from the use, occupancy and related activities of each property by the tenant, and to indemnify us against all costs related to any release, discovery, clean-up and removal of hazardous substances or materials, or other environmental responsibility with respect to each facility. These provisions, along with a growing senior demographic and the historical propensity for real estate to hold its value, collectively constitute much of the means by which the risk associated with the residual value of our properties is mitigated. Additionally, in monitoring the performance of our properties, we are positioned to respond appropriately to declines in physical plant or tenant performance. While we do not incorporate residual value guarantees, the above lease provisions and considerations inform our expectation of realizable value from our properties upon the expiration of their lease terms. The residual value of our real estate under lease is still subject to various market, asset, and tenant-specific risks and characteristics. As the classification of our leases is dependent on the fair value of estimated cash flows at lease commencement, residual values represent significant assumptions in our accounting for operating leases. Similarly, the exercise of options is also subject to these same risks, making a tenant’s lease term another significant variable in a lease’s cash flows. Most of our existing leases contain annual fixed escalators in rent payments, and, for financial statement purposes, rental income is recognized on a straight-line basis over the term of the lease. Other operators lease from us under leases that provide for variable escalation in lease payments based on contingent factors not determinable in advance. Principally, variable revenue from two operators constitutes 21% of our total revenue and derives from either an index applied to the measured level of operations or the consumer price index. Additionally, we derive variable payments from those operators discussed under the sub-heading “Tenant Transition” for which variable payments are determined as discussed later in Note 2. Our variable revenue from these operators is recognized when received. A summary of future minimum lease payments as of March 31, 2019, can be found in Note 2.
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. 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 would consolidate 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. If the Company has determined that an entity is not a VIE, the Company assesses the need for consolidation under all other provisions of Accounting Standards Codification (“ASC”) Topic 810 Consolidation . These provisions provide for consolidation of majority-owned entities where a majority voting interest held by the Company demonstrates control of such entities in the absence of any legal constraints. At March 31, 2019 , we held an interest in six 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 Senior Living Various 1 $ 59,943,000 $ 80,228,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 46,678,000 $ 58,921,000 Notes 2, 3 2015 Timber Ridge, LCS affiliate Notes receivable $ 58,765,000 $ 59,790,000 Note 3 2016 Senior Living Management Notes and straight-line receivable $ 26,632,000 $ 26,632,000 Note 3 2017 Evolve Senior Living Note receivable $ 9,933,000 $ 9,933,000 — 2018 Sagewood, LCS affiliate Notes receivable $ 91,013,000 $ 178,283,000 Note 3 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 to a new tenant. 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 and unamortized lease incentives. For VIE relationships listed above without a note reference, refer to our financial statements included in our most recent Annual Report on Form 10-K for the year ended December 31, 2018 .
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
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.
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 10.

Significant Accounting Polici_3

Significant Accounting Policies Significant Accounting Policies (Schedule of Variable Interest Entities) (Tables)	3 Months Ended
	Mar. 31, 2019
Variable Interest Entity, Not Primary Beneficiary, Disclosures [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	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 Senior Living Various 1 $ 59,943,000 $ 80,228,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 46,678,000 $ 58,921,000 Notes 2, 3 2015 Timber Ridge, LCS affiliate Notes receivable $ 58,765,000 $ 59,790,000 Note 3 2016 Senior Living Management Notes and straight-line receivable $ 26,632,000 $ 26,632,000 Note 3 2017 Evolve Senior Living Note receivable $ 9,933,000 $ 9,933,000 — 2018 Sagewood, LCS affiliate Notes receivable $ 91,013,000 $ 178,283,000 Note 3

Significant Accounting Polici_4

Significant Accounting Policies Schedule of Cash (Tables)	3 Months Ended
	Mar. 31, 2019
Schedule of Cash [Abstract]
Schedule of Cash, Cash Equivalents and Restricted Cash [Table Text Block]	The following table sets forth our cash, cash equivalents and restricted cash reported within the Company’s Condensed Consolidated Statements of Cash Flows (in thousands) : March 31, March 31, Cash and cash equivalents $ 5,177 $ 3,230 Restricted cash 10,377 5,381 $ 15,554 $ 8,611

Real Estate (Tables)

Real Estate (Tables)	3 Months Ended
	Mar. 31, 2019
Real Estate [Abstract]
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]	Presented in the following table are future minimum lease payments, as of March 31, 2019 , to be received by us under our operating leases, as determined under ASC 842 ( in thousands ): March 31, 2019 $ 192,261 2020 256,991 2021 257,610 2022 259,674 2023 253,653 Thereafter 1,719,019 $ 2,939,208
Schedule of Tenant Purchase Options [Table Text Block]	A summary of these tenant options is presented below ( $ in thousands ): Asset Number of Lease 1st Option Option Contractual Type Properties Expiration Open Year Basis Rent MOB 1 February 2025 Open i $ 302 SHO 4 September 2027 Open iv $ 1,560 HOSP 1 September 2027 2020 ii $ 2,673 SHO 8 December 2024 2020 ii $ 6,027 HOSP 1 March 2025 2020 iv $ 1,900 SHO 2 May 2031 2021 iv $ 4,892 HOSP 1 June 2022 2022 i $ 3,460 SNF 7 August 2028 2025 iii $ 3,732 SNF 1 September 2028 2028 iii $ 463
New Real Estate Investments [Table Text Block]	During the three months ended March 31, 2019 , we made the following real estate investments and commitments as described below ($ in thousands) : Operator Date Properties Asset Class Amount Wingate Healthcare January 2019 1 SHO $ 52,200 Holiday Retirement January 2019 1 SHO 38,000 $ 90,200
Schedule of Bickford Leases [Table Text Block]	As of March 31, 2019 , our Bickford Senior Living (“Bickford”) lease portfolio consists of the following ($ in thousands) : Lease Expiration June 2023 September 2027 May 2031 April 2033 Total Number of Properties 13 4 28 5 50 2019 Contractual Rent $ 11,468 $ 1,576 $ 30,765 $ 4,826 $ 48,635 2019 Straight Line Rent 358 195 3,937 843 5,333 $ 11,826 $ 1,771 $ 34,702 $ 5,669 $ 53,968
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, 2019 2018 Current year $ 877 $ 853 Prior year final certification 1 334 285 Total percentage rent income $ 1,211 $ 1,138 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 Rece_2

Mortgage And Other Notes Receivable Mortgage and Other Notes Receivable (Schedule of Bickford Construction Loans) (Tables)	3 Months Ended
	Mar. 31, 2019
Bickford Senior Living [Member]
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]	At March 31, 2019 , our construction loans to Bickford are summarized as follows: Commencement Rate Maturity Commitment Drawn Location July 2016 9% 5 years $ 14,000,000 $ (13,047,000 ) Illinois January 2017 9% 5 years 14,000,000 (13,191,000 ) Michigan January 2018 9% 5 years 14,000,000 (6,134,000 ) Virginia July 2018 9% 5 years 14,700,000 (4,042,000 ) Michigan $ 56,700,000 $ (36,414,000 )

Other Assets (Tables)

Other Assets (Tables)	3 Months Ended
	Mar. 31, 2019
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 $ 2,864 $ 6,381 Regulatory escrows 8,208 8,208 Unamortized lease incentive payments 8,538 7,456 Restricted cash 10,377 5,253 $ 29,987 $ 27,298

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Instruments [Abstract]
Schedule of Debt	Debt consists of the following ( in thousands ): March 31, December 31, Revolving credit facility - unsecured $ 89,000 $ 84,000 Bank term loans - unsecured 550,000 550,000 Private placement term loans - unsecured 400,000 400,000 HUD mortgage loans (net of discount of $1,299 and $1,320) 42,717 42,906 Fannie Mae term loans - secured, non-recourse 95,958 96,044 Convertible senior notes - unsecured (net of discount of $1,199 and $1,391) 118,802 118,609 Unamortized loan costs (9,272 ) (9,884 ) $ 1,287,205 $ 1,281,675
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of March 31, 2019 , and for each of the next five years and thereafter are as follows ( in thousands ): Twelve months ended March 31, 2020 $ 1,196 2021 1,244 2022 121,291 2023 465,340 2024 351,390 Thereafter 358,513 1,298,974 Less: discount (2,497 ) Less: unamortized loan costs (9,272 ) $ 1,287,205
Schedule of Unsecured Term Loans	Our unsecured private placement term loans, payable interest-only, are 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, 2019 2018 Interest expense on debt at contractual rates $ 13,074 $ 10,527 Losses reclassified from accumulated other comprehensive income (loss) into interest expense (292 ) 276 Capitalized interest (157 ) (24 ) Amortization of debt issuance costs and debt discount 893 835 Total interest expense $ 13,518 $ 11,614
Schedule of Interest Rate Derivatives	As of March 31, 2019 , we employ the following interest rate swap contracts to mitigate our interest rate risk on our bank term loans described above ( dollars in thousands ): Date Entered Maturity Date Fixed Rate Rate Index Notional Amount Fair Value May 2012 April 2019 2.84% 1-month LIBOR $ 40,000,000 $ 31 June 2013 June 2020 3.41% 1-month LIBOR $ 80,000,000 $ 230 March 2014 June 2020 3.46% 1-month LIBOR $ 130,000,000 $ 298 March 2019 December 2021 3.46% 1-month LIBOR $ 100,000,000 $ (92 ) March 2019 December 2021 3.47% 1-month LIBOR $ 100,000,000 $ (127 )

Commitments And Contingencies C

Commitments And Contingencies Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Schedule of Loan Commitments [Table Text Block]	Asset Class Type Total Funded Remaining Loan Commitments: LCS Sagewood Note A SHO Construction $ 118,800,000 $ (77,118,000 ) $ 41,682,000 LCS Sagewood Note B SHO Construction 61,200,000 (15,612,000 ) 45,588,000 LCS Timber Ridge Note A SHO Construction 60,000,000 (58,975,000 ) 1,025,000 Bickford Senior Living SHO Construction 56,700,000 (36,415,000 ) 20,285,000 Senior Living Communities SHO Revolving Credit 15,000,000 (2,758,000 ) 12,242,000 $ 311,700,000 $ (190,878,000 ) $ 120,822,000 See Note 3 to our condensed consolidated financial statements for full details of our loan commitments. As provided above, loans funded do not include the effects of discounts or commitment fees.
Schedule of Lease Commitments [Table Text Block]	Asset Class Type Total Funded Remaining Development Commitments: Ignite Medical Resorts SNF Construction $ 25,350,000 $ (6,621,000 ) $ 18,729,000 Woodland Village SHO Renovation 7,450,000 (7,268,000 ) 182,000 Senior Living Communities SHO Renovation 6,830,000 (5,808,000 ) 1,022,000 Senior Living Communities SHO Renovation 3,100,000 — 3,100,000 Bickford Senior Living SHO Renovation 1,750,000 (1,750,000 ) — Navion Senior Solutions SHO Construction 650,000 — 650,000 Discovery Senior Living SHO Renovation 500,000 (302,000 ) 198,000 $ 45,630,000 $ (21,749,000 ) $ 23,881,000
Schedule of Loss Contingencies [Table Text Block]	Asset Class Type Total Funded Remaining Contingencies: Bickford Senior Living SHO Lease Inducement $ 10,000,000 $ (8,750,000 ) $ 1,250,000 Bickford Senior Living SHO Incentive Loan Draws 8,000,000 (250,000 ) 7,750,000 Wingate Healthcare SHO Lease Inducement 5,000,000 — 5,000,000 Navion Senior Solutions SHO Lease Inducement 4,850,000 — 4,850,000 Ignite Medical Resorts SNF Lease Inducement 2,000,000 — 2,000,000 $ 29,850,000 $ (9,000,000 ) $ 20,850,000

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2019
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: 2019 2018 Dividend yield 5.5% 6.5% Expected volatility 18.6% 19.4% Expected lives 2.9 years 2.9 years Risk-free interest rate 2.50% 2.39%
Schedule of Stock Option Activity	The following table summarizes our outstanding stock options: Three Months Ended March 31, 2019 2018 Options outstanding January 1, 920,346 859,182 Options granted under 2012 Plan 602,000 560,000 Options exercised under 2012 Plan (352,830 ) — Options forfeited under 2012 Plan — (15,000 ) Options outstanding, December 31, 1,169,516 1,404,182 Exercisable at December 31, 678,997 949,160

Earnings and Dividends Per Sh_2

Earnings and Dividends Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 2018 Net income $ 35,679 $ 38,432 BASIC: Weighted average common shares outstanding 42,825,824 41,532,154 DILUTED: Weighted average common shares outstanding 42,825,824 41,532,154 Stock options 75,695 44,722 Convertible subordinated debentures 223,513 — Weighted average dilutive common shares outstanding 43,125,032 41,576,876 Net income per common share - basic $ .83 $ .93 Net income per common share - diluted $ .83 $ .92 Incremental anti-dilutive shares excluded: Net share effect of stock options with an exercise price in excess of the average market price for our common shares 17,415 118,639 Regular dividends declared per common share $ 1.05 $ 1.00

Fair Value Of Financial Instr_2

Fair Value Of Financial Instruments Fair Value Of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2019
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 $ 559 $ 1,297 Interest rate swap liability Accounts payable and accrued expenses $ (219 ) $ —
Fair Value Measurements, Nonrecurring [Table Text Block]	Carrying amounts and fair values of financial instruments that are not carried at fair value at March 31, 2019 and December 31, 2018 in the Condensed Consolidated Balance Sheets are as follows ( in thousands ): Carrying Amount Fair Value Measurement 2019 2018 2019 2018 Level 2 Variable rate debt $ 633,401 $ 628,010 $ 639,000 $ 634,000 Fixed rate debt $ 653,804 $ 653,665 $ 653,455 $ 644,745 Level 3 Mortgage and other notes receivable $ 257,481 $ 246,111 $ 260,119 $ 244,206

Significant Accounting Polici_5

Significant Accounting Policies Significant Accounting Policies (Details)	3 Months Ended
	Mar. 31, 2019properties
Lessor, Lease, Description [Line Items]
Lessor, Operating Lease, Renewal Term	5 years
Variable Interest Entity Number Of Entities Not Primary Beneficiary	6
Minimum [Member]
Lessor, Lease, Description [Line Items]
Lessor, Operating Lease, Term of Contract	10 years
Maximum [Member]
Lessor, Lease, Description [Line Items]
Lessor, Operating Lease, Term of Contract	15 years
Variable Lease Escalation [Member]
Lessor, Lease, Description [Line Items]
Percentage of Continuing Revenue	21.00%

Significant Accounting Polici_6

Significant Accounting Policies Significant Accounting Policies (Schedule of Variable Interest Entities) (Details) $ in Thousands	Mar. 31, 2019USD ($)
Straight-Line Rent Receivable [Member] | Bickford Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	$ 59,943
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	80,228
Straight-Line Rent Receivable [Member] | Senior Living Communities [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	46,678
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	58,921
Straight-Line Rent Receivable [Member] | Senior Living Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	26,632
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	26,632
Straight-Line Rent Receivable [Member] | Evolve Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	9,933
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	9,933
Straight-Line Rent Receivable [Member] | LCS Sagewood [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	91,013
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	178,283
Notes Receivable [Member] | LCS Timber Ridge [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	58,765
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	$ 59,790

Significant Accounting Polici_7

Significant Accounting Policies Schedule of Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Dec. 31, 2017
Schedule of Cash [Abstract]
Cash and cash equivalents	$ 5,177		$ 3,230
Restricted cash	10,377	$ 5,253	5,381
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	$ 15,554	$ 9,912	$ 8,611	$ 8,075

Real Estate Schedule of New Rea

Real Estate Schedule of New Real Estate Investments (Details)	3 Months Ended
	Mar. 31, 2019USD ($)properties
Real Estate Investments During The Period	$ 90,200,000
Wingate Healthcare [Member]
Number Of Real Estate Properties Acquired | properties	1
Real Estate Investments During The Period	$ 52,200,000
Holiday Lease Amendment [Member]
Number Of Real Estate Properties Acquired | properties	1
Real Estate Investments During The Period	$ 38,000,000

Real Estate Real Estate (Schedu

Real Estate Real Estate (Schedule of Bickford Leases) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)properties
Number of Properties | properties	220
Bickford Senior Living [Member]
Number of Properties | properties	50
2017 Contractual Rent	$ 48,635
Straight Line Rent Adjustment	5,333
Total Revenues	$ 53,968
Bickford Senior Living [Member] | June 2023 [Member]
Number of Properties | properties	13
2017 Contractual Rent	$ 11,468
Straight Line Rent Adjustment	358
Total Revenues	$ 11,826
Bickford Senior Living [Member] | September 2027 [Member]
Number of Properties | properties	4
2017 Contractual Rent	$ 1,576
Straight Line Rent Adjustment	195
Total Revenues	$ 1,771
Bickford Senior Living [Member] | May 2031 [Member]
Number of Properties | properties	28
2017 Contractual Rent	$ 30,765
Straight Line Rent Adjustment	3,937
Total Revenues	$ 34,702
Bickford Senior Living [Member] | April 2033 [Member]
Number of Properties | properties	5
2017 Contractual Rent	$ 4,826
Straight Line Rent Adjustment	843
Total Revenues	$ 5,669

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, 2019	Mar. 31, 2018
Total percentage rent	$ 1,211	$ 1,138
Current year [Member]
Total percentage rent	877	853
Prior year final certification [Member]
Total percentage rent	$ 334	$ 285

Real Estate Real Estate (Sche_2

Real Estate Real Estate (Schedule of Tenant Purchase Options) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)properties
Number of Real Estate Properties	220
Medical Office Building [Member]
Number of Real Estate Properties	2
Senior Housing Community [Member]
Number of Real Estate Properties	143
Skilled Nursing Facility [Member]
Number of Real Estate Properties	72
Hospital [Member]
Number of Real Estate Properties	3
Open Now [Member] | Medical Office Building [Member] | February 2025 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 302
Open Now [Member] | Senior Housing Community [Member] | September 2027 [Member]
Number of Real Estate Properties	4
Minimum Annual Lease Income | $	$ 1,560
2020 [Member] | Senior Housing Community [Member] | December 2024 [Member]
Number of Real Estate Properties	8
Minimum Annual Lease Income | $	$ 6,027
2020 [Member] | Hospital [Member] | September 2027 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 2,673
2020 [Member] | Hospital [Member] | March 2025 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 1,900
2021 [Member] | Senior Housing Community [Member] | May 2031 [Member]
Number of Real Estate Properties	2
Minimum Annual Lease Income | $	$ 4,892
2022 [Member] | Hospital [Member] | June 2022 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 3,460
2025 [Member] | Skilled Nursing Facility [Member] | August 2028 [Member]
Number of Real Estate Properties	7
Minimum Annual Lease Income | $	$ 3,732
2028 [Member] | Skilled Nursing Facility [Member] | September 2028 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 463

Real Estate (Narrative) (Detail

Real Estate (Narrative) (Details)	3 Months Ended
	Mar. 31, 2019USD ($)Master_Leasespropertiesbeds_or_unitsrenewalOptionsshares	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Number of Real Estate Properties | properties	220
Number of States in which Entity Operates	33
Nonportfolio Assets, Original Cost	$ 2,471,000
Real Estate Investment Property, Portfolio Assets	$ 2,900,846,000
Number of Lessees	30
Payments to Acquire Real Estate	$ 50,122,000	$ 14,404,000
Lessee Payment To Acquire Purchase Option	0	1,275,000
Real Estate Investments During The Period	90,200,000
Operating Leases, Income Statement, Lease Revenue	(70,953,000)	(69,253,000)
Deferred Rent Receivables, Net	75,123,000		$ 105,620,000
Straight Line Rent	$ 5,228,000	5,962,000
Lease Renewal Period In Years	5 years
Escrow Deposit	$ 8,208,000		8,208,000
Loan and Lease Losses and Recoveries, Net	2,500,000	0
Real Estate Held-for-sale	$ 3,745,000		$ 0
Wingate Healthcare [Member]
Number of Units in Real Estate Property | beds_or_units	267
Payments to Acquire Real Estate	$ 50,300,000
Asset Purchase Transaction Costs	300,000
Real Estate Investments During The Period	$ 52,200,000
Lessor, Operating Lease, Term of Contract	10 years
Initial lease rate	7.50%
Number Of Real Estate Properties Acquired | properties	1
Number Of Additional Lease Renewal Options | renewalOptions	3
Lease Renewal Period In Years	5 years
Capital Improvements Commitment	$ 1,900,000
Contingent Incentive Payments	5,000,000
Holiday Lease Amendment [Member]
Real Estate Investments During The Period	$ 38,000,000
Lease Escalator Minimum	2.00%
Lease Escalator Maximum	3.00%
Number Of Real Estate Properties Acquired | properties	1
Holiday Acquisition Holdings [Member]
Number of Real Estate Properties | properties	26
Initial lease rate	6.71%
Operating Leases, Income Statement, Lease Revenue	$ (9,930,000)	$ (10,954,000)
Percentage of Continuing Revenue	13.00%	15.00%
Straight Line Rent	$ (1,630,000)	$ (1,530,000)
National Healthcare Corporation [Member]
Number of Real Estate Properties | properties	42
Number of Master Leases | Master_Leases	2
Operating Leases, Income Statement, Lease Revenue	$ (9,748,000)	$ (9,674,000)
Percentage of Continuing Revenue	13.00%	13.00%
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
Non-Performing Lease [Member]
Number of Lease Portfolios	3
SH Regency Leasing LLC [Member]
Number of Real Estate Properties | properties	3
Lease Payment, NOI Based, Percent	95.00%
The Lasalle Group [Member]
Number of Real Estate Properties | properties	5
Lease Payment, NOI Based, Percent	100.00%
Operating Lease, Lease Income	$ 0
Landmark Senior Living [Member]
Operating Lease, Lease Income	$ 625,000
BAKA Enterprises [Member]
Lease Payment, NOI Based, Percent	95.00%
Lessor, Operating Lease, Term of Contract	8 years
Bickford Senior Living [Member]
Number of Real Estate Properties | properties	50
Operating Leases, Income Statement, Lease Revenue	$ (13,244,000)	$ (11,445,000)
Percentage of Continuing Revenue	17.00%	16.00%
Straight Line Rent	$ (1,371,000)	$ (1,169,000)
Minimum Annual Lease Income	48,635,000
Operating Lease, Lease Income	$ 53,968,000
Senior Living Communities [Member]
Number of Real Estate Properties | properties	11
Number of Units in Real Estate Property | beds_or_units	2,216
Lessor, Operating Lease, Term of Contract	15 years
Lease Escalator Rate after Lease Year 4	3.00%
Operating Leases, Income Statement, Lease Revenue	$ (11,532,000)	$ (11,449,000)
Percentage of Continuing Revenue	15.00%	16.00%
Straight Line Rent	$ (1,058,000)	$ (1,359,000)
Number Of Additional Lease Renewal Options | renewalOptions	2
Lease Renewal Period In Years	5 years
Capital Improvements Commitment	$ 3,100,000
Default Tenant [Member]
Operating Leases, Income Statement, Lease Revenue	$ (702,000)	$ (3,172,000)
Material Non-Compliance Tenant [Member]
Percentage of Continuing Revenue	1.00%	4.00%
Senior Housing Community [Member]
Number of Real Estate Properties | properties	143
Skilled Nursing Facility [Member]
Number of Real Estate Properties | properties	72
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
Asset Held For Sale [Member]
Number of Real Estate Properties | properties	2
Write Off Of Straight Line Rent Receivable	$ 124,000
Vero Beach Acquisition [Member] | Independent Living Facility [Member] | Holiday Acquisition Holdings [Member]
Number of Units in Real Estate Property | beds_or_units	157
Vero Beach Acquisition [Member] | Assisted Living Facility [Member] | Holiday Acquisition Holdings [Member]
Number of Units in Real Estate Property | beds_or_units	71
Right of First Offer [Member] | Wingate Healthcare [Member]
Number of Real Estate Properties | properties	2
Holiday Lease Amendment [Member]
Lease Amendment Consideration	$ 55,125,000
Escrow Deposit	21,275,000
Holiday Lease Amendment [Member] | Forfeiture Amount [Member]
Escrow Deposit	10,637,000
Holiday Lease Amendment [Member] | Cash Portion [Member]
Lease Amendment Consideration	17,125,000
Holiday Lease Amendment [Member] | Holiday Acquisition Holdings [Member]
Minimum Annual Lease Income	31,500,000
Prior to Lease Amendment [Member] | Holiday Acquisition Holdings [Member]
Minimum Annual Lease Income	$ 39,000,000
Indiana [Member] | SH Regency Leasing LLC [Member]
Lease Payment, NOI Based, Percent	100.00%

Real Estate Real Estate (Sche_3

Real Estate Real Estate (Schedule of Future Minimum Lease Payments) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Schedule of Future Minimum Lease Payments [Abstract]
Operating Leases, Future Minimum Payments Due, Next Twelve Months	$ 192,261	$ 304,887
Operating Leases, Future Minimum Payments, Due in Two Years	256,991	254,321
Operating Leases, Future Minimum Payments, Due in Three Years	257,610	255,806
Operating Leases, Future Minimum Payments, Due in Four Years	259,674	258,245
Operating Leases, Future Minimum Payments, Due in Five Years	253,653	252,602
Operating Leases, Future Minimum Payments, Due Thereafter	1,719,019	1,705,141
Operating Leases, Future Minimum Payments Due	$ 2,939,208	$ 3,031,002

Mortgage And Other Notes Rece_3

Mortgage And Other Notes Receivable Mortgage and Other Notes Receivable (Schedule of Bickford Construction Loans) (Details) - USD ($)	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Loans and Leases Receivable, Commitments, Fixed Rates	$ 311,700,000
Loans and Leases Receivable, Net Amount	(257,481,000)	$ (246,111,000)
Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	56,700,000
Loans and Leases Receivable, Net Amount	$ (36,414,000)
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	$ (13,047,000)
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	$ (13,191,000)
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	$ (6,134,000)
July 2018 [Member] | Bickford Note Investment [Member]
Note Receivable Interest Rate	9.00%
Loan Term	5 years
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,700,000
Loans and Leases Receivable, Net Amount	$ (4,042,000)

Mortgage And Other Notes Rece_4

Mortgage And Other Notes Receivable (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2019USD ($)propertiesbeds_or_units	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Mortgage and other notes receivable, net	$ (257,481,000)		$ (246,111,000)
Amortization of Deferred Loan Origination Fees, Net	$ 119,000	$ 552,000
Number of health care properties related to mortgage notes receivables | properties	12
Loans and Leases Receivable, Commitments, Fixed Rates	$ (311,700,000)
Allowance for Loan and Lease Losses, Write-offs	$ 0		$ 0
Number of Real Estate Properties | properties	220
Secured By Real Estate [Member]
Mortgage and other notes receivable, net	$ (213,563,000)
Not Secured By Real Estate [Member]
Mortgage and other notes receivable, net	(43,918,000)
LCS Sagewood [Member]
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 180,000,000
Notes Receivable, Number Of Loans, Master Credit Agreement	2
LCS Timber Ridge [Member]
Mortgage and other notes receivable, net	$ (58,975,000)
Loans and Leases Receivable, Commitments, Fixed Rates	(60,000,000)
Notes Receivable, Total Borrowings, Master Credit Agreement	154,500,000
Purchase Option, Amount, Minimum	$ 115,000,000
Purchase Option, Period, Months	120 days
Senior Living Communities [Member]
Loans Receivable, Description of Variable Rate Basis, Reference Rate Maturity	10 years
Loans Receivable, Description of Variable Rate Basis	0.0241
Number of Units in Real Estate Property | beds_or_units	2,216
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	$ (2,758,000)
Loans Receivable, Basis Spread on Variable Rate	6.00%
Number of Term Loans	2
Note Receivable Interest Rate	10.00%
Number of Real Estate Properties | properties	11
Senior Living Communities [Member] | Not Secured By Real Estate [Member]
Number of Units in Real Estate Property | beds_or_units	186
Bickford Note Investment [Member]
Mortgage and other notes receivable, net	$ (36,414,000)
Contingent Incentive Payments	2,000,000
Loans and Leases Receivable, Commitments, Fixed Rates	(56,700,000)
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
July 2016 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net	$ (13,047,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ (14,000,000)
Note Receivable Interest Rate	9.00%
Loan Term	5 years
Note A [Member] | LCS Sagewood [Member]
Mortgage and other notes receivable, net	$ (77,118,000)
Loans and Leases Receivable, Commitments, Fixed Rates	(118,800,000)
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 118,800,000
Notes Receivable, Interest Rate, Master Credit Agreement, At Inception	6.75%
Note Receivable, First Note Year For Rate Escalator	3 years
Loan Term	10 years
Note Receivable, Prepayment Penalty, Rate	2.00%
Note Receivable, Prepayment Penalty, Rate Decrease	1.00%
Notes Receivable, Interest Rate, Master Credit Agreement	6.95%
Loans And Leases Receivable, Commitment, Fixed Rates, Escalator, Basis Points	10
Note A [Member] | LCS Timber Ridge [Member]
Mortgage and other notes receivable, net	$ (58,975,000)
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	7.25%
Loans And Leases Receivable, Commitment, Fixed Rates, Escalator, Basis Points	10
Note A [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ (12,000,000)
Note B [Member] | LCS Sagewood [Member]
Mortgage and other notes receivable, net	(15,612,000)
Loans and Leases Receivable, Commitments, Fixed Rates	(61,200,000)
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 61,200,000
Loan Term	5 years
Notes Receivable, Interest Rate, Master Credit Agreement	8.50%
Note B [Member] | LCS Timber Ridge [Member]
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 94,500,000
Note B [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	(2,000,000)
January 2017 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net	(13,191,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ (14,000,000)
Note Receivable Interest Rate	9.00%
Loan Term	5 years
January 2018 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net	$ (6,134,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ (14,000,000)
Note Receivable Interest Rate	9.00%
Loan Term	5 years
July 2018 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net	$ (4,042,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ (14,700,000)
Note Receivable Interest Rate	9.00%
Loan Term	5 years

Other Assets (Schedule of Other

Other Assets (Schedule of Other Assets) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018
Equity Method Investments And Other Assets [Abstract]
Accounts receivable and other assets	$ 2,864	$ 6,381
Regulatory deposits	8,208	8,208
Unamortized lease incentive payments	8,538	7,456
Restricted cash	10,377	5,253	$ 5,381
Other Assets	$ 29,987	$ 27,298

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 89,000	$ 84,000
Convertible Debt	118,802	118,609
Bank term loans - unsecured	400,000
Unamortized Debt Issuance Expense	(9,272)	(9,884)
Debt, Long-term and Short-term, Combined Amount	1,287,205	1,281,675
Bank Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	550,000	550,000
Debt Instrument, Name, HUD Mortgages [Member]
Debt Instrument [Line Items]
Secured Debt	42,717	42,906
Private Placement Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	400,000	400,000
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Debt Instrument [Line Items]
Secured Debt	$ 95,958	$ 96,044

Debt Debt (Schedule of Debt) (C

Debt Debt (Schedule of Debt) (Captions) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	$ (2,497)
Debt Instrument, Name, Q3 2014 HUD Mortgages [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	(1,299)	$ (1,320)
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	$ (1,199)	$ (1,391)

Debt Debt (Schedule of Maturiti

Debt Debt (Schedule of Maturities of Long-term Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Schedule of Maturities of Long-term Debt [Abstract]
Long-term Debt, Maturities, Repayments of Principal in Next Rolling Twelve Months	$ 1,196
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Two	1,244
Long-term Debt, Maturities, Repayments of Principal in Next Rolling Year Three	121,291
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Four	465,340
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Five	351,390
Long-term Debt, Maturities, Repayments of Principal in Rolling after Year Five	358,513
Long-term Debt, Gross	1,298,974
Debt Instrument, Unamortized Discount	(2,497)
Unamortized Debt Issuance Expense	(9,272)	$ (9,884)
Debt, Long-term and Short-term, Combined Amount	$ 1,287,205	$ 1,281,675

Debt Debt (Schedule of Unsecure

Debt Debt (Schedule of Unsecured Term Loans) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Unsecured Debt	$ 400,000
Private Placement [Member]
Unsecured Debt	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, 2019	Mar. 31, 2018
Schedule of Interest Expense [Abstract]
Interest Expense, Debt, Excluding Amortization	$ 13,074	$ 10,527
Derivative Instruments, Loss Reclassified from Accumulated OCI into Income, Effective Portion	292	276
Interest Costs Capitalized Adjustment	157	24
Amortization Of Financing Costs, Exclusive Of Amounts Written Off	893	835
Interest Expense	$ 13,518	$ 11,614

Debt (Schedule of Interest Rate

Debt (Schedule of Interest Rate Derivatives) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Interest Rate Swap, Date Entered, May 2012 [Member]
Derivative [Line Items]
Derivative, Inception Date	May 1, 2012
Derivative, Maturity Date	Apr. 1, 2019
Derivative, Fixed Interest Rate	2.84%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 40,000
Derivative Asset, Fair Value, Gross Asset	$ 31
Interest Rate Swap, Date Entered, June 2013 [Member]
Derivative [Line Items]
Derivative, Inception Date	Jun. 1, 2013
Derivative, Maturity Date	Jun. 1, 2020
Derivative, Fixed Interest Rate	3.41%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 80,000
Derivative Asset, Fair Value, Gross Asset	$ 230
Interest Rate Swap, Date Entered, March 2014 [Member]
Derivative [Line Items]
Derivative, Inception Date	Mar. 1, 2014
Derivative, Maturity Date	Jun. 1, 2020
Derivative, Fixed Interest Rate	3.46%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 130,000
Derivative Asset, Fair Value, Gross Asset	$ 298
Interest Rate Swap, Date Entered, March 2019 - 3.46% [Member]
Derivative [Line Items]
Derivative, Inception Date	Mar. 1, 2019
Derivative, Maturity Date	Dec. 1, 2021
Derivative, Fixed Interest Rate	3.46%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 100,000
Interest Rate Derivative Liabilities, at Fair Value	$ (92)
Interest Rate Swap, Date Entered, March 2019 - 3.47% [Member]
Derivative [Line Items]
Derivative, Inception Date	Mar. 1, 2019
Derivative, Maturity Date	Dec. 1, 2021
Derivative, Fixed Interest Rate	3.47%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 100,000
Interest Rate Derivative Liabilities, at Fair Value	(127)
Fair Value, Inputs, Level 2 [Member]
Derivative [Line Items]
Cash Flow Hedge Derivative Instrument Assets at Fair Value	$ 559	$ 1,297

Debt (Narrative) (Details)

Debt (Narrative) (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2019USD ($)propertiessharesnumber_of_loans$ / shares	Mar. 31, 2018USD ($)shares	Dec. 31, 2018USD ($)
Debt Instrument, Unamortized Discount	$ (2,497,000)
Derivative, Fair Value, Net	339,000		$ 1,297,000
Repayments of Convertible Debt	0	$ 29,958,000
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	$ 881,000
Debt Instrument, Convertible, Conversion Ratio	14.47
Debt Instrument, Convertible, Conversion Price | $ / shares	$ 69.11
Debt Instrument, Convertible, If-converted Value in Excess of Principal	$ 16,390,000
Debt Instrument, Convertible, Number of Equity Instruments | shares	1,736,340
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities | shares	223,513	0
Convertible Debt	$ 118,802,000		$ 118,609,000
Payments of Debt Issuance Costs	67,000	$ 0
Gain (Loss) on Extinguishment of Debt	$ 0	$ (738,000)
Debt Instrument, Variable Rate Basis, Minimum	24945.00%		25026.90%
Portion of Debt Instrument Not Fixed with Interest Rate Derivative	$ 100,000,000
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	220
Debt Instrument, Name, Q3 2014 HUD Mortgages [Member]
Debt Instrument, Unamortized Discount	$ (1,299,000)		(1,320,000)
$250M Term Loan [Member]
Term Loans, Outstanding Balance	250,000,000
$300M Term Loan [Member]
Term Loans, Outstanding Balance	$ 300,000,000
Bank Term Loans [Member]
Debt Instrument, Basis Spread on Variable Rate	12700.00%
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument, Unamortized Discount	$ (1,199,000)		$ (1,391,000)
Debt Instrument, Interest Rate, Stated Percentage	3.25%
Convertible Debt Instrument, Conversion Ratio, Principal Amount, Basis	$ 1,000
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	$ 461,000,000
FNMA Berkadia Note [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Face Amount of Mortgages	$ 17,874,000
Debt Instrument, Interest Rate, Stated Percentage	4.60%
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Debt Instrument, Term	10 years
SEC Schedule, 12-29, Real Estate Companies, Investment in 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	$ 137,416,000
Debt Instrument, Name, HUD Mortgages [Member]
Number of Real Estate Properties | properties	10
Net Book Value of Real Estate Pledged Toward Mortgage	$ 50,437,000
Debt Instrument, Name, HUD Mortgages [Member] | Minimum [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Interest Rate	4.30%
Debt Instrument, Name, HUD Mortgages [Member] | Maximum [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Interest Rate			4.40%
Debt Instrument, HUD Mortgages, 2049 Maturity [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Number of Loans | number_of_loans	9
Debt Instrument, HUD Mortgages, 2047 Maturity [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Number of Loans | number_of_loans	1
Bickford Senior Living [Member]
Number of Real Estate Properties | properties	50
Middletown, OH [Member] | Bickford Senior Living [Member]
Noncash or Part Noncash Acquisition, Noncash Financial or Equity Instrument Consideration, Rate	2.90%
Noncash or Part Noncash Acquisition, Debt Assumed	$ 8,652,000
Noncash or Part Noncash Acquisition, Value of Liabilities Assumed	7,353,000
Fair Value, Inputs, Level 2 [Member]
Cash Flow Hedge Derivative Instrument Assets at Fair Value	559,000		$ 1,297,000
Interest Rate Swap, Date Entered, March 2019 [Member]
Derivative, Notional Amount	$ 200,000,000

Commitments And Contingencies (

Commitments And Contingencies (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)properties	Dec. 31, 2018USD ($)
Incentive to Lessee	$ 8,538	$ 7,456
Number of Real Estate Properties | properties	220
Bickford Development Properties [Member]
Developer Incentive Payments	$ 250,000
Incentive to Lessee	$ 1,750,000
Number Of Development Projects Active | properties	5

Commitments And Contingencies_2

Commitments And Contingencies Commitments and Contingencies (Schedule of Loan Commitments) (Details) - USD ($)	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Loans and Leases Receivable, Commitments, Fixed Rates	$ 311,700,000
Loans and Leases Receivable, Net Amount	(257,481,000)	$ (246,111,000)
Notes Receivable Funding Commitment	120,822,000
Bickford Senior Living [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	56,700,000
Loans and Leases Receivable, Net Amount	(36,415,000)
Notes Receivable Funding Commitment	20,285,000
LCS Timber Ridge [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	60,000,000
Loans and Leases Receivable, Net Amount	(58,975,000)
Notes Receivable Funding Commitment	1,025,000
Note A [Member] | LCS Sagewood [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	118,800,000
Loans and Leases Receivable, Net Amount	(77,118,000)
Notes Receivable Funding Commitment	41,682,000
Note A [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	12,000,000
Note A [Member] | LCS Timber Ridge [Member]
Loans and Leases Receivable, Net Amount	(58,975,000)
Revolving Credit Facility [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	15,000,000
Loans and Leases Receivable, Net Amount	(2,758,000)
Notes Receivable Funding Commitment	12,242,000
Notes Receivable Remain Unfunded [Member]
Loans and Leases Receivable, Net Amount	(190,878,000)
Note B [Member] | LCS Sagewood [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	61,200,000
Loans and Leases Receivable, Net Amount	(15,612,000)
Notes Receivable Funding Commitment	45,588,000
Note B [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 2,000,000

Commitments And Contingencies_3

Commitments And Contingencies Commitments and Contingencies (Schedule of Lease Commitments) (Details)	Mar. 31, 2019USD ($)
Maximum Commitment For All Active Development Projects	$ 45,630,000
Development in Process	(21,749,000)
Remaining Unfunded Development Commitment	23,881,000
Senior Living Communities [Member]
Capital Improvements Commitment	3,100,000
Capital Improvement Commitment [Member] | Bickford Senior Living [Member]
Maximum Commitment For All Active Development Projects	1,750,000
Development in Process	(1,750,000)
Remaining Unfunded Development Commitment	0
Capital Improvement Commitment [Member] | Senior Living Communities [Member]
Maximum Commitment For All Active Development Projects	6,830,000
Development in Process	(5,808,000)
Remaining Unfunded Development Commitment	1,022,000
Capital Improvement Commitment [Member] | Discovery Senior Living [Member]
Maximum Commitment For All Active Development Projects	500,000
Development in Process	(302,000)
Remaining Unfunded Development Commitment	198,000
Capital Improvement Commitment [Member] | Village Concepts [Member]
Maximum Commitment For All Active Development Projects	7,450,000
Development in Process	(7,268,000)
Remaining Unfunded Development Commitment	182,000
Development Commitment [Member] | Ignite Medical Resorts [Member]
Maximum Commitment For All Active Development Projects	25,350,000
Development in Process	(6,621,000)
Remaining Unfunded Development Commitment	18,729,000
Development Commitment [Member] | Senior Living Communities [Member]
Development in Process	0
Remaining Unfunded Development Commitment	3,100,000
Development Commitment [Member] | Navion Senior Solutions [Member]
Maximum Commitment For All Active Development Projects	650,000
Development in Process	0
Remaining Unfunded Development Commitment	$ 650,000

Commitments And Contingencies_4

Commitments And Contingencies Commitments and Contingencies (Schedule of Loss Contingencies) (Details)	Mar. 31, 2019USD ($)
Lease Inducement [Member]
Contingent Funding Commitment	$ 29,850,000
Contingent Funding Commitment, Amount Funded	(9,000,000)
Contingent Funding Commitment, Remaining Unfunded Amount	20,850,000
Bickford Senior Living [Member] | Lease Inducement [Member]
Contingent Funding Commitment	10,000,000
Contingent Funding Commitment, Amount Funded	(8,750,000)
Contingent Funding Commitment, Remaining Unfunded Amount	1,250,000
Bickford Senior Living [Member] | Incentive Loan Draws [Member]
Contingent Funding Commitment	8,000,000
Contingent Funding Commitment, Amount Funded	(250,000)
Contingent Funding Commitment, Remaining Unfunded Amount	7,750,000
Wingate Healthcare [Member] | Lease Inducement [Member]
Contingent Funding Commitment	5,000,000
Contingent Funding Commitment, Amount Funded	0
Contingent Funding Commitment, Remaining Unfunded Amount	5,000,000
Navion Senior Solutions [Member] | Lease Inducement [Member]
Contingent Funding Commitment	4,850,000
Contingent Funding Commitment, Amount Funded	0
Contingent Funding Commitment, Remaining Unfunded Amount	4,850,000
Ignite Medical Resorts [Member] | Lease Inducement [Member]
Contingent Funding Commitment	2,000,000
Contingent Funding Commitment, Amount Funded	0
Contingent Funding Commitment, Remaining Unfunded Amount	$ 2,000,000

Stock-Based Compensation Stock-

Stock-Based Compensation Stock-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Schedule of Stock Option Valuation Assumptions [Abstract]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate	5.50%	6.50%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate	18.60%	19.40%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	2 years 10 months 24 days	2 years 10 months 24 days
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	2.50%	2.39%

Stock-Based Compensation (Sched

Stock-Based Compensation (Schedule Of Stock Option Activity) (Details) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Options outstanding, January 1	920,346	859,182
Options outstanding, March 31	1,169,516	1,404,182
Options exercisable, March 31	678,997	949,160
2012 Plan [Member]
Options granted	602,000	560,000
Options exercised	(352,830)	0
Options forfeited	0	(15,000)

Stock-Based Compensation (Narra

Stock-Based Compensation (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	May 03, 2019	May 03, 2018	May 07, 2015	May 31, 2012
Nonemployee director annual stock grants	25,000
Unrecognized compensation cost	$ 2,298
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 6.17	$ 4.49
Allocated Share-based Compensation Expense	$ 2,001	$ 1,425
2012 Plan [Member]
Shares available for grants	319,669			3,500,000	3,000,000	1,500,000
Stock Option Plan, Award Vesting Period	5 years
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period	10 years
2019 Plan [Member]
Stock Option Plan, Award Vesting Period	5 years
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period	10 years
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
Expected To Be Recognized During 2019 [Member]
Unrecognized compensation cost	$ 1,430
Expected To Be Recognized During 2020 [Member]
Unrecognized compensation cost	776
Expected To Be Recognized During 2021 [Member]
Unrecognized compensation cost	$ 92
Subsequent Event [Member] | 2019 Plan [Member]
Shares available for grants			3,000,000

Earnings and Dividends Per Sh_3

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, 2019	Mar. 31, 2018
Earnings Per Share [Abstract]
Net income (loss) attributable to common stockholders	$ 35,679	$ 38,432
BASIC:
Weighted Average Number of Shares Outstanding, Basic	42,825,824	41,532,154
Earnings Per Share, Basic	$ 0.83	$ 0.93
DILUTED:
Weighted average common shares outstanding, diluted	42,825,824	41,532,154
Stock options, diluted	75,695	44,722
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities	223,513	0
Average dilutive common shares outstanding	43,125,032	41,576,876
Earnings Per Share, Diluted	$ 0.83	$ 0.92
Incremental shares excluded since anti-dilutive:
Stock options with an exercise price in excess of the market price for our common shares	17,415	118,639
Common Stock, Dividends, Per Share, Declared	$ 1.05	$ 1

Fair Value Of Financial Instr_3

Fair Value Of Financial Instruments (Schedule Of Assets And Liabilities Measured On A Recurring Basis) (Details) - Fair Value, Inputs, Level 2 [Member] - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Cash Flow Hedge Derivative Instrument Assets at Fair Value	$ 559	$ 1,297
Cash Flow Hedge Derivative Instrument Liabilities at Fair Value	$ (219)	$ 0

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Fair Value Measurements, Nonrecurring) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	$ 257,481	$ 246,111
Reported 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	257,481	246,111
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	633,401	628,010
Reported 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	653,804	653,665
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	260,119	244,206
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	639,000	634,000
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	$ 653,455	$ 644,745

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements Recent Accounting Pronouncements (Details) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Recent Accounting Pronouncements [Abstract]
Lessor Property Costs Paid From Tenant Escrow	$ 1,090,000	$ 0
Operating Lease, Right-of-Use Asset	$ 1,176,000

Subsequent Events Subsequent _2

Subsequent Events Subsequent Events (Narrative) (Details)	Apr. 29, 2019USD ($)	Mar. 31, 2019USD ($)properties	Mar. 31, 2018USD ($)	Apr. 30, 2019USD ($)beds_or_unitsrenewalOptions	Dec. 31, 2018USD ($)
Subsequent Event [Line Items]
Number of Real Estate Properties | properties		220
Escrow Deposit		$ 8,208,000			$ 8,208,000
Minimum Annual Lease Income		70,953,000	$ 69,253,000
Deferred Rent Receivables, Net		75,123,000			$ 105,620,000
Payments to Acquire Real Estate		$ 50,122,000	$ 14,404,000
Lessor, Operating Lease, Renewal Term		5 years
Comfort Care Senior Living [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Number of Units in Real Estate Property | beds_or_units				60
Payments to Acquire Real Estate	$ 10,800,000
Initial lease rate				7.75%
Lessor, Operating Lease, Term of Contract				10 years
Number Of Additional Lease Renewal Options | renewalOptions				2
Lessor, Operating Lease, Renewal Term				5 years
Contingent Incentive Payments				$ 3,000,000
Asset under Construction [Member] | Comfort Care Senior Living [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Number of Units in Real Estate Property | beds_or_units				14