National Health Investors (NHI) 10-Q 7 Nov 19 2019 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Nov. 04, 2019
Document And Entity Information [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2019
Document Transition Report	false
Entity File Number	001-10822
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	62-1470956
Entity Address, Address Line One	222 Robert Rose Drive
Entity Address, City or Town	Murfreesboro
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37129
City Area Code	(615)
Local Phone Number	890-9100
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	NHI
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		43,960,521
Amendment Flag	false
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Entity Registrant Name	National Health Investors Inc
Entity Central Index Key	0000877860
Current Fiscal Year End Date	--12-31

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Assets:
Land	$ 213,102	$ 202,196
Buildings and improvements	2,827,227	2,599,526
Construction in progress	19,954	16,643
Real estate properties, gross	3,060,283	2,818,365
Less accumulated depreciation	(494,834)	(451,483)
Real estate properties, net	2,565,449	2,366,882
Mortgage and other notes receivable, net	315,316	246,111
Cash and cash equivalents	5,882	4,659
Straight-line rent receivable	82,634	105,620
Assets held for sale, net	18,420	0
Other assets	31,659	27,298
Total Assets	3,019,360	2,750,570
Liabilities and Stockholders' Equity:
Debt	1,449,360	1,281,675
Accounts payable and accrued expenses	28,625	19,890
Dividends Payable	46,154	42,700
Lease deposit liabilities	10,638	10,638
Deferred income	21,590	5,954
Total Liabilities	1,556,367	1,360,857
Commitments and Contingencies
National Health Investors, Inc. Stockholders' Equity:
Common stock, $.01 par value; 60,000,000 shares authorized; 43,357,018 and 42,700,411 shares issued and outstanding, respectively	440	427
Capital in excess of par value	1,467,289	1,369,919
Cumulative net income in excess of dividends	(554)	18,068
Accumulated other comprehensive income	(4,809)	1,299
Total National Health Investors, Inc. Stockholders' Equity	1,462,366	1,389,713
Noncontrolling interest	627	0
Total Equity	1,462,993	1,389,713
Total Liabilities and Equity	$ 3,019,360	$ 2,750,570

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 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	43,956,238	42,700,411
Common stock, shares outstanding	43,956,238	42,700,411

Consolidated Statements Of Inco

Consolidated Statements Of Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Revenues:
Rental income	$ 75,247	$ 71,688	$ 218,777	$ 210,809
Interest income and other	6,435	3,227	17,109	9,807
Revenues	81,682	74,915	235,886	220,616
Expenses:
Depreciation	19,695	18,153	57,206	53,282
Interest	14,661	12,374	41,925	36,207
Legal	40	371	409	705
Franchise, excise and other taxes	121	245	1,441	857
General and administrative	2,802	2,793	9,787	9,727
Property taxes and insurance on leased properties	1,608	0	4,205	0
Loan and realty losses	0	0	2,500	1,849
Total operating expenses	38,927	33,936	117,473	102,627
Income before loss on convertible note retirement	42,755	40,979	118,413	117,989
Loss on convertible note retirement	0	0	0	(738)
Net income	42,755	40,979	118,413	117,251
Net income
Less: net loss attributable to noncontrolling interest	3	0	4	0
Net income	$ 42,758	$ 40,979	$ 118,417	$ 117,251
Weighted average common shares outstanding:
Basic	43,505,332	42,187,077	43,187,847	41,808,017
Diluted	43,861,089	42,434,499	43,494,714	41,932,736
Basic:
Net income attributable to common stockholders - basic	$ 0.98	$ 0.97	$ 2.74	$ 2.80
Diluted:
Net income attributable to common stockholders - diluted	$ 0.97	$ 0.97	$ 2.72	$ 2.80

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement of Comprehensive Income [Abstract]
Net income	$ 42,755	$ 40,979	$ 118,413	$ 117,251
Net income (loss) attributable to common stockholders	42,758	40,979	118,417	117,251
Other comprehensive income (loss):
Increase (decrease) in fair value of cash flow hedge	960	(401)	5,077	(2,774)
Less: reclassification adjustment for amounts recognized in net income	(390)	(27)	(1,031)	326
Total other comprehensive income (loss)	(1,350)	374	(6,108)	3,100
Comprehensive income	41,405	41,353	112,305	120,351
Less: comprehensive loss attributable to noncontrolling interest	3	0	4	0
Comprehensive income	$ 41,408	$ 41,353	$ 112,309	$ 120,351

Consolidated Statements Of Cash

Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income	$ 118,413	$ 117,251
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	57,206	53,282
Amortization	3,664	3,229
Amortization of commitment fees	(365)	(625)
Amortization of lease incentives	607	240
Straight-line rental income	(16,255)	(17,516)
Non-cash interest income on construction loan	(1,509)	(1,257)
Loss on modification and extinguishment of debt	0	738
Loan and realty losses	2,500	1,849
Payment of lease incentives	(3,100)	(3,000)
Share-based compensation	2,955	2,131
Change in operating assets and liabilities:
Other assets	2,059	(3,350)
Accounts payable and accrued expenses	1,757	4,030
Deferred income	16,877	(690)
Net cash provided by operating activities	184,809	156,312
Cash flows from investing activities:
Investment in mortgage and other notes receivable	(83,946)	(16,144)
Collection of mortgage and other notes receivable	2,566	3,640
Investment in real estate	(209,227)	(129,558)
Investment in renovations of existing real estate	(14,295)	(7,412)
Net cash used in investing activities	(304,902)	(149,474)
Cash flows from financing activities:
Proceeds from revolving credit facilities	332,000	211,000
Payments on revolving credit facilities	(166,000)	(409,000)
Borrowings on term loan	0	300,000
Payments on term loans	(886)	(854)
Debt issuance costs	(126)	(2,113)
Proceeds for noncontrolling interest	631	0
Value of shares withheld from options exercised for employee tax withholding	(1,374)	(730)
Proceeds from issuance of common shares, net	95,802	47,893
Consideration provided in convertible bond repurchase	0	(29,985)
Dividends paid to stockholders	(133,585)	(123,160)
Net cash provided by (used in) financing activities	126,462	(6,949)
Increase in cash and cash equivalents and restricted cash	6,369	(111)
Cash and cash equivalents and restricted cash, beginning of period	16,281	7,964
Supplemental disclosure of cash flow information:
Interest paid, net of amounts capitalized	39,355	32,680
Supplemental schedule of non-cash investing and financing activities:
Change in accounts payable related to investments in real estate construction	(1,981)	568
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 mortgage notes receivable related to investments in real estate	14,035	0
Change in other assets related to investments in real estate	176	0
Tenant investment in leased asset	$ 0	$ 3,775

Consolidated Statement Of Equit

Consolidated Statement Of Equity - USD ($)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Cumulative Dividends In Excess Of Net Income [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Parent [Member]	Noncontrolling Interest [Member]
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	$ 1,322,117,000	$ 415,000	$ 1,289,919,000	$ 32,605,000	$ (822,000)	$ 1,322,117,000	$ 0
Balance, shares at Dec. 31, 2017		41,532,154
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders				76,272,000	2,726,000	78,998,000
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest							0
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	$ 78,998,000
Stock Issued During Period, Shares, New Issues	628,403
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	11,309
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt, Subsequent Adjustments	$ (2,427,000)		(2,427,000)			(2,427,000)
Stock Issued During Period, Value, New Issues	44,920,000	$ 7,000	44,913,000			44,920,000	0
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(325,000)		325,000			325,000	0
Share-based compensation	1,794,000		1,794,000			1,794,000	0
Dividends declared, $1.54 per share	(83,703,000)			(83,703,000)		(83,703,000)	0
Balance, shares at Dec. 31, 2017		41,532,154
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	117,251,000
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	120,351,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	120,351,000
Balance, shares at Sep. 30, 2018		42,230,851
Cumulative Effect of New Accounting Principle in Period of Adoption				(235,000)	235,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	40,979,000			40,979,000	374,000	41,353,000
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	41,353,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	$ 41,353,000
Stock Issued During Period, Shares, New Issues	39,669
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	19,316
Stock Issued During Period, Value, New Issues	$ 2,973,000		2,973,000			2,973,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(405,000)		405,000			405,000
Share-based compensation	337,000		337,000			337,000
Dividends declared, $1.54 per share	(42,232,000)			(42,232,000)		(42,232,000)
Balance, shares at Sep. 30, 2018		42,230,851
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	1,363,400,000	$ 422,000	1,336,779,000	23,686,000	2,513,000	1,363,400,000	0
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	$ 1,389,713,000	$ 427,000	1,369,919,000	18,068,000	1,299,000	1,389,713,000	0
Balance, shares at Dec. 31, 2018	42,700,411	42,700,411
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	$ 118,417,000
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	112,309,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	$ 112,305,000
Balance, shares at Sep. 30, 2019	43,956,238	43,956,238
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	$ 1,462,993,000	$ 440,000	$ 1,467,289,000	$ (554,000)	$ (4,809,000)	$ 1,462,366,000	$ 627,000

Consolidated Statement Of Equ_2

Consolidated Statement Of Equity Consolidated Statement of Equity (Parenthetical) - $ / shares	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement of Stockholders' Equity [Abstract]
Common Stock, Dividends, Per Share, Declared	$ 1.05	$ 1.05	$ 1.05	$ 1	$ 1	$ 1	$ 3.15	$ 3

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 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 September 30, 2019 , we held interests in seven 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 either amortized cost or net realizable value for straight-line receivables. 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 $ 60,133,000 $ 69,665,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 83,814,000 $ 94,059,000 Notes 2, 3 2015 Timber Ridge, LCS affiliate Notes receivable $ 59,156,000 $ 59,808,000 Note 3 2016 Senior Living Management Notes and straight-line receivable $ 26,796,000 $ 26,796,000 Note 3 2017 Evolve Senior Living Note receivable $ 9,943,000 $ 9,943,000 — 2018 Sagewood, LCS affiliate Notes receivable $ 107,890,000 $ 178,498,000 Note 3 2019 41 Management, LLC Notes receivable $ 3,223,000 $ 10,800,000 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) : September 30, September 30, Cash and cash equivalents $ 5,882 $ 2,638 Restricted cash (included in Other assets) 10,399 5,326 $ 16,281 $ 7,964 Leases - Operating leases entered into during 2019 are accounted for 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. 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, management’s projected 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. 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	9 Months Ended
	Sep. 30, 2019
Real Estate [Abstract]
Real Estate Disclosure [Text Block]	REAL ESTATE As of September 30, 2019 , we owned 222 health care real estate properties located in 34 states and consisting of 145 senior housing communities (“SHO”), 72 skilled nursing facilities, 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 $2,508,000 ) consisted of properties with an original cost of approximately $3,057,775,000 rented under triple-net leases to 31 lessees. During the nine months ended September 30, 2019 , we made the following real estate investments and related commitments as described below ($ in thousands) : Operator Date Properties Asset Class Amount Wingate Healthcare January 2019 1 SHO $ 52,200 Holiday Retirement January 2019 1 SHO 38,000 Comfort Care Senior Living April 2019 1 SHO 10,800 Comfort Care Senior Living May 2019 1 SHO 13,500 Discovery Senior Living (PropCo Joint Venture) May 2019 6 SHO 127,917 Capella Living Solutions July 2019 1 SHO 7,600 Bickford Senior Living September 2019 1 SHO 15,100 $ 265,117 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 renewal options of five years each, 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 has a right of first offer on two additional Wingate-operated facilities. We accounted for the transaction as an asset purchase. Comfort Care On April 30, 2019, we acquired a newly-constructed 60 -unit assisted living facility in Shelby, Michigan which has 14 memory care units under construction. The total commitment of $10,800,000 includes $9,282,000 funded at closing with the remaining amount to be funded as construction progresses. On May 20, 2019, we acquired a property in Brighton, Michigan, consisting of 73 assisted living/memory care units. The purchase price for the Brighton acquisition was $13,500,000 , inclusive of closing costs. We leased the properties to Comfort Care Senior Living (“Comfort Care”), under leases which provide for initial lease rate of 7.75% , with annual fixed escalators beginning in year three over the term of ten years plus two renewal options of five years each. The leases each include a $3,000,000 earnout incentive which will be added to the respective lease base if funded. We accounted for the acquisitions as asset purchases. Discovery On May 31, 2019, we invested $25,028,000 in cash for a 97.5% equity interest in a consolidated subsidiary ("Discovery PropCo"), which simultaneously acquired from a third party six senior housing facilities comprising 145 independent-living units, 356 assisted-living units and 95 memory-care units, for a total of 596 units. Discovery Senior Housing Investor XXIV, LLC, (“Discovery”) contributed $631,000 for its non-controlling 2.5% equity interest. We invested an additional $102,258,000 as a preferred equity contribution, for a total NHI investment of $127,286,000 . The additional equity contribution of $102,258,000 carries a preference in liquidation as well as in the distribution of operating cash flow. After the completion of all transaction accounting during the quarter ended September 30, 2019, minor adjustments were made to reconcile the partnership equity interests. Total cash of $127,917,000 invested in Discovery PropCo included approximately $1,067,000 in closing costs. The facilities were leased by Discovery PropCo to Discovery for a term of ten years with two renewal periods of five years each at an initial lease rate of 6.5% with fixed annual escalators through the fifth year of the initial lease term followed by CPI-based escalators, subject to floor and ceiling, thereafter. Discovery is eligible, beginning in 2023, for up to $4,000,000 of lease inducement payments upon meeting specified performance metrics. Inducement payments funded under the agreement will be added to the lease base. Additionally, PropCo has committed to Discovery for funding up to $2,000,000 toward the purchase of condominium units located at one of the facilities. The total purchase price for the properties acquired, as discussed above, was allocated to the tangible assets based upon their relative fair values consisting of $6,301,000 to the land and $121,616,000 to the buildings and improvements. We accounted for the transaction as an asset purchase. As the managing member, NHI manages Discovery Propco, subject to certain consent rights of Discovery for significant business decisions. Because of our control of Discovery PropCo, we include its assets, liabilities, noncontrolling interest and operations in our condensed consolidated financial statements. Cappella Living Solutions On July 23, 2019, we acquired a 51 -unit assisted living facility in Pueblo, Colorado for $7,600,000 including $100,000 of closing costs. We leased the facility to Christian Living Services, Inc., d/b/a Cappella Living Solutions, for a term of 15 years at an initial lease rate of 7.25% , with CPI escalators subject to a floor and ceiling. We accounted for this 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 a cash payment 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 September 30, 2019 . As of September 30, 2019 , we leased 26 independent living facilities to Holiday. Of our total revenues, $10,176,000 ( 12% ) and $10,954,000 ( 15% ) were derived from Holiday for the three months ended September 30, 2019 and 2018 , including $1,664,000 and $1,530,000 in straight-line rent income, respectively. Of our total revenues, $30,283,000 ( 13% ) and $32,863,000 ( 15% ) were derived from Holiday for the nine months ended September 30, 2019 and 2018 , including $4,958,000 and $4,591,000 in straight-line rent income, respectively. Our tenant operates the facilities pursuant to a management agreement with a Holiday-affiliated manager. Bickford As of September 30, 2019 , our Bickford Senior Living (“Bickford”) lease portfolio consists of the following ($ in thousands) : Lease Expiration June 2023 September 2024 September 2027 May 2031 April 2033 Total Number of Properties 13 10 4 19 5 51 2019 Contractual Rent $ 11,468 $ 9,542 $ 1,576 $ 12,203 $ 4,918 $ 39,707 2019 Straight Line Rent 358 670 195 1,695 860 3,778 $ 11,826 $ 10,212 $ 1,771 $ 13,898 $ 5,778 $ 43,485 On September 1, 2019, NHI amended a master lease, which matures in May 2031 and covers 14 Bickford properties, to change the annual escalator from a fixed percentage to a CPI-based escalator with a floor of 2% and a ceiling of 3% . On September 10, 2019, we acquired a 60 -unit assisted living/memory care facility located in Gurnee, Illinois, from Bickford. The acquisition price was $15,100,000 , including $100,000 in closing costs, and the cancellation of an outstanding construction note receivable of $14,035,000 , including interest. The $965,000 difference was funded into an agreed-upon escrow. We leased the building for a term of twelve years at an initial lease rate of 8% , with CPI escalators subject to a floor and ceiling. We accounted for the transaction as an asset purchase. Of our total revenues, $13,285,000 ( 16% ) and $12,937,000 ( 17% ) were recognized as rental income from Bickford for the three months ended September 30, 2019 and 2018 , including $1,117,000 and $1,169,000 in straight-line rent income, respectively. Of our total revenues, $39,796,000 ( 17% ) and $36,792,000 ( 17% ) were recognized as rental income from Bickford for the nine months ended September 30, 2019 and 2018 , including $3,812,000 and $3,541,000 in straight-line rent income, respectively. Effective October 1, 2019, NHI and Bickford amended the master lease covering ten Bickford properties secured by HUD financing to reduce the annual rent by $466,000 . Included in the amendment, NHI agreed to change the annual escalator from a fixed percentage to CPI-based subject to a floor and ceiling. Senior Living Communities As of September 30, 2019 , we leased 10 retirement communities totaling 2,068 units to Senior Living Communities, LLC (“Senior Living”). The 15 -year master lease, which began in December 2014 , contains two renewal options of five years each and provides for an annual escalator of 3% effective January 1, 2019. Of our total revenues, $11,924,000 ( 15% ) and $11,469,000 ( 15% ) in rental income were derived from Senior Living for the three months ended September 30, 2019 and 2018 , including $1,404,000 and $1,359,000 in straight-line rent income, respectively. Of our total revenues, $35,001,000 ( 15% ) and $34,374,000 ( 16% ) in rental income were derived from Senior Living for the nine months ended September 30, 2019 and 2018 , including $3,519,000 and $4,076,000 in straight-line rent income, respectively. NHC As of September 30, 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 three 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”) that includes our 35 legacy properties and a master lease agreement dated August 30, 2013 (“the 2013 lease”) that includes 7 skilled nursing facilities acquired in 2013. The 1991 lease expiration is December 31, 2026. There are two additional renewal options of five years , each at fair rental value as negotiated between the parties. 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 Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Current year $ 924 $ 853 $ 2,726 $ 2,558 Prior year final certification 1 — — 334 285 Total percentage rent income $ 924 $ 853 $ 3,060 $ 2,843 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, $9,461,000 ( 12% ) and $9,389,000 ( 13% ) in rental income were derived from NHC for the three months ended September 30, 2019 and 2018 , respectively. Of our total revenues, $28,670,000 ( 12% ) and $28,453,000 ( 13% ) in rental income were derived from NHC for the nine months ended September 30, 2019 and 2018 , respectively. The chairman of our board of directors is also a director on NHC’s board of directors. As of September 30, 2019 , NHC owned 1,630,462 shares of our common stock. Other Portfolio Activity Tenant Transitioning 41 Management As part of a geographical realignment by Bickford, we transitioned four Minnesota properties on October 1, 2019, to 41 Management. The lease calls for first-year rent of $906,000 and a term of 15 years with two renewal options of five years each. Annual escalators are fixed at 2.5% . Bickford has agreed to fund a monthly lease termination fee through December 2020, totaling $734,000 . Other As of September 30, 2019 , we had completed the contractual transition of three lease portfolios to new tenants following a period of non-compliance by the former operators, background for which is provided in the audited financial statements included in our 2018 Annual Report on Form 10-K. The portfolios consist of three former SH-Regency Leasing, LLC (“Regency”) buildings, five former LaSalle Group (“LaSalle”) buildings and one facility formerly leased to Landmark Senior Living (“Landmark”). To expedite stabilization of the facilities, we committed to specified income-generating capital expenditures for the re-branding and refurbishment of certain of these properties. The new leases each specify initial periods during which rental income to NHI shall be based on net operating income (“NOI”), after deduction of management fees. Following the initial periods, each lease converts to a structured payment based on a fair-value calculation. The former Regency buildings have been leased to three operators, Senior Living, Discovery, and Vitality MC TN, LLC (“Vitality”). Of our total revenues, $515,000 and $1,367,000 ( 2% ) in rental income were derived from the three former Regency buildings for the three months ended September 30, 2019 and 2018 , respectively. Of our total revenues, $660,000 and $4,100,000 ( 3% ) in rental income were derived from the three former Regency buildings for the nine months ended September 30, 2019 and 2018 , respectively. Effective July 1, 2019 we transitioned an Indiana, independent living/assisted living facility to Discovery in conjunction with our other properties in transition. The triple-net lease matures in June 2024 with two renewal options of five years each. Rent is initially based on net operating income. Beginning in 2022, rent is to reset to the greater of $1,400,000 or fair value as provided by formula. For the duration of the lease, the rent, as reset, is subject to a 2.5% escalator. Concurrent with Discovery’s entrance into the lease, NHI provided a working capital loan for amounts up to $750,000 at an interest rate of 6.5% and a $900,000 capital improvement commitment to fund improvements to the facility. The loan extends during the term of the lease. On April 16, 2019, Chancellor Health Care leased the five former LaSalle buildings. Our lease agreement with Chancellor provides for NHI to receive 100% of net operating cash flow generated by the facilities, after management fees, pending stabilization of the operations of the facility. During the first quarter of 2019, we also commenced litigation for the recovery of certain funds owed by LaSalle under the lease and against the principal executive, personally, under the guaranty agreement. Of our total revenues, $437,000 and $1,317,000 ( 2% ) in rental income were derived from the five former LaSalle buildings for the three months ended September 30, 2019 and 2018 , respectively. Of our total revenues, $725,000 and $3,950,000 ( 3% ) in rental income were derived from the five former LaSalle buildings for the nine months ended September 30, 2019 and 2018 , respectively. At December 31, 2018, we had a single-property lease in Wisconsin with Landmark that was non-performing. In February 2019, we transitioned the lease to BAKA Enterprises, temporarily acting under a management agreement with Landmark. Under terms of the new lease, NHI receives 95% of net 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 , with renewal options. Of our total revenues, $150,000 and $247,000 were derived from the former Landmark property for the three months ended September 30, 2019 and 2018 , respectively. Of our total revenues, $925,000 ( 0% ) and $1,041,000 ( 1% ) were derived from the former Landmark property for the nine months ended September 30, 2019 and 2018 , respectively, including $625,000 received during 2019 as a settlement payment. 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. Assets Held For Sale In September 2019, we classified a portfolio of eight assisted living properties located in Arizona ( 4 ), Tennessee ( 3 ) and South Carolina ( 1 ) as held for sale, after the current tenant expressed an intention to exercise its purchase option on the properties. The purchase option provides for an even split of the excess of fair value over NHI's acquisition costs. Based on preliminary discussions, we expect the eventual selling price to exceed the portfolio’s current carrying value. Of our total revenues, $1,062,000 ( 1.3% ) and $3,187,000 ( 1.4% ) in rental income were derived from this eight property portfolio for the three and nine months ended September 30, 2019 , respectively. We expect the transaction to be finalized during the first quarter of 2020. We have identified two assisted living properties for disposal and have begun 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 2019 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 and have classified the assets as held for sale on the Condensed Consolidated Balance Sheet at September 30, 2019 . 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, excluding properties classified as held for sale, 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 $ 306 HOSP 1 September 2027 2020 ii $ 2,713 HOSP 1 March 2025 2020 iv $ 1,957 SHO 2 May 2031 2021 iv $ 5,063 HOSP 1 June 2022 2022 i $ 3,502 SNF 7 August 2028 2025 iii $ 3,671 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. 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 September 30, 2019 , to be received by us under our operating leases, as determined under ASC 842 ( in thousands ): Twelve months ended September 30, 2019 2020 $ 270,629 2021 271,169 2022 274,491 2023 272,498 2024 264,457 Thereafter 1,608,080 $ 2,961,324 We assess the collectibility of our lease receivables, consisting primarily of straight-line 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 able to collect substantially all of the receivable, we de-recognize all rent receivable assets, including the straight-line rent receivable asset and record as a reduction in rental revenue. Variable Lease Payments Most of our existing leases contain annual escalators in rent payments. For financial statement purposes, rental income is recognized on a straight-line basis over the term of the lease where the lease contains fixed escalators. Some of our leases contain escalators that are determined annually based on a variable index or other factor that is indeterminable at the inception of the lease. The table below indicates the amount of lease revenue recognized during the three and nine months ended September 30, 2019 as a result of fixed and variable lease escalators ( in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Lease payments based on fixed escalators $ 67,172 $ 64,884 $ 196,411 $ 190,267 Lease payments based on variable escalators 747 1,085 1,906 3,026 Straight-line rent income 5,720 5,719 16,255 17,516 Escrow funds received from tenants 1,608 — 4,205 — Rental income $ 75,247 $ 71,688 $ 218,777 $ 210,809

Mortgage And Other Notes Receiv

Mortgage And Other Notes Receivable	9 Months Ended
	Sep. 30, 2019
Financing Receivable, after Allowance for Credit Loss [Abstract]
Mortgage Notes Receivable	MORTGAGE AND OTHER NOTES RECEIVABLE At September 30, 2019 , we had net investments in mortgage notes receivable with a carrying value of $269,718,000 , secured by real estate and UCC liens on the personal property of 14 facilities, and other notes receivable with a carrying value of $45,598,000 , 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 September 30, 2019 or December 31, 2018 . Discovery On August 30, 2019, NHI extended a senior mortgage loan of $6,423,000 at 7% annual interest to affiliates of Discovery to acquire a senior housing facility in Indiana for which Discovery PropCo, will have the option to purchase at stabilization. The facility consists of 52 assisted living units and 22 memory care units. 41 Management On June 14, 2019, we committed to providing first mortgage financing to 41 Management, LLC (d/b/a as Matthews Senior Living) for up to $10,800,000 to fund the construction of a 51 -unit assisted living facility in Wisconsin. The loan carries an interest rate of 8.50% for its term of five years , subject to two renewals of one year each. The agreement includes a purchase option, which is to open upon stabilization of the facility. Additional security on the loan includes personal and corporate guarantees and the funding of a $2,400,000 working capital escrow. The total amount funded on the note was $3,324,000 as of September 30, 2019 . Our loan to 41 Management represents a variable interest. 41 Management 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. As discussed more fully in Note 1, we have concluded that we are not the primary beneficiary. Senior Living Communities On June 25, 2019, we provided a mortgage loan of $32,700,000 to Senior Living for the acquisition of a 248 -unit continuing care retirement community in Columbia, South Carolina. The financing is for a term of five years with two one year extensions and carries an interest rate of 7.25% . Additionally, the loan conveys to NHI a purchase option at a stated minimum price of $38,250,000 , subject to adjustment for market conditions. 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, $4,755,000 at September 30, 2019 , bear interest at an annual rate equal to the prevailing 10 -year U.S. Treasury rate, 1.68% at September 30, 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 September 30, 2019 , and provided NHI with a fixed capitalization rate 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. As discussed more fully in Note 1, we have concluded that we are not the primary beneficiary. Bickford At September 30, 2019 , our construction loans to Bickford are summarized as follows: Commencement Rate Maturity Commitment Drawn Location January 2017 9% 5 years 14,000,000 (14,000,000 ) Michigan January 2018 9% 5 years 14,000,000 (10,493,000 ) Virginia July 2018 9% 5 years 14,700,000 (8,675,000 ) Michigan $ 42,700,000 $ (33,168,000 ) 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. As discussed in Note 2, on September 10, 2019, we acquired the Illinois location constructed by Bickford for $15,100,000 . In the exchange we cancelled Bickford’s outstanding debt, including interest, on the property of $14,035,000 . 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. As discussed more fully in Note 1, we have concluded that we are not the primary beneficiary. 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. As discussed more fully in Note 1, we have concluded that we are not the primary beneficiary. 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 three years and has a term of 10 years . We have funded $77,340,000 of Note A as of September 30, 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 maturity of five years . The total amount funded on Note B was $32,052,000 as of September 30, 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 three years and has a term of 10 years . We have funded $59,349,000 of Note A as of September 30, 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 an option window that opened in February 2019. 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 extensions of one year and two years . NHI has a right of first refusal if SLM elects to sell the facilities. The loans were fully funded as of September 30, 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. As discussed more fully in Note 1, we have concluded that we are not the primary beneficiary.

Other Assets

Other Assets	9 Months Ended
	Sep. 30, 2019
Other Assets [Abstract]
Other Assets Disclosure [Text Block]	OTHER ASSETS Other assets consist of the following ( in thousands ): September 30, December 31, Accounts receivable and other assets $ 3,104 $ 6,381 Regulatory escrows 8,208 8,208 Unamortized lease incentive payments 9,948 7,456 Restricted cash 10,399 5,253 $ 31,659 $ 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	9 Months Ended
	Sep. 30, 2019
Debt Instruments [Abstract]
Debt Disclosure	DEBT Debt consists of the following ( in thousands ): September 30, December 31, Revolving credit facility - unsecured $ 250,000 $ 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 $1,258 and $1,320) 42,333 42,906 Fannie Mae term loans - secured, non-recourse 95,793 96,044 Convertible senior notes - unsecured (net of discount of $807 and $1,391) 119,193 118,609 Unamortized loan costs (7,959 ) (9,884 ) $ 1,449,360 $ 1,281,675 Aggregate principal maturities of debt as of September 30, 2019 , and for each of the next five years and thereafter are as follows ( in thousands ): 2020 $ 1,219 2021 121,267 2022 501,315 2023 426,366 2024 51,416 Thereafter 357,801 1,459,384 Less: discount (2,065 ) Less: unamortized loan costs (7,959 ) $ 1,449,360 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 and June 28, 2019, we entered into swap agreements to fix the interest rates on $340,000,000 of term loans and $60,000,000 of our revolving credit facility through December 2021, when LIBOR is scheduled for discontinuation. 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 120 bps and a blended 132 bps, respectively. At September 30, 2019 and December 31, 2018 , 30-day LIBOR was 202 and 250 bps, respectively. Within the facility, the employment of interest rate swaps for a portion of our fixed term debt leaves only $190,000,000 of our revolving credit facility exposed to interest rate risk through June 2020 , when our $80,000,000 and $130,000,000 swaps expire. Our swaps and the financial instruments to which they relate are described in the table below, under the caption “Interest Rate Swap Agreements.” At September 30, 2019 , we had $300,000,000 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 September 30, 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. As discussed more fully at Note 11, we have elected to issue public credit ratings from Fitch Ratings and S&P Global Ratings. Our unsecured private placement term loan agreements include a rate increase provision that is effective if any rating agency lowers our credit rating on our senior unsecured debt below investment grade and our compliance leverage increases to 50% or more. HUD mortgage loans Our HUD mortgage loans are secured by ten properties leased to Bickford and having a net book value of $49,577,000 at September 30, 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 $8,546,000 and a carrying value of $7,288,000 , 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 $17,709,000 at September 30, 2019 . All together, these notes are secured by facilities having a net book value of $135,267,000 at September 30, 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 September 30, 2019 , our senior unsecured convertible notes were convertible at a rate of 14.57 shares of common stock per $1,000 principal amount, representing a conversion price of approximately $68.63 per share for a total of 1,748,616 shares on the remaining $120,000,000 of senior unsecured convertible notes. For the three months ended September 30, 2019 , dilution resulting from the conversion option within our convertible debt is 275,824 shares. If NHI’s current share price increases above the adjusted $68.63 conversion price, further dilution will be attributable to the conversion feature. On September 30, 2019 , the value of the convertible debt, computed as if the debt were immediately eligible for conversion, exceeded its face amount by $24,068,000 . 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 $610,000,000 ( $400,000,000 after June 2020) of our bank loans. During the next year, approximately $2,217,000 of gains, which are included in accumulated other comprehensive income (loss), are projected to be reclassified into earnings. As of September 30, 2019 , we employ the following interest rate swap contracts to mitigate our interest rate risk on our bank term and revolver loans described above ( dollars in thousands ): Date Entered Maturity Date Fixed Rate Rate Index Notional Amount Fair Value (Liability) June 2013 June 2020 3.46% 1-month LIBOR $ 80,000,000 $ (238 ) March 2014 June 2020 3.51% 1-month LIBOR $ 130,000,000 $ (431 ) March 2019 December 2021 3.51% 1-month LIBOR $ 100,000,000 $ (1,691 ) March 2019 December 2021 3.52% 1-month LIBOR $ 100,000,000 $ (1,720 ) June 2019 December 2021 2.89% 1-month LIBOR $ 150,000,000 $ (538 ) June 2019 December 2021 2.93% 1-month LIBOR $ 50,000,000 $ (193 ) 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 accounts payable and 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 September 30, 2019 and December 31, 2018 were $(4,810,000) and $1,297,000 , respectively. The following table summarizes interest expense ( in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Interest expense on debt at contractual rates $ 14,308 $ 11,637 $ 40,736 $ 33,579 Losses reclassified from accumulated other comprehensive income (loss) into interest expense (390 ) (27 ) (1,031 ) 326 Capitalized interest (161 ) (50 ) (476 ) (123 ) Amortization of debt issuance costs and debt discount 904 814 2,696 2,425 Total interest expense $ 14,661 $ 12,374 $ 41,925 $ 36,207

Commitments And Contingencies

Commitments And Contingencies	9 Months Ended
	Sep. 30, 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 consisting of 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 September 30, 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 $ (77,340,000 ) $ 41,460,000 LCS Sagewood Note B SHO Construction 61,200,000 (32,052,000 ) 29,148,000 LCS Timber Ridge Note A SHO Construction 60,000,000 (59,349,000 ) 651,000 Bickford Senior Living SHO Construction 42,700,000 (33,168,000 ) 9,532,000 Senior Living Communities SHO Revolving Credit 15,000,000 (4,755,000 ) 10,245,000 41 Management SHO Construction 10,800,000 (3,324,000 ) 7,476,000 Discovery Senior Living SHO Working Capital 750,000 — 750,000 $ 309,250,000 $ (209,988,000 ) $ 99,262,000 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 $ (13,255,000 ) $ 12,095,000 Woodland Village SHO Renovation 7,450,000 (7,374,000 ) 76,000 Senior Living Communities SHO Renovation 6,830,000 (6,004,000 ) 826,000 Senior Living Communities SHO Renovation 3,100,000 (2,000,000 ) 1,100,000 Wingate Healthcare SHO Renovation 1,900,000 (212,000 ) 1,688,000 Discovery Senior Living SHO Renovation 1,400,000 — 1,400,000 Navion Senior Solutions SHO Construction 650,000 — 650,000 $ 46,680,000 $ (28,845,000 ) $ 17,835,000 In addition to the commitments listed above, Discovery PropCo has committed to Discovery for funding up to $2,000,000 toward the purchase of condominium units located at one of the facilities. Asset Class Type Total Funded Remaining Contingencies: Bickford Senior Living SHO Lease Inducement $ 10,000,000 $ (10,000,000 ) $ — Bickford Senior Living SHO Incentive Loan Draws 6,000,000 — 6,000,000 Comfort Care Senior Living SHO Lease Inducement 6,000,000 — 6,000,000 Wingate Healthcare SHO Lease Inducement 5,000,000 — 5,000,000 Navion Senior Solutions SHO Lease Inducement 4,850,000 (500,000 ) 4,350,000 Discovery Senior Living SHO Lease Inducement 4,000,000 — 4,000,000 Ignite Medical Resorts SNF Lease Inducement 2,000,000 — 2,000,000 $ 37,850,000 $ (10,500,000 ) $ 27,350,000 Contingent lease inducement payments of $10,000,000 related primarily to the five Bickford development properties constructed in 2016 and 2017 which included 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 were added to the lease base and are being amortized against rental income. On exercise of our purchase options for additional Bickford development properties, under the 2016 agreement governing the unwind of our joint venture with Bickford, unfunded loan incentives convert to lease inducements on a dollar-for-dollar basis. Litigation Our facilities are subject to claims and suits in the ordinary course of business. Our lessees and borrowers have indemnified, and are obligated to continue to indemnify us, against all liabilities arising from the operation of the facilities, and are further obligated to indemnify us against environmental or title problems affecting the real estate underlying such facilities. While there may be lawsuits pending against certain of the owners and/or lessees of the facilities, management believes that the ultimate resolution of all such pending proceedings will have no material adverse effect on our financial condition, results of operations or cash flows. In June 2018, East Lake Capital Management LLC and certain related entities, including Regency (for three assisted living facilities in Tennessee, Indiana and North Carolina), 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. Litigation is ongoing. LaSalle defaulted on its rent payment in November 2018. We transitioned the properties to a new operator and on April 16, 2019, we placed the five buildings with a new tenant under similar arrangements to those in place over the former Regency buildings, with NHI to receive operating cash flow, after management fees, generated by the facilities pending stabilization. We also commenced litigation for the recovery of certain funds owed under the lease and against the principal executive, Mitch Warren personally, under a guaranty agreement. In the meantime, Autumn Leaves, the manager, has declared bankruptcy under Chapter 11. The litigation is ongoing.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 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 September 30, 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 September 30, 2019 and 2018 was $477,000 and $337,000 , respectively and is included in general and administrative expense in the Condensed Consolidated Statements of Income. Non-cash compensation expense reported for the nine months ended September 30, 2019 and 2018 was $2,955,000 and $2,131,000 , respectively and is included in general and administrative expense in the Condensed Consolidated Statements of Income. At September 30, 2019 , we had, net of expected forfeitures, $1,345,000 of unrecognized compensation cost related to unvested stock options which is expected to be expensed over the following periods: 2019 - $477,000 , 2020 - $776,000 and 2021 - $92,000 . The weighted average fair value per share of options granted during the nine months ended September 30, 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: Nine Months Ended September 30, 2019 2018 Options outstanding January 1, 920,346 859,182 Options granted under 2012 Plan 602,000 560,000 Options exercised under 2012 Plan (431,993 ) (241,669 ) Options forfeited under 2012 Plan — (30,001 ) Options exercised under 2005 Plan — (6,668 ) Options outstanding, September 30, 1,090,353 1,140,844 Exercisable at September 30, 599,834 697,490

Earnings and Dividends Per Shar

Earnings and Dividends Per Share	9 Months Ended
	Sep. 30, 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 Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Net income attributable to common stockholders $ 42,758 $ 40,979 $ 118,417 $ 117,251 BASIC: Weighted average common shares outstanding 43,505,332 42,187,077 43,187,847 41,808,017 DILUTED: Weighted average common shares outstanding 43,505,332 42,187,077 43,187,847 41,808,017 Stock options 79,933 98,269 73,924 66,917 Convertible subordinated debentures 275,824 149,153 232,943 57,802 Weighted average dilutive common shares outstanding 43,861,089 42,434,499 43,494,714 41,932,736 Net income attributable to common stockholders - basic $ .98 $ .97 $ 2.74 $ 2.80 Net income attributable to common stockholders - diluted $ .97 $ .97 $ 2.72 $ 2.80 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 7,858 615 11,200 31,616 Regular dividends declared per common share $ 1.05 $ 1.00 $ 3.15 $ 3.00

Fair Value Of Financial Instrum

Fair Value Of Financial Instruments	9 Months Ended
	Sep. 30, 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. 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 September 30, December 31, Level 2 Interest rate swap asset Other assets $ — $ 1,297 Interest rate swap liability Accounts payable and accrued expenses $ 4,810 $ — Carrying amounts and fair values of financial instruments that are not carried at fair value at September 30, 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 $ 795,276 $ 628,010 $ 800,000 $ 634,000 Fixed rate debt $ 654,084 $ 653,665 $ 674,713 $ 644,745 Level 3 Mortgage and other notes receivable $ 315,316 $ 246,111 $ 324,156 $ 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 September 30, 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	9 Months Ended
	Sep. 30, 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 prior 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 $1,608,000 and $4,205,000 of reimbursements within revenue and in expenses in our Condensed Consolidated Statements of Income for the three and nine months ended September 30, 2019 , respectively, 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 September 30, 2019 among “Accounts payable and accrued expenses” and “Real estate properties, net,” 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 prior 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 an 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	9 Months Ended
	Sep. 30, 2019
Subsequent Events [Abstract]
Subsequent Events [Text Block]	NOTE 11. SUBSEQUENT EVENTS In November 2015, Fitch Ratings issued to us a private monitored credit rating of BBB- with a ‘Stable’ rating outlook. In December 2018 and again on October 31, 2019, Fitch Ratings affirmed their BBB- rating and ‘Stable’ rating outlook. NHI has elected to make this rating public and to that effect, on November 4, 2019, Fitch Ratings announced a public issuer credit rating of BBB- with an outlook of ‘Stable.’ On the same day, S&P Global Ratings announced our public issuer credit rating of BBB- with an outlook of ‘Stable.’ The ratings from both agencies were provided on NHI as an issuer as well as on our senior unsecured debt. Our unsecured bank credit facility discussed more fully at Note 5, includes an option to shift from a leverage-based LIBOR margin schedule to a ratings-based LIBOR margin schedule.

Significant Accounting Polici_2

Significant Accounting Policies (Policy)	9 Months Ended
	Sep. 30, 2019
Policy Text Block [Abstract]
Consolidation, Policy	Principles of Consolidation - The accompanying condensed consolidated financial statements include our accounts and the accounts of our wholly-owned subsidiaries, joint ventures, partnerships and consolidated variable interest entities (“VIE”), if any. All intercompany transactions and balances have been eliminated in consolidation. 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 September 30, 2019 , we held interests in seven 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 either amortized cost or net realizable value for straight-line receivables. 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 $ 60,133,000 $ 69,665,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 83,814,000 $ 94,059,000 Notes 2, 3 2015 Timber Ridge, LCS affiliate Notes receivable $ 59,156,000 $ 59,808,000 Note 3 2016 Senior Living Management Notes and straight-line receivable $ 26,796,000 $ 26,796,000 Note 3 2017 Evolve Senior Living Note receivable $ 9,943,000 $ 9,943,000 — 2018 Sagewood, LCS affiliate Notes receivable $ 107,890,000 $ 178,498,000 Note 3 2019 41 Management, LLC Notes receivable $ 3,223,000 $ 10,800,000 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, 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) : September 30, September 30, Cash and cash equivalents $ 5,882 $ 2,638 Restricted cash (included in Other assets) 10,399 5,326 $ 16,281 $ 7,964
Lessor, Leases [Policy Text Block]	Leases - Operating leases entered into during 2019 are accounted for 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. 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, management’s projected 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.
Use of Estimates, Policy	Use of Estimates -
Earnings Per Share, Policy	Earnings 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)	9 Months Ended
	Sep. 30, 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 $ 60,133,000 $ 69,665,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 83,814,000 $ 94,059,000 Notes 2, 3 2015 Timber Ridge, LCS affiliate Notes receivable $ 59,156,000 $ 59,808,000 Note 3 2016 Senior Living Management Notes and straight-line receivable $ 26,796,000 $ 26,796,000 Note 3 2017 Evolve Senior Living Note receivable $ 9,943,000 $ 9,943,000 — 2018 Sagewood, LCS affiliate Notes receivable $ 107,890,000 $ 178,498,000 Note 3 2019 41 Management, LLC Notes receivable $ 3,223,000 $ 10,800,000 Note 3

Significant Accounting Polici_4

Significant Accounting Policies Schedule of Cash (Tables)	9 Months Ended
	Sep. 30, 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) : September 30, September 30, Cash and cash equivalents $ 5,882 $ 2,638 Restricted cash (included in Other assets) 10,399 5,326 $ 16,281 $ 7,964

Real Estate (Tables)

Real Estate (Tables)	9 Months Ended
	Sep. 30, 2019
Real Estate [Abstract]
Schedule of Fixed and Variable Lease Payments [Table Text Block]	The table below indicates the amount of lease revenue recognized during the three and nine months ended September 30, 2019 as a result of fixed and variable lease escalators ( in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Lease payments based on fixed escalators $ 67,172 $ 64,884 $ 196,411 $ 190,267 Lease payments based on variable escalators 747 1,085 1,906 3,026 Straight-line rent income 5,720 5,719 16,255 17,516 Escrow funds received from tenants 1,608 — 4,205 — Rental income $ 75,247 $ 71,688 $ 218,777 $ 210,809
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]	Presented in the following table are future minimum lease payments, as of September 30, 2019 , to be received by us under our operating leases, as determined under ASC 842 ( in thousands ): Twelve months ended September 30, 2019 2020 $ 270,629 2021 271,169 2022 274,491 2023 272,498 2024 264,457 Thereafter 1,608,080 $ 2,961,324
New Real Estate Investments [Table Text Block]	During the nine months ended September 30, 2019 , we made the following real estate investments and related 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 Comfort Care Senior Living April 2019 1 SHO 10,800 Comfort Care Senior Living May 2019 1 SHO 13,500 Discovery Senior Living (PropCo Joint Venture) May 2019 6 SHO 127,917 Capella Living Solutions July 2019 1 SHO 7,600 Bickford Senior Living September 2019 1 SHO 15,100 $ 265,117
Schedule of Bickford Leases [Table Text Block]	As of September 30, 2019 , our Bickford Senior Living (“Bickford”) lease portfolio consists of the following ($ in thousands) : Lease Expiration June 2023 September 2024 September 2027 May 2031 April 2033 Total Number of Properties 13 10 4 19 5 51 2019 Contractual Rent $ 11,468 $ 9,542 $ 1,576 $ 12,203 $ 4,918 $ 39,707 2019 Straight Line Rent 358 670 195 1,695 860 3,778 $ 11,826 $ 10,212 $ 1,771 $ 13,898 $ 5,778 $ 43,485
Summary of NHC Percentage Rent [Table Text Block]	The following table summarizes the percentage rent income from NHC ( in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Current year $ 924 $ 853 $ 2,726 $ 2,558 Prior year final certification 1 — — 334 285 Total percentage rent income $ 924 $ 853 $ 3,060 $ 2,843 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.
Schedule of Tenant Purchase Options [Table Text Block]	A summary of these tenant options, excluding properties classified as held for sale, 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 $ 306 HOSP 1 September 2027 2020 ii $ 2,713 HOSP 1 March 2025 2020 iv $ 1,957 SHO 2 May 2031 2021 iv $ 5,063 HOSP 1 June 2022 2022 i $ 3,502 SNF 7 August 2028 2025 iii $ 3,671 SNF 1 September 2028 2028 iii $ 463

Mortgage And Other Notes Rece_2

Mortgage And Other Notes Receivable Mortgage and Other Notes Receivable (Schedule of Bickford Construction Loans) (Tables)	9 Months Ended
	Sep. 30, 2019
Bickford Senior Living [Member]
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]	At September 30, 2019 , our construction loans to Bickford are summarized as follows: Commencement Rate Maturity Commitment Drawn Location January 2017 9% 5 years 14,000,000 (14,000,000 ) Michigan January 2018 9% 5 years 14,000,000 (10,493,000 ) Virginia July 2018 9% 5 years 14,700,000 (8,675,000 ) Michigan $ 42,700,000 $ (33,168,000 )

Other Assets (Tables)

Other Assets (Tables)	9 Months Ended
	Sep. 30, 2019
Other Assets [Abstract]
Schedule of Other Assets [Table Text Block]	Other assets consist of the following ( in thousands ): September 30, December 31, Accounts receivable and other assets $ 3,104 $ 6,381 Regulatory escrows 8,208 8,208 Unamortized lease incentive payments 9,948 7,456 Restricted cash 10,399 5,253 $ 31,659 $ 27,298

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2019
Debt Instruments [Abstract]
Schedule of Debt	Debt consists of the following ( in thousands ): September 30, December 31, Revolving credit facility - unsecured $ 250,000 $ 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 $1,258 and $1,320) 42,333 42,906 Fannie Mae term loans - secured, non-recourse 95,793 96,044 Convertible senior notes - unsecured (net of discount of $807 and $1,391) 119,193 118,609 Unamortized loan costs (7,959 ) (9,884 ) $ 1,449,360 $ 1,281,675
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of September 30, 2019 , and for each of the next five years and thereafter are as follows ( in thousands ): 2020 $ 1,219 2021 121,267 2022 501,315 2023 426,366 2024 51,416 Thereafter 357,801 1,459,384 Less: discount (2,065 ) Less: unamortized loan costs (7,959 ) $ 1,449,360
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 Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Interest expense on debt at contractual rates $ 14,308 $ 11,637 $ 40,736 $ 33,579 Losses reclassified from accumulated other comprehensive income (loss) into interest expense (390 ) (27 ) (1,031 ) 326 Capitalized interest (161 ) (50 ) (476 ) (123 ) Amortization of debt issuance costs and debt discount 904 814 2,696 2,425 Total interest expense $ 14,661 $ 12,374 $ 41,925 $ 36,207
Schedule of Interest Rate Derivatives	As of September 30, 2019 , we employ the following interest rate swap contracts to mitigate our interest rate risk on our bank term and revolver loans described above ( dollars in thousands ): Date Entered Maturity Date Fixed Rate Rate Index Notional Amount Fair Value (Liability) June 2013 June 2020 3.46% 1-month LIBOR $ 80,000,000 $ (238 ) March 2014 June 2020 3.51% 1-month LIBOR $ 130,000,000 $ (431 ) March 2019 December 2021 3.51% 1-month LIBOR $ 100,000,000 $ (1,691 ) March 2019 December 2021 3.52% 1-month LIBOR $ 100,000,000 $ (1,720 ) June 2019 December 2021 2.89% 1-month LIBOR $ 150,000,000 $ (538 ) June 2019 December 2021 2.93% 1-month LIBOR $ 50,000,000 $ (193 )

Commitments And Contingencies C

Commitments And Contingencies Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 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 $ (77,340,000 ) $ 41,460,000 LCS Sagewood Note B SHO Construction 61,200,000 (32,052,000 ) 29,148,000 LCS Timber Ridge Note A SHO Construction 60,000,000 (59,349,000 ) 651,000 Bickford Senior Living SHO Construction 42,700,000 (33,168,000 ) 9,532,000 Senior Living Communities SHO Revolving Credit 15,000,000 (4,755,000 ) 10,245,000 41 Management SHO Construction 10,800,000 (3,324,000 ) 7,476,000 Discovery Senior Living SHO Working Capital 750,000 — 750,000 $ 309,250,000 $ (209,988,000 ) $ 99,262,000 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 $ (13,255,000 ) $ 12,095,000 Woodland Village SHO Renovation 7,450,000 (7,374,000 ) 76,000 Senior Living Communities SHO Renovation 6,830,000 (6,004,000 ) 826,000 Senior Living Communities SHO Renovation 3,100,000 (2,000,000 ) 1,100,000 Wingate Healthcare SHO Renovation 1,900,000 (212,000 ) 1,688,000 Discovery Senior Living SHO Renovation 1,400,000 — 1,400,000 Navion Senior Solutions SHO Construction 650,000 — 650,000 $ 46,680,000 $ (28,845,000 ) $ 17,835,000
Schedule of Loss Contingencies [Table Text Block]	Asset Class Type Total Funded Remaining Contingencies: Bickford Senior Living SHO Lease Inducement $ 10,000,000 $ (10,000,000 ) $ — Bickford Senior Living SHO Incentive Loan Draws 6,000,000 — 6,000,000 Comfort Care Senior Living SHO Lease Inducement 6,000,000 — 6,000,000 Wingate Healthcare SHO Lease Inducement 5,000,000 — 5,000,000 Navion Senior Solutions SHO Lease Inducement 4,850,000 (500,000 ) 4,350,000 Discovery Senior Living SHO Lease Inducement 4,000,000 — 4,000,000 Ignite Medical Resorts SNF Lease Inducement 2,000,000 — 2,000,000 $ 37,850,000 $ (10,500,000 ) $ 27,350,000

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 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: Nine Months Ended September 30, 2019 2018 Options outstanding January 1, 920,346 859,182 Options granted under 2012 Plan 602,000 560,000 Options exercised under 2012 Plan (431,993 ) (241,669 ) Options forfeited under 2012 Plan — (30,001 ) Options exercised under 2005 Plan — (6,668 ) Options outstanding, September 30, 1,090,353 1,140,844 Exercisable at September 30, 599,834 697,490

Earnings and Dividends Per Sh_2

Earnings and Dividends Per Share (Tables)	9 Months Ended
	Sep. 30, 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 Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Net income attributable to common stockholders $ 42,758 $ 40,979 $ 118,417 $ 117,251 BASIC: Weighted average common shares outstanding 43,505,332 42,187,077 43,187,847 41,808,017 DILUTED: Weighted average common shares outstanding 43,505,332 42,187,077 43,187,847 41,808,017 Stock options 79,933 98,269 73,924 66,917 Convertible subordinated debentures 275,824 149,153 232,943 57,802 Weighted average dilutive common shares outstanding 43,861,089 42,434,499 43,494,714 41,932,736 Net income attributable to common stockholders - basic $ .98 $ .97 $ 2.74 $ 2.80 Net income attributable to common stockholders - diluted $ .97 $ .97 $ 2.72 $ 2.80 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 7,858 615 11,200 31,616 Regular dividends declared per common share $ 1.05 $ 1.00 $ 3.15 $ 3.00

Fair Value Of Financial Instr_2

Fair Value Of Financial Instruments Fair Value Of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 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 September 30, December 31, Level 2 Interest rate swap asset Other assets $ — $ 1,297 Interest rate swap liability Accounts payable and accrued expenses $ 4,810 $ —
Fair Value Measurements, Nonrecurring [Table Text Block]	Carrying amounts and fair values of financial instruments that are not carried at fair value at September 30, 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 $ 795,276 $ 628,010 $ 800,000 $ 634,000 Fixed rate debt $ 654,084 $ 653,665 $ 674,713 $ 644,745 Level 3 Mortgage and other notes receivable $ 315,316 $ 246,111 $ 324,156 $ 244,206

Significant Accounting Polici_5

Significant Accounting Policies Significant Accounting Policies (Details)	Sep. 30, 2019properties
Lessor, Lease, Description [Line Items]
Lessor, Operating Lease, Renewal Term	5 years
Variable Interest Entity Number Of Entities Not Primary Beneficiary	7
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

Significant Accounting Polici_6

Significant Accounting Policies Significant Accounting Policies (Schedule of Variable Interest Entities) (Details) $ in Thousands	Sep. 30, 2019USD ($)
Straight-Line Rent Receivable [Member] | Bickford Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	$ 60,133
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	69,665
Straight-Line Rent Receivable [Member] | Senior Living Communities [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	83,814
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	94,059
Straight-Line Rent Receivable [Member] | Senior Living Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	26,796
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	26,796
Notes Receivable [Member] | LCS Timber Ridge [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	59,156
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	59,808
Notes Receivable [Member] | Evolve Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	9,943
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	9,943
Notes Receivable [Member] | LCS Sagewood [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	107,890
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	178,498
Notes Receivable [Member] | 41 Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	3,223
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	$ 10,800

Significant Accounting Polici_7

Significant Accounting Policies Schedule of Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Dec. 31, 2017
Schedule of Cash [Abstract]
Cash and cash equivalents	$ 5,882		$ 2,638
Restricted cash	10,399	$ 5,253	5,326
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	$ 16,281	$ 9,912	$ 7,964	$ 8,075

Real Estate Schedule of New Rea

Real Estate Schedule of New Real Estate Investments (Details)	9 Months Ended
	Sep. 30, 2019USD ($)properties	Sep. 30, 2018USD ($)
Real Estate Investments During The Period	$ 265,117,000
Payments to Acquire Real Estate	$ 209,227,000	$ 129,558,000
Wingate Healthcare [Member]
Number Of Real Estate Properties Acquired | properties	1
Real Estate Investments During The Period	$ 52,200,000
Payments to Acquire Real Estate	$ 50,300,000
Holiday Lease Amendment [Member]
Number Of Real Estate Properties Acquired | properties	1
Real Estate Investments During The Period	$ 38,000,000
Comfort Care Senior Living [Member] | April 2019 [Member]
Number Of Real Estate Properties Acquired | properties	1
Real Estate Investments During The Period	$ 10,800,000
Payments to Acquire Real Estate	$ 9,282,000
Comfort Care Senior Living [Member] | May 2019 [Member]
Number Of Real Estate Properties Acquired | properties	1
Real Estate Investments During The Period	$ 13,500,000
Discovery Senior Living [Member]
Number Of Real Estate Properties Acquired | properties	6
Real Estate Investments During The Period	$ 127,917,000
Cappella Living Solutions [Member]
Number Of Real Estate Properties Acquired | properties	1
Payments to Acquire Real Estate	$ 7,600,000
Bickford Senior Living [Member]
Number Of Real Estate Properties Acquired | properties	1

Real Estate Real Estate (Schedu

Real Estate Real Estate (Schedule of Bickford Leases) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)properties
Number of Properties | properties	222
Bickford Senior Living [Member]
Number of Properties | properties	51
2019 Contractual Rent	$ 39,707
2019 Straight Line Rent	3,778
Total Revenues	$ 43,485
Bickford Senior Living [Member] | June 2023 [Member]
Number of Properties | properties	13
2019 Contractual Rent	$ 11,468
2019 Straight Line Rent	358
Total Revenues	$ 11,826
Bickford Senior Living [Member] | September 2024 [Member]
Number of Properties | properties	10
2019 Contractual Rent	$ 9,542
2019 Straight Line Rent	670
Total Revenues	$ 10,212
Bickford Senior Living [Member] | September 2027 [Member]
Number of Properties | properties	4
2019 Contractual Rent	$ 1,576
2019 Straight Line Rent	195
Total Revenues	$ 1,771
Bickford Senior Living [Member] | May 2031 [Member]
Number of Properties | properties	19
2019 Contractual Rent	$ 12,203
2019 Straight Line Rent	1,695
Total Revenues	$ 13,898
Bickford Senior Living [Member] | April 2033 [Member]
Number of Properties | properties	5
2019 Contractual Rent	$ 4,918
2019 Straight Line Rent	860
Total Revenues	$ 5,778

Real Estate (Summary of NHC Per

Real Estate (Summary of NHC Percentage Rent) (Details) - National Healthcare Corporation [Member] - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Total percentage rent income	$ 924	$ 853	$ 3,060	$ 2,843
Final Determination Based On Current Year Revenues [Member]
Total percentage rent income	924	853	2,726	2,558
Final Determination Based On Prior Year Revenues [Member]
Total percentage rent income	$ 0	$ 0	$ 334	$ 285

Real Estate Real Estate (Sche_2

Real Estate Real Estate (Schedule of Tenant Purchase Options) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2019USD ($)properties	Sep. 30, 2019properties
Number of Real Estate Properties		222
Medical Office Building [Member]
Number of Real Estate Properties		2
Senior Housing Community [Member]
Number of Real Estate Properties		145
Hospital [Member]
Number of Real Estate Properties		3
Skilled Nursing Facility [Member]
Number of Real Estate Properties		72
Open Now [Member] | Medical Office Building [Member] | February 2025 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 306
2020 [Member] | Hospital [Member] | September 2027 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 2,713
2020 [Member] | Hospital [Member] | March 2025 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 1,957
2021 [Member] | Senior Housing Community [Member] | May 2031 [Member]
Number of Real Estate Properties	2
Minimum Annual Lease Income | $	$ 5,063
2022 [Member] | Hospital [Member] | June 2022 [Member]
Number of Real Estate Properties	1
Minimum Annual Lease Income | $	$ 3,502
2025 [Member] | Skilled Nursing Facility [Member] | August 2028 [Member]
Number of Real Estate Properties	7
Minimum Annual Lease Income | $	$ 3,671
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				6 Months Ended		9 Months Ended
	Sep. 30, 2019USD ($)	Jun. 30, 2019USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)	Sep. 30, 2019USD ($)properties	Sep. 30, 2018USD ($)	Sep. 30, 2019Master_Leases	Sep. 30, 2019properties	Sep. 30, 2019	Sep. 30, 2019shares	Sep. 30, 2019beds_or_units	Sep. 30, 2019USD ($)	Sep. 30, 2019renewalOptions	Dec. 31, 2018USD ($)
Number of Real Estate Properties | properties										222
Number of States in which Entity Operates											34
Nonportfolio Assets, Original Cost														$ 2,508,000
Real Estate Investment Property, Portfolio Assets														3,057,775,000
Number of Lessees											31
Real Estate Investments During The Period							$ 265,117,000
Payments to Acquire Real Estate							$ 209,227,000	$ 129,558,000
Lease Renewal Period In Years	5 years						5 years
Incentive to Lessee														9,948,000		$ 7,456,000
Escrow Deposit														8,208,000		8,208,000
Loans and Leases Receivable, Commitments, Fixed Rates							$ 309,250,000
Operating Leases, Income Statement, Lease Revenue	$ (75,247,000)		$ (71,688,000)				(218,777,000)	(210,809,000)
Straight Line Rent							$ 16,255,000	17,516,000
Document Period End Date							Sep. 30, 2019
Loan and Lease Losses and Recoveries, Net	$ 0		0				$ 2,500,000	1,849,000
Real Estate Held-for-sale														18,420,000		$ 0
Wingate Healthcare [Member]
Number Of Real Estate Properties Acquired | properties							1
Real Estate Investments During The Period							$ 52,200,000
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
Lessor, Operating Lease, Term of Contract	10 years						10 years
Number Of Additional Lease Renewal Options | renewalOptions															3
Lease Renewal Period In Years	5 years						5 years
Initial lease rate											7.50%
Capital Improvements Commitment														1,900,000
Contingent Incentive Payments														5,000,000
Holiday Lease Amendment [Member]
Number Of Real Estate Properties Acquired | properties							1
Real Estate Investments During The Period							$ 38,000,000
Lease Escalator Minimum											2.00%
Lease Escalator Maximum											3.00%
Holiday Acquisition Holdings [Member]
Number of Real Estate Properties | properties										26
Initial lease rate											6.71%
Operating Leases, Income Statement, Lease Revenue	$ (10,176,000)		$ (10,954,000)				$ (30,283,000)	$ (32,863,000)
Percentage of Continuing Revenue	12.00%		15.00%				13.00%	15.00%
Straight Line Rent	$ (1,664,000)		$ (1,530,000)				$ (4,958,000)	$ (4,591,000)
Comfort Care Senior Living [Member]
Lessor, Operating Lease, Term of Contract	10 years						10 years
Number Of Additional Lease Renewal Options | renewalOptions															2
Lease Renewal Period In Years	5 years						5 years
Initial lease rate											7.75%
Discovery Senior Living [Member]
Number Of Real Estate Properties Acquired | properties							6
Real Estate Investments During The Period							$ 127,917,000
Number of Units in Real Estate Property | beds_or_units													596
Asset Purchase Transaction Costs							$ 1,067,000
Lessor, Operating Lease, Term of Contract	10 years						10 years
Number Of Additional Lease Renewal Options | renewalOptions															2
Lease Renewal Period In Years	5 years						5 years
Initial lease rate											6.50%
Contingent Incentive Payments														4,000,000
Long-term Purchase Commitment, Amount							$ 2,000,000
Loans and Leases Receivable, Commitments, Fixed Rates							$ 750,000
Note Receivable Interest Rate											7.00%
Cappella Living Solutions [Member]
Number Of Real Estate Properties Acquired | properties							1
Number of Units in Real Estate Property | beds_or_units													51
Payments to Acquire Real Estate							$ 7,600,000
Asset Purchase Transaction Costs							$ 100,000
Lessor, Operating Lease, Term of Contract	15 years						15 years
Initial lease rate											7.25%
BAKA Enterprises [Member]
Lessor, Operating Lease, Term of Contract	8 years						8 years
Operating Leases, Income Statement, Lease Revenue	$ (150,000)		(247,000)				$ (925,000)	$ (1,041,000)
Percentage of Continuing Revenue							0.00%	1.00%
Lease Payment, NOI Based, Percent											95.00%
Bickford Senior Living [Member]
Number of Real Estate Properties | properties										51
Number Of Real Estate Properties Acquired | properties							1
Minimum Annual Lease Income							$ 39,707,000
Loans and Leases Receivable, Commitments, Fixed Rates							42,700,000
Operating Leases, Income Statement, Lease Revenue	$ (13,285,000)		$ (12,937,000)				$ (39,796,000)	$ (36,792,000)
Percentage of Continuing Revenue	16.00%		17.00%				17.00%	17.00%
Straight Line Rent	$ (1,117,000)		$ (1,169,000)				$ (3,812,000)	$ (3,541,000)
Senior Living Communities [Member]
Number of Real Estate Properties | properties										10
Number of Units in Real Estate Property | beds_or_units													2,068
Lessor, Operating Lease, Term of Contract	15 years						15 years
Number Of Additional Lease Renewal Options											2				2
Lease Renewal Period In Years	5 years						5 years
Note Receivable Interest Rate											10.00%
Operating Leases, Income Statement, Lease Revenue	$ (11,924,000)		$ (11,469,000)				$ (35,001,000)	$ (34,374,000)
Percentage of Continuing Revenue	15.00%		15.00%				15.00%	16.00%
Straight Line Rent	$ (1,404,000)		$ (1,359,000)				$ (3,519,000)	$ (4,076,000)
Lease Escalator Rate after Lease Year 4											3.00%
National Healthcare Corporation [Member]
Number of Real Estate Properties | properties										42
Operating Leases, Income Statement, Lease Revenue	$ (9,461,000)		$ (9,389,000)				$ (28,670,000)	$ (28,453,000)
Percentage of Continuing Revenue	12.00%		13.00%				12.00%	13.00%
Number of Master Leases | Master_Leases									2
Lessor Equity Shares Owned, Significant Lessee | shares												1,630,462
41 Management [Member]
Number of Units in Real Estate Property | beds_or_units													51
Number Of Additional Lease Renewal Options											2
Loans and Leases Receivable, Commitments, Fixed Rates							$ 10,800,000
Non-Performing Lease [Member]
Operating Leases, Income Statement, Lease Revenue							(625,000)
Number of Lease Portfolios											3
SH Regency Leasing LLC [Member]
Number of Real Estate Properties | properties										3
Chancellor Health Care [Member]
Number of Real Estate Properties | properties										5
Operating Leases, Income Statement, Lease Revenue	$ (437,000)		$ (1,317,000)				(725,000)	$ (3,950,000)
Percentage of Continuing Revenue			2.00%					3.00%
Lease Payment, NOI Based, Percent											100.00%
SH Regency Transition Properties [Member]
Operating Leases, Income Statement, Lease Revenue		$ (515,000)		$ (1,367,000)	$ (660,000)	$ (4,100,000)
Percentage of Continuing Revenue				2.00%		3.00%
Senior Housing Community [Member]
Number of Real Estate Properties | properties										145
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
Hospital [Member]
Number of Real Estate Properties | properties										3
Medical Office Building [Member]
Number of Real Estate Properties | properties										2
Assisted Living Facility [Member] | Discovery Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units													356
Independent Living Facility [Member] | Discovery Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units													145
Independent Living Facility [Member] | National Healthcare Corporation [Member]
Number of Real Estate Properties | properties										3
Memory Care [Member] | Discovery Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units													95
Joint Venture Controlling Equity Interest [Member] | Discovery Senior Living [Member]
Real Estate Investments During The Period							127,286,000
Joint Venture Preferred Equity Interest [Member] | Discovery Senior Living [Member]
Real Estate Investments During The Period							102,258,000
Joint Venture Noncontrolling Equity Interest [Member] | Discovery Senior Living [Member]
Real Estate Investments During The Period							631,000
Joint Venture Equity Interest [Member] | Discovery Senior Living [Member]
Real Estate Investments During The Period							25,028,000
Noncontrolling Interest, Ownership Percentage by Parent											97.50%
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners											2.50%
Bickford Lease Amendment [Member]
Number of Real Estate Properties | properties										14
Bickford Lease Amendment [Member] | Bickford Senior Living [Member]
Lease Escalator Minimum											2.00%
Lease Escalator Maximum											3.00%
MN Transition Properties [Member] | Bickford Senior Living [Member]
Operating Leases, Income Statement, Lease Revenue							$ (734,000)
MN Transition Properties [Member] | 41 Management [Member]
Lessor, Operating Lease, Term of Contract	15 years						15 years
Number Of Additional Lease Renewal Options | renewalOptions															2
Lease Renewal Period In Years	5 years						5 years
Lease Escalator Minimum											2.50%
Operating Leases, Income Statement, Lease Revenue							$ (906,000)
Discovery Transition Property [Member] | Discovery Senior Living [Member]
Number Of Additional Lease Renewal Options | renewalOptions															2
Lease Renewal Period In Years	5 years						5 years
Lease Escalator Minimum											2.50%
Loans and Leases Receivable, Commitments, Fixed Rates							$ 750,000
Note Receivable Interest Rate											6.50%
Operating Leases, Income Statement, Lease Revenue							(1,400,000)
Contingent Payment [Member] | Comfort Care Senior Living [Member]
Incentive to Lessee														3,000,000
Vero Beach Acquisition [Member] | Assisted Living Facility [Member] | Holiday Acquisition Holdings [Member]
Number of Units in Real Estate Property | beds_or_units													71
Vero Beach Acquisition [Member] | Independent Living Facility [Member] | Holiday Acquisition Holdings [Member]
Number of Units in Real Estate Property | beds_or_units													157
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] | 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
Asset Held For Sale [Member]
Number of Real Estate Properties | properties										2
Write Off Of Straight Line Rent Receivable							124,000
Asset Held For Sale [Member] | Brookdale Senior Living [Member]
Number of Real Estate Properties | properties										8
Operating Leases, Income Statement, Lease Revenue	$ (1,062,000)						$ (3,187,000)
Percentage of Continuing Revenue	(1.30%)						(1.40%)
Gurnee, IL [Member]
Sale Leaseback Transaction, Transaction Costs, Investing Activities							$ 100,000
Gurnee, IL [Member] | Bickford Senior Living [Member]
Number of Real Estate Properties | properties										60
Payments to Acquire Real Estate							15,100,000
Notes Reduction							14,035,000
Payments to Acquire Assets, Investing Activities							$ 965,000
Lessor, Operating Lease, Term of Contract	12 years						12 years
Initial lease rate											8.00%
ARIZONA | Asset Held For Sale [Member] | Brookdale Senior Living [Member]
Number of Real Estate Properties | properties										4
TENNESSEE | Asset Held For Sale [Member] | Brookdale Senior Living [Member]
Number of Real Estate Properties | properties										3
SOUTH CAROLINA | Asset Held For Sale [Member] | Brookdale Senior Living [Member]
Number of Real Estate Properties | properties										1
Building and Building Improvements [Member] | Discovery Senior Living [Member]
Real Estate Investments During The Period							$ 121,616,000
Forfeiture Amount [Member] | Holiday Lease Amendment [Member]
Escrow Deposit														10,637,000
Cash Portion [Member] | Holiday Lease Amendment [Member]
Lease Amendment Consideration														17,125,000
Subleased Facilities [Member] | Skilled Nursing Facility [Member] | National Healthcare Corporation [Member]
Number of Real Estate Properties | properties										4
NHC - 1991 Lease [Member] | National Healthcare Corporation [Member]
Number of Real Estate Properties | properties										35
Number Of Additional Lease Renewal Options | renewalOptions															2
Lease Renewal Period In Years	5 years						5 years
Minimum Annual Lease Income							$ 30,750,000
Percentage Rent Rate							0.04
May 2019 [Member] | Comfort Care Senior Living [Member]
Number Of Real Estate Properties Acquired | properties							1
Real Estate Investments During The Period							$ 13,500,000
May 2019 [Member] | Assisted Living Facility [Member] | Comfort Care Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units													73
Land [Member] | Discovery Senior Living [Member]
Real Estate Investments During The Period							$ 6,301,000
April 2019 [Member] | Comfort Care Senior Living [Member]
Number Of Real Estate Properties Acquired | properties							1
Real Estate Investments During The Period							$ 10,800,000
Number of Units in Real Estate Property | beds_or_units													60
Payments to Acquire Real Estate							$ 9,282,000
April 2019 [Member] | Asset under Construction [Member] | Comfort Care Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units													14
NHC - 2013 Lease [Member] | National Healthcare Corporation [Member]
Number Of Real Estate Properties Acquired | properties							7
Minimum Annual Lease Income							$ 3,450,000
Percentage Rent Rate							0.04
Purchase Option Amount														$ 49,000,000

Real Estate Real Estate (Sche_3

Real Estate Real Estate (Schedule of Future Minimum Lease Payments) (Details) $ in Thousands	Sep. 30, 2019USD ($)
Schedule of Future Minimum Lease Payments [Abstract]
Operating Leases, Future Minimum Payments Due, Next Twelve Months	$ 270,629
Operating Leases, Future Minimum Payments, Due in Two Years	271,169
Operating Leases, Future Minimum Payments, Due in Three Years	274,491
Operating Leases, Future Minimum Payments, Due in Four Years	272,498
Operating Leases, Future Minimum Payments, Due in Five Years	264,457
Operating Leases, Future Minimum Payments, Due Thereafter	1,608,080
Operating Leases, Future Minimum Payments Due	$ 2,961,324

Real Estate Real Estate (Sche_4

Real Estate Real Estate (Schedule of Fixed and Variable Lease Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Operating Leases, Income Statement, Lease Revenue	$ 75,247	$ 71,688	$ 218,777	$ 210,809
Fixed Lease Escalation [Member]
Operating Leases, Income Statement, Lease Revenue	67,172	64,884	196,411	190,267
Variable Lease Escalation [Member]
Operating Leases, Income Statement, Lease Revenue	747	1,085	1,906	3,026
Straight Line Rent Income [Member]
Operating Leases, Income Statement, Lease Revenue	5,720	5,719	16,255	17,516
Escrow Funds Received From Tenants [Member]
Operating Leases, Income Statement, Lease Revenue	$ 1,608	$ 0	$ 4,205	$ 0

Mortgage And Other Notes Rece_3

Mortgage And Other Notes Receivable Mortgage and Other Notes Receivable (Schedule of Bickford Construction Loans) (Details) - USD ($)	9 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Loans and Leases Receivable, Commitments, Fixed Rates	$ 309,250,000
Loans and Leases Receivable, Net Amount	(315,316,000)	$ (246,111,000)
Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	42,700,000
Loans and Leases Receivable, Net Amount	(33,168,000)
January 2017 [Member] | Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loan Term	5 years
Loans and Leases Receivable, Net Amount	$ (14,000,000)
Note Receivable Interest Rate	9.00%
January 2018 [Member] | Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loan Term	5 years
Loans and Leases Receivable, Net Amount	$ (10,493,000)
Note Receivable Interest Rate	9.00%
July 2018 [Member] | Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,700,000
Loan Term	5 years
Loans and Leases Receivable, Net Amount	$ (8,675,000)
Note Receivable Interest Rate	9.00%

Mortgage And Other Notes Rece_4

Mortgage And Other Notes Receivable (Details)	9 Months Ended		12 Months Ended
	Sep. 30, 2019USD ($)	Sep. 30, 2018USD ($)	Dec. 31, 2018USD ($)	Sep. 30, 2019properties	Sep. 30, 2019	Sep. 30, 2019beds_or_units	Sep. 30, 2019USD ($)	Sep. 30, 2019renewalOptions
Mortgage and other notes receivable, net			$ (246,111,000)				$ (315,316,000)
Number of health care properties related to mortgage notes receivables | properties				14
Allowance for Loan and Lease Losses, Write-offs	$ 0		$ 0
Loans and Leases Receivable, Commitments, Fixed Rates	$ 309,250,000
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	2000.00%
Payments to Acquire Real Estate	$ 209,227,000	$ 129,558,000
Number of Real Estate Properties | properties				222
Discovery Senior Living [Member]
Mortgage and other notes receivable, net							(6,423,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 750,000
Number of Units in Real Estate Property | beds_or_units						596
Number Of Additional Lease Renewal Options | renewalOptions								2
Lessor, Operating Lease, Term of Contract	10 years
Note Receivable Interest Rate					7.00%
Contingent Incentive Payments							4,000,000
41 Management [Member]
Mortgage and other notes receivable, net							(3,324,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 10,800,000
Number of Units in Real Estate Property | beds_or_units						51
Notes Receivable, Interest Rate, Master Credit Agreement					8.50%
Loan Term	5 years
Number Of Additional Lease Renewal Options					2
Note Receivable Renewal Term	1 year
Payments Related To Mortgage Loan Reserved For Working Capital	$ 2,400,000
Senior Living Communities [Member]
Mortgage and other notes receivable, net							(32,700,000)
Number of Units in Real Estate Property | beds_or_units						2,068
Notes Receivable, Interest Rate, Master Credit Agreement					7.25%
Loan Term	5 years
Number Of Additional Lease Renewal Options					2			2
Note Receivable Renewal Term	1 year
Purchase Option, Amount, Minimum							38,250,000
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							(4,755,000)
Loans Receivable, Description of Variable Rate Basis, Reference Rate Maturity	10 years
Loans Receivable, Description, Variable Rate Basis, Reference Rate	1.68%
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				10
Bickford Note Investment [Member]
Mortgage and other notes receivable, net							(33,168,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 42,700,000
Contingent Incentive Payments							2,000,000
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							(59,349,000)
Loans and Leases Receivable, Commitments, Fixed Rates	60,000,000
Purchase Option, Amount, Minimum							115,000,000
Notes Receivable, Total Borrowings, Master Credit Agreement							154,500,000
Notes Receivable, Number Of Loans, Master Credit Agreement					2
Senior Living Management [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 24,500,000
Notes Receivable, Interest Rate, Master Credit Agreement					8.25%
Loan Term	5 years
Notes Receivable, Number Of Loans, Master Credit Agreement					2
Number of Real Estate Properties | properties				5
Secured By Real Estate [Member]
Mortgage and other notes receivable, net							(269,718,000)
Not Secured By Real Estate [Member]
Mortgage and other notes receivable, net							(45,598,000)
Not Secured By Real Estate [Member] | Senior Living Communities [Member]
Number of Units in Real Estate Property | beds_or_units						186
June 2019 Transaction [Member] | Senior Living Communities [Member]
Number of Units in Real Estate Property | beds_or_units						248
Note A [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 12,000,000
Note A [Member] | LCS Sagewood [Member]
Mortgage and other notes receivable, net							(77,340,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 118,800,000
Notes Receivable, Interest Rate, Master Credit Agreement					7.25%
Loan Term	10 years
Notes Receivable, Total Borrowings, Master Credit Agreement							118,800,000
Loans And Leases Receivable, Commitment, Fixed Rates, Escalator, Basis Points					10
Note Receivable, First Note Year For Rate Escalator	3 years
Note Receivable, Prepayment Penalty, Rate					2.00%
Note Receivable, Prepayment Penalty, Rate Decrease					1.00%
Note A [Member] | LCS Timber Ridge [Member]
Mortgage and other notes receivable, net							(59,349,000)
Notes Receivable, Interest Rate, Master Credit Agreement					6.95%
Loan Term	10 years
Notes Receivable, Total Borrowings, Master Credit Agreement							60,000,000
Loans And Leases Receivable, Commitment, Fixed Rates, Escalator, Basis Points					10
Note Receivable, First Note Year For Rate Escalator	3 years
Note Receivable, Prepayment Penalty, Rate					5.00%
Note Receivable, Prepayment Penalty, Rate Decrease					1.00%
Notes Receivable, Interest Rate, Master Credit Agreement, At Inception					6.75%
Note Receivable, Prepayment, Disallowance Period	3 years
Prepayment Penalty, Reduction, Period, Years	5 years
Note B [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 2,000,000
Note B [Member] | LCS Sagewood [Member]
Mortgage and other notes receivable, net							(32,052,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 61,200,000
Notes Receivable, Interest Rate, Master Credit Agreement					8.50%
Loan Term	5 years
Notes Receivable, Total Borrowings, Master Credit Agreement							61,200,000
Note B [Member] | LCS Timber Ridge [Member]
Notes Receivable, Total Borrowings, Master Credit Agreement							94,500,000
January 2017 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net							(14,000,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loan Term	5 years
Note Receivable Interest Rate					9.00%
January 2018 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net							(10,493,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loan Term	5 years
Note Receivable Interest Rate					9.00%
July 2018 [Member] | Bickford Note Investment [Member]
Mortgage and other notes receivable, net							$ (8,675,000)
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,700,000
Loan Term	5 years
Note Receivable Interest Rate					9.00%
First Renewal [Member] | Senior Living Management [Member]
Note Receivable Renewal Term	1 year
Second Renewal [Member] | Senior Living Management [Member]
Note Receivable Renewal Term	2 years
Assisted Living Facility [Member] | Discovery Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units						52
Memory Care [Member] | Discovery Senior Living [Member]
Number of Units in Real Estate Property | beds_or_units						22

Other Assets (Schedule of Other

Other Assets (Schedule of Other Assets) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018	Sep. 30, 2018
Equity Method Investments And Other Assets [Abstract]
Accounts receivable and other assets	$ 3,104	$ 6,381
Regulatory escrows	8,208	8,208
Unamortized lease incentive payments	9,948	7,456
Restricted cash	10,399	5,253	$ 5,326
Other Assets	$ 31,659	$ 27,298

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 250,000	$ 84,000
Bank term loans - unsecured	400,000
Convertible senior notes - unsecured	119,193	118,609
Unamortized loan costs	(7,959)	(9,884)
Debt, Long-term and Short-term, Combined Amount	1,449,360	1,281,675
Bank Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	550,000	550,000
Private Placement Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	400,000	400,000
Debt Instrument, Name, HUD Mortgages [Member]
Debt Instrument [Line Items]
Secured Debt	42,333	42,906
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Debt Instrument [Line Items]
Secured Debt	$ 95,793	$ 96,044

Debt Debt (Schedule of Debt) (C

Debt Debt (Schedule of Debt) (Captions) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	$ (2,065)
Debt Instrument, Name, Q3 2014 HUD Mortgages [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	(1,258)	$ (1,320)
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	$ (807)	$ (1,391)

Debt Debt (Schedule of Maturiti

Debt Debt (Schedule of Maturities of Long-term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Schedule of Maturities of Long-term Debt [Abstract]
Long-term Debt, Maturities, Repayments of Principal in Next Rolling Twelve Months	$ 1,219
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Two	121,267
Long-term Debt, Maturities, Repayments of Principal in Next Rolling Year Three	501,315
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Four	426,366
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Five	51,416
Long-term Debt, Maturities, Repayments of Principal in Rolling after Year Five	357,801
Long-term Debt, Gross	1,459,384
Debt Instrument, Unamortized Discount	(2,065)
Unamortized loan costs	(7,959)	$ (9,884)
Debt, Long-term and Short-term, Combined Amount	$ 1,449,360	$ 1,281,675

Debt Debt (Schedule of Unsecure

Debt Debt (Schedule of Unsecured Term Loans) (Details) - USD ($) $ in Thousands	Sep. 30, 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		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Schedule of Interest Expense [Abstract]
Interest expense on debt at contractual rates	$ 14,308	$ 11,637	$ 40,736	$ 33,579
Losses reclassified from accumulated other comprehensive income (loss) into interest expense	(390)	(27)	(1,031)	(326)
Capitalized interest	(161)	(50)	(476)	(123)
Amortization of debt issuance costs and debt discount	904	814	2,696	2,425
Total Interest Expense	$ 14,661	$ 12,374	$ 41,925	$ 36,207

Debt (Schedule of Interest Rate

Debt (Schedule of Interest Rate Derivatives) (Details)	9 Months Ended
	Sep. 30, 2019USD ($)
Derivative [Line Items]
Derivative, Notional Amount	$ 610,000,000
Interest Rate Swap, Date Entered, June 2013 [Member]
Derivative [Line Items]
Derivative, Fixed Interest Rate	3.46%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 80,000,000
Derivative Asset, Fair Value, Gross Asset	$ (238,000)
Interest Rate Swap, Date Entered, March 2014 [Member]
Derivative [Line Items]
Derivative, Fixed Interest Rate	3.51%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 130,000,000
Derivative Asset, Fair Value, Gross Asset	$ (431,000)
Interest Rate Swap, Date Entered, March 2019 - 3.46% [Member]
Derivative [Line Items]
Derivative, Fixed Interest Rate	3.51%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 100,000,000
Interest Rate Derivative Liabilities, at Fair Value	$ (1,691,000)
Interest Rate Swap, Date Entered, March 2019 - 3.47% [Member]
Derivative [Line Items]
Derivative, Fixed Interest Rate	3.52%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 100,000,000
Interest Rate Derivative Liabilities, at Fair Value	$ (1,720,000)
Interest Rate Swap, Date Entered, June 2019 - 2.84% [Member]
Derivative [Line Items]
Derivative, Fixed Interest Rate	2.89%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 150,000,000
Interest Rate Derivative Liabilities, at Fair Value	$ (538,000)
Interest Rate Swap, Date Entered, June 2019 - 2.88% [Member]
Derivative [Line Items]
Derivative, Fixed Interest Rate	2.93%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 50,000,000
Interest Rate Derivative Liabilities, at Fair Value	$ (193,000)

Debt (Narrative) (Details)

Debt (Narrative) (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2019USD ($)properties$ / sharesshares	Sep. 30, 2018shares	Sep. 30, 2019USD ($)propertiessharesnumber_of_loans$ / shares	Sep. 30, 2018shares	Dec. 31, 2018USD ($)
Debt Leverage Limit, Coupon Change, Trigger			50.00%
Document Period End Date			Sep. 30, 2019
Credit Facility, Current Revolving Borrowing Capacity	$ 550,000,000		$ 550,000,000
Derivative, Notional Amount	$ 610,000,000		$ 610,000,000
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage			2000.00%
Debt Instrument, Variable Rate Basis, Minimum	20200.00%		20200.00%		25000.00%
Long-term Line of Credit	$ 250,000,000		$ 250,000,000		$ 84,000,000
Number of Real Estate Properties | properties	222		222
Debt Instrument, Convertible, Conversion Ratio			14.57
Debt Instrument, Convertible, Conversion Price | $ / shares	$ 68.63		$ 68.63
Debt Instrument, Convertible, Number of Equity Instruments | shares			1,748,616
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities | shares	275,824	149,153	232,943	57,802
Debt Instrument, Convertible, If-converted Value in Excess of Principal			$ 24,068,000
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	$ 2,217,000		2,217,000
Derivative, Fair Value, Net	(4,810,000)		(4,810,000)		$ 1,297,000
$250M Term Loan [Member]
Term Loans, Outstanding Balance	250,000,000		250,000,000
$300M Term Loan [Member]
Term Loans, Outstanding Balance	300,000,000		$ 300,000,000
Debt Instrument, Name, Revolving Credit Facility [Member]
Debt Instrument, Basis Spread on Variable Rate			12000.00%
Unused balance of the unsecured revolving credit facility	300,000,000		$ 300,000,000
Bank Term Loans [Member]
Debt Instrument, Basis Spread on Variable Rate			13200.00%
Variable Interest Rate Debt [Member]
Long-term Line of Credit	$ 190,000,000		$ 190,000,000
Debt Instrument, Name, HUD Mortgages [Member]
Number of Real Estate Properties | properties	10		10
Net Book Value of Real Estate Pledged Toward Mortgage	$ 49,577,000		$ 49,577,000
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
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Number of Real Estate Properties	13		13
Net Book Value of Real Estate Pledged Toward Mortgage	$ 135,267,000		$ 135,267,000
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Face Amount of Mortgages	$ 78,084,000		$ 78,084,000
Debt Instrument, Interest Rate, Stated Percentage	3.79%		3.79%
Debt Instrument, Term			10 years
FNMA Berkadia Note [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Face Amount of Mortgages	$ 17,709,000		$ 17,709,000
Debt Instrument, Interest Rate, Stated Percentage	4.60%		4.60%
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		$ 71.81
Debt Instrument, Convertible, Number of Equity Instruments | shares			2,785,200
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument, Interest Rate, Stated Percentage	3.25%		3.25%
Convertible Debt Instrument, Conversion Ratio, Principal Amount, Basis			$ 1,000
Bickford Senior Living [Member]
Number of Real Estate Properties | properties	51		51
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			$ 8,546,000
Noncash or Part Noncash Acquisition, Value of Liabilities Assumed			7,288,000
Interest Rate Swap(s), Date Entered, March & June 2019 [Member] | Debt Instrument, Name, Revolving Credit Facility [Member]
Derivative, Notional Amount	$ 60,000,000		60,000,000
Interest Rate Swap(s), Date Entered, March & June 2019 [Member] | Bank Term Loans [Member]
Derivative, Notional Amount	340,000,000		340,000,000
Interest Rate Swap, Date Entered, June 2013 [Member]
Derivative, Notional Amount	80,000,000		80,000,000
Interest Rate Swap, Date Entered, March 2014 [Member]
Derivative, Notional Amount	130,000,000		130,000,000
Interest Rate Swaps, Maturity Date, After June 2020 [Member]
Derivative, Notional Amount	$ 400,000,000		$ 400,000,000

Commitments And Contingencies_2

Commitments And Contingencies Commitments and Contingencies (Schedule of Loan Commitments) (Details) - USD ($)	9 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Loans and Leases Receivable, Commitments, Fixed Rates	$ 309,250,000
Loans and Leases Receivable, Net Amount	(315,316,000)	$ (246,111,000)
Notes Receivable Funding Commitment	99,262,000
LCS Timber Ridge [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	60,000,000
Loans and Leases Receivable, Net Amount	(59,349,000)
Notes Receivable Funding Commitment	651,000
Bickford Senior Living [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	42,700,000
Loans and Leases Receivable, Net Amount	(33,168,000)
Notes Receivable Funding Commitment	9,532,000
Senior Living Communities [Member]
Loans and Leases Receivable, Net Amount	(32,700,000)
41 Management [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	10,800,000
Loans and Leases Receivable, Net Amount	(3,324,000)
Notes Receivable Funding Commitment	7,476,000
Discovery Senior Living [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	750,000
Loans and Leases Receivable, Net Amount	(6,423,000)
Notes Receivable Funding Commitment	750,000
Note A [Member] | LCS Sagewood [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	118,800,000
Loans and Leases Receivable, Net Amount	(77,340,000)
Notes Receivable Funding Commitment	41,460,000
Note A [Member] | LCS Timber Ridge [Member]
Loans and Leases Receivable, Net Amount	(59,349,000)
Note A [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	12,000,000
Note B [Member] | LCS Sagewood [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	61,200,000
Loans and Leases Receivable, Net Amount	(32,052,000)
Notes Receivable Funding Commitment	29,148,000
Note B [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	2,000,000
Revolving Credit Facility [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	15,000,000
Loans and Leases Receivable, Net Amount	(4,755,000)
Notes Receivable Funding Commitment	10,245,000
Notes Receivable Remain Unfunded [Member]
Loans and Leases Receivable, Net Amount	(209,988,000)
Notes Receivable Remain Unfunded [Member] | Discovery Senior Living [Member]
Loans and Leases Receivable, Net Amount	$ 0

Commitments And Contingencies_3

Commitments And Contingencies Commitments and Contingencies (Schedule of Lease Commitments) (Details)	Sep. 30, 2019USD ($)
Maximum Commitment For All Active Development Projects	$ 46,680,000
Development in Process	(28,845,000)
Remaining Unfunded Development Commitment	17,835,000
Development Commitment [Member] | Ignite Medical Resorts [Member]
Maximum Commitment For All Active Development Projects	25,350,000
Development in Process	(13,255,000)
Remaining Unfunded Development Commitment	12,095,000
Development Commitment [Member] | Senior Living Communities [Member]
Maximum Commitment For All Active Development Projects	3,100,000
Development in Process	(2,000,000)
Remaining Unfunded Development Commitment	1,100,000
Development Commitment [Member] | Wingate Healthcare [Member]
Maximum Commitment For All Active Development Projects	1,900,000
Development in Process	(212,000)
Remaining Unfunded Development Commitment	1,688,000
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
Capital Improvement Commitment [Member] | Woodland Village [Member]
Maximum Commitment For All Active Development Projects	7,450,000
Development in Process	(7,374,000)
Remaining Unfunded Development Commitment	76,000
Capital Improvement Commitment [Member] | Senior Living Communities [Member]
Maximum Commitment For All Active Development Projects	6,830,000
Development in Process	(6,004,000)
Remaining Unfunded Development Commitment	826,000
Capital Improvement Commitment [Member] | Discovery Senior Living [Member]
Maximum Commitment For All Active Development Projects	1,400,000
Development in Process	0
Remaining Unfunded Development Commitment	$ 1,400,000

Commitments And Contingencies_4

Commitments And Contingencies Commitments and Contingencies (Schedule of Loss Contingencies) (Details)	Sep. 30, 2019USD ($)
Lease Inducement [Member]
Contingent Funding Commitment	$ 37,850,000
Contingent Funding Commitment, Amount Funded	(10,500,000)
Contingent Funding Commitment, Remaining Unfunded Amount	27,350,000
Bickford Senior Living [Member] | Lease Inducement [Member]
Contingent Funding Commitment	10,000,000
Contingent Funding Commitment, Amount Funded	(10,000,000)
Contingent Funding Commitment, Remaining Unfunded Amount	0
Bickford Senior Living [Member] | Incentive Loan Draws [Member]
Contingent Funding Commitment	6,000,000
Contingent Funding Commitment, Amount Funded	0
Contingent Funding Commitment, Remaining Unfunded Amount	6,000,000
Comfort Care Senior Living [Member] | Lease Inducement [Member]
Contingent Funding Commitment	6,000,000
Contingent Funding Commitment, Amount Funded	0
Contingent Funding Commitment, Remaining Unfunded Amount	6,000,000
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	(500,000)
Contingent Funding Commitment, Remaining Unfunded Amount	4,350,000
Discovery Senior Living [Member] | Lease Inducement [Member]
Contingent Funding Commitment	4,000,000
Contingent Funding Commitment, Amount Funded	0
Contingent Funding Commitment, Remaining Unfunded Amount	4,000,000
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

Commitments And Contingencies (

Commitments And Contingencies (Details)	9 Months Ended
	Sep. 30, 2019USD ($)properties	Dec. 31, 2018USD ($)
Document Period End Date	Sep. 30, 2019
Unamortized lease incentive payments	$ 9,948,000	$ 7,456,000
Bickford Development Properties [Member]
Number Of Development Projects Active | properties	5
Developer Incentive Payments	$ 250,000
Unamortized lease incentive payments	$ 1,750,000

Stock-Based Compensation Stock-

Stock-Based Compensation Stock-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Schedule of Stock Option Valuation Assumptions [Abstract]
Dividend yield	5.50%	6.50%
Expected volatility	18.60%	19.40%
Expected lives	2 years 10 months 24 days	2 years 10 months 24 days
Risk-free interest rate	2.50%	2.39%

Stock-Based Compensation (Sched

Stock-Based Compensation (Schedule Of Stock Option Activity) (Details) - shares	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Options outstanding January 1,	920,346	859,182
Options outstanding, June 30,	1,090,353	1,140,844
Exercisable at June 30,	599,834	697,490
2012 Plan [Member]
Options granted under 2012 Plan	602,000	560,000
Options exercised under 2012 Plan	(431,993)	(241,669)
Options forfeited under 2012 Plan	0	(30,001)
Two Thousand Five Stock Option Plan [Member]
Options forfeited under 2012 Plan	0	(6,668)

Stock-Based Compensation (Narra

Stock-Based Compensation (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	May 03, 2019	May 04, 2018	May 07, 2015	May 31, 2012
Nonemployee director annual stock grants			25,000
Document Period End Date			Sep. 30, 2019
Share-based Payment Arrangement, Expense	$ 477	$ 337	$ 2,955	$ 2,131
Unrecognized compensation cost	$ 1,345		$ 1,345
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value			$ 6.17	$ 4.49
2012 Plan [Member]
Shares available for grants	319,669		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
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
2019 Plan [Member]
Shares available for grants					3,000,000
Stock Option Plan, Award Vesting Period			5 years
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period			10 years
Expected To Be Recognized During 2019 [Member]
Unrecognized compensation cost	$ 477		$ 477
Expected To Be Recognized During 2020 [Member]
Unrecognized compensation cost	776		776
Expected To Be Recognized During 2021 [Member]
Unrecognized compensation cost	$ 92		$ 92

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						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Earnings Per Share [Abstract]
Net income (loss) attributable to common stockholders	$ 42,758			$ 40,979			$ 118,417	$ 117,251
BASIC:
Weighted average common shares outstanding	43,505,332			42,187,077			43,187,847	41,808,017
Net income per common share - basic	$ 0.98			$ 0.97			$ 2.74	$ 2.80
DILUTED:
Weighted average common shares outstanding	43,505,332			42,187,077			43,187,847	41,808,017
Stock options	79,933			98,269			73,924	66,917
Convertible subordinated debentures	275,824			149,153			232,943	57,802
Weighed average dilutive common shares outstanding	43,861,089			42,434,499			43,494,714	41,932,736
Net income per common share - diluted	$ 0.97			$ 0.97			$ 2.72	$ 2.80
Incremental shares excluded since anti-dilutive:
Net share effect of stock options with an exercise price in excess of the average market price for our common shares	7,858			615			11,200	31,616
Regular dividends declared per common share	$ 1.05	$ 1.05	$ 1.05	$ 1	$ 1	$ 1	$ 3.15	$ 3

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	Sep. 30, 2019	Dec. 31, 2018
Interest rate swap asset	$ 0	$ 1,297
Interest rate swap liability	$ (4,810)	$ 0

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Fair Value Measurements, Nonrecurring) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
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	$ 315,316	$ 246,111
Reported 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	795,276	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	654,084	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	324,156	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	800,000	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	$ 674,713	$ 644,745

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements Recent Accounting Pronouncements (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Recent Accounting Pronouncements [Abstract]
Cumulative Effect of New Accounting Principle in Period of Adoption	$ 0		$ 0
Lessor Property Costs Paid From Tenant Escrow	1,608,000	$ 0	4,205,000	$ 0
Operating Lease, Right-of-Use Asset	$ 1,176,000		$ 1,176,000

Subsequent Events Subsequent _2

Subsequent Events Subsequent Events (Narrative) (Details)	Oct. 02, 2019USD ($)	Oct. 01, 2019properties	Sep. 30, 2019properties
Subsequent Event [Line Items]
Number of Real Estate Properties			222
Bickford Lease Amendment [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Number of Real Estate Properties		10
Minimum Annual Lease Income | $	$ 466,000
Lease Escalator Minimum		2.00%
Lease Escalator Maximum		3.00%

Uncategorized Items - nhi-93020

Label	Element	Value
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	$ 90,885,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	46,154,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	358,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	1,016,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,948,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,854,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	2,478,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	$ 477,000
Stock Issued During Period, Shares, New Issues	us-gaap_StockIssuedDuringPeriodSharesNewIssues	618,654
Stock Issued During Period, Shares, New Issues	us-gaap_StockIssuedDuringPeriodSharesNewIssues	590,868
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	$ 11,000
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	37,953
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	8,352
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	$ 642,000
Additional Paid-in Capital [Member]
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	(1,016,000)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	(358,000)
Stock Issued During Period, Value, Stock Options Exercised	us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised	1,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,942,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,848,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	477,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	2,478,000
Parent [Member]
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	70,901,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	41,408,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	90,885,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	46,154,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	(1,016,000)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	(358,000)
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,948,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,854,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	477,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	2,478,000
Retained Earnings, Appropriated [Member]
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	42,758,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	75,659,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	90,885,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	46,154,000
Noncontrolling Interest [Member]
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	(3,000)
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	(1,000)
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	(11,000)
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	642,000
Common Stock [Member]
Stock Issued During Period, Value, Stock Options Exercised	us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised	1,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	6,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	6,000
AOCI Attributable to Parent [Member]
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	(4,758,000)
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	$ (1,350,000)