Diversicare Healthcare Services (DVCR) 10-Q 31 Oct 19 2019 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Oct. 28, 2019
Document and Entity Information [Abstract]
Entity Registrant Name	Diversicare Healthcare Services, Inc.
Entity Central Index Key	0000919956
Document Type	10-Q
Document Period End Date	Sep. 30, 2019
Amendment Flag	false
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		6,675,161

INTERIM CONSOLIDATED BALANCE SH

INTERIM CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
CURRENT ASSETS:
Cash and cash equivalents	$ 3,940	$ 2,685
Receivables	62,036	66,257
Self-insurance receivables, current portion	1,672	4,475
Other receivables	1,849	1,191
Prepaid expenses and other current assets	4,278	4,659
Income tax refundable	778	1,115
Current assets of discontinued operations	0	155
Total current assets	74,553	80,537
PROPERTY AND EQUIPMENT, at cost	131,326	127,644
Less accumulated depreciation and amortization	(82,878)	(76,801)
Property and equipment, net	48,448	50,843
OTHER ASSETS:
Deferred income taxes, net	0	15,851
Deferred leasehold costs	0	206
Operating lease assets	316,626	0
Acquired leasehold interest, net	5,869	6,307
Other noncurrent assets	3,644	3,244
Noncurrent assets of discontinued operations	0	2,256
Total other assets	326,139	27,864
Total assets	449,140	159,244
CURRENT LIABILITIES:
Current portion of long-term debt and finance lease obligations, net	12,333	12,449
Trade accounts payable	14,401	15,659
Current liabilities of discontinued operations	0	86
Current portion of operating lease liabilities	22,986
Accrued expenses:
Payroll and employee benefits	16,969	19,471
Self-insurance reserves, current portion	12,235	13,158
Other current liabilities	11,468	9,522
Total current liabilities	90,392	70,345
NONCURRENT LIABILITIES:
Long-term debt and finance lease obligations, less current portion and deferred financing costs, net	63,167	60,984
Operating lease liabilities, less current portion	301,905	0
Self-insurance reserves, noncurrent portion	17,007	16,057
Litigation contingency, less current portion	9,000	6,400
Other noncurrent liabilities	1,497	6,656
Total noncurrent liabilities	392,576	90,097
COMMITMENTS AND CONTINGENCIES
SHAREHOLDERS’ DEFICIT:
Common stock, authorized 20,000 shares, $.01 par value, 6,907 and 6,751 shares issued, and 6,675 and 6,519 shares outstanding, respectively	69	68
Treasury stock at cost, 232 shares of common stock	(2,500)	(2,500)
Paid-in capital	23,883	23,413
Accumulated deficit	(55,832)	(23,016)
Accumulated other comprehensive income	552	837
Total shareholders’ deficit	(33,828)	(1,198)
Total liabilities and shareholder's equity	$ 449,140	$ 159,244

INTERIM CONSOLIDATED BALANCE _2

INTERIM CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Common stock, par value (dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (shares)	20,000,000	20,000,000
Common stock, shares issued (shares)	6,907,000	6,751,000
Common stock, shares outstanding (shares)	6,675,000	6,519,000
Treasury stock, shares (shares)	232,000	232,000

INTERIM CONSOLIDATED STATEMENTS

INTERIM CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
PATIENT REVENUES, net	$ 118,630	$ 119,035	$ 354,145	$ 357,406
EXPENSES:
Operating	95,591	95,768	284,643	284,823
Lease and rent expense	13,251	12,060	39,480	36,105
Professional liability	1,737	1,604	5,182	4,898
Litigation contingency expense (Note 7)	0	6,400	3,100	6,400
General and administrative	6,902	6,873	21,267	23,046
Depreciation and amortization	2,279	2,662	6,812	7,686
Total expenses	119,760	125,367	360,484	362,958
OPERATING LOSS	(1,130)	(6,332)	(6,339)	(5,552)
OTHER INCOME (EXPENSE):
Gain on sale of investment in unconsolidated affiliate			0	308
Other income	25	0	207	113
Interest expense, net	(1,554)	(1,382)	(4,424)	(4,147)
Total other expense	(1,529)	(1,382)	(4,217)	(3,726)
LOSS FROM CONTINUING OPERATIONS BEFORE INCOME TAXES	(2,659)	(7,714)	(10,556)	(9,278)
BENEFIT FOR INCOME TAXES	741	252	(15,544)	903
LOSS FROM CONTINUING OPERATIONS	(1,918)	(7,462)	(26,100)	(8,375)
INCOME (LOSS) FROM DISCONTINUED OPERATIONS:
Operating income (loss), net of tax benefit	(3,689)	65	(7,449)	564
Gain on disposal, net of tax	733	0	733	0
Income (loss) from discontinued operations	(2,956)	65	(6,716)	564
NET LOSS	$ (4,874)	$ (7,397)	$ (32,816)	$ (7,811)
Per common share – basic
Continuing operations (in dollars per share)	$ (0.30)	$ (1.17)	$ (4.04)	$ (1.32)
Discontinued operations (in dollars per share)	(0.45)	0.01	(1.04)	0.09
Net loss per common share – basic (dollars per share)	(0.75)	(1.16)	(5.08)	(1.23)
Per common share – diluted
Continuing operations (in dollars per share)	(0.30)	(1.17)	(4.04)	(1.32)
Discontinued operations (in dollars per share)	(0.45)	0.01	(1.04)	0.09
Net income (loss) per common share – diluted (dollars per share)	(0.75)	(1.16)	(5.08)	(1.23)
COMMON STOCK DIVIDENDS DECLARED PER SHARE OF COMMON STOCK (dollars per share)	$ 0	$ 0.055	$ 0	$ 0.165
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING:
Basic (shares)	6,470	6,400	6,455	6,362
Diluted (shares)	6,470	6,400	6,455	6,362

INTERIM CONSOLIDATED STATEMEN_2

INTERIM CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Tax benefit, effect on operating loss	$ (459)	$ (45)	$ 570	$ 222

INTERIM CONSOLIDATED STATEMEN_3

INTERIM CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - 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 LOSS	$ (4,874)	$ (7,397)	$ (32,816)	$ (7,811)
OTHER COMPREHENSIVE INCOME:
Change in fair value of cash flow hedge, net of tax	(37)		(285)
Change in fair value of cash flow hedge, net of tax		46		501
Less: reclassification adjustment for amounts recognized in net loss			0
Less: reclassification adjustment for amounts recognized in net loss				(151)
Total other comprehensive income (loss)	(37)	46	(285)	350
COMPREHENSIVE LOSS	$ (4,911)	$ (7,351)	$ (33,101)	$ (7,461)

INTERIM CONSOLIDATED STATEMEN_4

INTERIM CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (DEFICIT) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Treasury Stock	Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)
Balance (in shares) at Dec. 31, 2017		6,687	232
Balance at Dec. 31, 2017	$ 6,462	$ 67	$ (2,500)	$ 22,720	$ (14,534)	$ 709
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(103)				(103)
Common stock dividends declared	(350)			13	(363)
Issuance/redemption of equity grants, net (in shares)		86
Issuance/redemption of equity grants, net	(78)	$ 1		(79)
Interest rate cash flow hedge	208					208
Stock-based compensation	236			236
Balance (in shares) at Mar. 31, 2018		6,773	232
Balance at Mar. 31, 2018	6,375	$ 68	$ (2,500)	22,890	(15,000)	917
Balance (in shares) at Dec. 31, 2017		6,687	232
Balance at Dec. 31, 2017	6,462	$ 67	$ (2,500)	22,720	(14,534)	709
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(7,811)
Balance (in shares) at Sep. 30, 2018		6,749	232
Balance at Sep. 30, 2018	(1,538)	$ 68	$ (2,500)	23,267	(23,432)	1,059
Balance (in shares) at Mar. 31, 2018		6,773	232
Balance at Mar. 31, 2018	6,375	$ 68	$ (2,500)	22,890	(15,000)	917
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(311)				(311)
Common stock dividends declared	(351)			11	(362)
Issuance/redemption of equity grants, net (in shares)		(5)
Issuance/redemption of equity grants, net	0
Interest rate cash flow hedge	96					96
Stock-based compensation	348			348
Balance (in shares) at Jun. 30, 2018		6,768	232
Balance at Jun. 30, 2018	6,157	$ 68	$ (2,500)	23,249	(15,673)	1,013
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(7,397)				(7,397)
Common stock dividends declared	(353)			9	(362)
Issuance/redemption of equity grants, net (in shares)		(19)
Issuance/redemption of equity grants, net	(140)			(140)
Interest rate cash flow hedge	46					46
Stock-based compensation	149			149
Balance (in shares) at Sep. 30, 2018		6,749	232
Balance at Sep. 30, 2018	(1,538)	$ 68	$ (2,500)	23,267	(23,432)	1,059
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	416				416
Issuance/redemption of equity grants, net (in shares)		2
Issuance/redemption of equity grants, net	0
Interest rate cash flow hedge	(222)					(222)
Stock-based compensation	146			146
Balance (in shares) at Dec. 31, 2018		6,751	232
Balance at Dec. 31, 2018	(1,198)	$ 68	$ (2,500)	23,413	(23,016)	837
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(3,346)				(3,346)
Issuance/redemption of equity grants, net (in shares)		163
Issuance/redemption of equity grants, net	42	$ 1		41
Interest rate cash flow hedge	(63)					(63)
Stock-based compensation	140			140
Balance (in shares) at Mar. 31, 2019		6,914	232
Balance at Mar. 31, 2019	(4,425)	$ 69	$ (2,500)	23,594	(26,362)	774
Balance (in shares) at Dec. 31, 2018		6,751	232
Balance at Dec. 31, 2018	(1,198)	$ 68	$ (2,500)	23,413	(23,016)	837
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(32,816)
Balance (in shares) at Sep. 30, 2019		6,907	232
Balance at Sep. 30, 2019	(33,828)	$ 69	$ (2,500)	23,883	(55,832)	552
Balance (in shares) at Mar. 31, 2019		6,914	232
Balance at Mar. 31, 2019	(4,425)	$ 69	$ (2,500)	23,594	(26,362)	774
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(24,596)				(24,596)
Issuance/redemption of equity grants, net (in shares)		(3)
Issuance/redemption of equity grants, net	0
Interest rate cash flow hedge	(185)					(185)
Stock-based compensation	144			144
Balance (in shares) at Jun. 30, 2019		6,911	232
Balance at Jun. 30, 2019	(29,062)	$ 69	$ (2,500)	23,738	(50,958)	589
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(4,874)				(4,874)
Issuance/redemption of equity grants, net (in shares)		(4)
Issuance/redemption of equity grants, net	0
Interest rate cash flow hedge	(37)					(37)
Stock-based compensation	145			145
Balance (in shares) at Sep. 30, 2019		6,907	232
Balance at Sep. 30, 2019	$ (33,828)	$ 69	$ (2,500)	$ 23,883	$ (55,832)	$ 552

INTERIM CONSOLIDATED STATEMEN_5

INTERIM CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
CASH FLOWS FROM OPERATING ACTIVITIES:
NET LOSS	$ (32,816)	$ (7,811)
Discontinued operations	(6,716)	564
Loss from continuing operations	(26,100)	(8,375)
Adjustments to reconcile loss from continuing operations to net cash provided by (used in) operating activities:
Depreciation and amortization	6,812	7,686
Deferred income tax provision (benefit)	15,851	(829)
Provision for self-insured professional liability, net of cash payments	4,682	2,224
Litigation contingency expense	3,100	6,400
Stock-based and deferred compensation	429	947
Gain on sale of unconsolidated affiliate	0	(308)
Provision (benefit) for leases in excess of cash payments	3,768	(1,363)
Other	643	251
Changes in assets and liabilities affecting operating activities:
Receivables, net	7,024	(2,134)
Prepaid expenses and other assets	(4,071)	(2,379)
Trade accounts payable and accrued expenses	(3,451)	2,391
Net cash provided by continuing operations	8,687	4,511
Discontinued operations	(5,130)	1,153
Net cash provided by operating activities	3,557	5,664
NET CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of property and equipment	(3,745)	(4,689)
Proceeds from sale of unconsolidated affiliate	0	308
Net cash used in continuing operations	(3,745)	(4,381)
Discontinued operations	6	(1,275)
Net cash used in investing activities	(3,739)	(5,656)
CASH FLOWS FROM FINANCING ACTIVITIES:
Repayment of debt and finance lease obligations	(6,867)	(15,330)
Proceeds from issuance of debt	8,477	17,203
Financing costs	(215)	(137)
Issuance and redemption of employee equity awards, net	42	(219)
Payment of common stock dividends	0	(1,053)
Payment for preferred stock restructuring	0	(508)
Net cash provided by (used in) continuing operations	1,437	(44)
Discontinued operations	0	0
Net cash provided by (used in) financing activities	1,437	(44)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS	1,255	(36)
CASH AND CASH EQUIVALENTS, beginning of period	2,685	3,524
CASH AND CASH EQUIVALENTS, end of period	3,940	3,488
SUPPLEMENTAL INFORMATION:
Cash payments of interest	4,100	4,511
Cash payments of income taxes	241	474
SUPPLEMENTAL INFORMATION ON NON-CASH INVESTING AND FINANCING TRANSACTIONS:
Acquisition of equipment through finance leases	234	203
Acquisition of operating leases though adoption of ASC 842	389,403	$ 0
Lease modification	$ (48,877)

BUSINESS

BUSINESS	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BUSINESS	BUSINESS Diversicare Healthcare Services, Inc. (together with its subsidiaries, “Diversicare” or the “Company”) provides long-term care services to nursing center patients in nine states, primarily in the Southeast, Midwest, and Southwest. The Company’s centers provide a range of health care services to their patients and residents that include nursing, personal care, and social services. Additionally, the Company’s nursing centers also offer a variety of comprehensive rehabilitation services, as well as nutritional support services. The Company's continuing operations include centers in Alabama, Florida, Indiana, Kansas, Mississippi, Missouri, Ohio, Tennessee, and Texas. As of September 30, 2019 , the Company’s continuing operations consist of 62 nursing centers with 7,329 licensed nursing beds. The Company owns 15 and leases 47 of its nursing centers. Our nursing centers range in size from 50 to 320 licensed nursing beds. The licensed nursing bed count does not include 397 licensed assisted and residential living beds. On August 30, 2019, the Company terminated operations of ten centers in Kentucky, which included 885 licensed nursing beds.

CONSOLIDATION AND BASIS OF PRES

CONSOLIDATION AND BASIS OF PRESENTATION OF FINANCIAL STATEMENTS	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
CONSOLIDATION AND BASIS OF PRESENTATION OF FINANCIAL STATEMENTS	CONSOLIDATION AND BASIS OF PRESENTATION OF FINANCIAL STATEMENTS The interim consolidated financial statements for the three and nine month periods ended September 30, 2019 and 2018 , included herein have been prepared by the Company, without audit, pursuant to the rules and regulations of the Securities and Exchange Commission. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles in the United States of America ("GAAP") have been condensed or omitted pursuant to such rules and regulations. In the opinion of management of the Company, the accompanying interim consolidated financial statements reflect all normal, recurring adjustments necessary to present fairly the Company’s financial position at September 30, 2019 , and the results of operations, and changes in shareholders' deficit for the three and nine month periods ended September 30, 2019 and 2018 , and cash flows for the nine month period ended September 30, 2019 and 2018 . The Company’s balance sheet information at December 31, 2018 , was derived from its audited consolidated financial statements as of December 31, 2018 . Effective January 1, 2019, we adopted the requirements of Accounting Standards Update ("ASU") No. 2016-02, Leases (Topic 842), as discussed in Notes 3 and 6 to the interim consolidated financial statements. Effective January 1, 2018, we adopted the requirements of ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), as discussed in Notes 3 and 4 to the interim consolidated financial statements. All amounts and disclosures set forth in this Form 10-Q have been updated to comply with the new standards. The results of operations for the periods ended September 30, 2019 and 2018 are not necessarily indicative of the operating results that may be expected for a full year. These interim consolidated financial statements should be read in connection with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2018 . Discontinued Operations On December 1, 2018, the Company sold three Kentucky properties for a purchase price of $18.7 million , which are collectively referred to as the "Kentucky Properties." On August 30, 2019, the Company terminated operations of ten centers in Kentucky and concurrently transferred operations to a new operator. These ten centers are collectively referred to as the "Kentucky Centers." The sale of the Kentucky Properties and the termination of operations at the Kentucky Centers are referred to collectively as the "Kentucky Exit." As a result of the Kentucky Exit, the Company no longer operates any skilled nursing centers in the State of Kentucky. The Company's exit from the state represents a strategic shift that has (or will have) a major effect on the Company's financial position, results of operations and cash flows. In accordance with ASC 205, the Company's discontinued operating results have been reclassified on the face of the financial statements and footnotes for all periods presented to reflect the discontinued status of these operations. Refer to Note 12, "Discontinued Operations" for more information.

RECENT ACCOUNTING GUIDANCE

RECENT ACCOUNTING GUIDANCE	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
RECENT ACCOUNTING GUIDANCE	RECENT ACCOUNTING GUIDANCE Recent Accounting Standards Adopted by the Company In February 2016, the Financial Accounting Standards Board ("FASB") issued ASU No. 2016-02, Leases (Topic 842). The standard establishes a right-of-use ("ROU") model that requires a lessee to record a ROU asset and a lease liability on the balance sheet. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. For short-term leases (those with a term of 12 months or less and that do not include a lessee purchase option that is reasonably certain to be exercised), a lessee is permitted to make (and the Company chose to utilize) an accounting policy election by asset class not to recognize ROU assets and lease liabilities, which would generally result in lease expense for these short term leases being recognized on a straight-line basis over the lease term. The standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. The Company adopted the requirements of this standard effective January 1, 2019. In July 2018, the FASB issued ASU 2018-11, Leases - Targeted Improvements, which allows lessees and lessors to recognize and measure existing leases at the beginning of the period of adoption without modifying the comparative period financial statements (which therefore will remain under prior GAAP, Topic 840, Leases). The Company elected to use the optional expedient to reflect adoption in the period of adoption (January 1, 2019) rather than the earliest period presented. The Company also elected the package of practical expedients upon transition, which includes retaining the lease classification for any leases that exist prior to adoption of the standard. The adoption of the new standard resulted in the recording of net lease assets and lease liabilities of $384,187 and $389,403 , respectively, as of January 1, 2019. The standard did not materially impact our consolidated net earnings and had no impact on cash flows. See Note 6, "Leases" for a discussion regarding leases under the new standard. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities, which is intended to simplify and amend the application of hedge accounting to more clearly portray the economics of an entity’s risk management strategies in its financial statements. The new guidance will make more financial and nonfinancial hedging strategies eligible for hedge accounting and reduce complexity in fair value hedges of interest rate risk. The new guidance also changes how companies assess effectiveness and amends the presentation and disclosure requirements. The new guidance eliminates the requirement to separately measure and report hedge ineffectiveness and generally the entire change in the fair value of a hedging instrument will be required to be presented in the same income statement line as the hedged item. The new guidance also eases certain documentation and assessment requirements and modifies the accounting for components excluded from the assessment of hedge effectiveness. The new guidance is effective for public entities for fiscal years beginning after December 15, 2018, including interim periods within those years. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In October 2018, the FASB issued ASU No. 2018-16, Derivatives and Hedging (Topic 805): Inclusion of the Secured Overnight Financing Rate ("SOFR") Overnight Index Swap ("OIS") Rate as a Benchmark Interest Rate for Hedge Accounting Purposes. The ASU amends ASC 815 to add the OIS rate based on the SOFR as a fifth US benchmark interest rate. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In February 2018, the FASB issued ASU No. 2018-02, Income Statement- Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income. The new guidance allows entities the option to reclassify stranded tax effects resulting from the Tax Cuts and Jobs Act from accumulated other comprehensive income (OCI) to retained earnings. The new guidance allows the option to apply the guidance retrospectively or in the period of adoption. The guidance is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In June 2018, the FASB issued ASU No. 2018-07, Compensation-Stock Compensation (Topic 718): Improvement to Nonemployee Share-Based Payment Accounting, which modifies the accounting for share-based payment awards issued to nonemployees to largely align it with the accounting for share-based payment awards issued to employees. The standard is effective for fiscal years beginning after December 15, 2018. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. The new guidance is effective for annual and interim reporting periods beginning after December 15, 2017. The Company adopted the requirements of this standard effective January 1, 2018. The Company elected to apply the modified retrospective approach with the cumulative transition effect recognized in beginning retained earnings as of the date of adoption. The adoption of ASC 606 represents a change in accounting principle that more closely aligns revenue recognition with the delivery of the Company's services. The cumulative effect of applying the new guidance to all contracts with customers as of January 1, 2018 was not material to the interim consolidated financial statements. See Note 4, "Revenue Recognition" for a discussion regarding revenue recognition under the new standard. Accounting Standards Recently Issued But Not Yet Adopted by the Company In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The new guidance intends to improve financial reporting by requiring timelier recognition of credit losses on loans and other financial instruments that are not accounted for at fair value through net income, including loans held for investment, held-to-maturity debt securities, trade and other receivables, net investment in leases and other such commitments. This update requires that financial statement assets measured at an amortized cost be presented at the net amount expected to be collected, through an allowance for credit losses that is deducted from the amortized cost basis. This standard is effective for the fiscal year beginning after December 15, 2022 with early adoption permitted. The Company is in the initial stages of evaluating the impact from the adoption of this new standard on the consolidated financial statements and related disclosures. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurements (Topic 820): Disclosure Framework- Changes to the Disclosure Requirements for Fair Value Measurement. The amendments in this update modify the disclosure requirements of fair value measurements under Topic 820. The standard is effective for fiscal years beginning after December 15, 2019. Early adoption is permitted. The Company is evaluating the effect this guidance will have on our consolidated financial statements and related disclosures.

REVENUE RECOGNITION

REVENUE RECOGNITION	9 Months Ended
	Sep. 30, 2019
Revenue from Contract with Customer [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION On January 1, 2018, the Company adopted Accounting Standards Codification ("ASC") 606 using the modified retrospective method for all contracts as of the date of adoption. The adoption of ASC 606 represents a change in accounting principle that more closely aligns revenue recognition with the delivery of the Company's services. The cumulative effect of applying the new guidance to all contracts with customers as of January 1, 2018 was not material to the interim consolidated financial statements. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these services. Performance obligations are promises made in a contract to transfer a distinct good or service to the customer. A contract's transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. The Company has concluded that the contracts with patients and residents represent a bundle of distinct services that are substantially the same, with the same pattern of transfer to the customer. Accordingly, the promise to provide quality care is accounted for as a single performance obligation. The Company performed analyses using the application of the portfolio approach as a practical expedient to group patient contracts with similar characteristics, such that revenue for a given portfolio would not be materially different than if it were evaluated on a contract-by-contract basis. These analyses incorporated consideration of reimbursements at varying rates from Medicaid, Medicare, Managed Care, Private Pay, Assisted Living, Hospice, and Veterans for services provided in each corresponding state. It was determined that the contracts are not materially different for the following groups: Medicaid, Medicare, Managed Care and Private Pay and other (Assisted Living, Hospice and Veterans). In order to determine the transaction price, the Company estimates the amount of variable consideration at the beginning of the contract using the expected value method. The estimates consider (i) payor type, (ii) historical payment trends, (iii) the maturity of the portfolio, and (iv) geographic payment trends throughout a class of similar payors. The Company typically enters into agreements with third-party payors that provide for payments at amounts different from the established charges. These arrangement terms provide for subsequent settlement and cash flows that may occur well after the service is provided. The Company constrains (reduces) the estimates of variable consideration such that it is probable that a significant reversal of previously recognized revenue will not occur throughout the life of the contract. Changes in the Company's expectation of the amount it will receive from the patient or third-party payors will be recorded in revenue unless there is a specific event that suggests the patient or third-party payor no longer has the ability and intent to pay the amount due and, therefore, the changes in its estimate of variable consideration better represent an impairment, or bad debt. These estimates are re-assessed each reporting period, and any amounts allocated to a satisfied performance obligation are recognized as revenue or a reduction of revenue in the period in which the transaction price changes. The Company satisfies its performance obligation by providing quality of care services to its patients and residents on a daily basis until termination of the contract. The performance obligation is recognized on a time elapsed basis, by day, for which the services are provided. For these contracts, the Company has the right to consideration from the customer in an amount that directly corresponds with the value to the customer of the Company's performance to date. Therefore, the Company recognizes revenue based on the amount billable to the customer in accordance with the practical expedient in ASC 606-10-55-18. Additionally, because the Company applied ASC 606 using certain practical expedients, the Company elected not to disclose the aggregate amount of the transaction price for unsatisfied, or partially unsatisfied, performance obligations for all contracts with an original expected length of one year or less. The Company incurs costs related to patient/resident contracts, such as legal and advertising expenses. The contract costs are expensed as incurred. They are not expected to be recovered and are not chargeable to the patient/resident regardless of whether the contract is executed. Disaggregation of Revenue and Accounts Receivable The following table summarizes revenue from contracts with customers by payor source from continuing operations for the periods presented (dollar amounts in thousands): Three Months Ended September 30, 2019 2018 Medicaid $ 57,191 48.2 % $ 55,910 47.0 % Medicare 19,274 16.2 % 20,318 17.1 % Managed Care 11,794 9.9 % 11,248 9.4 % Private Pay and other 30,371 25.7 % 31,559 26.5 % Total $ 118,630 100.0 % $ 119,035 100.0 % Nine Months Ended September 30, 2019 2018 Medicaid $ 164,815 46.5 % $ 159,706 44.7 % Medicare 59,211 16.7 % 64,713 18.1 % Managed Care 37,911 10.7 % 36,748 10.3 % Private Pay and other 92,208 26.1 % 96,239 26.9 % Total $ 354,145 100.0 % $ 357,406 100.0 % Accounts receivable from continuing operations as of September 30, 2019 and December 31, 2018 are summarized in the following table: September 30 December 31, 2019 2018 Medicaid $ 25,366 $ 27,532 Medicare 10,686 15,706 Managed Care 8,376 8,126 Private Pay and other 17,608 14,893 Total accounts receivable $ 62,036 $ 66,257

LONG-TERM DEBT AND INTEREST RAT

LONG-TERM DEBT AND INTEREST RATE SWAP	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
LONG-TERM DEBT AND INTEREST RATE SWAP	LONG-TERM DEBT AND INTEREST RATE SWAP The Company has agreements with a syndicate of banks for a mortgage term loan ("Original Mortgage Loan") and the Company’s revolving credit agreement ("Original Revolver"). On February 26, 2016, the Company executed an Amended and Restated Credit Agreement (the "Credit Agreement") which modified the terms of the Original Mortgage Loan and the Original Revolver Agreements dated April 30, 2013. The Credit Agreement increased the Company's borrowing capacity to $100,000 allocated between a $72,500 Mortgage Loan ("Amended Mortgage Loan") and a $27,500 Revolver ("Amended Revolver"). The Amended Mortgage Loan consists of a $60,000 term loan facility and a $12,500 acquisition loan facility. Loan acquisition costs associated with the Amended Mortgage Loan and the Amended Revolver were capitalized in the amount of $2,162 and are being amortized over the five -year term of the agreements. Under the terms of the amended agreements, the syndicate of banks provided the Amended Mortgage Loan with an original principal balance of $72,500 with a five -year maturity through February 26, 2021, and a $27,500 Amended Revolver through February 26, 2021. The Amended Mortgage Loan has a term of five years, with principal and interest payable monthly based on a 25 -year amortization. Interest on the term and acquisition loan facilities is based on LIBOR plus 4.0% and 4.75% , respectively. A portion of the Amended Mortgage Loan is effectively fixed at 5.79% pursuant to an interest rate swap with an initial notional amount of $30,000 . The Amended Mortgage Loan balance was $59,645 as of September 30, 2019 , consisting of $50,245 on the term loan facility with an interest rate of 6.00% and $9,400 on the acquisition loan facility with an interest rate of 6.75% . The Amended Mortgage Loan is secured by fifteen owned nursing centers, related equipment and a lien on the accounts receivable of these centers. The Amended Mortgage Loan and the Amended Revolver are cross-collateralized and cross-defaulted. The Company’s Amended Revolver has an interest rate of LIBOR plus 4.0% and is secured by accounts receivable and is subject to limits on the maximum amount of loans that can be outstanding under the revolver based on borrowing base restrictions. Effective October 3, 2016, the Company entered into the Second Amendment ("Second Revolver Amendment") to amend the Amended Revolver. The Second Revolver Amendment increased the Amended Revolver capacity from the $27,500 in the Amended Revolver to $52,250 ; provided that the maximum revolving facility be reduced to $42,250 on August 1, 2017. Subsequently, on June 30, 2017, the Company executed a Fourth Amendment (the "Fourth Revolver Amendment") to amend the Amended Revolver, which modifies the capacity of the revolver to remain at $52,250 . On December 29, 2016, the Company executed a Third Amendment ("Third Revolver Amendment") to amend the Amended Revolver. The Third Amendment modified the terms of the Amended Revolving Agreement by increasing the Company’s letter of credit sublimit from $10,000 to $15,000 . Effective June 30, 2017, the Company entered into a Second Amendment ("Second Term Amendment") to amend the Amended Mortgage Loan. The Second Term Amendment amended the terms of the Amended Mortgage Loan Agreement by increasing the Company's term loan facility by $7,500 . Effective February 27, 2018, the Company executed a Fifth Amendment to the Amended Revolver and a Third Amendment to the Amended Mortgage Loan. Under the terms of the Amendments, the minimum fixed charge coverage ratio shall not be less than 1.01 to 1.00 as of March 31, 2018 and for each quarter thereafter. Effective December 1, 2018, the Company entered into the Sixth Amendment ("Sixth Revolver Amendment") to amend the Amended Revolver. The Sixth Amendment decreased the Amended Revolver capacity from $52,250 to $42,250 . The Company also applied $4,947 of net proceeds from the sale of the Kentucky Properties to the outstanding borrowings under the Amended Revolver. Effective December 1, 2018, the Company executed a Fourth Amendment (the "Fourth Term Amendment") to amend the Amended Mortgage Loan. The Company applied $11,100 and $2,100 of net proceeds from the sale of the Kentucky Properties to the Term Loan and Acquisition Loan, respectively. Additionally, we amended the Acquisition Loan availability to include a reserve of $2,100 , and therefore, our borrowing capacity is $10,400 . For further discussion of the sale of the Kentucky Properties, refer to Note 12, "Discontinued Operations." On August 30, 2019, the Company completed a transaction to exit Kentucky and no longer operates any skilled nursing centers in the state. The Company entered into a consent under the Amended Revolver to remove the Kentucky Properties as borrowers. Refer to Note 12, "Discontinued Operations" for more information. The Company is participating in the Texas Quality Incentive Payment Program ("QIPP"). Effective May 13, 2019, the Company entered into a Fifth Amendment (the “Fifth Term Amendment”) to amend the Amended Mortgage Loan to release the operators of three of the QIPP centers in Texas from the Amended Mortgage Loan and a Seventh Amendment (the “Seventh Revolver Amendment”) to amend the Amended Revolver to remove the operators of all four of the QIPP centers in Texas from the Amended Revolver and to permanently reduce the amount available under the Amended Revolver by $2,000 . At the same time, the operators of these four facilities entered into a separate revolving loan (the "affiliated revolver") with the same syndicate of banks to provide for the temporary working capital requirements of the four QIPP centers. The affiliated revolver, which is guaranteed by the Company, has an initial capacity of $5,000 , which amount is reduced by $1,000 on each of January 1, 2020, April 1, 2020 and July 1, 2020. The affiliated revolver has the same maturity date as the Amended Revolver and the Amended Mortgage Loan of February 26, 2021. The affiliated revolver is cross-defaulted with the Amended Revolver and the Amended Mortgage Loan. For further discussion of the QIPP centers in Texas, refer to Note 11, "Business Development and Other Significant Transactions." As of September 30, 2019 , the Company had $2,000 borrowings outstanding under the affiliated revolver. The interest rate related to the affiliated revolver was 6.00% as of September 30, 2019 . As of September 30, 2019 , the Company had $14,000 borrowings outstanding under the Amended Revolver compared to $15,000 outstanding as of December 31, 2018 . The interest rate related to the Amended Revolver was 6.00% as of September 30, 2019 . The outstanding borrowings on the revolver were used primarily for temporary working capital requirements. Annual fees for letters of credit issued under the Amended Revolver are 3.0% of the amount outstanding. The Company has four letters of credit with a total value of $12,017 outstanding as of September 30, 2019 . Considering the balance of eligible accounts receivable, the letters of credit, the amounts outstanding under the revolving credit facility and the maximum loan amount of $32,284 the balance available for borrowing under the Amended Revolver and affiliated revolver was $4,267 at September 30, 2019 . The Company’s debt agreements contain various financial covenants, the most restrictive of which relates to debt service coverage ratios. The Company is in compliance with all such covenants at September 30, 2019 . Interest Rate Swap Transaction Pursuant to the Company's debt agreements, the Company has an interest rate swap agreement with a member of the bank syndicate as the counterparty. The Company's interest rate swap is designated as a cash flow hedge, and the earnings component of the hedge, net of taxes, is reflected as a component of other comprehensive income (loss). The interest rate swap agreement has the same effective date and maturity date as the Amended Mortgage Loan, and has an amortizing notional amount that was $27,015 as of September 30, 2019 . The interest rate swap agreement requires the Company to make fixed rate payments to the bank calculated on the applicable notional amount at an annual fixed rate of 5.79% while the bank is obligated to make payments to the Company based on LIBOR on the same notional amount. The Company assesses the effectiveness of its interest rate swap on a quarterly basis, and at September 30, 2019 , the Company determined that the interest rate swap was highly effective. The interest rate swap valuation model indicated a net liability of $77 at September 30, 2019 . The fair value of the interest rate swap is included in “other noncurrent liabilities” on the Company’s interim consolidated balance sheet. The change in the interest rate swap liability is included in accumulated other comprehensive income at September 30, 2019 is $60 net of the income tax provision of $17 . As the Company’s interest rate swap is not traded on a market exchange, the fair value is determined using a discounted cash flow analysis. This analysis reflects the contractual terms of the interest rate swap agreement and uses observable market-based inputs, including estimated future LIBOR interest rates. The interest rate swap valuation is classified in Level 2 of the fair value hierarchy, in accordance with the FASB guidance set forth in ASC 820, Fair Value Measurement .

LEASES

LEASES	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
LEASES	LEASES The Company has operating and finance leases for facilities, corporate offices, and certain equipment. The Company recognizes lease expense for these operating leases on a straight-line basis over the lease term. Leases with an initial term of one year or less are not recorded on the balance sheet. The Company's other leases have original lease terms of one to twelve years, some of which include options to extend the lease for up to twenty years, and some of which include options to terminate the leases within one year. The exercise of lease renewal options is at our sole discretion. The Company's lease agreements do not contain any material residual value guarantees or material restrictive covenants. Upon adoption of Topic 842, the Company elected the practical expedient to not separate lease and non-lease components for all of its leases as the non-lease components are not significant to the overall lease costs. Leases Classification September 30, 2019 Assets Operating lease assets Operating lease assets $ 316,626 Finance lease assets Property and equipment, net (a) 972 Total leased assets $ 317,598 Liabilities Current Operating Current portion of operating lease liabilities $ 22,986 Finance Current portion of long-term debt and finance lease obligations, net 273 Noncurrent Operating Operating lease liabilities 301,905 Finance Long-term debt and finance lease obligations, less current portion and deferred financing costs, net 508 Total lease liabilities $ 325,672 (a) Finance lease assets are recorded net of accumulated amortization of $1,456 as of September 30, 2019. Lease Cost Three Months Ended Nine Months Ended Classification September 30, 2019 September 30, 2019 Operating lease cost (a) Lease and rent expense $ 13,251 $ 39,480 Finance lease cost: Amortization of finance lease assets Depreciation and amortization 54 196 Interest on finance lease liabilities Interest expense, net 11 37 Short term lease cost Operating expense 169 472 Net lease cost $ 13,485 $ 40,185 (a) Includes variable lease costs, which are immaterial Maturity of Lease Liabilities As of September 30, 2019 Operating Leases (a) Finance Leases (a) Total 2019 $ 50,592 $ 313 $ 50,905 2020 51,533 243 51,776 2021 52,553 206 52,759 2022 53,593 65 53,658 2023 53,897 27 53,924 After 2023 214,168 — 214,168 Total lease payments $ 476,336 $ 854 $ 477,190 Less: Interest (151,445 ) (73 ) (151,518 ) Present value of lease liabilities $ 324,891 $ 781 $ 325,672 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The Company's future minimum lease commitments for continuing operations as of December 31, 2018, under Accounting Standards Codification Topic 840, predecessor to Topic 842, are as follows: As of December 31, 2018 Operating Leases (a) Finance Leases (a) Total 2018 $ 48,701 $ 454 $ 49,155 2019 49,595 174 49,769 2020 50,570 173 50,743 2021 51,587 127 51,714 2022 52,624 — 52,624 After 2022 245,225 — 245,225 Total lease payments $ 498,302 $ 928 $ 499,230 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The measurement of right-of-use assets and lease liabilities requires the Company to estimate appropriate discount rates. To the extent the rate implicit in the lease is readily determinable, such rate is utilized. However, based on information available at lease commencement for the majority of our leases, the rate implicit in the lease is not known. In these instances, the Company utilizes an incremental borrowing rate, which represents the rate of interest that it would pay to borrow on a collateralized basis over a similar term. Lease Term and Discount Rate September 30, 2019 Weighted-average remaining lease term (years) Operating leases 9.04 Finance leases 2.02 Weighted-average discount rate Operating leases 8.9% Finance leases 5.5% Other Information Nine Months Ended September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows for operating leases $ 42,816 Operating cash flows for finance leases $ 37 Financing cash flows for finance leases $ 373 Acquisition of operating leases though adoption of ASC 842 $ 389,403 Lease modification $ (48,877 )
LEASES	LEASES The Company has operating and finance leases for facilities, corporate offices, and certain equipment. The Company recognizes lease expense for these operating leases on a straight-line basis over the lease term. Leases with an initial term of one year or less are not recorded on the balance sheet. The Company's other leases have original lease terms of one to twelve years, some of which include options to extend the lease for up to twenty years, and some of which include options to terminate the leases within one year. The exercise of lease renewal options is at our sole discretion. The Company's lease agreements do not contain any material residual value guarantees or material restrictive covenants. Upon adoption of Topic 842, the Company elected the practical expedient to not separate lease and non-lease components for all of its leases as the non-lease components are not significant to the overall lease costs. Leases Classification September 30, 2019 Assets Operating lease assets Operating lease assets $ 316,626 Finance lease assets Property and equipment, net (a) 972 Total leased assets $ 317,598 Liabilities Current Operating Current portion of operating lease liabilities $ 22,986 Finance Current portion of long-term debt and finance lease obligations, net 273 Noncurrent Operating Operating lease liabilities 301,905 Finance Long-term debt and finance lease obligations, less current portion and deferred financing costs, net 508 Total lease liabilities $ 325,672 (a) Finance lease assets are recorded net of accumulated amortization of $1,456 as of September 30, 2019. Lease Cost Three Months Ended Nine Months Ended Classification September 30, 2019 September 30, 2019 Operating lease cost (a) Lease and rent expense $ 13,251 $ 39,480 Finance lease cost: Amortization of finance lease assets Depreciation and amortization 54 196 Interest on finance lease liabilities Interest expense, net 11 37 Short term lease cost Operating expense 169 472 Net lease cost $ 13,485 $ 40,185 (a) Includes variable lease costs, which are immaterial Maturity of Lease Liabilities As of September 30, 2019 Operating Leases (a) Finance Leases (a) Total 2019 $ 50,592 $ 313 $ 50,905 2020 51,533 243 51,776 2021 52,553 206 52,759 2022 53,593 65 53,658 2023 53,897 27 53,924 After 2023 214,168 — 214,168 Total lease payments $ 476,336 $ 854 $ 477,190 Less: Interest (151,445 ) (73 ) (151,518 ) Present value of lease liabilities $ 324,891 $ 781 $ 325,672 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The Company's future minimum lease commitments for continuing operations as of December 31, 2018, under Accounting Standards Codification Topic 840, predecessor to Topic 842, are as follows: As of December 31, 2018 Operating Leases (a) Finance Leases (a) Total 2018 $ 48,701 $ 454 $ 49,155 2019 49,595 174 49,769 2020 50,570 173 50,743 2021 51,587 127 51,714 2022 52,624 — 52,624 After 2022 245,225 — 245,225 Total lease payments $ 498,302 $ 928 $ 499,230 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The measurement of right-of-use assets and lease liabilities requires the Company to estimate appropriate discount rates. To the extent the rate implicit in the lease is readily determinable, such rate is utilized. However, based on information available at lease commencement for the majority of our leases, the rate implicit in the lease is not known. In these instances, the Company utilizes an incremental borrowing rate, which represents the rate of interest that it would pay to borrow on a collateralized basis over a similar term. Lease Term and Discount Rate September 30, 2019 Weighted-average remaining lease term (years) Operating leases 9.04 Finance leases 2.02 Weighted-average discount rate Operating leases 8.9% Finance leases 5.5% Other Information Nine Months Ended September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows for operating leases $ 42,816 Operating cash flows for finance leases $ 37 Financing cash flows for finance leases $ 373 Acquisition of operating leases though adoption of ASC 842 $ 389,403 Lease modification $ (48,877 )
LEASES	LEASES The Company has operating and finance leases for facilities, corporate offices, and certain equipment. The Company recognizes lease expense for these operating leases on a straight-line basis over the lease term. Leases with an initial term of one year or less are not recorded on the balance sheet. The Company's other leases have original lease terms of one to twelve years, some of which include options to extend the lease for up to twenty years, and some of which include options to terminate the leases within one year. The exercise of lease renewal options is at our sole discretion. The Company's lease agreements do not contain any material residual value guarantees or material restrictive covenants. Upon adoption of Topic 842, the Company elected the practical expedient to not separate lease and non-lease components for all of its leases as the non-lease components are not significant to the overall lease costs. Leases Classification September 30, 2019 Assets Operating lease assets Operating lease assets $ 316,626 Finance lease assets Property and equipment, net (a) 972 Total leased assets $ 317,598 Liabilities Current Operating Current portion of operating lease liabilities $ 22,986 Finance Current portion of long-term debt and finance lease obligations, net 273 Noncurrent Operating Operating lease liabilities 301,905 Finance Long-term debt and finance lease obligations, less current portion and deferred financing costs, net 508 Total lease liabilities $ 325,672 (a) Finance lease assets are recorded net of accumulated amortization of $1,456 as of September 30, 2019. Lease Cost Three Months Ended Nine Months Ended Classification September 30, 2019 September 30, 2019 Operating lease cost (a) Lease and rent expense $ 13,251 $ 39,480 Finance lease cost: Amortization of finance lease assets Depreciation and amortization 54 196 Interest on finance lease liabilities Interest expense, net 11 37 Short term lease cost Operating expense 169 472 Net lease cost $ 13,485 $ 40,185 (a) Includes variable lease costs, which are immaterial Maturity of Lease Liabilities As of September 30, 2019 Operating Leases (a) Finance Leases (a) Total 2019 $ 50,592 $ 313 $ 50,905 2020 51,533 243 51,776 2021 52,553 206 52,759 2022 53,593 65 53,658 2023 53,897 27 53,924 After 2023 214,168 — 214,168 Total lease payments $ 476,336 $ 854 $ 477,190 Less: Interest (151,445 ) (73 ) (151,518 ) Present value of lease liabilities $ 324,891 $ 781 $ 325,672 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The Company's future minimum lease commitments for continuing operations as of December 31, 2018, under Accounting Standards Codification Topic 840, predecessor to Topic 842, are as follows: As of December 31, 2018 Operating Leases (a) Finance Leases (a) Total 2018 $ 48,701 $ 454 $ 49,155 2019 49,595 174 49,769 2020 50,570 173 50,743 2021 51,587 127 51,714 2022 52,624 — 52,624 After 2022 245,225 — 245,225 Total lease payments $ 498,302 $ 928 $ 499,230 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The measurement of right-of-use assets and lease liabilities requires the Company to estimate appropriate discount rates. To the extent the rate implicit in the lease is readily determinable, such rate is utilized. However, based on information available at lease commencement for the majority of our leases, the rate implicit in the lease is not known. In these instances, the Company utilizes an incremental borrowing rate, which represents the rate of interest that it would pay to borrow on a collateralized basis over a similar term. Lease Term and Discount Rate September 30, 2019 Weighted-average remaining lease term (years) Operating leases 9.04 Finance leases 2.02 Weighted-average discount rate Operating leases 8.9% Finance leases 5.5% Other Information Nine Months Ended September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows for operating leases $ 42,816 Operating cash flows for finance leases $ 37 Financing cash flows for finance leases $ 373 Acquisition of operating leases though adoption of ASC 842 $ 389,403 Lease modification $ (48,877 )
LEASES	LEASES The Company has operating and finance leases for facilities, corporate offices, and certain equipment. The Company recognizes lease expense for these operating leases on a straight-line basis over the lease term. Leases with an initial term of one year or less are not recorded on the balance sheet. The Company's other leases have original lease terms of one to twelve years, some of which include options to extend the lease for up to twenty years, and some of which include options to terminate the leases within one year. The exercise of lease renewal options is at our sole discretion. The Company's lease agreements do not contain any material residual value guarantees or material restrictive covenants. Upon adoption of Topic 842, the Company elected the practical expedient to not separate lease and non-lease components for all of its leases as the non-lease components are not significant to the overall lease costs. Leases Classification September 30, 2019 Assets Operating lease assets Operating lease assets $ 316,626 Finance lease assets Property and equipment, net (a) 972 Total leased assets $ 317,598 Liabilities Current Operating Current portion of operating lease liabilities $ 22,986 Finance Current portion of long-term debt and finance lease obligations, net 273 Noncurrent Operating Operating lease liabilities 301,905 Finance Long-term debt and finance lease obligations, less current portion and deferred financing costs, net 508 Total lease liabilities $ 325,672 (a) Finance lease assets are recorded net of accumulated amortization of $1,456 as of September 30, 2019. Lease Cost Three Months Ended Nine Months Ended Classification September 30, 2019 September 30, 2019 Operating lease cost (a) Lease and rent expense $ 13,251 $ 39,480 Finance lease cost: Amortization of finance lease assets Depreciation and amortization 54 196 Interest on finance lease liabilities Interest expense, net 11 37 Short term lease cost Operating expense 169 472 Net lease cost $ 13,485 $ 40,185 (a) Includes variable lease costs, which are immaterial Maturity of Lease Liabilities As of September 30, 2019 Operating Leases (a) Finance Leases (a) Total 2019 $ 50,592 $ 313 $ 50,905 2020 51,533 243 51,776 2021 52,553 206 52,759 2022 53,593 65 53,658 2023 53,897 27 53,924 After 2023 214,168 — 214,168 Total lease payments $ 476,336 $ 854 $ 477,190 Less: Interest (151,445 ) (73 ) (151,518 ) Present value of lease liabilities $ 324,891 $ 781 $ 325,672 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The Company's future minimum lease commitments for continuing operations as of December 31, 2018, under Accounting Standards Codification Topic 840, predecessor to Topic 842, are as follows: As of December 31, 2018 Operating Leases (a) Finance Leases (a) Total 2018 $ 48,701 $ 454 $ 49,155 2019 49,595 174 49,769 2020 50,570 173 50,743 2021 51,587 127 51,714 2022 52,624 — 52,624 After 2022 245,225 — 245,225 Total lease payments $ 498,302 $ 928 $ 499,230 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The measurement of right-of-use assets and lease liabilities requires the Company to estimate appropriate discount rates. To the extent the rate implicit in the lease is readily determinable, such rate is utilized. However, based on information available at lease commencement for the majority of our leases, the rate implicit in the lease is not known. In these instances, the Company utilizes an incremental borrowing rate, which represents the rate of interest that it would pay to borrow on a collateralized basis over a similar term. Lease Term and Discount Rate September 30, 2019 Weighted-average remaining lease term (years) Operating leases 9.04 Finance leases 2.02 Weighted-average discount rate Operating leases 8.9% Finance leases 5.5% Other Information Nine Months Ended September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows for operating leases $ 42,816 Operating cash flows for finance leases $ 37 Financing cash flows for finance leases $ 373 Acquisition of operating leases though adoption of ASC 842 $ 389,403 Lease modification $ (48,877 )

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	9 Months Ended
	Sep. 30, 2019
Health Care Organizations [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES Professional Liability and Other Liability Insurance The Company has professional liability insurance coverage for its nursing centers that, based on historical claims experience, is likely to be substantially less than the claims that are expected to be incurred. Effective July 1, 2013, the Company established a wholly-owned, offshore limited purpose insurance subsidiary, SHC Risk Carriers, Inc. (“SHC”), to replace some of the expiring commercial policies. SHC covers losses up to specified limits per occurrence. All of the Company's nursing centers in Florida, and Tennessee are now covered under the captive insurance policies along with many of the nursing centers in Alabama, Kentucky, and Texas. The insurance coverage provided for these centers under the SHC policy provides coverage limits of at least $1,000 per medical incident with a sublimit per center of $3,000 and total annual aggregate policy limits of $5,000 . All other centers within the Company's portfolio are covered through various commercial insurance policies which provide similar coverage limits per medical incident, per location, and on an aggregate basis for covered centers. The deductibles for these policies are covered through the insurance subsidiary. Reserve for Estimated Self-Insured Professional Liability Claims Because the Company’s actual liability for existing and anticipated professional liability and general liability claims will likely exceed the Company’s limited insurance coverage, the Company has recorded total liabilities for reported and estimated future claims of $26,680 and $27,201 as of September 30, 2019 and December 31, 2018 , respectively. This accrual includes estimates of liability for incurred but not reported claims, estimates of liability for reported but unresolved claims, actual liabilities related to settlements, including settlements to be paid over time, and estimates of legal costs related to these claims. All losses are projected on an undiscounted basis and are presented without regard to any potential insurance recoveries. Amounts are added to the accrual for estimates of anticipated liability for claims incurred during each period, and amounts are deducted from the accrual for settlements paid on existing claims during each period. The Company evaluates the adequacy of this liability on a quarterly basis. Semi-annually, the Company retains a third-party actuarial firm to assist in the evaluation of this reserve. Since May 2012, Merlinos & Associates, Inc. (“Merlinos”) has assisted management in the preparation of the appropriate accrual for incurred but not reported general and professional liability claims based on data furnished as of May 31 and November 30 of each year. Merlinos primarily utilizes historical data regarding the frequency and cost of the Company's past claims over a multi-year period, industry data and information regarding the number of occupied beds to develop its estimates of the Company's ultimate professional liability cost for current periods. On a quarterly basis, the Company obtains reports of asserted claims and lawsuits incurred. These reports, which are provided by the Company’s insurers and a third-party claims administrator, contain information relevant to the actual expense already incurred with each claim as well as the third-party administrator’s estimate of the anticipated total cost of the claim. This information is reviewed by the Company quarterly and provided to the actuary semi-annually. Based on the Company’s evaluation of the actual claim information obtained, the semi-annual estimates received from the third-party actuary, the amounts paid and committed for settlements of claims and on estimates regarding the number and cost of additional claims anticipated in the future, the reserve estimate for a particular period may be revised upward or downward on a quarterly basis. Any increase in the accrual decreases results of operations in the period and any reduction in the accrual increases results of operations during the period. As of September 30, 2019 , the Company is engaged in 91 professional liability lawsuits. Thirty-one lawsuits are currently scheduled for trial or arbitration during the next twelve months, and it is expected that additional cases will be set for trial or hearing. The Company’s cash expenditures for self-insured professional liability costs were $5,398 and $5,088 for the nine months ended September 30, 2019 and 2018 , respectively. The Company follows the accounting guidance in ASC Topic 954 that clarifies that a health care entity should not net insurance recoveries against a related professional liability claim and that the amount of the claim liability should be determined without consideration of insurance recoveries. Accordingly, the estimated insurance recovery receivables are included within "Self-insurance receivables" on the Consolidated Balance Sheet. As of September 30, 2019 and December 31, 2018 there are estimated insurance recovery receivables of $2,305 and $5,475 , respectively. Although the Company adjusts its accrual for professional and general liability claims on a quarterly basis and retains a third-party actuarial firm semi-annually to assist management in estimating the appropriate accrual, professional and general liability claims are inherently uncertain, and the liability associated with anticipated claims is very difficult to estimate. Professional liability cases have a long cycle from the date of an incident to the date a case is resolved, and final determination of the Company’s actual liability for claims incurred in any given period is a process that takes years. As a result, the Company’s actual liabilities may vary significantly from the accrual, and the amount of the accrual has and may continue to fluctuate by a material amount in any given period. Each change in the amount of this accrual will directly affect the Company’s reported earnings and financial position for the period in which the change in accrual is made. Civil Investigative Demand ("CID") In July 2013, the Company learned that the United States Attorney for the Middle District of Tennessee ("DOJ") had commenced a civil investigation of potential violations of the False Claims Act ("FCA"). In October 2014, the Company learned that the investigation was started by the filing under seal of a false claims action against the two centers that were subject of the original civil investigative demand ("CID"). In connection with this matter, between July 2013 and early February 2016, the Company received three civil investigative demands (a form of subpoena) for documents. The Company responded to those demands and also provided voluntarily additional information requested by the DOJ. The DOJ also obtained testimony from current and former employees of the Company. In May 2018, the Company learned that a second FCA complaint had been filed in late 2016 relating to the Company’s practices and policies for rehabilitation therapy at some of its facilities. The government’s investigation relates to the Company’s practices and policies for rehabilitation and other services at all of its facilities, for preadmission evaluation forms ("PAEs") required by TennCare and for Pre-Admission Screening and Resident Reviews ("PASRRs") required by the Medicare program. In June, 2019, the Company and the DOJ reached an agreement in principle on the financial terms of a settlement regarding this investigation. The Company has agreed to the settlement in principle in order to avoid the uncertainty and expense of litigation. Based on the agreement in principle and in anticipation of the execution of final agreements and payment of a settlement amount of $9,500 (the “Settlement Amount”) the Company recorded an additional loss contingency expense in the amount of $3,100 in the second quarter of 2019, to increase its previously estimated and recorded liability related to this investigation, of which based on the payment terms of the settlement in principle, $500 has been recorded as a current liability. The Company expects to remit the Settlement Amount to the government over a period of five (5) years, once the settlement has been fully documented and executed, and further expects the settlement to require a contingent payment in the event the Company sells any of its owned facilities during the five year payment period and a payment of attorneys' fees to relator's counsel. The agreement in principle is subject to negotiation, completion and execution of appropriate implementing agreements, including a settlement agreement and a corporate integrity agreement, which are expected to be finalized prior to the end of 2019, and the final approval of the respective parties. There can be no assurance that the Company will enter into a final settlement agreement with the DOJ. The Company denies any wrong doing and is prepared to vigorously defend its actions if a settlement is not reached. Other Insurance With respect to workers’ compensation insurance, substantially all of the Company’s employees became covered under either a prefunded deductible policy or state-sponsored programs. The Company has been and remains a non-subscriber to the Texas workers’ compensation system and is, therefore, completely self-insured for employee injuries with respect to its Texas operations. From June 30, 2003 until June 30, 2007, the Company’s workers’ compensation insurance programs provided coverage for claims incurred with premium adjustments depending on incurred losses. From the period from July 1, 2008 through September 30, 2019 , the Company is covered by a prefunded deductible policy. Under this policy, the Company is self-insured for the first $500 per claim, subject to an aggregate maximum of $3,000 . The Company funds a loss fund account with the insurer to pay for claims below the deductible. The Company accounts for premium expense under this policy based on its estimate of the level of claims subject to the policy deductibles expected to be incurred. The liability for workers’ compensation claims is $806 and $618 at September 30, 2019 and December 31, 2018 , respectively. The Company has a non-current receivable for workers’ compensation policies covering previous years of $1,538 and $1,258 as of September 30, 2019 and December 31, 2018 , respectively. The non-current receivable is a function of payments paid to the Company’s insurance carrier in excess of the estimated level of claims expected to be incurred. As of September 30, 2019 , the Company is self-insured for health insurance benefits for certain employees and dependents for amounts up to $200 per individual annually. The Company provides reserves for the settlement of outstanding self-insured health claims at amounts believed to be adequate. The liability for reported claims and estimates for incurred but unreported claims is $1,756 at September 30, 2019 . The differences between actual settlements and reserves are included in expense in the period finalized.

STOCK-BASED COMPENSATION

STOCK-BASED COMPENSATION	9 Months Ended
	Sep. 30, 2019
Share-based Payment Arrangement [Abstract]
STOCK-BASED COMPENSATION	STOCK-BASED COMPENSATION Overview of Plans In June 2008, the Company adopted the Advocat Inc. 2008 Stock Purchase Plan for Key Personnel (“Stock Purchase Plan”). The Stock Purchase Plan provides for the granting of rights to purchase shares of the Company's common stock to directors and officers. The Stock Purchase Plan allows participants to elect to utilize a specified portion of base salary, annual cash bonus, or director compensation to purchase restricted shares or restricted share units (“RSU's”) at 85% of the quoted market price of a share of the Company's common stock on the date of purchase. The restriction period under the Stock Purchase Plan is generally two years from the date of purchase and during which the shares will have the rights to receive dividends, however, the restricted share certificates will not be delivered to the shareholder and the shares cannot be sold, assigned or disposed of during the restriction period. In June 2016, our shareholders approved an amendment to the Stock Purchase Plan to increase the number of shares of our common stock authorized under the Plan from 150 shares to 350 shares. No grants can be made under the Stock Purchase Plan after April 25, 2028. In April 2010, the Compensation Committee of the Board of Directors adopted the 2010 Long-Term Incentive Plan (“2010 Plan”), followed by approval by the Company's shareholders in June 2010. The 2010 Plan allows the Company to issue stock appreciation rights, stock options and other share and cash based awards. In June 2017, our shareholders approved an amendment to the 2010 Plan to increase the number of shares of our common stock authorized under the 2010 Plan from 380 shares to 680 shares. No grants can be made under the 2010 Plan after May 31, 2027. Equity Grants and Valuations During the nine months ended September 30, 2019 and 2018 , the Compensation Committee of the Board of Directors approved grants totaling approximately 151 and 90 shares of restricted common stock to certain employees and members of the Board of Directors, respectively. The fair value of restricted shares is determined as the quoted market price of the underlying common shares at the date of the grant. The restricted shares typically vest one-third on the first, second and third anniversaries of the grant date. Unvested shares may not be sold or transferred. During the vesting period, dividends accrue on the restricted shares, but are paid in additional shares of common stock upon vesting, subject to the vesting provisions of the underlying restricted shares. The restricted shares are entitled to the same voting rights as other common shares. In computing the fair value estimates for options and stock-only stock appreciation rights ("SOSARs") using the Black-Scholes-Merton valuation method, the Company took into consideration the exercise price of the equity grants and the market price of the Company's stock on the date of grant. The Company used an expected volatility that equals the historical volatility over the most recent period equal to the expected life of the equity grants. The risk free interest rate is based on the U.S. treasury yield curve in effect at the time of grant. The Company used the expected dividend yield at the date of grant, reflecting the level of annual cash dividends currently being paid on its common stock. Upon vesting of equity awards, all restrictions are removed. Our policy is to account for forfeitures of share-based compensation awards as they occur. Summarized activity of the equity compensation plans is presented below: Weighted Options/ Average SOSARs Exercise Price Outstanding, December 31, 2018 122 $ 7.29 Granted — — Exercised (2 ) 2.37 Expired or cancelled (22 ) 8.33 Outstanding, September 30, 2019 98 $ 7.17 Exercisable, September 30, 2019 89 $ 7.05 Weighted Average Restricted Grant Date Shares Fair Value Outstanding, December 31, 2018 120 $ 8.77 Granted 151 3.93 Vested (58 ) 8.91 Cancelled (7 ) 5.97 Outstanding, September 30, 2019 206 $ 5.28 Summarized activity of the Restricted Share Units for the Stock Purchase Plan is as follows: Weighted Average Restricted Grant Date Share Units Fair Value Outstanding, December 31, 2018 43 $ 9.26 Granted 36 3.93 Vested (30 ) 9.76 Outstanding, September 30, 2019 49 $ 5.05 The SOSARs and Options were valued and recorded in the same manner, and, other than amounts that may be settled pursuant to employment agreements with certain members of management, will be settled with issuance of new stock for the difference between the market price on the date of exercise and the exercise price. The Company estimated the total recognized and unrecognized compensation related to SOSARs and stock options using the Black-Scholes-Merton equity grant valuation model. The following table summarizes information regarding stock options and SOSAR grants outstanding as of September 30, 2019 : Weighted Average Intrinsic Intrinsic Range of Exercise Grants Value-Grants Grants Value-Grants Exercise Prices Prices Outstanding Outstanding Exercisable Exercisable $8.14 to $10.21 $ 8.83 45 $ — 35 $ — $5.45 to $5.86 $ 5.76 54 $ — 54 $ — 99 89 Stock-based compensation expense is non-cash and is included as a component of general and administrative expense or operating expense based upon the classification of cash compensation paid to the related employees. The Company recorded total stock-based compensation expense of $429 and $947 in the nine month periods ended September 30, 2019 and 2018 , respectively.

INCOME TAXES

INCOME TAXES	9 Months Ended
	Sep. 30, 2019
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company recorded an income tax provision of $15,544 during the nine months ended September 30, 2019 and a benefit of $903 during the nine months ended September 30, 2018 . When assessing the recoverability of the Company’s recorded deferred tax assets, the accounting guidance, ASC 740, Income Taxes , requires that all available positive and negative evidence be considered in evaluating the likelihood that the Company will be able to realize the benefit of its deferred tax assets in the future, which is highly judgmental. Such evidence includes, but may not be limited to, scheduled reversals of deferred tax assets and liabilities, projected future taxable income, tax-planning strategies, and the results of recent operations. When assessing all available evidence, the Company recognized that governmental and regulatory changes have put downward revenue pressure on the long-term care industry as a piece of negative evidence in its analysis. In 2019 and 2018 combined, the Company recognized a total expense of $9.5 million related to the CID settlement in principle. Additionally, in 2017 it recorded an additional $5.5 million of income tax expense related to the revaluation of deferred tax assets in accordance with the Tax Cuts and Jobs Act. Because of these items and other financial results, the Company entered a cumulative loss for the 36 preceding months ended June 30, 2019 and performed a thorough assessment of the available positive and negative evidence in order to ascertain whether it is more likely than not that in future periods the Company will generate sufficient pre-tax income to utilize all of its federal deferred tax assets and its net operating loss and other carryforwards and credits. The Company also identified several pieces of positive evidence that were considered and weighed in the analysis performed regarding the valuation of deferred tax assets. The evidence included the termination of operations for 10 nursing facilities in Kentucky completed in the third quarter of 2019, the related corporate and regional restructuring and other cost saving initiatives already in process. The evidence also included consideration of participation in revenue incentive programs that are expected to generate additional revenue, the long-term expiration dates of a majority of the net operating losses and credits, and the Company’s history of not having carryforwards or credits expire unutilized. In performing the analysis, the Company contemplated utilization of the recorded deferred tax assets under multiple scenarios. After consideration of these factors, the Company determined that a full valuation allowance of $20.0 million was necessary as of June 30, 2019. As of September 30, 2019, the Company has a valuation allowance in the amount of $21.1 million . The Company will continue to periodically assess the realizability of its future deferred tax assets. The Company is not currently under examination by any major income tax jurisdiction. During 2019, the statutes of limitations will lapse on the Company's 2015 Federal tax year and certain 2014 and 2015 state tax years. The Company does not believe the Federal or state statute lapses or any other event will significantly impact the balance of unrecognized tax benefits in the next twelve months. The net balance of unrecognized tax benefits was not material to the Interim Financial Statements for the nine months ended September 30, 2019 and 2018 .

EARNINGS PER COMMON SHARE

EARNINGS PER COMMON SHARE	9 Months Ended
	Sep. 30, 2019
Earnings Per Share [Abstract]
EARNINGS PER COMMON SHARE	EARNINGS PER COMMON SHARE Information with respect to basic and diluted net loss per common share is presented below in thousands, except per share: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net loss Loss from continuing operations $ (1,918 ) $ (7,462 ) $ (26,100 ) $ (8,375 ) Income (loss) from discontinued operations, net of income taxes (2,956 ) 65 (6,716 ) 564 Net loss $ (4,874 ) $ (7,397 ) $ (32,816 ) $ (7,811 ) Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net loss per common share: Per common share – basic Loss from continuing operations $ (0.30 ) $ (1.17 ) $ (4.04 ) $ (1.32 ) Income (loss) from discontinued operations (0.45 ) 0.01 (1.04 ) 0.09 Net loss per common share – basic $ (0.75 ) $ (1.16 ) $ (5.08 ) $ (1.23 ) Per common share – diluted Loss from continuing operations $ (0.30 ) $ (1.17 ) $ (4.04 ) $ (1.32 ) Income (loss) from discontinued operations (0.45 ) 0.01 (1.04 ) 0.09 Net loss per common share – diluted $ (0.75 ) $ (1.16 ) $ (5.08 ) $ (1.23 ) Weighted Average Common Shares Outstanding: Basic 6,470 6,400 6,455 6,362 Diluted 6,470 6,400 6,455 6,362 The effects of 98 and 226 SOSARs and options outstanding were excluded from the computation of diluted earnings per common share in the nine months ended September 30, 2019 and 2018 , respectively, because these securities would have been anti-dilutive.

BUSINESS DEVELOPMENTS AND OTHER

BUSINESS DEVELOPMENTS AND OTHER SIGNIFICANT TRANSACTIONS	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
BUSINESS DEVELOPMENTS AND OTHER SIGNIFICANT TRANSACTIONS	BUSINESS DEVELOPMENTS AND OTHER SIGNIFICANT TRANSACTIONS 2018 New Master Lease Agreement On October 1, 2018, the Company entered into a New Master Lease Agreement (the "Lease") with Omega Healthcare Investors (the "Lessor") to lease 34 centers currently owned by the Lessor and operated by Diversicare. The old Master Lease with the Lessor provided for its operation of 23 skilled nursing centers in Texas, Kentucky, Alabama, Tennessee, Florida, and Ohio. Additionally, Diversicare operated 11 centers owned by the Lessor under separate leases in Missouri, Kentucky, Indiana, and Ohio. The Lease entered into by Diversicare and the Lessor consolidated the leases for all 34 centers under one New Master Lease. The Lease has an initial term of twelve years with two optional 10 -year extensions. The Lease has a common date of annual lease fixed escalators of 2.15% beginning on October 1, 2019. On August 30, 2019, the Company terminated operations of ten centers in Kentucky and concurrently transferred operations to a new operator. The agreement effectively amended the Master Lease Agreement with Omega Healthcare Investors to remove the ten Kentucky facilities, reduce the annual rent expense, and release the Company from any further obligations arising under the Master Lease Agreement with respect to the Kentucky facilities. The remaining Lease terms remain unchanged with an initial term of twelve years and two optional 10 -year extensions. The annual lease fixed escalator remains at 2.15% beginning on October 1, 2019. Quality Incentive Payment Program The Company recently expanded its participation in QIPP as administered by the Texas Health and Human Services Commission. QIPP provides supplemental Medicaid payments for skilled nursing centers that achieve certain quality measures. The Company previously had one of its Texas skilled nursing centers participating in the QIPP. During April 2019, the Company enrolled an additional eleven of its Texas skilled nursing centers in the program, such that twelve of the Company’s centers participate in the QIPP effective September 1, 2019. To allow four of these centers to meet the QIPP participation requirements, the Company entered into a transaction with a Texas medical district already participating in the QIPP, providing for the transfer of the provider license from the Company to the medical district. The Company’s operating subsidiary retained the management of the centers on behalf of the medical district.

DISCONTINUED OPERATIONS (Notes)

DISCONTINUED OPERATIONS (Notes)	9 Months Ended
	Sep. 30, 2019
Discontinued Operations and Disposal Groups [Abstract]
DISCONTINUED OPERATIONS	DISCONTINUED OPERATIONS Kentucky Disposition On October 30, 2018 the Company entered into an Asset Purchase Agreement (the "Agreement") with Fulton Nursing and Rehabilitation, LLC, Holiday Fulton Propco LLC, Birchwood Nursing and Rehabilitation LLC, Padgett Clinton Propco LLC, Westwood Nursing and Rehabilitation LLC, and Westwood Glasgow Propco (the "Buyers") to sell the assets and transfer the operations of Diversicare of Fulton, LLC, Diversicare of Clinton, LLC and Diversicare of Glasgow, LLC (the "Kentucky Properties"). On December 1, 2018, the Company completed the sale of the Kentucky Properties with the Buyers for a purchase price of $18,700 . This transaction did not meet the accounting criteria to be reported as a discontinued operation. The carrying value of these centers' assets was $13,331 , resulting in a gain of $4,825 , with remaining proceeds for miscellaneous closing costs. The proceeds were used to relieve debt, which is required under the terms of the Company's Amended Mortgage Loan and Amended Revolver. Refer to Note 5, "Long-term Debt and Interest Rate Swap" for more information on this transaction. On May 22, 2019, the Company announced that it entered into an agreement with Omega to amend its master lease to terminate operations of ten nursing facilities, totaling approximately 885 skilled nursing beds, located in Kentucky and to concurrently transfer operations to an operator selected by Omega. These ten centers are collectively referred to as the "Kentucky Centers." The sale of the Kentucky Properties and the termination of operations at the Kentucky Centers are referred to collectively as the "Kentucky Exit." On August 30, 2019, the Company completed the transaction and no longer operates any skilled nursing centers in the State of Kentucky. The sale of the Kentucky Properties and the termination of operations at the Kentucky Centers are referred to collectively as the "Kentucky Exit." The Company's exit from the state represents a strategic shift that has (or will have) a major effect on the Company's operations and financial results. In accordance with ASC 205, the Company's discontinued financial position, results of operations and cash flows have been reclassified on the face of the financial statements and footnotes for all periods presented to reflect the discontinued status of these operations. The transaction resulted in a gain on the modification of the Omega lease, which is presented within Discontinued Operations on the Consolidated Statements of Operations. The pretax gain on the transaction was $733 . The net income or loss for the nursing centers included in discontinued operations does not reflect any allocation of corporate general and administrative expense or any allocation of corporate interest expense. The Company considered these additional costs along with the centers' future prospects based upon operating history when determining the contribution of the skilled nursing centers to its operations. The discontinued assets and liabilities of the disposed skilled nursing centers have been reclassified and are segregated in the interim consolidated balance sheets as assets and liabilities of discontinued operations.The Company did not transfer the accounts receivable or liabilities, inclusive of the reserves for professional liability and workers' compensation, to the new operator. The Company expects to collect the balance of the accounts receivable and pay the remaining liabilities in the ordinary course of business through its future operating cash flows. A summary of the Kentucky Exit discontinued operations follows: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 PATIENT REVENUES, net $ 11,812 $ 22,396 $ 46,019 $ 66,392 EXPENSES: Operating 9,229 18,031 36,947 52,694 Lease and rent expense 1,792 1,704 7,169 5,097 Professional liability 2,468 1,329 5,401 3,992 General and administrative 259 664 985 1,925 Depreciation and amortization 1,287 302 2,250 1,006 Operating income (loss) (3,223 ) 366 (6,733 ) 1,678 Other income 728 36 736 2 Interest expense, net (2 ) (284 ) (149 ) (849 ) Income (loss) from discontinued operations before taxes (2,497 ) 118 (6,146 ) 831 Income tax (expense) benefit (459 ) (45 ) (570 ) (233 ) Income (loss) from discontinued operations, net of tax $ (2,956 ) $ 73 $ (6,716 ) $ 598 A summary of other discontinued operations follows: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Loss from discontinued operations before taxes — (8 ) — (45 ) Income tax benefit — — — 11 Loss from discontinued operations, net of tax $ — $ (8 ) $ — $ (34 ) A summary of cash inflows and outflows related to the the Kentucky Exit discontinued operations follows: Nine Months Ended September 30, 2019 2018 Net cash provided by (used in) operating activities (5,130 ) 1,153 Net cash provided by (used in) investing activities 6 (1,275 )

CONSOLIDATION AND BASIS OF PR_2

CONSOLIDATION AND BASIS OF PRESENTATION OF FINANCIAL STATEMENTS (Policies)	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Accounting	The interim consolidated financial statements for the three and nine month periods ended September 30, 2019 and 2018 , included herein have been prepared by the Company, without audit, pursuant to the rules and regulations of the Securities and Exchange Commission. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles in the United States of America ("GAAP") have been condensed or omitted pursuant to such rules and regulations. In the opinion of management of the Company, the accompanying interim consolidated financial statements reflect all normal, recurring adjustments necessary to present fairly the Company’s financial position at September 30, 2019 , and the results of operations, and changes in shareholders' deficit for the three and nine month periods ended September 30, 2019 and 2018 , and cash flows for the nine month period ended September 30, 2019 and 2018 . The Company’s balance sheet information at December 31, 2018 , was derived from its audited consolidated financial statements as of December 31, 2018 . Effective January 1, 2019, we adopted the requirements of Accounting Standards Update ("ASU") No. 2016-02, Leases (Topic 842), as discussed in Notes 3 and 6 to the interim consolidated financial statements. Effective January 1, 2018, we adopted the requirements of ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), as discussed in Notes 3 and 4 to the interim consolidated financial statements. All amounts and disclosures set forth in this Form 10-Q have been updated to comply with the new standards. The results of operations for the periods ended September 30, 2019 and 2018 are not necessarily indicative of the operating results that may be expected for a full year. These interim consolidated financial statements should be read in connection with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2018 .
Discontinued Operations	In accordance with ASC 205, the Company's discontinued operating results have been reclassified on the face of the financial statements and footnotes for all periods presented to reflect the discontinued status of these operations.
Recent Accounting Standards Adopted and Not Adopted by the Company	Recent Accounting Standards Adopted by the Company In February 2016, the Financial Accounting Standards Board ("FASB") issued ASU No. 2016-02, Leases (Topic 842). The standard establishes a right-of-use ("ROU") model that requires a lessee to record a ROU asset and a lease liability on the balance sheet. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. For short-term leases (those with a term of 12 months or less and that do not include a lessee purchase option that is reasonably certain to be exercised), a lessee is permitted to make (and the Company chose to utilize) an accounting policy election by asset class not to recognize ROU assets and lease liabilities, which would generally result in lease expense for these short term leases being recognized on a straight-line basis over the lease term. The standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. The Company adopted the requirements of this standard effective January 1, 2019. In July 2018, the FASB issued ASU 2018-11, Leases - Targeted Improvements, which allows lessees and lessors to recognize and measure existing leases at the beginning of the period of adoption without modifying the comparative period financial statements (which therefore will remain under prior GAAP, Topic 840, Leases). The Company elected to use the optional expedient to reflect adoption in the period of adoption (January 1, 2019) rather than the earliest period presented. The Company also elected the package of practical expedients upon transition, which includes retaining the lease classification for any leases that exist prior to adoption of the standard. The adoption of the new standard resulted in the recording of net lease assets and lease liabilities of $384,187 and $389,403 , respectively, as of January 1, 2019. The standard did not materially impact our consolidated net earnings and had no impact on cash flows. See Note 6, "Leases" for a discussion regarding leases under the new standard. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities, which is intended to simplify and amend the application of hedge accounting to more clearly portray the economics of an entity’s risk management strategies in its financial statements. The new guidance will make more financial and nonfinancial hedging strategies eligible for hedge accounting and reduce complexity in fair value hedges of interest rate risk. The new guidance also changes how companies assess effectiveness and amends the presentation and disclosure requirements. The new guidance eliminates the requirement to separately measure and report hedge ineffectiveness and generally the entire change in the fair value of a hedging instrument will be required to be presented in the same income statement line as the hedged item. The new guidance also eases certain documentation and assessment requirements and modifies the accounting for components excluded from the assessment of hedge effectiveness. The new guidance is effective for public entities for fiscal years beginning after December 15, 2018, including interim periods within those years. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In October 2018, the FASB issued ASU No. 2018-16, Derivatives and Hedging (Topic 805): Inclusion of the Secured Overnight Financing Rate ("SOFR") Overnight Index Swap ("OIS") Rate as a Benchmark Interest Rate for Hedge Accounting Purposes. The ASU amends ASC 815 to add the OIS rate based on the SOFR as a fifth US benchmark interest rate. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In February 2018, the FASB issued ASU No. 2018-02, Income Statement- Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income. The new guidance allows entities the option to reclassify stranded tax effects resulting from the Tax Cuts and Jobs Act from accumulated other comprehensive income (OCI) to retained earnings. The new guidance allows the option to apply the guidance retrospectively or in the period of adoption. The guidance is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In June 2018, the FASB issued ASU No. 2018-07, Compensation-Stock Compensation (Topic 718): Improvement to Nonemployee Share-Based Payment Accounting, which modifies the accounting for share-based payment awards issued to nonemployees to largely align it with the accounting for share-based payment awards issued to employees. The standard is effective for fiscal years beginning after December 15, 2018. The Company adopted the requirements of this standard effective January 1, 2019. The adoption did not have a material impact on our consolidated financial statements and related disclosures. In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. The new guidance is effective for annual and interim reporting periods beginning after December 15, 2017. The Company adopted the requirements of this standard effective January 1, 2018. The Company elected to apply the modified retrospective approach with the cumulative transition effect recognized in beginning retained earnings as of the date of adoption. The adoption of ASC 606 represents a change in accounting principle that more closely aligns revenue recognition with the delivery of the Company's services. The cumulative effect of applying the new guidance to all contracts with customers as of January 1, 2018 was not material to the interim consolidated financial statements. See Note 4, "Revenue Recognition" for a discussion regarding revenue recognition under the new standard. Accounting Standards Recently Issued But Not Yet Adopted by the Company In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The new guidance intends to improve financial reporting by requiring timelier recognition of credit losses on loans and other financial instruments that are not accounted for at fair value through net income, including loans held for investment, held-to-maturity debt securities, trade and other receivables, net investment in leases and other such commitments. This update requires that financial statement assets measured at an amortized cost be presented at the net amount expected to be collected, through an allowance for credit losses that is deducted from the amortized cost basis. This standard is effective for the fiscal year beginning after December 15, 2022 with early adoption permitted. The Company is in the initial stages of evaluating the impact from the adoption of this new standard on the consolidated financial statements and related disclosures. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurements (Topic 820): Disclosure Framework- Changes to the Disclosure Requirements for Fair Value Measurement. The amendments in this update modify the disclosure requirements of fair value measurements under Topic 820. The standard is effective for fiscal years beginning after December 15, 2019. Early adoption is permitted. The Company is evaluating the effect this guidance will have on our consolidated financial statements and related disclosures.
Revenue Recognition	On January 1, 2018, the Company adopted Accounting Standards Codification ("ASC") 606 using the modified retrospective method for all contracts as of the date of adoption. The adoption of ASC 606 represents a change in accounting principle that more closely aligns revenue recognition with the delivery of the Company's services. The cumulative effect of applying the new guidance to all contracts with customers as of January 1, 2018 was not material to the interim consolidated financial statements. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these services. Performance obligations are promises made in a contract to transfer a distinct good or service to the customer. A contract's transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. The Company has concluded that the contracts with patients and residents represent a bundle of distinct services that are substantially the same, with the same pattern of transfer to the customer. Accordingly, the promise to provide quality care is accounted for as a single performance obligation. The Company performed analyses using the application of the portfolio approach as a practical expedient to group patient contracts with similar characteristics, such that revenue for a given portfolio would not be materially different than if it were evaluated on a contract-by-contract basis. These analyses incorporated consideration of reimbursements at varying rates from Medicaid, Medicare, Managed Care, Private Pay, Assisted Living, Hospice, and Veterans for services provided in each corresponding state. It was determined that the contracts are not materially different for the following groups: Medicaid, Medicare, Managed Care and Private Pay and other (Assisted Living, Hospice and Veterans). In order to determine the transaction price, the Company estimates the amount of variable consideration at the beginning of the contract using the expected value method. The estimates consider (i) payor type, (ii) historical payment trends, (iii) the maturity of the portfolio, and (iv) geographic payment trends throughout a class of similar payors. The Company typically enters into agreements with third-party payors that provide for payments at amounts different from the established charges. These arrangement terms provide for subsequent settlement and cash flows that may occur well after the service is provided. The Company constrains (reduces) the estimates of variable consideration such that it is probable that a significant reversal of previously recognized revenue will not occur throughout the life of the contract. Changes in the Company's expectation of the amount it will receive from the patient or third-party payors will be recorded in revenue unless there is a specific event that suggests the patient or third-party payor no longer has the ability and intent to pay the amount due and, therefore, the changes in its estimate of variable consideration better represent an impairment, or bad debt. These estimates are re-assessed each reporting period, and any amounts allocated to a satisfied performance obligation are recognized as revenue or a reduction of revenue in the period in which the transaction price changes. The Company satisfies its performance obligation by providing quality of care services to its patients and residents on a daily basis until termination of the contract. The performance obligation is recognized on a time elapsed basis, by day, for which the services are provided. For these contracts, the Company has the right to consideration from the customer in an amount that directly corresponds with the value to the customer of the Company's performance to date. Therefore, the Company recognizes revenue based on the amount billable to the customer in accordance with the practical expedient in ASC 606-10-55-18. Additionally, because the Company applied ASC 606 using certain practical expedients, the Company elected not to disclose the aggregate amount of the transaction price for unsatisfied, or partially unsatisfied, performance obligations for all contracts with an original expected length of one year or less. The Company incurs costs related to patient/resident contracts, such as legal and advertising expenses. The contract costs are expensed as incurred. They are not expected to be recovered and are not chargeable to the patient/resident regardless of whether the contract is executed.

REVENUE RECOGNITION (Tables)

REVENUE RECOGNITION (Tables)	9 Months Ended
	Sep. 30, 2019
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following table summarizes revenue from contracts with customers by payor source from continuing operations for the periods presented (dollar amounts in thousands): Three Months Ended September 30, 2019 2018 Medicaid $ 57,191 48.2 % $ 55,910 47.0 % Medicare 19,274 16.2 % 20,318 17.1 % Managed Care 11,794 9.9 % 11,248 9.4 % Private Pay and other 30,371 25.7 % 31,559 26.5 % Total $ 118,630 100.0 % $ 119,035 100.0 % Nine Months Ended September 30, 2019 2018 Medicaid $ 164,815 46.5 % $ 159,706 44.7 % Medicare 59,211 16.7 % 64,713 18.1 % Managed Care 37,911 10.7 % 36,748 10.3 % Private Pay and other 92,208 26.1 % 96,239 26.9 % Total $ 354,145 100.0 % $ 357,406 100.0 %
Schedule of Accounts Receivable	Accounts receivable from continuing operations as of September 30, 2019 and December 31, 2018 are summarized in the following table: September 30 December 31, 2019 2018 Medicaid $ 25,366 $ 27,532 Medicare 10,686 15,706 Managed Care 8,376 8,126 Private Pay and other 17,608 14,893 Total accounts receivable $ 62,036 $ 66,257

LEASES (Tables)

LEASES (Tables)	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Assets and Liabilities, Leases	Leases Classification September 30, 2019 Assets Operating lease assets Operating lease assets $ 316,626 Finance lease assets Property and equipment, net (a) 972 Total leased assets $ 317,598 Liabilities Current Operating Current portion of operating lease liabilities $ 22,986 Finance Current portion of long-term debt and finance lease obligations, net 273 Noncurrent Operating Operating lease liabilities 301,905 Finance Long-term debt and finance lease obligations, less current portion and deferred financing costs, net 508 Total lease liabilities $ 325,672 (a) Finance lease assets are recorded net of accumulated amortization of $1,456 as of September 30, 2019.
Lease, Cost	Lease Cost Three Months Ended Nine Months Ended Classification September 30, 2019 September 30, 2019 Operating lease cost (a) Lease and rent expense $ 13,251 $ 39,480 Finance lease cost: Amortization of finance lease assets Depreciation and amortization 54 196 Interest on finance lease liabilities Interest expense, net 11 37 Short term lease cost Operating expense 169 472 Net lease cost $ 13,485 $ 40,185 (a) Includes variable lease costs, which are immaterial
Lessee, Operating Lease, Liability, Maturity	As of September 30, 2019 Operating Leases (a) Finance Leases (a) Total 2019 $ 50,592 $ 313 $ 50,905 2020 51,533 243 51,776 2021 52,553 206 52,759 2022 53,593 65 53,658 2023 53,897 27 53,924 After 2023 214,168 — 214,168 Total lease payments $ 476,336 $ 854 $ 477,190 Less: Interest (151,445 ) (73 ) (151,518 ) Present value of lease liabilities $ 324,891 $ 781 $ 325,672 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The Company's future minimum lease commitments for continuing operations as of December 31, 2018, under Accounting Standards Codification Topic 840, predecessor to Topic 842, are as follows: As of December 31, 2018 Operating Leases (a) Finance Leases (a) Total 2018 $ 48,701 $ 454 $ 49,155 2019 49,595 174 49,769 2020 50,570 173 50,743 2021 51,587 127 51,714 2022 52,624 — 52,624 After 2022 245,225 — 245,225 Total lease payments $ 498,302 $ 928 $ 499,230 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised.
Finance Lease, Liability, Maturity	Maturity of Lease Liabilities As of September 30, 2019 Operating Leases (a) Finance Leases (a) Total 2019 $ 50,592 $ 313 $ 50,905 2020 51,533 243 51,776 2021 52,553 206 52,759 2022 53,593 65 53,658 2023 53,897 27 53,924 After 2023 214,168 — 214,168 Total lease payments $ 476,336 $ 854 $ 477,190 Less: Interest (151,445 ) (73 ) (151,518 ) Present value of lease liabilities $ 324,891 $ 781 $ 325,672 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised. The Company's future minimum lease commitments for continuing operations as of December 31, 2018, under Accounting Standards Codification Topic 840, predecessor to Topic 842, are as follows: As of December 31, 2018 Operating Leases (a) Finance Leases (a) Total 2018 $ 48,701 $ 454 $ 49,155 2019 49,595 174 49,769 2020 50,570 173 50,743 2021 51,587 127 51,714 2022 52,624 — 52,624 After 2022 245,225 — 245,225 Total lease payments $ 498,302 $ 928 $ 499,230 (a) Operating and Finance lease payments exclude option to extend lease terms that are not reasonably certain of being exercised.
Summary of Other Lease Information	Lease Term and Discount Rate September 30, 2019 Weighted-average remaining lease term (years) Operating leases 9.04 Finance leases 2.02 Weighted-average discount rate Operating leases 8.9% Finance leases 5.5% Other Information Nine Months Ended September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows for operating leases $ 42,816 Operating cash flows for finance leases $ 37 Financing cash flows for finance leases $ 373 Acquisition of operating leases though adoption of ASC 842 $ 389,403 Lease modification $ (48,877 )

STOCK-BASED COMPENSATION (Table

STOCK-BASED COMPENSATION (Tables)	9 Months Ended
	Sep. 30, 2019
Share-based Payment Arrangement [Abstract]
Summarized activity of equity compensation plans	Summarized activity of the equity compensation plans is presented below: Weighted Options/ Average SOSARs Exercise Price Outstanding, December 31, 2018 122 $ 7.29 Granted — — Exercised (2 ) 2.37 Expired or cancelled (22 ) 8.33 Outstanding, September 30, 2019 98 $ 7.17 Exercisable, September 30, 2019 89 $ 7.05
Schedule of summarized activity of Restricted Share Units	Weighted Average Restricted Grant Date Shares Fair Value Outstanding, December 31, 2018 120 $ 8.77 Granted 151 3.93 Vested (58 ) 8.91 Cancelled (7 ) 5.97 Outstanding, September 30, 2019 206 $ 5.28 Summarized activity of the Restricted Share Units for the Stock Purchase Plan is as follows: Weighted Average Restricted Grant Date Share Units Fair Value Outstanding, December 31, 2018 43 $ 9.26 Granted 36 3.93 Vested (30 ) 9.76 Outstanding, September 30, 2019 49 $ 5.05
Schedule of summarized information regarding stock options and SOSAR grants outstanding	The following table summarizes information regarding stock options and SOSAR grants outstanding as of September 30, 2019 : Weighted Average Intrinsic Intrinsic Range of Exercise Grants Value-Grants Grants Value-Grants Exercise Prices Prices Outstanding Outstanding Exercisable Exercisable $8.14 to $10.21 $ 8.83 45 $ — 35 $ — $5.45 to $5.86 $ 5.76 54 $ — 54 $ — 99 89

EARNINGS PER COMMON SHARE (Tabl

EARNINGS PER COMMON SHARE (Tables)	9 Months Ended
	Sep. 30, 2019
Earnings Per Share [Abstract]
Basic and diluted net income (loss) per common share	Information with respect to basic and diluted net loss per common share is presented below in thousands, except per share: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net loss Loss from continuing operations $ (1,918 ) $ (7,462 ) $ (26,100 ) $ (8,375 ) Income (loss) from discontinued operations, net of income taxes (2,956 ) 65 (6,716 ) 564 Net loss $ (4,874 ) $ (7,397 ) $ (32,816 ) $ (7,811 ) Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net loss per common share: Per common share – basic Loss from continuing operations $ (0.30 ) $ (1.17 ) $ (4.04 ) $ (1.32 ) Income (loss) from discontinued operations (0.45 ) 0.01 (1.04 ) 0.09 Net loss per common share – basic $ (0.75 ) $ (1.16 ) $ (5.08 ) $ (1.23 ) Per common share – diluted Loss from continuing operations $ (0.30 ) $ (1.17 ) $ (4.04 ) $ (1.32 ) Income (loss) from discontinued operations (0.45 ) 0.01 (1.04 ) 0.09 Net loss per common share – diluted $ (0.75 ) $ (1.16 ) $ (5.08 ) $ (1.23 ) Weighted Average Common Shares Outstanding: Basic 6,470 6,400 6,455 6,362 Diluted 6,470 6,400 6,455 6,362

DISCONTINUED OPERATIONS (Tables

DISCONTINUED OPERATIONS (Tables)	9 Months Ended
	Sep. 30, 2019
Discontinued Operations and Disposal Groups [Abstract]
Summary of assets and liabilities related to the Kentucky discontinued operations	A summary of the Kentucky Exit discontinued operations follows: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 PATIENT REVENUES, net $ 11,812 $ 22,396 $ 46,019 $ 66,392 EXPENSES: Operating 9,229 18,031 36,947 52,694 Lease and rent expense 1,792 1,704 7,169 5,097 Professional liability 2,468 1,329 5,401 3,992 General and administrative 259 664 985 1,925 Depreciation and amortization 1,287 302 2,250 1,006 Operating income (loss) (3,223 ) 366 (6,733 ) 1,678 Other income 728 36 736 2 Interest expense, net (2 ) (284 ) (149 ) (849 ) Income (loss) from discontinued operations before taxes (2,497 ) 118 (6,146 ) 831 Income tax (expense) benefit (459 ) (45 ) (570 ) (233 ) Income (loss) from discontinued operations, net of tax $ (2,956 ) $ 73 $ (6,716 ) $ 598 A summary of other discontinued operations follows: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Loss from discontinued operations before taxes — (8 ) — (45 ) Income tax benefit — — — 11 Loss from discontinued operations, net of tax $ — $ (8 ) $ — $ (34 ) A summary of cash inflows and outflows related to the the Kentucky Exit discontinued operations follows: Nine Months Ended September 30, 2019 2018 Net cash provided by (used in) operating activities (5,130 ) 1,153 Net cash provided by (used in) investing activities 6 (1,275 )

BUSINESS (Details)

BUSINESS (Details)	Sep. 30, 2019statefacilitycenterbed	Aug. 30, 2019facilitybed	Oct. 01, 2018center
Accounting Policies [Line Items]
Number of states in which entity operates | state	9
Number of nursing centers | center	62
Number of licensed nursing beds	7,329
Number of nursing center facilities owned | center	15
Number of nursing center facilities leased | center	47		34
Number of licensed assisted and residential living beds	397
Number of nursing center facilities terminated | facility	10
Minimum
Accounting Policies [Line Items]
Number of licensed nursing beds per center	50
Maximum
Accounting Policies [Line Items]
Number of licensed nursing beds per center	320
Kentucky Properties | Discontinued Operations
Accounting Policies [Line Items]
Number of nursing center facilities terminated | facility		10
Number of skilled nursing beds terminated		885

CONSOLIDATION AND BASIS OF PR_3

CONSOLIDATION AND BASIS OF PRESENTATION OF FINANCIAL STATEMENTS CONSOLIDATION AND BASIS OF PRESENTATION OF FINANCIAL STATEMENTS (Details) $ in Thousands	Dec. 01, 2018USD ($)property	Sep. 30, 2019facility	Aug. 30, 2019facility
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of nursing center facilities terminated		10
Kentucky Properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of properties sold | property	3
Proceeds from sale of assets | $	$ 18,700
Kentucky Properties | Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of nursing center facilities terminated			10

RECENT ACCOUNTING GUIDANCE (Det

RECENT ACCOUNTING GUIDANCE (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Jan. 01, 2019
Accounting Policies [Abstract]
Net lease assets	$ 317,598	$ 384,187
Lease liabilities	$ 325,672	$ 389,403

REVENUE RECOGNITION - Disaggreg

REVENUE RECOGNITION - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Total revenues	$ 118,630		$ 354,145
Total revenues, as a percent	100.00%		100.00%
Medicaid
Disaggregation of Revenue [Line Items]
Total revenues	$ 57,191		$ 164,815
Total revenues, as a percent	48.20%		46.50%
Medicare
Disaggregation of Revenue [Line Items]
Total revenues	$ 19,274		$ 59,211
Total revenues, as a percent	16.20%		16.70%
Managed Care
Disaggregation of Revenue [Line Items]
Total revenues	$ 11,794		$ 37,911
Total revenues, as a percent	9.90%		10.70%
Private Pay and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 30,371		$ 92,208
Total revenues, as a percent	25.70%		26.10%
Calculated under Revenue Guidance in Effect before Topic 606
Disaggregation of Revenue [Line Items]
Total revenues		$ 119,035		$ 357,406
Total revenues, as a percent		100.00%		100.00%
Calculated under Revenue Guidance in Effect before Topic 606 | Medicaid
Disaggregation of Revenue [Line Items]
Total revenues		$ 55,910		$ 159,706
Total revenues, as a percent		47.00%		44.70%
Calculated under Revenue Guidance in Effect before Topic 606 | Medicare
Disaggregation of Revenue [Line Items]
Total revenues		$ 20,318		$ 64,713
Total revenues, as a percent		17.10%		18.10%
Calculated under Revenue Guidance in Effect before Topic 606 | Managed Care
Disaggregation of Revenue [Line Items]
Total revenues		$ 11,248		$ 36,748
Total revenues, as a percent		9.40%		10.30%
Calculated under Revenue Guidance in Effect before Topic 606 | Private Pay and other
Disaggregation of Revenue [Line Items]
Total revenues		$ 31,559		$ 96,239
Total revenues, as a percent		26.50%		26.90%

REVENUE RECOGNITION - Summary o

REVENUE RECOGNITION - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total accounts receivable	$ 62,036	$ 66,257
Medicaid
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total accounts receivable	25,366	27,532
Medicare
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total accounts receivable	10,686	15,706
Managed Care
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total accounts receivable	8,376	8,126
Private Pay and other
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total accounts receivable	$ 17,608	$ 14,893

LONG-TERM DEBT AND INTEREST R_2

LONG-TERM DEBT AND INTEREST RATE SWAP (Details)	Dec. 01, 2018USD ($)	Feb. 26, 2016USD ($)center	Sep. 30, 2019USD ($)letter_of_credit	Mar. 31, 2019center	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)letter_of_credit	Sep. 30, 2018USD ($)	Sep. 01, 2019center	May 13, 2019USD ($)center	Apr. 30, 2019center	Dec. 31, 2018USD ($)	Aug. 01, 2017USD ($)	Jun. 30, 2017USD ($)	Dec. 29, 2016USD ($)	Dec. 28, 2016USD ($)	Oct. 03, 2016USD ($)
Line of Credit Facility [Line Items]
Number of skilled nursing centers participating in QIPP | center				1				12	4	11
Accumulated other comprehensive income (loss)			$ 552,000			$ 552,000					$ 837,000
Income tax expense (benefit)			(741,000)		$ (252,000)	15,544,000	$ (903,000)
Interest rate swap
Line of Credit Facility [Line Items]
Notional amount of interest rate derivatives			$ 27,015,000			$ 27,015,000
Annual fixed rate percentage			5.79%			5.79%
Net asset based on interest rate swap valuation model			$ 77,000			$ 77,000
Accumulated other comprehensive income (loss)			$ 60,000			60,000
Income tax expense (benefit)						$ (17,000)
Amended and restated credit agreement
Line of Credit Facility [Line Items]
Loan acquisition costs		$ 2,162,000
Number of letters of credit | letter_of_credit			4			4
Credit agreement | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity		$ 100,000,000
Term of agreements		5 years
Mortgage loan | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity		$ 72,500,000
Term of agreements		5 years
Period of amortization		25 years
Amended mortgage loan balance			$ 59,645,000			$ 59,645,000
Number of owned nursing centers to secure Amended Mortgage Loan | center		15
Mortgage loan | Amended and restated credit agreement | Interest rate swap
Line of Credit Facility [Line Items]
Debt interest rate at period end		5.79%
Amended revolver | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity	$ 42,250,000	$ 27,500,000	32,284,000			32,284,000			$ 5,000			$ 42,250,000	$ 52,250,000			$ 52,250,000
Fixed charge coverage ratio				1.01
Repayments of lines of credit	4,947,000
Reduction in credit facility									2,000
Borrowings outstanding			14,000,000			$ 14,000,000					$ 15,000,000
Interest rate during period						6.00%
Amended revolver | Amended and restated credit agreement | LIBOR
Line of Credit Facility [Line Items]
Interest rate percentage		4.00%
Amended revolver | Affiliated Revolving Credit Agreement
Line of Credit Facility [Line Items]
Periodic reduction in capacity									$ 1,000
Balance available for borrowing under revolving credit center			2,000,000			$ 2,000,000
Amended revolver | Amended Revolver and Affiliated Revolver
Line of Credit Facility [Line Items]
Balance available for borrowing under revolving credit center			$ 4,267,000			$ 4,267,000
Letter of credit | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity														$ 15,000,000	$ 10,000,000
Annual fees for letters of credit issued under Revolver (as a percentage)		3.00%
Mortgage term loan | Mortgage loan | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity		$ 60,000,000
Debt interest rate at period end			6.00%			6.00%
Amended mortgage loan balance			$ 50,245,000			$ 50,245,000
Increase to credit facility limit													$ 7,500,000
Mortgage term loan | Mortgage loan | Amended and restated credit agreement | Interest rate swap | Designated as hedging instrument
Line of Credit Facility [Line Items]
Notional amount of interest rate derivatives		$ 30,000,000
Mortgage term loan | Mortgage loan | Amended and restated credit agreement | LIBOR
Line of Credit Facility [Line Items]
Interest rate percentage		4.00%
Mortgage term loan | Amended revolver | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Repayments of lines of credit	11,100,000
Acquisition loan facility | Mortgage loan | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity		$ 12,500,000
Debt interest rate at period end			6.75%			6.75%
Amended mortgage loan balance			$ 9,400,000			$ 9,400,000
Acquisition loan facility | Mortgage loan | Amended and restated credit agreement | LIBOR
Line of Credit Facility [Line Items]
Interest rate percentage		4.75%
Acquisition loan facility | Amended revolver | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Borrowing capacity	10,400,000
Repayments of lines of credit	$ 2,100,000
Omega Healthcare Investors Inc | Amended revolver | Amended and restated credit agreement
Line of Credit Facility [Line Items]
Letters of credit security deposit for a lease			$ 12,017,000			$ 12,017,000

LEASES - Narrative (Details)

LEASES - Narrative (Details)	9 Months Ended
	Sep. 30, 2019
Lessee, Lease, Description [Line Items]
Other leases renewal term	20 years
Other leases termination period	1 year
Minimum
Lessee, Lease, Description [Line Items]
Other leases remaining lease term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Other leases remaining lease term	12 years

LEASES - Balance Sheet Classifi

LEASES - Balance Sheet Classification (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Jan. 01, 2019	Dec. 31, 2018
Assets:
Operating lease assets	$ 316,626		$ 0
Finance lease assets	972
Total leased assets	317,598	$ 384,187
Liabilities, Current [Abstract]
Current portion of operating lease liabilities	22,986
Finance lease, current	273
Liabilities, Noncurrent [Abstract]
Operating lease liabilities, less current portion	301,905		$ 0
Finance lease, noncurrent	508
Total lease liabilities	325,672	$ 389,403
Accumulated amortization of finance leases	$ 1,456

LEASES - Lease Cost (Details)

LEASES - Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Leases [Abstract]
Operating lease cost	$ 13,251	$ 12,060	$ 39,480	$ 36,105
Amortization of finance lease assets	54		196
Interest on finance lease liabilities	11		37
Short term lease cost	169		472
Net lease cost	$ 13,485		$ 40,185

LEASES - Maturities of Operatin

LEASES - Maturities of Operating and Financing Lease Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Operating Leases
2019	$ 50,592
2020	51,533
2021	52,553
2022	53,593
2023	53,897
After 2023	214,168
Total lease payments	476,336
Less: Interest	(151,445)
Present value of lease liabilities	324,891
2019		$ 48,701
2020		49,595
2021		50,570
2022		51,587
2023		52,624
After 2023		245,225
Total lease payments		498,302
Finance Leases
2019	313
2020	243
2021	206
2022	65
2023	27
After 2023	0
Total lease payments	854
Less: Interest	(73)
Present value of lease liabilities	781
2018		454
2019		174
2020		173
2021		127
2022		0
After 2022		0
Total lease payments		928
Operating and Finance Lease Liabilities, Payments, Due [Abstract]
2019	50,905	49,155
2020	51,776	49,769
2021	52,759	50,743
2022	53,658	51,714
2023	53,924	52,624
After 2023	214,168	245,225
Total lease payments	477,190	$ 499,230
Less: Interest	(151,518)
Present value of lease liabilities	$ 325,672

LEASES - Other Lease Informatio

LEASES - Other Lease Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Weighted-average remaining lease term (years)
Operating leases	9 years 15 days
Finance leases	2 years 7 days
Weighted-average discount rate
Operating leases	8.90%
Finance leases	5.50%
Operating cash flows for operating leases	$ 42,816
Operating cash flows for finance leases	37
Financing cash flows for finance leases	373
Acquisition of operating leases	389,403	$ 0
Lease modification	$ (48,877)

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details)	3 Months Ended		9 Months Ended		32 Months Ended
	Sep. 30, 2019USD ($)lawsuit	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)lawsuit	Sep. 30, 2018USD ($)	Feb. 14, 2016civil_investigative_demand	Dec. 31, 2018USD ($)	Oct. 31, 2014facility
Malpractice Insurance [Line Items]
Number of professional liability lawsuits | lawsuit	91		91
Cash expenditures for self-insured professional liability costs			$ 5,398,000	$ 5,088,000
Estimated insurance recovery receivables	$ 2,305,000		2,305,000			$ 5,475,000
Litigation contingency, less current portion	9,000,000		9,000,000			6,400,000
Litigation contingency expense	0	$ 6,400,000	3,100,000	$ 6,400,000
Other Insurance
Liability for workers compensation claims	806,000		806,000			618,000
Workers compensation insurance, non current receivable for excess premiums paid	1,538,000		1,538,000			1,258,000
Unfavorable regulatory action | Potential violations of false claims act
Malpractice Insurance [Line Items]
Number of facilities | facility							2
Number of civil investigative demands received | civil_investigative_demand					3
Litigation contingency, less current portion	9,500,000		9,500,000
Litigation contingency expense	3,100,000
Litigation contingency, current	500,000		$ 500,000
Expected period to remit settlement			5 years
Professional malpractice liability insurance
Malpractice Insurance [Line Items]
Liability for reported and estimated future claims	26,680,000		$ 26,680,000			$ 27,201,000
Prefunded deductible policy
Malpractice Insurance [Line Items]
Insurance policy coverage limits per claim			500,000
Other Insurance
Insurance policy coverage limits per claim			500,000
Professional liability insurance, annual coverage limit per facility			3,000,000
Health insurance, maximum self-insured annual amount per individual	200,000		200,000
Liability for reported claims and estimates for incurred but unreported claims	$ 1,756,000		1,756,000
SHC Risk Carriers, Inc | Professional malpractice liability insurance
Malpractice Insurance [Line Items]
Insurance policy coverage limits per claim			1,000,000
Malpractice insurance annual sublimit per center			3,000,000
Aggregate policy limit			5,000,000
Other Insurance
Insurance policy coverage limits per claim			$ 1,000,000
Scheduled for trial or arbitration over next 12 months
Malpractice Insurance [Line Items]
Number of professional liability lawsuits | lawsuit	31		31

STOCK-BASED COMPENSATION - Nar

STOCK-BASED COMPENSATION - Narrative (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Jun. 30, 2017	May 31, 2017	Jun. 30, 2016	May 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation expense	$ 429	$ 947
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grant of restricted common stock (shares)	151,000	90,000
Restricted Stock | First anniversary of grant date
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage of awards	33.33%
Restricted Stock | Second anniversary of grant date
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage of awards	33.33%
Restricted Stock | Third anniversary of grant date
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage of awards	33.33%
2008 Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of quoted market price offering rate	85.00%
Restriction period	2 years
Shares authorized under the plan (shares)					350,000	150,000
2010 Long Term Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved for future issuance (shares)			680,000	380,000

STOCK-BASED COMPENSATION - Sch

STOCK-BASED COMPENSATION - Schedule of Activity of Equity Compensation Plans (Details) - Stock Options and Stock Appreciation Rights (SARs) shares in Thousands	9 Months Ended
	Sep. 30, 2019$ / sharesshares
Number of Shares
Outstanding, beginning (shares) | shares	122
Granted (shares) | shares	0
Exercised (shares) | shares	(2)
Expired or cancelled (shares) | shares	(22)
Outstanding, ending (shares) | shares	98
Exercisable (shares) | shares	89
Weighted Average Exercise Price
Outstanding, beginning (dollars per share) | $ / shares	$ 7.29
Granted (dollars per share) | $ / shares	0
Exercised (dollars per share) | $ / shares	2.37
Expired or cancelled (dollars per share) | $ / shares	8.33
Outstanding, ending (dollars per share) | $ / shares	7.17
Exercisable, weighted average exercise price (dollars per share) | $ / shares	$ 7.05

STOCK-BASED COMPENSATION - S_2

STOCK-BASED COMPENSATION - Schedule of Restricted Stock and Restricted Stock Units Activity (Details) - $ / shares shares in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Restricted Shares
Number of Shares
Outstanding, beginning (shares)	120
Granted (shares)	151	90
Vested (shares)	(58)
Cancelled (shares)	(7)
Outstanding, ending (shares)	206
Weighted Average Granted Date Fair Value
Outstanding, beginning (dollars per share)	$ 8.77
Granted (dollars per share)	3.93
Vested (dollars per share)	8.91
Cancelled (dollars per share)	5.97
Outstanding, ending (dollars per share)	$ 5.28
Restricted Stock Units (RSUs)
Number of Shares
Outstanding, beginning (shares)	43
Granted (shares)	36
Vested (shares)	(30)
Outstanding, ending (shares)	49
Weighted Average Granted Date Fair Value
Outstanding, beginning (dollars per share)	$ 9.26
Granted (dollars per share)	3.93
Vested (dollars per share)	9.76
Outstanding, ending (dollars per share)	$ 5.05

STOCK-BASED COMPENSATION - S_3

STOCK-BASED COMPENSATION - Schedule of Awards Outstanding and Exercisable (Details) - Stock Options and Stock Appreciation Rights (SARs) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average exercise prices (dollars per share)	$ 7.17	$ 7.29
Grants outstanding (shares)	99
Grants exercisable (shares)	89
$8.14 to $10.21
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of exercise prices, minimum (dollars per share)	$ 8.14
Range of exercise prices, maximum (dollars per share)	10.21
Weighted average exercise prices (dollars per share)	$ 8.83
Grants outstanding (shares)	45
Intrinsic value - grants outstanding	$ 0
Grants exercisable (shares)	35
Intrinsic value - grants exercisable	$ 0
$5.45 to $5.86
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of exercise prices, minimum (dollars per share)	$ 5.45
Range of exercise prices, maximum (dollars per share)	5.86
Weighted average exercise prices (dollars per share)	$ 5.76
Grants outstanding (shares)	54
Intrinsic value - grants outstanding	$ 0
Grants exercisable (shares)	54
Intrinsic value - grants exercisable	$ 0

INCOME TAXES (Details)

INCOME TAXES (Details) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2019USD ($)facility	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)facility	Sep. 30, 2018USD ($)	Dec. 31, 2017USD ($)	Jun. 30, 2019USD ($)
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ (741)	$ (252)	$ 15,544	$ (903)
Contingent liability expense			$ 9,500
Tax Cuts and Jobs Act, additional income tax expense					$ 5,500
Number of nursing center facilities terminated | facility	10		10
Deferred tax asset, valuation allowance	$ 21,100		$ 21,100			$ 20,000

EARNINGS PER COMMON SHARE - Ba

EARNINGS PER COMMON SHARE - Basic and Diluted Net Income (Loss) Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Net loss
Loss from continuing operations	$ (1,918)	$ (7,462)	$ (26,100)	$ (8,375)
Income (loss) from discontinued operations, net of income taxes	(2,956)	65	(6,716)	564
Disposal Group, Including Discontinued Operation, Operating Income (Loss)	(3,689)	65	(7,449)	564
Net loss	$ (4,874)	$ (7,397)	$ (32,816)	$ (7,811)
Per common share – basic
Loss from continuing operations (in dollars per share)	$ (0.30)	$ (1.17)	$ (4.04)	$ (1.32)
Loss from discontinued operations (dollars per share)	(0.45)	0.01	(1.04)	0.09
Net loss per common share – basic (dollars per share)	(0.75)	(1.16)	(5.08)	(1.23)
Per common share – diluted
Loss from continuing operations (dollars per share)	(0.30)	(1.17)	(4.04)	(1.32)
Loss from discontinued operations (dollars per share)	(0.45)	0.01	(1.04)	0.09
Net income (loss) per common share – diluted (dollars per share)	$ (0.75)	$ (1.16)	$ (5.08)	$ (1.23)
Weighted Average Common Shares Outstanding:
Basic (shares)	6,470	6,400	6,455	6,362
Diluted (shares)	6,470	6,400	6,455	6,362

EARNINGS PER COMMON SHARE - Na

EARNINGS PER COMMON SHARE - Narrative (Details) - shares shares in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Earnings Per Share [Abstract]
Antidilutive shares excluded from computation of diluted earnings per share (shares)	98	226

BUSINESS DEVELOPMENTS AND OTH_2

BUSINESS DEVELOPMENTS AND OTHER SIGNIFICANT TRANSACTIONS - Narrative (Details)	Oct. 01, 2018centerextension	Sep. 30, 2019facilitycenter	Sep. 01, 2019center	Aug. 30, 2019facility	May 13, 2019center	Apr. 30, 2019center	Mar. 31, 2019center
Business Acquisition [Line Items]
Number of nursing center facilities leased	34	47
Number of skilled nursing centers under lease	23
Operating lease, initial term	12 years
Number of lease extensions allowed | extension	2
Lease extension period	10 years
Number of nursing center facilities terminated | facility		10
Annual lease fixed escalators, percent	2.15%
Number of skilled nursing centers participating in QIPP			12		4	11	1
Omega Healthcare Investors Inc
Business Acquisition [Line Items]
Number of nursing center facilities leased	11
Discontinued Operations | Kentucky Properties
Business Acquisition [Line Items]
Number of nursing center facilities terminated | facility				10

DISCONTINUED OPERATIONS - Narra

DISCONTINUED OPERATIONS - Narrative (Details) $ in Thousands	Aug. 30, 2019USD ($)facilitybed	Dec. 01, 2018USD ($)	Dec. 31, 2018USD ($)	Sep. 30, 2019facility
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of nursing center facilities terminated | facility				10
Kentucky Properties | Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of nursing center facilities terminated | facility	10
Number of skilled nursing beds terminated | bed	885
Pretax gain on transaction	$ 733
Kentucky Properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of assets		$ 18,700
Carrying value of centers			$ 13,331
Gain on disposition of assets			$ 4,825

DISCONTINUED OPERATIONS - Summa

DISCONTINUED OPERATIONS - Summary of Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
EXPENSES:
Operating income (loss)	$ (3,689)	$ 65	$ (7,449)	$ 564
Income tax (expense) benefit	(459)	(45)	570	222
Income (loss) from discontinued operations, net of tax	(2,956)	65	(6,716)	564
Kentucky Properties | Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
PATIENT REVENUES, net	11,812	22,396	46,019	66,392
EXPENSES:
Operating	9,229	18,031	36,947	52,694
Lease and rent expense	1,792	1,704	7,169	5,097
Professional liability	2,468	1,329	5,401	3,992
General and administrative	259	664	985	1,925
Depreciation and amortization	1,287	302	2,250	1,006
Operating income (loss)	(3,223)	366	(6,733)	1,678
Other income	728	36	736	2
Interest expense, net	(2)	(284)	(149)	(849)
Income (loss) from discontinued operations before taxes	(2,497)	118	(6,146)	831
Income tax (expense) benefit	(459)	(45)	(570)	(233)
Income (loss) from discontinued operations, net of tax	(2,956)	73	(6,716)	598
Other | Discontinued Operations
EXPENSES:
Income (loss) from discontinued operations before taxes	0	(8)	0	(45)
Income tax (expense) benefit	0	0	0	11
Income (loss) from discontinued operations, net of tax	$ 0	$ (8)	$ 0	$ (34)

DISCONTINUED OPERATIONS - Sum_2

DISCONTINUED OPERATIONS - Summary of Cash Flow (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash provided by (used in) operating activities	$ (5,130)	$ 1,153
Net cash provided by (used in) investing activities	6	(1,275)
Net cash provided by (used in) financing activities	0	0
Kentucky Properties | Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash provided by (used in) operating activities	(5,130)	1,153
Net cash provided by (used in) investing activities	$ 6	$ (1,275)