10-Q

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
☒ QUARTERLY REPORT UNDER SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2017
OR
☐   TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF
THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _____ to ____________
Commission file number    001–13489
(Exact name of registrant as specified in its Charter)
Delaware		52–2057472
(State or other jurisdiction of		(I.R.S. Employer
incorporation or organization		Identification No.)
100 E. Vine Street
Murfreesboro, TN 37130
(Address of principal executive offices)
(Zip Code)
(615) 890–2020
Registrant's telephone number, including area code
Indicate by check mark whether the registrant: (1) Has filed all reports required to be filed by Section 13 or 15(d), of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes [x] No [ ]
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S–T (§232.405 of this chapter) during the preceding 12 months (or for such period that the registrant was required to submit and post such files). Yes  [x]      No  [ ] Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non–accelerated filer, smaller reporting company or an emerging growth company. See the definitions of "large accelerated file," "accelerated filer," "smaller reporting company," and "emerging growth company" in Rule 12b–2 of the Exchange Act.
Large Accelerated filer [ ]	Accelerated filer  [x]
Non–accelerated filer (Do not check if a smaller reporting company) [ ]	Smaller reporting company [ ]
	Emerging growth company [ ]

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  [ ]

Indicate by check mark whether the registrant is a shell company (as is defined in Rule 12b–2 of the Exchang

Act). Yes [ ]   No [x]

15,196,855 shares of common stock of the registrant were outstanding as of November 7, 2017.

TABLE OF CONTENTS

PART I. FINANCIAL INFORMATION
		Page
Item 1.	Financial Statements	3
Item 2.	Management's Discussion and Analysis of Financial Condition and Results of Operations	27
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	38
Item 4.	Controls and Procedures	39
PART II. OTHER INFORMATION
Item 1.	Legal Proceedings	40
Item 1A	Risk Factors	40
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	40
Item 3.	Defaults Upon Senior Securities	40
Item 5.	Other Information	40
Item 6.	Exhibits	41

PART I. FINANCIAL INFORMATION

Item 1. Financial Statements.

NATIONAL HEALTHCARE CORPORATION

Interim Condensed Consolidated Statements of Income

 (in thousands, except share and per share amounts)

(unaudited)

	Three Months Ended September 30						Nine Months Ended September 30
	2017			2016			2017			2016
Revenues:
Net patient revenues	$	230,048		$	218,647		$	685,854		$	653,240
Other revenues		11,937			12,634			34,831			35,397
Net operating revenues		241,985			231,281			720,685			688,637
Cost and Expenses:
Salaries, wages and benefits		145,900			140,403			426,639			405,491
Other operating		64,039			58,956			190,778			177,571
Facility rent		10,106			10,314			30,273			30,960
Depreciation and amortization		10,833			9,998			31,609			28,847
Interest		1,322			1,020			3,599			2,913
Total costs and expenses		232,200			220,691			682,898			645,782
Income Before Non–Operating Income		9,785			10,590			37,787			42,855
Non–Operating Income		6,090			5,091			16,047			14,789
Income Before Income Taxes		15,875			15,681			53,834			57,644
Income Tax Provision		(4,691	)		(4,571	)		(19,448	)		(20,969	)
Net Income		11,184			11,110			34,386			36,675
Loss Attributable To Noncontrolling Interest		168			-			349			-
Net Income Attributable to National HealthCare Corporation	$	11,352		$	11,110		$	34,735		$	36,675
Earnings Per Share Attributable to National HealthCare Corporation Stockholders:
Basic	$	0.75		$	0.73		$	2.29		$	2.42
Diluted	$	0.75		$	0.73		$	2.28		$	2.41
Weighted Average Common Shares Outstanding:
Basic		15,195,394			15,198,696			15,186,315			15,128,728
Diluted		15,220,567			15,222,648			15,217,797			15,216,838
Dividends Declared Per Common Share	$	0.48		$	0.45		$	1.41		$	1.30

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

3

NATIONAL HEALTHCARE CORPORATION

Interim Condensed Consolidated Statements of Comprehensive Income

(unaudited – in thousands)

	Three Months Ended September 30						Nine Months Ended September 30
	2017			2016			2017			2016
Net Income	$	11,184		$	11,110		$	34,386		$	36,675
Other Comprehensive Income (Loss):
Unrealized gains (loss) on investments in marketable securities		(3,976	)		5,458			8,380			36,085
Reclassification adjustment for realized gains on sale of securities		(17	)		(264	)		(255	)		(804	)
Income tax (expense) benefit related to items of other comprehensive income		1,572			(2,028	)		(3,074	)		(13,582	)
Other Comprehensive Income (Loss), net of tax		(2,421	)		3,166			5,051			21,699
Loss Attributable to Noncontrolling Interest		168			-			349			-
Comprehensive Income Attributable to National HealthCare Corporation	$	8,931		$	14,276		$	39,786		$	58,374

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

4

NATIONAL HEALTHCARE CORPORATION

Interim Condensed Consolidated Balance Sheets

(in thousands)

	September 30, 2017			December 31, 2016
	unaudited
Assets
Current Assets:
Cash and cash equivalents	$	69,790		$	26,335
Restricted cash and cash equivalents		9,783			3,125
Marketable securities		143,763			138,013
Restricted marketable securities		15,627			22,773
Accounts receivable, less allowance for doubtful accounts of $7,999 and $5,743, respectively		80,258			82,531
Inventories		7,113			7,508
Prepaid expenses and other assets		2,582			2,648
Notes receivable, current portion		1,267			3,259
Federal income tax receivable		5,913			4,665
Total current assets		336,096			290,857
Property and Equipment:
Property and equipment, at cost		954,739			933,140
Accumulated depreciation and amortization		(402,396	)		(373,516	)
Net property and equipment		552,343			559,624
Other Assets:
Restricted cash and cash equivalents		2,167			2,129
Restricted marketable securities		148,983			160,931
Deposits and other assets		6,228			5,244
Goodwill		17,600			17,600
Notes receivable, less current portion		11,989			13,820
Investments in limited liability companies		35,431			37,242
Total other assets		222,398			236,966
Total assets	$	1,110,837		$	1,087,447

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

5

NATIONAL HEALTHCARE CORPORATION

Interim Condensed Consolidated Balance Sheets (continued)

(in thousands, except share and per share amounts)

	September 30, 2017		December 31, 2016
	unaudited
Liabilities and Stockholders’ Equity
Current Liabilities:
Trade accounts payable	$	14,736	$	18,593
Capital lease obligations, current portion		3,641		3,481
Accrued payroll		55,586		65,912
Amounts due to third party payors		20,649		17,019
Accrued risk reserves, current portion		25,410		25,898
Other current liabilities		20,293		13,207
Dividends payable		7,294		6,818
Total current liabilities		147,609		150,928
Long–term debt		120,000		120,000
Capital lease obligations, less current portion		23,997		26,748
Accrued risk reserves, less current portion		70,103		65,264
Refundable entrance fees		8,827		9,924
Obligation to provide future services		3,236		3,236
Deferred income taxes		26,027		22,072
Other noncurrent liabilities		15,542		16,302
Deferred revenue		4,007		3,362
Total liabilities		419,348		417,836
Stockholders’ Equity:
Common stock, $.01 par value; 45,000,000 shares authorized; 15,196,855 and 15,162,938 shares, respectively, issued and outstanding		152		152
Capital in excess of par value		214,347		211,457
Retained earnings		405,250		391,934
Accumulated other comprehensive income		71,119		66,068
Total National HealthCare Corporation stockholders’ equity		690,868		669,611
Noncontrolling interest		621		-
Total stockholders' equity		691,489		669,611
Total liabilities and stockholders’ equity	$	1,110,837	$	1,087,447

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

6

NATIONAL HEALTHCARE CORPORATION

Interim Condensed Consolidated Statements of Cash Flows

(unaudited – in thousands)

	Nine Months Ended September 30
	2017			2016
				(as adjusted)
Cash Flows From Operating Activities:
Net income	$	34,386		$	36,675
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		31,609			28,847
Provision for doubtful accounts receivable		5,612			5,774
Equity in earnings of unconsolidated investments		(5,908	)		(4,926	)
Distributions from unconsolidated investments		7,748			7,163
Gains on sale of restricted marketable securities		(255	)		(804	)
Deferred income taxes		881			909
Stock–based compensation		1,263			502
Changes in operating assets and liabilities, net of the effect of acquisitions:
Accounts receivable		(3,339	)		1,667
Income tax receivable		(1,248	)		(1,003	)
Inventories		395			122
Prepaid expenses and other assets		(942	)		(704	)
Trade accounts payable		(3,857	)		(2,769	)
Accrued payroll		(10,326	)		(14,759	)
Amounts due to third party payors		3,630			2,353
Accrued risk reserves		4,375			(899	)
Other current liabilities		7,086			5,880
Other noncurrent liabilities		(760	)		(84	)
Deferred revenue		645			837
Net cash provided by operating activities		70,995			64,781
Cash Flows From Investing Activities:
Additions to property and equipment		(24,328	)		(50,466	)
Investments in unconsolidated companies		(176	)		(1,282	)
Investments in notes receivable		–			(2,419	)
Collections of notes receivable		3,970			845
Purchases of restricted marketable securities		(24,874	)		(34,747	)
Sales of restricted marketable securities		46,598			30,963
Net cash provided by (used in) investing activities		1,190			(57,106	)
Cash Flows From Financing Activities:
Tax expense from stock–based compensation		–			(1,134	)
Principal payments under capital lease obligations		(2,591	)		(2,440	)
Dividends paid to common stockholders		(20,943	)		(18,977	)
Issuance of common shares		1,627			10,070
Repurchase of common shares		–			(8,195	)
Equity attributable to noncontrolling interest		970			–
Entrance fee refunds		(1,097	)		(196	)
Change in deposits		–			253
Net cash used in financing activities		(22,034	)		(20,619	)
Net Increase (Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		50,151			(12,944	)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		31,589			49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	$	81,740		$	36,370
Balance Sheet Classifications:
Cash and cash equivalents	$	69,790		$	19,212
Restricted cash and cash equivalents		11,950			17,158
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	$	81,740		$	36,370

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

7

NATIONAL HEALTHCARE CORPORATION

Interim Condensed Consolidated Statements of Stockholders’ Equity

(in thousands, except share and per share amounts)

(unaudited)

	Common Stock						Capital in Excess of			Retained			Accumulated Other Comprehensive		Non- controlling			Total Stockholders’
	Shares			Amount			Par Value			Earnings			Income		Interest			Equity
Balance at January 1, 2016		15,000,616		$	150		$	209,469		$	368,013		$	53,364	$	–		$	630,996
Net income attributable to National HealthCare Corporation		–			–			–			36,675			–		–			36,675
Other comprehensive income		–			–			–			–			21,699		–			21,699
Stock–based compensation		–			–			502			–			–		–			502
Tax expense from exercise of stock options		–			–			(1,134	)		–			–		–			(1,134	)
Shares sold – options exercised		278,623			3			10,067			–			–		–			10,070
Repurchase of common stock		(130,000	)		(1	)		(8,194	)		–			–		–			(8,195	)
Dividends declared to common stockholders ($1.30 per share)		–			–			–			(19,798	)		–		–			(19,798	)
Balance at September 30, 2016		15,149,239		$	152		$	210,710		$	384,890		$	75,063	$	–		$	670,815
Balance at January 1, 2017		15,162,938		$	152		$	211,457		$	391,934		$	66,068	$	–		$	669,611
Net income attributable to National HealthCare Corporation		–			–			–			34,735			–		–			34,735
Net loss attributable to noncontrolling interest		–			–			–			–			–		(349	)		(349	)
Equity contributed by noncontrolling interest		–			–			–			–			–		970			970
Other comprehensive income		–			–			–			–			5,051		–			5,051
Stock–based compensation		–			–			1,263			–			–		–			1,263
Shares sold – options exercised		33,917			–			1,627			–			–		–			1,627
Dividends declared to common stockholders ($1.41 per share)		–			–			–			(21,419	)		–		–			(21,419	)
Balance at September 30, 2017		15,196,855		$	152		$	214,347		$	405,250		$	71,119	$	621		$	691,489

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

8

NATIONAL HEALTHCARE CORPORATION

Notes to Interim Condensed Consolidated Financial Statements

September 30, 2017

(unaudited)

Note 1 – Description of Business

National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. As of September 30, 2017, we operate or manage, through certain affiliates, 76 skilled nursing facilities with a total of 9,597 licensed beds, 24 assisted living facilities, five independent living facilities, and 36 homecare programs. We operate specialized care units within certain of our healthcare centers such as Alzheimer's disease care units and sub-acute nursing units. We also have a noncontrolling ownership interest in a hospice care business that services NHC owned skilled nursing facilities and others. In addition, we provide insurance services, management and accounting services, and we lease properties to operators of skilled nursing facilities. We operate in 10 states and are located primarily in the southeastern United States.

Note 2 – Summary of Significant Accounting Policies

The listing below is not intended to be a comprehensive list of all our significant accounting policies. In many cases, the accounting treatment of a particular transaction is specifically dictated by generally accepted accounting principles, with limited need for management’s judgment in their application. There are also areas in which management’s judgment in selecting any available alternative would not produce a materially different result. See our audited December 31, 2016 consolidated financial statements and notes thereto which contain accounting policies and other disclosures required by generally accepted accounting principles. Our audited December 31, 2016 consolidated financial statements are available at our web site: www.nhccare.com.

Basis of Presentation

The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. The consolidated financial statements include the accounts of all entities controlled by NHC. The Company presents noncontrolling interest within the equity section of its consolidated balance sheets. The Company presents the amount of consolidated net income (loss) that is attributable to NHC and the noncontrolling interest in its consolidated statements of income.

We assume that users of these interim financial statements have read or have access to the audited December 31, 2016 consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is not necessarily indicative of the results that may be expected for a full year for a variety of reasons.

Estimates and Assumptions

The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.

9

Change in Accounting Principle

Effective December 31, 2016, the Company retrospectively adopted a change in accounting principle related to the early adoption of Accounting Standards Update (“ASU”) No. 2016–18, Statement of Cash Flows (Topic 230)—Restricted Cash—a consensus of the FASB Emerging Issues Task Force. The updated guidance requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash and restricted cash equivalents. As such, amounts generally described as restricted cash and restricted cash equivalents should be included in the “beginning–of–period” and “end–of–period” total amounts shown on the statements of cash flows.

As described in the guidance for accounting changes under ASC Topic 250, the comparative consolidated statement of cash flows of prior periods are adjusted to apply the new accounting method retrospectively. The following table presents the effect on the interim condensed consolidated statement of cash flows for the nine months ending September 30, 2016 for the accounting change that was retrospectively adopted on December 31, 2016:

Consolidated Statement of Cash Flows

(in thousands)

	Nine Months Ended September 30, 2016
	As Previously Reported			Effect of Accounting Change			As Adjusted
Cash Flows from Operating Activities:
Restricted cash and cash equivalents	$	(15,507	)	$	15,507		$	–
Net cash provided by operating activities		49,274			15,507			64,781
Cash Flows from Investing Activities:
Change in restricted cash and cash equivalents		9,455			(9,455	)		–
Net cash used in investing activities		(47,651	)		(9,455	)		(57,106	)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		(18,996	)		6,052			(12,944	)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period		38,208			11,106			49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, End of Period	$	19,212		$	17,158		$	36,370

Recently Adopted Accounting Guidance

In November 2016, the Financial Accounting Standards Board ("FASB") issued ASU No. 2016–18, “Statement of Cash Flows (Topic 230)—Restricted Cash—a consensus of the FASB Emerging Issues Task Force”. This revised standard is an effort by the FASB to reduce diversification in practice by providing specific guidance on the presentation of restricted cash or restricted cash equivalents in the statement of cash flows. The updated guidance requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash and restricted cash equivalents. As such, amounts generally described as restricted cash and restricted cash equivalents should be included in the “beginning–of–period” and “end–of–period” total amounts shown on the statement of cash flows. The effective date for this standard is for years beginning after December 15, 2017, with early adoption permitted. Effective December 31, 2016, the Company elected to early adopt this standard. The adoption of this standard represented a change in accounting principle which was applied retrospectively; see the paragraphs above under “Change in Accounting Principle” for further discussion on the adoption of ASU No. 2016–18.

10

In March 2016, the FASB issued ASU 2016-09, “Compensation – Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting.” ASU 2016-09 simplifies the accounting for share-based payment award transactions including: income tax consequences, classification of awards as either equity or liabilities and classification on the statement of cash flows. ASU 2016-09 is effective for fiscal years beginning after December 15, 2016, including interim periods within those fiscal years. On January 1, 2017, the Company adopted the provisions of ASU 2016-09. As a result of the adoption, the Company has recognized $0 and $235,000 of excess tax benefits related to share-based payments in our provision for income taxes for the three and nine months ended September 30, 2017, respectively. These items were historically recorded in additional paid-in capital. In addition, cash flows related to excess tax benefits are now classified as an operating activity along with other income tax related cash flows. The Company elected to apply the change in presentation of excess tax benefits in the statements of cash flows on a prospective basis.

Recent Accounting Guidance Not Yet Adopted

In February 2016, the FASB issued ASU 2016-02, "Leases (Topic 842)." The objective of this update is to increase transparency and comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and disclosing key information about leasing arrangements. This ASU is effective for fiscal years beginning after December 15, 2018, including interim periods within those annual periods and is to be applied utilizing a modified retrospective approach. We anticipate this standard will have a material impact on our consolidated financial statements. Additionally, we are currently evaluating the impact this standard will have on our policies and procedures and internal control framework.

In January 2016, the FASB issued ASU No. 2016-01, “Financial Instruments - Recognition and Measurement of Financial Assets and Financial Liabilities(Topic 825)”. ASU No. 2016-01 revises the classification and measurement of investments in certain equity investments and the presentation of certain fair value changes for certain financial liabilities measured at fair value. ASU No. 2016-01 requires the change in fair value of many equity investments to be recognized in net income.  ASU No. 2016-01 is effective for interim and annual periods beginning after December 15, 2017, with early adoption permitted.   Adopting ASU No. 2016-01 may result in a cumulative effect adjustment to the Company’s retained earnings as of the beginning of the year of adoption. We are currently evaluating the potential effects of adopting the provisions of ASU No. 2016-01.

In May 2014, the FASB issued ASU No. 2014–09 “Revenue from Contracts with Customers”, also known as the “New Revenue Standard”. This update is the result of a collaborative effort by the FASB and the International Accounting Standards Board to simplify revenue recognition guidance, remove inconsistencies in the application of revenue recognition, and to improve comparability of revenue recognition practices across entities, industries, jurisdictions, and capital markets. The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to receive for those goods or services. The New Revenue Standard is applied through the following five-step process:

1. Identify the contract(s) with a customer.

2. Identify the performance obligation in the contract.

3. Determine the transaction price.

4. Allocate the transaction price to the performance obligations in the contract.

5. Recognize revenue when (or as) the entity satisfies a performance obligation.

For a public entity, this update is effective for annual reporting periods beginning after December 15, 2017, including interim periods within that reporting period by applying either the full retrospective method or the cumulative catch-up transition method. The full retrospective method requires application of the provisions of the New Revenue Standard for all periods presented while the cumulative catch-up transition method requires the application of the provisions of the New Revenue Standard as of the date of adoption with the cumulative effect of the retrospective application of the provisions as an adjustment through retained earnings. Currently, the Company is evaluating which method to apply.

11

As we continue to progress with our implementation efforts to adopt the New Revenue Standard, management continues to evaluate and refine its estimates of the anticipated impacts it will have on our revenue recognition policies, procedures, financial position, results of operations, cash flows, financial disclosures and control framework.  In addition, the Company is monitoring specific developments for the senior living industry and evaluating potential changes to our business processes, systems, and controls to support the recognition disclosure under the new standard. Specifically, the Company is continuing to evaluate revenue sources to determine the potential effects the New Revenue Standard will have on the amount or timing of certain industry-specific healthcare revenue sources, which at this time, includes revenue recorded from our continuing care retirement community (“CCRC”), timing of revenue recorded from our homecare operations, and settlements with third party payors. At this time, we do not expect any significant impacts. 

Revenue Recognition – Third Party Payors

Approximately 65% of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment no longer being subject to audit or review. We have recorded liabilities of approximately $20,649,000 and $17,019,000 as of September 30, 2017 and December 31, 2016, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.

Revenue Recognition – Private Pay

For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.

Revenue Recognition – Subordination of Fees and Uncertain Collections

We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge 6% to 7% of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the healthcare facility being managed. Furthermore, for certain of the third parties with whom we have contracted to provide services and which we have determined that collection is not reasonably assured; our policy is to recognize income only in the period in which the amounts are realized. We may receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.

We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may continue to provide services to certain managed centers despite not being fully paid currently so that we may be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. Also, we may benefit from providing other ancillary services to the managed center.

Segment Reporting

In accordance with the provisions of ASC 280, “Segment Reporting”, the Company is required to report financial and descriptive information about its reportable operating segments. Beginning in the first quarter of 2017 with the leadership change of the Company’s Chief Executive Officer, we reassessed and realigned our reportable operating segments to coincide with the way our new leadership and chief operating decision maker ("CODM") measures Company performance and allocates resources. The Company now has two reportable operating segments: (1) inpatient services, which includes the operation of skilled nursing facilities and assisted and independent living facilities, and (2) homecare services. The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. See Note 5 for further disclosure of the Company’s operating segments.

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Other Operating Expenses

Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance.

General and Administrative Costs

With the Company being a healthcare provider, the majority of our expenses are "cost of revenue" items. Costs that could be classified as "general and administrative" by the Company would include its corporate office costs, which were $22,442,000 and $21,222,000 for the nine months ended September 30, 2017 and 2016, respectively.

Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20-40 years and equipment and furniture, 3-15 years. Leasehold improvements are amortized over periods that do not exceed the non-cancelable respective lease terms using the straight-line method.

Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic 840-30, Leases – Capital Leases. Amortization of capital lease assets is included in depreciation and amortization expense.

Accrued Risk Reserves

We are self–insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to engage an external, independent actuary to assist in estimating our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis.

Professional liability remains an area of particular concern to us. The long-term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by skilled nursing facilities and their employees in providing care to residents. As of September 30, 2017, we and/or our managed healthcare facilities are defendants in 60 such claims. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.

We are principally self-insured for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.

Continuing Care Contracts and Refundable Entrance Fee

We have one CCRC within our operations. Residents at this retirement center may enter into continuing care contracts with us. The contracts provide that 10% of the resident entry fee becomes non-refundable upon occupancy, and the remaining refundable portion of the entry fee is calculated using the lessor of the price at which the apartment is re-assigned or 90% of the original entry fee, plus 40% of any appreciation if the apartment exceeds the original resident’s entry fee. In each case, we amortize the non-refundable part of these fees into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of September 30, 2017 and December 31, 2016 were $8,827,000 and $9,924,000, respectively.

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Obligation to Provide Future Services

We annually estimate the present value of the cost of future services and the use of facilities to be provided to the current CCRC residents and compare that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of September 30, 2017, and December 31, 2016, we have recorded a future service obligation in the amount of $3,236,000.

Other Noncurrent Liabilities

Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions.

Deferred Revenue

Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”), the non-refundable portion (10%) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are not yet earned.

Noncontrolling Interest

The noncontrolling interest in a subsidiary is presented within total equity in the Company's interim condensed consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income attributable to NHC in its interim condensed consolidated statements of income. The Company’s earnings per share is calculated based on net income attributable to NHC’s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest.

Variable Interest Entities

We have equity interests in unconsolidated limited liability companies that operate various post-acute and senior healthcare businesses. We analyze our investments in these limited liability companies to determine if the company is considered a VIE and would require consolidation. To the extent that we own interests in a VIE and we (i) are the sole entity that has the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary.

The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and may or may not be limited to its investment in the unconsolidated VIE. The investments in unconsolidated VIEs are classified as “investments in limited liability companies” in the consolidated balance sheets.

Note 3 – Other Revenues

Other revenues are outlined in the table below. Revenues from management and accounting services include management and accounting fees provided to managed healthcare facilities and other health care centers. Revenues from rental income include health care real estate properties owned by us and leased to third party operators. Revenues from insurance services include premiums for workers’ compensation and professional liability insurance policies that our wholly–owned limited purpose insurance subsidiaries have written for certain health care centers to which we provide management or accounting services. "Other" revenues include miscellaneous health care related earnings.

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Other revenues include the following:

	Three Months Ended September 30				Nine Months Ended September 30
(in thousands)	2017		2016		2017		2016
Rental Income	$	5,500	$	5,434	$	16,501	$	16,439
Management and accounting services fees		4,130		5,061		11,741		12,316
Insurance services		2,077		1,729		5,721		5,468
Other		230		410		868		1,174
	$	11,937	$	12,634	$	34,831	$	35,397

Management Fees from National

We manage five skilled nursing facilities owned by National. For the three months and nine months ended September 30, 2017, we recognized management fees and interest on management fees of $977,000 and $2,902,000 from these centers, respectively. For the three months and nine months ended September 30, 2016, we recognized management fees and interest on management fees of $939,000 and $2,834,000 from these centers.

Because the amount collectable cannot be reasonably determined when the management services are provided, and because we cannot estimate the timing or amount of expected future collections, the unpaid fees from the five centers owned by National will be recognized as revenues only when the collectability of these fees can be reasonably assured.  Under the terms of our management agreement with National, the payment of these fees to us may be subordinated to other expenditures of the five long–term care centers.  We continue to manage these centers so that we may be able to collect our fees in the future and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit.  We may receive payment for the unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the five centers or the proceeds from the sale of the centers are sufficient to pay the fees.  There can be no assurance that such future improved cash flows will occur. 

Insurance Services

For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the three months and nine months ended September 30, 2017 were $1,399,000 and $4,087,000. For the three months and nine months ended September 30, 2016, the workers' compensation premium revenues reflected in the interim condensed consolidated statements of income were $1,064,000 and $3,447,000, respectively. Associated losses and expenses are reflected in the interim condensed consolidated statements of income as "Salaries, wages and benefits."

For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the three months and nine months ended September 30, 2017 were $678,000 and $1,634,000, respectively. For the three months and nine months ended September 30, 2016, the professional liability insurance premium revenues reflected in the interim condensed consolidated statements of income were $665,000 and $2,021,000, respectively. Associated losses and expenses including those for self–insurance are included in the interim condensed consolidated statements of income as "Other operating costs and expenses".

Note 4 – Non–Operating Income

Non–operating income is outlined in the table below. Non–operating income includes equity in earnings of unconsolidated investments, dividends and other realized gains and losses on marketable securities, and interest income. Our most significant equity method investment is a 75.1% non–controlling ownership interest in Caris HealthCare L.P. (“Caris”), a business that specializes in hospice care services.

	Three Months Ended September 30				Nine Months Ended September 30
(in thousands)	2017		2016		2017		2016
Equity in earnings of unconsolidated investments	$	2,528	$	1,806	$	5,908	$	4,926
Dividends and other net realized gains and losses on sales of securities		1,696		1,892		5,319		5,654
Interest income		1,866		1,393		4,820		4,209
	$	6,090	$	5,091	$	16,047	$	14,789

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Note 5 – Business Segments

The Company has two reportable operating segments: (1) inpatient services, which includes the operation of skilled nursing facilities and assisted and independent living facilities, and (2) homecare services. These reportable operating segments are consistent with information used by the Company’s Chief Executive Officer, as CODM, to assess performance and allocate resources.

The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. The Company has presented the financial information for the three months and nine months ended September 30, 2016 on a comparative basis to conform with the current year segment presentation. For additional information on these reportable segments see Note 1 - “Description of Business”.

The Company’s CODM evaluates performance and allocates capital resources to each segment based on an operating model that is designed to improve the quality of patient care and profitability of the Company while enhancing long-term shareholder value. The CODM does not review assets by segment in his resource allocation and therefore, assets by segment are not disclosed below.

The following table sets forth the Company’s unaudited interim condensed consolidated statements of income by business segment (in thousands):

	Three Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	214,360	$	15,688	$	-		$	230,048
Other revenues		181		-		11,756			11,937
Net operating revenues		214,541		15,688		11,756			241,985
Costs and Expenses:
Salaries, wages and benefits		127,050		8,317		10,533			145,900
Other Operating		56,851		5,291		1,897			64,039
Rent		8,128		502		1,476			10,106
Depreciation and Amortization		9,756		41		1,036			10,833
Interest		423		-		899			1,322
Total costs and expenses		202,208		14,151		15,841			232,200
Income (Loss) Before Non-Operating Income		12,333		1,537		(4,085	)		9,785
Non-Operating Income		-		-		6,090			6,090
Income Before Income Taxes	$	12,333	$	1,537	$	2,005		$	15,875

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	Three Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	202,925	$	15,722	$	-		$	218,647
Other revenues		-		-		12,634			12,634
Net operating revenues		202,925		15,722		12,634			231,281
Costs and Expenses:
Salaries, wages and benefits		122,496		8,103		9,804			140,403
Other Operating		51,717		5,108		2,131			58,956
Rent		8,028		476		1,810			10,314
Depreciation and Amortization		8,862		46		1,090			9,998
Interest		474		-		546			1,020
Total costs and expenses		191,577		13,733		15,381			220,691
Income (Loss) Before Non-Operating Income		11,348		1,989		(2,747	)		10,590
Non-Operating Income		-		-		5,091			5,091
Income Before Income Taxes	$	11,348	$	1,989	$	2,344		$	15,681

	Nine Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	638,550	$	47,304	$	-		$	685,854
Other revenues		632		-		34,199			34,831
Net operating revenues		639,182		47,304		34,199			720,685
Costs and Expenses:
Salaries, wages and benefits		369,585		24,760		32,294			426,639
Other Operating		169,710		15,484		5,584			190,778
Rent		24,552		1,490		4,231			30,273
Depreciation and Amortization		28,362		120		3,127			31,609
Interest		1,309		-		2,290			3,599
Total costs and expenses		593,518		41,854		47,526			682,898
Income (Loss) Before Non-Operating Income		45,664		5,450		(13,327	)		37,787
Non-Operating Income		-		-		16,047			16,047
Income Before Income Taxes	$	45,664	$	5,450	$	2,720		$	53,834

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	Nine Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	605,626	$	47,614	$	-		$	653,240
Other revenues		250		-		35,147			35,397
Net operating revenues		605,876		47,614		35,147			688,637
Costs and Expenses:
Salaries, wages and benefits		350,166		24,300		31,025			405,491
Other Operating		156,068		15,494		6,009			177,571
Rent		24,838		1,443		4,679			30,960
Depreciation and Amortization		25,435		139		3,273			28,847
Interest		1,459		-		1,454			2,913
Total costs and expenses		557,966		41,376		46,440			645,782
Income (Loss) Before Non-Operating Income		47,910		6,238		(11,293	)		42,855
Non-Operating Income		-		-		14,789			14,789
Income Before Income Taxes	$	47,910	$	6,238	$	3,496		$	57,644

Note 6 – Long-Term Leases

Capital Leases

Fixed assets recorded under the capital leases, which are included in property and equipment in the interim condensed consolidated balance sheets, are as follows:

	September 30, 2017			December 31, 2016
	(in thousands)
Buildings and personal property	$	39,032		$	39,032
Accumulated amortization		(14,064	)		(11,120	)
	$	24,968		$	27,912

Operating Leases

At September 30, 2017, NHC leases from National Health Investors, Inc. (“NHI”) the real property of 35 skilled nursing facilities, seven assisted living facilities and three independent living facilities under two separate lease agreements. Base rent expense under both lease agreements totals $34,200,000 annually with rent thereafter escalating by 4% of the increase in facility revenue over the base year. Total facility rent expense to NHI was $9,314,000 and $9,480,000 for the three months ended September 30, 2017 and 2016, respectively. Total facility rent expense to NHI was $27,942,000 and $28,440,000 for the nine months ended September 30, 2017 and 2016, respectively.

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Minimum Lease Payments

The approximate future minimum lease payments required under all leases that have remaining non-cancelable lease terms at September 30, 2017 are as follows:

	Operating Leases		Capital Leases
	(in thousands)
2018	$	34,200	$	5,200
2019		34,200		5,200
2020		34,200		5,200
2021		34,200		5,200
2022		34,200		5,200
Thereafter		151,100		7,367
Total minimum lease payments	$	322,100	$	33,367
Less: Amounts representing interest				(5,729	)
Present value of minimum lease payments				27,638
Less: Current portion				(3,641	)
Long-term capital lease obligations			$	23,997

Note 7 – Earnings per Share

Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings.

The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share (in thousands, except for share and per share amounts):

	Three Months Ended Sept.30				Nine Months Ended Sept. 30
	2017		2016		2017		2016
Basic:
Weighted average common shares outstanding		15,195,394		15,198,696		15,186,315		15,128,728
Net income attributable to National HealthCare Corporation	$	11,352	$	11,110	$	34,735	$	36,675
Earnings per common share, basic	$	0.75	$	0.73	$	2.29	$	2.42
Diluted:
Weighted average common shares outstanding		15,195,394		15,198,696		15,186,315		15,128,728
Dilutive effect of stock options		25,173		23,952		31,482		23,588
Dilutive effect of contingent issuable stock		-		-		-		64,522
Weighted average common shares outstanding		15,220,567		15,222,648		15,217,797		15,216,838
Net income attributable to National HealthCare Corporation	$	11,352	$	11,110	$	34,735	$	36,675
Earnings per common share, diluted	$	0.75	$	0.73	$	2.28	$	2.41

In the above table, options to purchase 1,122,585 shares of our common stock have been excluded for the three months and nine months ended September 30, 2017 due to their anti–dilutive impact. Options to purchase 11,592 shares of our common stock have been excluded for the three months and nine months ended September 30, 2016 due to their anti–dilutive impact.

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Note 8 – Investments in Marketable Securities

Our investments in marketable securities are classified as available for sale securities. Realized gains and losses from securities sales are recognized in results of operations upon disposition of the securities using the specific identification method on a trade date basis. Refer to Note 9 for a description of the Company's methodology for determining the fair value of marketable securities.

Marketable securities and restricted marketable securities consist of the following (in thousands):

	September 30, 2017				December 31, 2016
	Amortized Cost		Fair Value		Amortized Cost		Fair Value
Investments available for sale:
Marketable equity securities	$	30,176	$	143,763	$	30,176	$	138,013
Restricted investments available for sale:
Corporate debt securities		68,538		69,311		71,311		71,100
Commercial mortgage–backed securities		50,762		50,517		56,889		56,168
U.S. Treasury securities		21,297		20,926		25,748		25,181
State and municipal securities		23,903		23,856		32,020		31,255
	$	194,676	$	308,373	$	216,144	$	321,717

Included in the available for sale marketable equity securities are the following(in thousands, except share amounts):

	September 30, 2017						December 31, 2016
	Shares		Cost		Fair Value		Shares		Cost		Fair Value
NHI Common Stock		1,630,642	$	24,734	$	126,032		1,630,642	$	24,734	$	120,945

The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows (in thousands):

	September 30, 2017				December 31, 2016
	Cost		Fair Value		Cost		Fair Value
Maturities:
Within 1 year	$	11,060	$	11,081	$	14,181	$	14,216
1 to 5 years		68,297		68,620		79,827		79,502
6 to 10 years		80,290		80,073		91,211		89,269
Over 10 years		4,853		4,836		749		717
	$	164,500	$	164,610	$	185,968	$	183,704

Gross unrealized gains related to available for sale securities are $114,891,000 and $108,730,000 as of September 30, 2017 and December 31, 2016, respectively. Gross unrealized losses related to available for sale securities are $1,194,000 and $3,157,000 as of September 30, 2017 and December 31, 2016, respectively. For the marketable securities in gross unrealized loss positions, (a) it is more likely than not that the Company will not be required to sell the investment securities before recovery of the unrealized losses, and (b) the Company expects that the contractual principal and interest will be received on the investment securities. As a result, the Company recognized no other-than-temporary impairment during the nine months ended September 30, 2017 or for the year ended December 31, 2016.

Proceeds from the sale of securities during the nine months ended September 30, 2017 and 2016 were $46,598,000 and $30,963,000, respectively. Investment gains of $255,000 and $804,000 were realized on these sales during the nine months ended September 30, 2017 and 2016, respectively.

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Note 9 – Fair Value Measurements

The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes the three levels of inputs that may be used to measure fair value:

Level 1 – The valuation is based on quoted prices in active markets for identical instruments.

Level 2 – The valuation is based on observable inputs such as quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model–based valuation techniques for which all significant assumptions are observable in the market.

Level 3 – The valuation is based on unobservable inputs that are supported by minimal or no market activity and that are significant to the fair value of the instrument. Level 3 valuations are typically performed using pricing models, discounted cash flow methodologies, or similar techniques that incorporate management’s own estimates of assumptions that market participants would use in pricing the instrument, or valuations that require significant management judgment or estimation.

A financial instrument’s level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement.

Valuation of Marketable Securities

The Company determines fair value for marketable securities with Level 1 inputs through quoted market prices. The Company determines fair value for marketable securities with Level 2 inputs through broker or dealer quotations or alternative pricing sources with reasonable levels of price transparency. Our Level 2 marketable securities have been initially valued at the transaction price and subsequently valued, at the end of each month, typically utilizing third party pricing services or other market observable data. The pricing services utilize industry standard valuation models, including both income and market based approaches and observable market inputs to determine value. These observable market inputs include reportable trades, benchmark yields, credit spreads, broker/dealer quotes, bids, offers, and other industry and economic events.

We validated the prices provided by our broker by reviewing their pricing methods, obtaining market values from other pricing sources, analyzing pricing data in certain instances and confirming that the relevant markets are active. After completing our validation procedures, we did not adjust or override any fair value measurements provided by our broker as of September 30, 2017. We did not have any transfers of assets between Level 1 and Level 2 of the fair value measurement hierarchy during the nine months ended September 30, 2017.

Other

The carrying amounts of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, and accounts payable approximate fair value due to their short–term nature. The estimated fair value of notes receivable approximates the carrying value based principally on their underlying interest rates and terms, maturities, collateral and credit status of the receivables. Our long–term debt approximates fair value due to variable interest rates, but fair value is also determined using Level 2 inputs through alternative pricing sources. At September 30, 2017, there were no material differences between the carrying amounts and fair values of NHC’s financial instruments.

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The following table summarizes fair value measurements by level at September 30, 2017 and December 31, 2016 for assets and liabilities measured at fair value on a recurring basis (in thousands):

	Fair Value Measurements Using
September 30, 2017	Fair Value		Quoted Prices in Active Markets For Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Cash and cash equivalents	$	69,790	$	69,790	$	–	$	–
Restricted cash and cash equivalents		11,950		11,950		–		–
Marketable equity securities		143,763		143,763		–		–
Corporate debt securities		69,311		48,929		20,382		–
Mortgage–backed securities		50,517		–		50,517		–
U.S. Treasury securities		20,926		20,926		–		–
State and municipal securities		23,856		–		23,856		–
Total financial assets	$	390,113	$	295,358	$	94,755	$	–

	Fair Value Measurements Using
December 31, 2016	Fair Value		Quoted Prices in Active Markets For Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Cash and cash equivalents	$	26,335	$	26,335	$	–	$	–
Restricted cash and cash equivalents		5,254		5,254		–		–
Marketable equity securities		138,013		138,013		–		–
Corporate debt securities		71,100		42,323		28,777		–
Mortgage-backed securities		56,168		–		56,168		–
U.S. Treasury securities		25,181		25,181		–		–
State and municipal securities		31,255		–		31,255		–
Total financial assets	$	353,306	$	237,106	$	116,200	$	–

Note 10 – Long–Term Debt

Long–term debt consists of the following:

	Weighted Average Interest Rate			Maturities		September 30, 2017		December 31, 2016
	Variable					(dollars in thousands)
Revolving Credit Facility, interest payable monthly		2.6	%		2020	$	110,000	$	110,000
Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		3.6	%		2018		10,000		10,000
							120,000		120,000
Less current portion							–		–
						$	120,000	$	120,000

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The $10 million unsecured term note payable to National is due January 1, 2018. The Company intends to extend the note payable beyond the current due date. If the Company is not able to extend the note payable with National, the Company’s $175 million credit facility is available to provide financing.

$175,000,000 Credit Facility

In October 2015, we entered into a $175 million credit facility that has a five year maturity date (October 2020). Loans bear interest at either (i) LIBOR plus 1.40% or (ii) the base rate plus 0.40%. The base rate is defined as the highest of (a) the Federal Funds Rate plus ½ of 1%, (b) the Bank of America prime rate, and (c) LIBOR plus 1.00%. The credit facility is available for general corporate purposes, including working capital and acquisitions. NHC is permitted, upon required notice to the lender, to prepay the loans outstanding under the credit facility at any time, without penalty.

The Credit Agreement contains customary representations and financial covenants, including covenants that restrict, among other things, asset dispositions, mergers and acquisitions, dividends, restricted payments, debt, liens, investments and affiliate transactions. The Credit Agreement contains customary events of default.

Note 11 - Stock Repurchase Program

In August 2017, the Board of Directors authorized a new common stock purchase program. The program will allow for repurchases of up to $25 million of its common stock. The new stock repurchase plan began on September 1, 2017 and will expire on August 31, 2018. No repurchases of common stock have been executed under this current program.

Note 12 – Stock–Based Compensation

NHC recognizes stock–based compensation expense for all stock options and restricted stock granted over the requisite service period using the fair value for these grants as estimated at the date of grant either using the Black–Scholes pricing model for stock options or the quoted market price for restricted stock.

The Compensation Committee of the Board of Directors (“the Committee”) has the authority to select the participants to be granted options; to designate whether the option granted is an incentive stock option (“ISO”), a non–qualified option, or a stock appreciation right; to establish the number of shares of common stock that may be issued upon exercise of the option; to establish the vesting provision for any award; and to establish the term any award may be outstanding. The exercise price of any ISO’s granted will not be less than the fair market value of the shares of common stock on the date granted and the term of an ISO may not be any more than ten years. The exercise price of any non–qualified options granted will not be less than the fair market value of the shares of common stock on the date granted unless so determined by the Committee.

In May 2015, our stockholders voted to amend the 2010 Omnibus Equity Incentive Plan (“the 2010 Plan”) to increase the number of shares of our common stock authorized under the Plan from the original 1,200,000 shares to 2,575,000 shares. The shares granted during the nine months ended September 30, 2017 consisted of 1,062,500 shares to employees of the Company, 52,500 shares to the Directors of the Company, and 9,310 shares for the Employee Stock Purchase Plan. At September 30, 2017, 568,744 shares were available for future grants under the amended 2010 Plan.

Compensation expense is recognized only for the awards that ultimately vest. Stock–based compensation totaled $430,000 and $9,000 for the three months ended September 30, 2017 and 2016, respectively. Stock–based compensation totaled $1,263,000 and $502,000 for the nine months ended September 30, 2017 and 2016, respectively. Stock–based compensation is included in “Salaries, wages and benefits” in the interim condensed consolidated statements of income.

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At September 30, 2017, the Company had $7,520,000 of unrecognized compensation cost related to unvested stock–based compensation awards. This unrecognized compensation cost will be amortized over an approximate four year period.

Stock Options

The following table summarizes the significant assumptions used to value the options granted for the nine months ended September 30, 2017 and for the year ended December 31, 2016.

	2017			2016
Risk–free interest rate		2.08	%		0.89	%
Expected volatility		16.6	%		15.8	%
Expected life, in years		4.8			2.2
Expected dividend yield		3.10	%		3.09	%

The following table summarizes our outstanding stock options for the nine months ended September 30, 2017 and for the year ended December 31, 2016.

	Number of Shares			Weighted Average Exercise Price		Aggregate Intrinsic Value
Options outstanding at January 1, 2016		621,390		$	48.15	$	–
Options granted		56,291			62.54		–
Options exercised		(499,066	)		47.16		–
Options cancelled		(656	)		46.69		–
Options outstanding at December 31, 2016		177,959			55.48		–
Options granted		1,124,310			72.96		–
Options exercised		(33,717	)		47.89		–
Options cancelled		–			–		–
Options outstanding at September 30, 2017		1,268,552		$	71.17	$	758,000
Options exercisable at September 30, 2017		196,742		$	61.44	$	758,000

Options Outstanding September 30, 2017	Exercise Prices			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life in Years
60,000	$47.45	-	$52.93	$	50.88		1.2
1,208,552	$61.25	-	$75.45		72.18		4.3
1,268,552				$	71.17		4.2

Note 13 – Income Taxes

The income tax provision for the three months ended September 30, 2017 is $4,691,000 (an effective income tax rate of 29.5%). The income tax provision and effective tax rate for the three months ended September 30, 2017 were favorably impacted by statute of limitations expirations resulting in a benefit to the provision of $1,753,000 or 11.0% of income before taxes for the quarter. The income tax provision for the three months ended September 30, 2016 was $4,571,000 (an effective income tax rate of 29.1%). The income tax provision and effective tax rate for the three months ended September 30, 2016 were favorably impacted by statute of limitation expirations resulting in a benefit to the provision of $1,306,000 or 8.3% of income before taxes for the quarter.

The income tax provision for the nine months ended September 30, 2017 is $19,448,000 (an effective income tax rate of 36.1%). The income tax provision and effective tax rate for the nine months ended September 30, 2017 were favorably impacted by the statute of limitations expirations resulting in a benefit to the provision of $1,753,000 or 3.3% of income before taxes in 2017. The income tax provision for the nine months ended September 30, 2016 was $20,969,000 (an effective income tax rate of 36.4%). The income tax provision and effective tax rate for the nine months ended September 30, 2016 were favorably impacted by the statute of limitation expirations resulting in a benefit to the provision of $1,306,000 or 2.3% of income before taxes in 2016.

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Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense.

The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2014 (with certain state exceptions).

Note 14 – Contingencies and Commitments

Accrued Risk Reserves

We are self–insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims both for our owned or leased entities and certain of the entities to which we provide management or accounting services. The liability we have recognized for reported claims and estimates for incurred but unreported claims totals $95,513,000 and $91,162,000 at September 30, 2017 and December 31, 2016, respectively. The liability is included in accrued risk reserves in the interim condensed consolidated balance sheets and is subject to adjustment for actual claims incurred. It is possible that these claims plus unasserted claims could exceed our insurance coverages and our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

As a result of the terms of our insurance policies and our use of wholly–owned limited purpose insurance companies, we have retained significant insurance risk with respect to workers’ compensation and general and professional liability. We consider the professional services of independent actuaries to assist us in estimating our exposures for claims obligations (for both asserted and unasserted claims) related to deductibles and exposures in excess of coverage limits, and we maintain reserves for these obligations. Such estimates are based on many variables including historical and statistical information and other factors.

Workers’ Compensation

For workers’ compensation, we utilize a wholly–owned Tennessee domiciled property/casualty insurance company to write coverage for NHC affiliates and for third–party customers. Policies are written for a duration of twelve months and cover only risks related to workers’ compensation losses. All customers are companies which operate in the senior care industry. Business is written on a direct basis. Direct business coverage is written for statutory limits and the insurance company’s losses in excess of $1,000,000 per claim are covered by reinsurance.

General and Professional Liability Lawsuits and Insurance

The senior care industry has experienced increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by nursing facilities and their employees in providing care to residents. As of September 30, 2017, we and/or our managed centers are currently defendants in 60 such claims.

Insurance coverage for both periods includes both primary policies and excess policies. The primary coverage is in the amount of $1.0 million per incident, $3.0 million per location with an annual primary policy aggregate limit that is adjusted on an annual basis. For 2016 and 2017, the excess coverage is $9.0 million per occurrence. Additional insurance is purchased through third party providers that serve to supplement the coverage provided through our wholly–owned captive insurance company.

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Civil Investigative Demand

On December 19, 2013, the Company was served with a civil investigative demand (“CID”) from the U.S. Department of Justice and the Office of the U.S. Attorney for the Eastern District of Tennessee (“DOJ Investigation”) requesting the production of documents and interrogatory responses regarding the billing for and medical necessity of certain rehabilitative therapy services. Based upon our review, the CID appears to relate to services provided at our facilities based in Knoxville, Tennessee.

On October 7, 2014, the Company received a subpoena from the Office of Inspector General of the United Department of Health and Human Services (“OIG Subpoena”) related to the current DOJ Investigation.  The OIG Subpoena requests certain financial and organizational documents from the Company and certain of its subsidiaries and SNFs and medical records from certain of the Company’s Tennessee–based SNFs. 

The Company is cooperating fully with these requests. We are unable to evaluate the outcome of this investigation at this time.  It is possible that this investigation could lead to a claim that could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

Caris HealthCare, L.P. Investigation

On December 9, 2014, Caris Healthcare, L.P., a business that specializes in hospice care services in Company–owned health care centers and in other settings, received notice from the U.S. Attorney’s Office for the Eastern District of Tennessee and the Attorney Generals’ Offices for the State of Tennessee and State of Virginia that those government entities were conducting an investigation regarding patient eligibility for hospice services provided by Caris precipitated by a qui tam lawsuit.  We have a 75.1% non–controlling ownership interest in Caris.

A qui tam lawsuit was filed on May 22, 2014, in the U.S. District Court for the Eastern District of Tennessee by a former Caris employee, Barbara Hinkle, and is captioned United States of America, State of Tennessee, and State of Virginia ex rel. Barbara Hinkle v. Caris Healthcare, L.P., No. 3:14–cv–212 (E.D. Tenn.).

On June 16, 2016, the State of Tennessee and the State of Virginia declined to intervene in the qui tam lawsuit.  On June 20, 2016, the Court ordered that the complaint be unsealed.  On October 11, 2016, the United States filed a Complaint in Intervention against Caris Healthcare, L.P. and Caris Healthcare, LLC, a wholly owned subsidiary of Caris Healthcare, L.P. The United States' complaint alleges that Caris billed the government for ineligible hospice patients between June 2013 and December 2013 and retained overpayments regarding ineligible hospice patients from April 2010 through June 2013. It seeks treble damages and civil penalties under the Federal False Claims Act and asserts claims for payment under mistake of fact, unjust enrichment, and conversion. The relator has filed a notice of voluntary dismissal without prejudice of the non–intervened claims asserted in her qui tam complaint. On May 30, 2017, the district court denied Caris’ motion to dismiss, and the parties are engaged in discovery. This matter is set for trial in March 2019.

Caris denies the allegations in the United States' complaint and intends to defend itself vigorously. Given the early stage of this action, we are unable to assess the probable outcome or potential liability, if any, arising from this action.  It is possible that this claim could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

Financing Commitments

In conjunction with our management contract with National, we have entered into a line of credit arrangement whereby we may have amounts due from National from time to time. The maximum loan commitment under the line of credit is $2,000,000. At September 30, 2017, National did not have an outstanding balance on the line of credit.

Governmental Regulations

Laws and regulations governing the Medicare, Medicaid and other federal healthcare programs are complex and subject to interpretation. Management believes that it is in compliance with all applicable laws and regulations in all material respects. However, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusions from the Medicare, Medicaid and other federal healthcare programs.

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Note 15 – Common Stock Authorized

On May 9, 2017, our Board of Directors and shareholders approved to increase our authorized common stock by 15,000,000 shares, from 30,000,000 shares to 45,000,000 shares, par value $0.01. The additional shares of common stock available for issue are part of the existing class of common stock. These shares have the same rights and privileges as the shares of common stock previously outstanding.

Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations.

Overview

National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. We operate or manage, through certain affiliates, 76 skilled nursing facilities with a total of 9,597 licensed beds, 24 assisted living facilities, five independent living facilities, and 36 homecare programs. We operate specialized care units within certain of our healthcare centers such as Alzheimer's disease care units and sub-acute nursing units. We also have a non-controlling ownership interest in a hospice care business that services NHC owned health care centers and others. In addition, we provide insurance services, management and accounting services, and we lease properties to operators of skilled nursing centers. We operate in 10 states and are located primarily in the southeastern United States.

Summary of Goals and Areas of Focus

Earnings

To monitor our earnings, we have developed budgets and management reports to monitor labor, census, and the composition of revenues.

Occupancy

A primary area of management focus continues to be the rates of occupancy within our skilled nursing facilities. The overall census in owned and leased skilled nursing facilities for the nine months ending September 30, 2017 was 90.4% compared to 89.5% for the same period a year ago. With the average length of stay decreasing for a skilled nursing patient, as well as the increased availability of assisted living facilities and home and community based services, the challenge of maintaining desirable patient census levels has been amplified. Management has undertaken a number of steps in order to best position our current and future health care facilities. This includes working internally to examine and improve systems to be most responsive to referral sources and payors. Additionally, NHC is in various stages of partnerships with hospital systems, payors, and other post–acute alliances to better position ourselves so we are an active participant in the delivery of post-acute healthcare services.

Development and Growth

We are undertaking to expand our senior care operations while protecting our existing operations and markets. The following table lists our recent development activities.

Type of Operation	Description	Size	Location	Placed in Service
SNF	Bed Addition	44 beds	Charleston, SC	May, 2016
SNF/ALF	New Facility	90 beds / 80 units	Nashville, TN	June, 2016
SNF	Bed Addition	8 beds	Kingsport, TN	September, 2016
SNF	New Facility	112 beds	Columbia, TN	January, 2017
ALF	New Facility	78 units	Bluffton, SC	March, 2017
ALF	New Facility	80 units	Garden City, SC	June, 2017
Memory Care	Bed Addition	23 units	Murfreesboro, TN	July, 2017
SNF	Bed Addition	30 beds	Springfield, MO	Under construction

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For the project under construction at September 30, 2017, the 30-bed addition in Springfield, Missouri is expected to open in the first quarter of 2018.

We also plan to apply for Certificates of Need for additional beds in certain of our markets. We will evaluate the feasibility of expansion into new markets by primarily building private pay skilled nursing facilities and assisted living communities.

Accrued Risk Reserves

Our accrued professional liability and workers’ compensation reserves totaled $95,513,000 at September 30, 2017 and are a primary area of management focus. We have set aside restricted cash and cash equivalents and marketable securities to fund our estimated professional liability and workers’ compensation liabilities.

As to exposure for professional liability claims, we have developed performance certification criteria to measure and bring focus to the patient care issues most likely to produce professional liability exposure, including in–house acquired pressure ulcers, significant weight loss and numbers of falls. These programs for certification, which we regularly modify and improve, have produced measurable improvements in reducing these incidents. Our experience is that achieving goals in these patient care areas improves both patient and employee satisfaction.

Application of Critical Accounting Policies

There were no significant changes during the nine-month period ended September 30, 2017 to the items we disclosed as our critical accounting policies and estimates in our discussion and analysis of financial condition and results of operations in our December 31, 2016 Annual Report on Form 10–K filed with the SEC.

Government Program Financial Changes

Federal Health Care Reform

In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act ("PPACA" or, commonly, “ACA”) and the Health Care and Education Reconciliation Act of 2010 ("HCERA"), which represents significant changes to the current U.S. health care system (collectively the "Acts"). The primary goals of the Acts are to: (1) expand coverage to Americans without health insurance, (2) reform the delivery system to improve quality and drive efficiency, (3) and to lower the overall costs of providing health care. The timeline of the enacted provisions spans over several years – some of the provisions were effective immediately in 2010 and others may be phased in through 2020.

Since a significant goal of the ACA is to transform the delivery of health care by holding providers accountable for the cost and quality of care provided, Medicare and many commercial third-party payors are implementing Accountable Care Organization ("ACO") models in which groups of providers share in the benefit and risk of providing care to an assigned group of individuals. Other reimbursement methodology reforms in which we are participating or expect to participate in include value–based purchasing, in which a portion of provider reimbursement is redistributed based on relative performance on designated economic, clinical quality, and patient satisfaction metrics. Also, CMS is implementing demonstration programs to bundle acute care and post–acute care reimbursement to hold providers accountable for costs across a broader continuum of care. These reimbursement methodologies and similar programs are likely to continue and expand, both in public and commercial health plans. Providers who respond successfully to these trends and are able to deliver quality care at lower costs are likely to benefit financially.

If the ACA is repealed, replaced, or modified, we cannot predict what the replacement plan or modifications would be or whether any of the existing provisions will remain in place. The potential repeal, replace or modification of the ACA on our business is subject to numerous variables and the potential impact on the Company’s financial condition or results of operations is currently unknown.

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Medicare – Skilled Nursing Facilities

In July 2017, CMS released its final rule outlining the fiscal year 2018 Medicare payments and policy changes for skilled nursing facilities. The 2018 final rule provided for an approximate 1.0% rate update, which began October 1, 2017. CMS estimated a 2.7% market basket increase reduced by 0.4% for a multifactor productivity adjustment required by the ACA; however, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) mandated that all post-acute care providers receive a maximum market basket update of 1% in fiscal year 2018 to offset part of the cost of the legislation. CMS estimates the update will increase overall payments to skilled nursing facilities in fiscal year 2018 by $370 million compared to fiscal year 2017 levels. CMS also revised and rebased the market basket index by updating the base year from fiscal year 2010 to fiscal year 2014.

In July 2016, CMS released its final rule outlining the fiscal year 2017 Medicare payments and policy changes for skilled nursing facilities. The 2017 final rule provided for an approximate 2.4% rate update, which began October 1, 2016. This increase consisted of a 2.7% market basket increase reduced by 0.3% for a multifactor productivity adjustment required by the ACA. The policy changes in the 2017 final rule continued to shift Medicare payments from volume to value. The final rule also made changes to the SNF Quality Reporting Program and Value-Based Purchasing Program.

For the first nine months of 2017, our average Medicare per diem rate for skilled nursing facilities increased 2.7% compared to the same period in 2016.

Medicaid – Skilled Nursing Facilities

Effective July 1, 2017 and for the fiscal year 2018, the state of Tennessee implemented specific individual nursing facility rate increases. We estimate the resulting increase in revenue for the 2018 fiscal year will be approximately $3,600,000 annually, or $900,000 per quarter. Effective July 1, 2016 and for the fiscal year 2017, the state of Tennessee implemented specific individual nursing facility rate increases. The resulting increase in revenue beginning July 1, 2016 was approximately $1,700,000 annually, or $425,000 per quarter.

Effective October 1, 2017 and for the fiscal year 2018, South Carolina implemented specific individual nursing facility rate changes. We estimate the resulting increase in revenue for the 2018 fiscal year will be approximately $1,100,000 annually, or $275,000 per quarter. Effective October 1, 2016 and for the fiscal year 2017, South Carolina implemented specific individual nursing facility rate changes. The resulting increase in revenue for the 2017 fiscal year was approximately $1,000,000 annually, or $250,000 per quarter.           

Effective August 1, 2017 and for the fiscal year 2018, the state of Missouri approved a Medicaid rate decrease of $5.37 per patient day, or an approximate 3.5% decrease, to Missouri skilled nursing providers. We estimate the resulting decrease in revenue will be approximately $1,400,000 annually, or $350,000 per quarter. Effective July 1, 2016 and for the fiscal year 2017, the state of Missouri approved a Medicaid rate increase of $2.83 per patient day to Missouri skilled nursing providers. The resulting increase in revenue was approximately $800,000 annually, or $200,000 per quarter.

For the first nine months of 2017, our average Medicaid per diem increased 2.1% compared to the same period in 2016. We face challenges with respect to states’ Medicaid payments, because many currently do not cover the total costs incurred in providing care to those patients. States will continue to control Medicaid expenditures and also look for adequate funding sources, including provider assessments. There are several pieces of legislation that include provisions designed to reduce Medicaid spending. These provisions include, among others, provisions strengthening the Medicaid asset transfer restrictions for persons seeking to qualify for Medicaid long-term care coverage, which could, due to the timing of the penalty period, increase facilities’ exposure to uncompensated care. Other provisions could increase state funding for home and community-based services, potentially having an impact on funding for nursing facilities.

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Medicare – Homecare Programs

In October 2016 and effective January 1, 2017, CMS released its final rule for 2017 home health prospective payment system rates. CMS estimated the net impact of the PPS rule resulted in a 0.7% decrease ($130 million) in Medicare payments for agencies in 2017. The estimated decrease reflects the effects of a 2.5% home health payment update; rebasing adjustments to the national standardized 60-day episode payment rate, the national per-visit payment rate, and the non-routine medical supplies conversion factor (expected impact of -2.3%), and the effects of an adjustment to the national standardized 60-day episode payment rate to account for nominal case-mix growth (expected impact of -0.9%). However, the freestanding home health agencies are expected to have an overall reduction of 0.8%, and agencies in eight states including the states of South Carolina and Florida are expected to average a reimbursement decrease of 1.9%. NHC estimates the overall effect on its agencies will be a reduction of approximately 1.0%.

Segment Reporting

Beginning in the first quarter of 2017 with the leadership change of the Company’s Chief Executive Officer, we reassessed and realigned our reportable operating segments to coincide with the way our new leadership and CODM measures Company performance and allocates resources. The Company has two reportable operating segments: (1) inpatient services, which includes the operation of skilled nursing facilities and assisted and independent living facilities, and (2) homecare services. These reportable operating segments are consistent with information used by the Company’s Chief Executive Officer, as CODM, to assess performance and allocate resources.

The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. The Company has presented the financial information for the three months and nine months ended September 30, 2016 on a comparative basis to conform with the current year segment presentation. For additional information on these reportable segments see Note 1 - “Description of Business”.

The Company’s CODM evaluates performance and allocates capital resources to each segment based on an operating model that is designed to enhance the quality of patient care and profitability of the Company while enhancing long-term shareholder value. Our CODM does not review assets by segment in his resource allocation and therefore, assets by segment are not disclosed below.

The following tables set forth the Company’s unaudited condensed consolidated statements of income by business segment (in thousands):

	Three Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	214,360	$	15,688	$	-		$	230,048
Other revenues		181		-		11,756			11,937
Net operating revenues		214,541		15,688		11,756			241,985
Costs and Expenses:
Salaries, wages and benefits		127,050		8,317		10,533			145,900
Other Operating		56,851		5,291		1,897			64,039
Rent		8,128		502		1,476			10,106
Depreciation and Amortization		9,756		41		1,036			10,833
Interest		423		-		899			1,322
Total costs and expenses		202,208		14,151		15,841			232,200
Income (Loss) Before Non-Operating Income		12,333		1,537		(4,085	)		9,785
Non-Operating Income		-		-		6,090			6,090
Income Before Income Taxes	$	12,333	$	1,537	$	2,005		$	15,875

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	Three Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	202,925	$	15,722	$	-		$	218,647
Other revenues		-		-		12,634			12,634
Net operating revenues		202,925		15,722		12,634			231,281
Costs and Expenses:
Salaries, wages and benefits		122,496		8,103		9,804			140,403
Other Operating		51,717		5,108		2,131			58,956
Rent		8,028		476		1,810			10,314
Depreciation and Amortization		8,862		46		1,090			9,998
Interest		474		-		546			1,020
Total costs and expenses		191,577		13,733		15,381			220,691
Income (Loss) Before Non-Operating Income		11,348		1,989		(2,747	)		10,590
Non-Operating Income		-		-		5,091			5,091
Income Before Income Taxes	$	11,348	$	1,989	$	2,344		$	15,681

	Nine Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	638,550	$	47,304	$	-		$	685,854
Other revenues		632		-		34,199			34,831
Net operating revenues		639,182		47,304		34,199			720,685
Costs and Expenses:
Salaries, wages and benefits		369,585		24,760		32,294			426,639
Other Operating		169,710		15,484		5,584			190,778
Rent		24,552		1,490		4,231			30,273
Depreciation and Amortization		28,362		120		3,127			31,609
Interest		1,309		-		2,290			3,599
Total costs and expenses		593,518		41,854		47,526			682,898
Income (Loss) Before Non-Operating Income		45,664		5,450		(13,327	)		37,787
Non-Operating Income		-		-		16,047			16,047
Income Before Income Taxes	$	45,664	$	5,450	$	2,720		$	53,834

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	Nine Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	605,626	$	47,614	$	-		$	653,240
Other revenues		250		-		35,147			35,397
Net operating revenues		605,876		47,614		35,147			688,637
Costs and Expenses:
Salaries, wages and benefits		350,166		24,300		31,025			405,491
Other Operating		156,068		15,494		6,009			177,571
Rent		24,838		1,443		4,679			30,960
Depreciation and Amortization		25,435		139		3,273			28,847
Interest		1,459		-		1,454			2,913
Total costs and expenses		557,966		41,376		46,440			645,782
Income (Loss) Before Non-Operating Income		47,910		6,238		(11,293	)		42,855
Non-Operating Income		-		-		14,789			14,789
Income Before Income Taxes	$	47,910	$	6,238	$	3,496		$	57,644

Results of Operations

Three Months Ended September 30, 2017 Compared to Three Months Ended September 30, 2016

Results for the quarter ended September 30, 2017 include a 4.6% increase in net operating revenues and a 2.2% increase in net income attributable to NHC compared to the same period in 2016. There have been three newly constructed healthcare facilities placed in service during 2017 (one skilled nursing facility and two assisted living facilities). The operating losses before income taxes for these entities were approximately $989,000 for the three months ended September 30, 2017. Therefore, excluding the operating losses from these three newly constructed facilities, net income attributable to NHC for the quarter ended September 30, 2017 would have been $11,824,000, an increase of 6.4% compared to the same period in 2016.

The total census at owned and leased skilled nursing facilities for the quarter averaged 90.4% compared to an average of 89.3% for the same quarter a year ago. Medicare per diem rates increased 1.4% and Managed Care per diem rates increased 0.1% compared to the quarter a year ago. Medicaid and private pay per diem rates increased 2.9% and 2.7%, respectively, compared to the quarter a year ago. Overall, the composite skilled nursing facility per diem at our owned and leased skilled nursing facilities increased 2.6% compared to the quarter a year ago.

Net patient revenues increased $11,401,000, or 5.2%, compared to the same period last year. The newly constructed healthcare facilities placed in service during 2017 helped increase net patient revenues $1,718,000 compared to the same period a year ago. The remaining increase in our net patient revenues is primarily due to the census increase and per diem increases in our existing skilled nursing facility operations.

Other revenues decreased $697,000, or 5.5%, compared to the same quarter last year, as further detailed in Note 3 to our interim condensed consolidated financial statements. During the first quarter of 2017, we began management contract services for a third-party owner of two skilled nursing facilities in the middle Tennessee area. These two contracts helped increase management fee revenues by $176,000 for the three months ended September 30, 2017 compared to the quarter a year ago. The offsetting decrease in management fee revenue for the 2017 third quarter compared to the prior year quarter is derived from a consulting engagement that is sporadic in nature and decreased $1,121,000 when compared to the prior year quarter.

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Total costs and expenses for the third quarter of 2017 compared to the third quarter of 2016 increased $11,509,000 or 5.2%, to $232,200,000 from $220,691,000. Salaries, wages and benefits, the largest operating costs of our company, increased $5,497,000, or 3.9%, to $145,900,000 from $140,403,000. Other operating expenses increased $5,083,000, or 8.6%, to $64,039,000 for the 2017 period compared to $58,956,000 for the 2016 period. Facility rent expense decreased $208,000 to $10,106,000. Depreciation and amortization increased $835,000 to $10,833,000. Interest expense increased $302,000 to $1,322,000.

Salaries, wages and benefits as a percentage of net operating revenue was 60.3% compared to 60.7% for the three months ended September 30, 2017 and 2016, respectively. As a percentage of net operating revenues, the 2016 third-quarter salaries, wages and benefits were higher primarily due to unfavorable results within our self-insured health insurance plan ($1,460,000). The newly constructed healthcare facilities placed in service during 2017 increased salaries, wages and benefits by $975,000 compared to the same period a year ago. The remaining increase in salaries, wages and benefits for the current period is due to the increase in our existing skilled nursing facilities and the continued wage pressure in certain markets in which we operate.

Other operating expenses as a percentage of net operating revenue was 26.5% compared to 25.5% for the three months ended September 30, 2017 and 2016, respectively. The increase in other operating expenses for the current quarter was primarily due to the unfavorable results within our self-insurance accrued risk reserve programs compared to the quarter a year ago ($2,484,000) due to the increase in professional liability lawsuits at September 30, 2017. The newly constructed healthcare facilities also increased other operating expenses compared to the quarter a year ago ($1,049,000).

The increase in depreciation expense is primarily due to the newly constructed healthcare facilities compared to the quarter a year ago. The increase in interest expense is due to the increased interest rate on the line of credit borrowings compared to the same period a year ago. At September 30, 2017, we have $110 million outstanding on our credit facility.

Non–operating income increased by $999,000 compared to the same period last year, as further detailed in Note 4 to our interim condensed consolidated financial statements. The increase in non-operating income is primarily from the sale of the 83-unit assisted living facility in Evans, Georgia in which we had an equity method investment and 10% ownership stake. This sale transaction increased non-operating income $1,305,000 in comparison to the quarter a year ago. We also received approximately $250,000 annually in management services revenue from this entity, in which we will no longer be providing management services after September 30, 2017.

The noncontrolling interest in a subsidiary is the joint venture operations of a skilled nursing facility in Columbia, Tennessee. This facility opened and began operating in January 2017 in which NHC owns 80% of the operating entity and Maury Regional Medical Center owns 20% of the entity.

The income tax provision for the three months ended September 30, 2017 is $4,691,000 (an effective income tax rate of 29.5%). The income tax provision and effective tax rate for the three months ended September 30, 2017 were favorably impacted by statute of limitations expirations resulting in a benefit to the provision of $1,753,000, or 11.0% of income before taxes for the quarter.

Nine Months Ended September 30, 2017 Compared to Nine Months Ended September 30, 2016

Results for the nine months ended September 30, 2017 include a 4.7% increase in net operating revenues and a 5.3% decrease in net income attributable to NHC compared to the same period in 2016. There have been five newly constructed healthcare facilities placed in service during 2016 and 2017 (two skilled nursing facilities and three assisted living facilities). The operating losses before income taxes for these entities were approximately $5,503,000 for the nine months ended September 30, 2017. Therefore, excluding the operating losses from these five newly constructed facilities, net income attributable to NHC for the nine months ended September 30, 2017 would have been $37,745,000 and $37,984,000 for the nine months ended September 30, 2017 and 2016, respectively.

The total census at owned and leased skilled nursing facilities for the nine months averaged 90.4% compared to an average of 89.5% for the same period a year ago. Medicare per diem rates increased 2.7% and Managed Care per diem rates increased 1.3% compared to the nine months a year ago. Medicaid and private pay per diem rates increased 2.1% and 3.5%, respectively, compared to the nine months a year ago. Overall, the composite skilled nursing facility per diem at our owned and leased skilled nursing facilities increased 3.0% compared to the same period a year ago.

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Net patient revenues increased $32,614,000, or 5.0%, compared to the same period last year. The newly constructed healthcare facilities placed in service during 2016 and 2017 helped increase net patient revenues $13,462,000 compared to the same period a year ago. The remaining increase in our net patient revenues is primarily due to the census increase and per diem increases in our existing skilled nursing facility operations.

Other revenues decreased $566,000, or 1.6%, compared to the nine months last year, as further detailed in Note 3 to our interim condensed consolidated financial statements. During the first quarter of 2017, we began management contract services for a third-party owner of two skilled nursing facilities in the middle Tennessee area. These two contracts helped increase management fee revenues by $483,000 for the nine months ended September 30, 2017 compared to the same period a year ago. The offsetting decrease in management fee revenue for the 2017 period compared to the prior year period is derived from a consulting engagement that is sporadic in nature and decreased $1,166,000 when compared to the prior year period.

Total costs and expenses for the 2017 nine-month period compared to the same period in 2016 increased $37,116,000 or 5.7%, to $682,898,000 from $645,782,000. Salaries, wages and benefits, the largest operating costs of our company, increased $21,148,000, or 5.2%, to $426,639,000 from $405,491,000. Other operating expenses increased $13,207,000 or 7.4%, to $190,778,000 for the 2017 period compared to $177,571,000 for the 2016 period. Facility rent expense decreased $687,000 to $30,273,000. Depreciation and amortization increased $2,762,000 to $31,609,000. Interest expense increased $686,000 to $3,599,000.

Salaries, wages and benefits as a percentage of net operating revenue was 59.2% compared to 58.9% for the nine months ended September 30, 2017 and 2016, respectively. The newly constructed healthcare facilities placed in service during 2016 and 2017 increased salaries, wages and benefits by $6,746,000 compared to the same period a year ago. The remaining increase in salaries, wages and benefits for the current period is due to the increase in our existing skilled nursing facilities and the continued wage pressure in certain markets in which we operate.

Other operating expenses as a percentage of net operating revenue was 26.5% compared to 25.8% for the nine months ended September 30, 2017 and 2016, respectively. The increase in other operating expenses for the current nine-month period was primarily due to the operations of the newly constructed healthcare facilities compared to the same period a year ago ($7,706,000). We also had unfavorable results within our self-insurance accrued risk reserve programs compared to the same period a year ago ($3,458,000) due to the increase in professional liability lawsuits at September 30, 2017.

The increase in depreciation expense is primarily due to the newly constructed healthcare facilities compared to the nine months a year ago. The increase in interest expense is due to the increased interest rate on the line of credit borrowings compared to the same period a year ago. At September 30, 2017, we have $110 million outstanding on our credit facility.

Non–operating income increased by $1,258,000 compared to the same period last year, as further detailed in Note 4 to our interim condensed consolidated financial statements. The increase in non-operating income is primarily from the sale of the 83-unit assisted living facility in Evans, Georgia in which we had an equity method investment and 10% ownership stake. This sale transaction increased non-operating income $1,305,000 in comparison to the same period a year ago. We also received approximately $250,000 annually in management services revenue from this entity, in which we will no longer be providing management services after September 30, 2017.

The noncontrolling interest in a subsidiary is the joint venture operations of a skilled nursing facility in Columbia, Tennessee. This facility opened and began operating in January 2017 in which NHC owns 80% of the operating entity and Maury Regional Medical Center owns 20% of the entity.

The income tax provision for the nine months ended September 30, 2017 is $19,448,000 (an effective income tax rate of 36.1%). The income tax provision and effective tax rate for the nine months ended September 30, 2017 were favorably impacted by the statute of limitations expirations resulting in a benefit to the provision of $1,753,000 or 3.3% of income before taxes in 2017.

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Liquidity, Capital Resources, and Financial Condition

Our primary sources of cash include revenues from the operations of our healthcare and senior living facilities, management and accounting services, rental income, and investment income. Our primary uses of cash include salaries, wages and other operating costs of our healthcare and senior living facilities, the cost of additions to and acquisitions of real property, facility rent expenses, and dividend distributions. These sources and uses of cash are reflected in our interim condensed consolidated statements of cash flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows (dollars in thousands):

	Nine Months Ended September 30						Nine Month Change
	2017			2016			$			%
Cash, cash equivalents, restricted cash and restricted cash equivalents, at beginning of period	$	31,589		$	49,314		$	(17,725	)		(35.9	)%
Cash provided by operating activities		70,995			64,781			6,214			9.6	%
Cash provided by (used in) investing activities		1,190			(57,106	)		58,296			(102.1	)%
Cash used in financing activities		(22,034	)		(20,619	)		(1,415	)		(6.9	)%
Cash, cash equivalents, restricted cash and restricted cash equivalents, at end of period	$	81,740		$	36,370		$	45,370			124.7	%

Operating Activities

Net cash provided by operating activities for the nine months ended September 30, 2017 was $70,995,000 as compared to $64,781,000 in the same period last year. Cash provided by operating activities consisted of net income of $34,386,000, adjustments for non–cash items of $39,365,000, gains on the sale of restricted marketable securities of $255,000, and cash distributions in excess of earnings from equity method investments of $1,840,000. There was cash used for working capital needs in the amount of $4,341,000 for the nine months ended September 30, 2017 compared to $9,359,000 for the same period a year ago. Accrued payroll was the primary cause of the decrease of cash used for working capital needs. The majority of the decrease in accrued payroll is due to the timing and payments of incentive compensation related to the 2016 year, which was paid in the first quarter of 2017.

Investing Activities

Cash provided by investing activities totaled $1,190,000 for the nine months ended September 30, 2017 compared to cash used in investing activities of $57,106,000 for the nine months ended September 30, 2016. Cash used for property and equipment additions was $24,328,000 and $50,466,000 for the nine months ended September 30, 2017 and 2016, respectively. The Company made investments in unconsolidated partnerships in the amount of $176,000 and $1,282,000 for the nine months ended September 30, 2017 and 2016, respectively. The Company collected notes receivable of $3,970,000 and $845,000 for the nine months ended September 30, 2017 and 2016, respectively. Sales of restricted marketable securities, net of purchases, resulted in positive cash flow from investing activities of $21,724,000 for the nine months ended September 30, 2017.  During the first quarter of 2017, $30 million of the proceeds from the sales of restricted marketable securities were transferred out of our insurance companies to our unrestricted cash position.  For the nine months ended September 30, 2016, purchases and sales of marketable securities resulted in a net use of cash of $3,784,000.  

In 2017, construction and development costs included in additions to property and equipment include $1,982,000 for the final construction and furnishings of the 112-bed skilled nursing facility in Columbia, Tennessee; $3,214,000,000 for the final construction and furnishings of the two assisted living facilities in Bluffton, South Carolina and Garden City, South Carolina; $3,708,000 for the construction of the 23-unit memory care addition located in Murfreesboro, Tennessee; and $2,021,000 for the 30-bed addition to a skilled nursing facility in Springfield, Missouri.

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Financing Activities

Net cash used in financing activities totaled $22,034,000 and $20,619,000 for the nine months ending September 30, 2017 and 2016, respectively. Cash used for dividend payments to common stockholders totaled $20,943,000 in the current year period compared to $18,977,000 for the same period a year ago. In the current period, $1,627,000 was provided by the issuance of common stock compared to $10,070,000 in the prior year period. In the current period, there have been no repurchases of common stock compared to cash used of $8,195,000 in the prior year period.

Table of Contractual Obligations

Our contractual obligations as of September 30, 2017 are as follows (in thousands):

	Total		1 year		2–3 Years		4–5 Years		After 5 Years
Long–term debt – principal	$	120,000	$	10,000	$	110,000	$	−	$	−
Long–term debt – interest		8,827		2,984		5,787		56		−
Operating leases		322,100		34,200		68,400		68,400		151,100
Construction obligations		3,936		3,936		−		−		−
Capital lease obligations		33,367		5,200		10,400		10,400		7,367
Total contractual cash obligations	$	488,230	$	56,320	$	194,587	$	78,856	$	158,467

We started paying quarterly dividends on our common shares outstanding in 2004. We anticipate the continuation of the dividend payment as approved quarterly by the Board of Directors.

Short–term liquidity

We expect to meet our short-term liquidity requirements primarily from our cash flows from operating activities. In addition to cash flows from operations, our current cash on hand of $69,790,000, marketable securities of $143,763,000, and as needed, our borrowing capacity on the credit facility, are expected to be adequate to meet our contractual obligations, operating liquidity, and our growth and development plans in the next twelve months.

Long–term liquidity

We expect to meet our long-term liquidity requirements primarily from our cash flows from operating activities, our current cash on hand of $69,790,000, marketable securities of $143,763,000, and our borrowing capacity on the credit facility. At September 30, 2017, the outstanding balance on the credit facility is $110,000,000; therefore, leaving $65,000,000 available for future borrowings. The maturity date on the credit facility is October 7, 2020. The credit facility is available for general corporate purposes, including working capital and acquisitions.

Our ability to refinance the credit agreement, to meet our long–term contractual obligations and to finance our operating requirements, and growth and development plans will depend upon our future performance, which will be affected by business, economic, financial and other factors, including potential changes in state and federal government payment rates for healthcare, customer demand, success of our marketing efforts, pressures from competitors, and the state of the economy, including the state of financial and credit markets.

Commitment and Contingencies

Civil Investigative Demand

On December 19, 2013, the Company was served with a civil investigative demand (“CID”) from the U.S. Department of Justice and the Office of the U.S. Attorney for the Eastern District of Tennessee (“DOJ Investigation”) requesting the production of documents and interrogatory responses regarding the billing for and medical necessity of certain rehabilitative therapy services. Based upon our review, the CID appears to relate to services provided at our facilities based in Knoxville, Tennessee.

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On October 7, 2014, the Company received a subpoena from the Office of Inspector General of the United Department of Health and Human Services (“OIG Subpoena”) related to the current DOJ Investigation.  The OIG Subpoena requests certain financial and organizational documents from the Company and certain of its subsidiaries and SNFs and medical records from certain of the Company’s Tennessee–based SNFs. 

The Company is cooperating fully with these requests. We are unable to evaluate the outcome of this investigation at this time.  It is possible that this investigation could lead to a claim that could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

Caris HealthCare, L.P. Investigation

On December 9, 2014, Caris Healthcare, L.P., a business that specializes in hospice care services in Company–owned health care centers and in other settings, received notice from the U.S. Attorney’s Office for the Eastern District of Tennessee and the Attorney Generals’ Offices for the State of Tennessee and State of Virginia that those government entities were conducting an investigation regarding patient eligibility for hospice services provided by Caris precipitated by a qui tam lawsuit.  We have a 75.1% non–controlling ownership interest in Caris.

A qui tam lawsuit was filed on May 22, 2014, in the U.S. District Court for the Eastern District of Tennessee by a former Caris employee, Barbara Hinkle, and is captioned United States of America, State of Tennessee, and State of Virginia ex rel. Barbara Hinkle v. Caris Healthcare, L.P., No. 3:14–cv–212 (E.D. Tenn.).

On June 16, 2016, the State of Tennessee and the State of Virginia declined to intervene in the qui tam lawsuit.  On June 20, 2016, the Court ordered that the complaint be unsealed.  On October 11, 2016, the United States filed a Complaint in Intervention against Caris Healthcare, L.P. and Caris Healthcare, LLC, a wholly owned subsidiary of Caris Healthcare, L.P. The United States' complaint alleges that Caris billed the government for ineligible hospice patients between June 2013 and December 2013 and retained overpayments regarding ineligible hospice patients from April 2010 through June 2013. It seeks treble damages and civil penalties under the Federal False Claims Act and asserts claims for payment under mistake of fact, unjust enrichment, and conversion. The relator has filed a notice of voluntary dismissal without prejudice of the non–intervened claims asserted in her qui tam complaint. On May 30, 2017, the district court denied Caris’ motion to dismiss, and the parties are engaged in discovery. This matter is set for trial in March 2019.

Caris denies the allegations in the United States' complaint and intends to defend itself vigorously. Given the early stage of this action, we are unable to assess the probable outcome or potential liability, if any, arising from this action.  It is possible that this claim could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

New Accounting Pronouncements

See Note 2 to the Interim Condensed Consolidated Financial Statements for the impact of new accounting standards.

Forward–Looking Statements

References throughout this document to the Company include National HealthCare Corporation and its wholly–owned subsidiaries. In accordance with the Securities and Exchange Commissions “Plain English” guidelines, this Quarterly Report on Form 10–Q has been written in the first person. In this document, the words “we”, “our”, “ours” and “us” refer only to National HealthCare Corporation and its wholly–owned subsidiaries and not any other person.

This Quarterly Report on Form 10–Q and other information we provide from time to time, contains certain “forward–looking” statements as that term is defined by the Private Securities Litigation Reform Act of 1995. All statements regarding our expected future financial position, results of operations or cash flows, continued performance improvements, ability to service and refinance our debt obligations, ability to finance growth opportunities, ability to control our patient care liability costs, ability to respond to changes in government regulations, ability to execute our three–year strategic plan, and similar statements including, without limitations, those containing words such as “believes”, “anticipates”, “expects”, “intends”, “estimates”, “plans”, and other similar expressions are forward–looking statements.

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Forward–looking statements involve known and unknown risks and uncertainties that may cause our actual results in future periods to differ materially from those projected or contemplated in the forward–looking statements as a result of, but not limited to, the following factors:

● national and local economic conditions, including their effect on the availability and cost of labor, utilities and materials;

● the effect of government regulations and changes in regulations governing the healthcare industry, including our compliance with such regulations;

● changes in Medicare and Medicaid payment levels and methodologies and the application of such methodologies by the government and its fiscal intermediaries;

● liabilities and other claims asserted against us, including patient care liabilities, as well as the resolution of current litigation (see Note 14: Contingencies and Commitments);

● the ability of third parties for whom we have guaranteed debt, if any, to refinance certain short term debt obligations;

● the ability to attract and retain qualified personnel;

● the availability and terms of capital to fund acquisitions and capital improvements;

● the ability to refinance existing debt on favorable terms;

● the competitive environment in which we operate;

● the ability to maintain and increase census levels; and

● demographic changes.

See the notes to the quarterly financial statements, and “Item 1. Business” in our 2016 Annual Report on Form 10–K for a discussion of various governmental regulations and other operating factors relating to the healthcare industry and the risk factors inherent in them. This may be found on our web site at www.nhccare.com. You should carefully consider these risks before making any investment in the Company. These risks and uncertainties are not the only ones facing us. There may be additional risks that we do not presently know of or that we currently deem immaterial. If any of the risks actually occur, our business, financial condition or results of operations could be materially adversely affected. In that case, the trading price of our shares of stock could decline, and you may lose all or part of your investment. Given these risks and uncertainties, we can give no assurances that these forward–looking statements will, in fact, transpire and, therefore, caution investors not to place undue reliance on them.

Item 3.     Quantitative and Qualitative Disclosures About Market Risk.

Market risk represents the potential economic loss arising from adverse changes in the fair value of financial instruments. Currently, our exposure to market risk relates primarily to our fixed–income and equity portfolios. These investment portfolios are exposed primarily to, but not limited to, interest rate risk, credit risk, equity price risk, and concentration risk. We also have exposure to market risk that includes our cash and cash equivalents, notes receivable, revolving credit facility, and long–term debt. The Company's senior management has established comprehensive risk management policies and procedures to manage these market risks.

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Interest Rate Risk

The fair values of our fixed–income investments fluctuate in response to changes in market interest rates. Increases and decreases in prevailing interest rates generally translate into decreases and increases, respectively, in the fair values of those instruments. Additionally, the fair values of interest rate sensitive instruments may be affected by the creditworthiness of the issuer, prepayment options, the liquidity of the instrument and other general market conditions. At September 30, 2017, we have available for sale debt securities in the amount of $164,610,000. The fixed maturity portfolio is comprised of investments with primarily short–term and intermediate–term maturities. The portfolio composition allows flexibility in reacting to fluctuations of interest rates. The fixed maturity portfolio allows our insurance company subsidiaries to achieve an adequate risk–adjusted return while maintaining sufficient liquidity to meet obligations.

As of September 30, 2017, the Company has $120,000,000 of long–term debt that bears interest at variable interest rates. Based on our outstanding long–term debt, a 1% change in interest rates would change our annual interest cost by approximately $1,200,000.

Our cash and cash equivalents consist of highly liquid investments with a maturity of less than three months when purchased. As a result of the short–term nature of our cash instruments, a hypothetical 1% change in interest rates would have minimal impact on our future earnings and cash flows related to these instruments.

We do not currently use any derivative instruments to hedge our interest rate exposure. We have not used derivative instruments for trading purposes and the use of such instruments in the future would be subject to approvals by the Investment Committee of the Board.

Credit Risk

Credit risk is managed by diversifying the fixed maturity portfolio to avoid concentrations in any single industry group or issuer and by limiting investments in securities with lower credit ratings.

Equity Price and Concentration Risk

Our available for sale marketable equity securities are recorded at their fair market value based on quoted market prices. Thus, there is exposure to equity price risk, which is the potential change in fair value due to a change in quoted market prices. At September 30, 2017, the fair value of our marketable equity securities is approximately $143,763,000. Of the $143.8 million equity securities portfolio, our investment in National Health Investors, Inc. (“NHI”) comprises approximately $126.0 million, or 87.6%, of the total fair value. We manage our exposure to NHI by closely monitoring the financial condition, performance, and outlook of the company. Hypothetically, a 10% change in quoted market prices would result in a related increase or decrease in the fair value of our equity investments of approximately $14.3 million. At September 30, 2017, our equity securities had net unrealized gains of $113.6 million. Of the $113.6 million of net unrealized gains, $101.3 million is related to our investment in NHI.

Item 4. Controls and Procedures.

As of September 30, 2017, an evaluation was performed under the supervision and with the participation of the Company’s management, including the Chief Executive Officer (“CEO”) and Principal Accounting Officer (“PAO”), of the effectiveness of the design and operation of the Company’s disclosure controls and procedures. Based on that evaluation, the Company’s management, including the CEO and PAO, concluded that the Company’s disclosure controls and procedures were effective as of September 30, 2017. There have been no changes in the Company’s internal control over financial reporting during the quarter ended September 30, 2017 that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.

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PART II. OTHER INFORMATION

Item 1. Legal Proceedings.

For a discussion of prior, current and pending litigation of material significance to NHC, please see Note 14 of this Form 10–Q.

Item 1A. Risk Factors.

During the nine months ended September 30, 2017, there were no material changes to the risk factors that were disclosed in Item 1A of National HealthCare Corporation’s Annual Report on Form 10–K for the year ended December 31, 2016.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.

Not applicable

Item 3. Defaults Upon Senior Securities.

None

Item 5. Other Information.

None

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Item 6. Exhibits.

(a)     List of exhibits

EXHIBIT INDEX
Exhibit No.	Description
3.1	Certificate of Incorporation of National HealthCare Corporation (Incorporated by reference to Exhibit 3.1 to the Registrant’s registration statement on Form S-4 (File No. 333-37185) dated October 3, 1997.)
3.2	Certificate of Amendment to the Certificate of Incorporation of National HealthCare Corporation(Incorporated by reference to Exhibit 3.5 to the quarterly report on Form 10-Q filed on August 3, 2017.)
3.3	Certificate of Designation Series B Junior Participating Preferred Stock (Incorporated by reference to Exhibit 3.1 to the Registrant’s registration statement on Form 8-A, dated August 3, 2007.)
3.4	Restated Bylaws as amended February 14, 2013 (Incorporated by reference to Exhibit 3.5 to the quarterly report on Form 10-Q filed on May 8, 2013.)
4.1	Form of Common Stock (Incorporated by reference to Exhibit 4.1 to the quarterly report on Form 10-Q filed on August 3, 2017.)
4.2	Rights Agreement, dated as of August 2, 2007, between National HealthCare Corporation and Computershare Trust Company, N.A.   (Incorporated by reference to Exhibit 4.1 to the Registrant’s registration statement on Form 8-A, dated August 3, 2007.)
31.1	Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer
31.2	Rule 13a-14(a)/15d-14(a) Certification of Principal Accounting Officer
32	Certification pursuant to 18 U.S.C. Section 1350 by Chief Executive Officer and Principal Accounting Officer
101.INS	XBRL Instance Document
101.SCH	XBRL Taxonomy Extension Schema Document
101.CAL	XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF	XBRL Taxonomy Extension Definition Linkbase Document
101.LAB	XBRL Taxonomy Extension Label Linkbase Document
101.PRE	XBRL Taxonomy Extension Presentation Linkbase Document

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SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

	NATIONAL HEALTHCARE CORPORATION
	(Registrant)
Date: November 9, 2017	/s/ Stephen F. Flatt
	Stephen F. Flatt
	Chief Executive Officer
Date: November 9, 2017	/s/ Brian F. Kidd
	Brian F. Kidd
	Senior Vice President and Controller
	(Principal Accounting Officer)

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EX-31.1

EXHIBIT 31.1

CERTIFICATION

I, Stephen F. Flatt, certify that:

1. I have reviewed this quarterly report on Form 10-Q of National HealthCare Corporation;

2. Based on my knowledge, this quarterly report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this quarterly report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a. Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b. Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c. Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d. Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an quarterly report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5. The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent function);

a. All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b. Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: November 9, 2017

/s/ Stephen F. Flatt                              

Stephen F. Flatt

Chief Executive Officer

EX-31.2

EXHIBIT 31.2

CERTIFICATION

I, Brian F. Kidd, certify that:

1. I have reviewed this quarterly report on Form 10-Q of National HealthCare Corporation;

2. Based on my knowledge, this quarterly report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this quarterly report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a. Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b. Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c. Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d. Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an quarterly report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5. The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent function);

a. All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b. Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: November 9, 2017

 /s/ Brian F. Kidd                                           

Brian F. Kidd

Senior Vice President and Controller

(Principal Financial Officer)

EX-32

Exhibit 32

Certification of Quarterly Report on Form 10-Q

of National HealthCare Corporation

For the Quarter Ended September 30, 2017

The undersigned hereby certify, pursuant to 18 U.S.C. Section 906 of the Sarbanes-Oxley Act of 2002, that, to the undersigned's best knowledge and belief, the Quarterly Report on Form 10-Q for National HealthCare Corporation ("Issuer") for the period ending September 30, 2017 as filed with the Securities and Exchange Commission on the date hereof (the "Report"):

(a)	fully complies with the requirements of section 13(a) or 15(d) of the Securities
	Exchange Act of 1934; and
(b)	the information contained in the Report fairly presents, in all material respects,
	the financial condition and results of operations of the Issuer.

This Certification accompanies the Quarterly Report on Form 10-Q of the Issuer for the quarterly period ended September 30, 2017.

This Certification is executed as of November 9, 2017.

/s/Stephen F. Flatt                                  

Stephen F. Flatt

Chief Executive Officer

/s/ Brian F. Kidd                                    

Brian F. Kidd

Principal Accounting Officer

A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.

XML

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2017	Nov. 07, 2017
Document Information [Line Items]
Entity Registrant Name	NATIONAL HEALTHCARE CORP
Entity Central Index Key	0001047335
Trading Symbol	nhc
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Well-known Seasoned Issuer	No
Entity Common Stock, Shares Outstanding (in shares)		15,196,855
Document Type	10-Q
Document Period End Date	Sep. 30, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	Q3
Amendment Flag	false

XML

Interim Condensed Consolidated Statements of Income (Unaudited) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Revenues:
Net patient revenues	$ 230,048,000	$ 218,647,000	$ 685,854,000	$ 653,240,000
Other revenues	11,937,000	12,634,000	34,831,000	35,397,000
Net operating revenues	241,985,000	231,281,000	720,685,000	688,637,000
Cost and Expenses:
Salaries, wages and benefits	145,900,000	140,403,000	426,639,000	405,491,000
Other operating	64,039,000	58,956,000	190,778,000	177,571,000
Facility rent	10,106,000	10,314,000	30,273,000	30,960,000
Depreciation and amortization	10,833,000	9,998,000	31,609,000	28,847,000
Interest	1,322,000	1,020,000	3,599,000	2,913,000
Total costs and expenses	232,200,000	220,691,000	682,898,000	645,782,000
Income Before Non–Operating Income	9,785,000	10,590,000	37,787,000	42,855,000
Non–Operating Income	6,090,000	5,091,000	16,047,000	14,789,000
Income Before Income Taxes	15,875,000	15,681,000	53,834,000	57,644,000
Income Tax Provision	(4,691,000)	(4,571,000)	(19,448,000)	(20,969,000)
Net Income	11,184,000	11,110,000	34,386,000	36,675,000
Loss Attributable To Noncontrolling Interest	168,000		349,000
Net Income Attributable to National HealthCare Corporation	$ 11,352,000	$ 11,110,000	$ 34,735,000	$ 36,675,000
Earnings Per Share Attributable to National HealthCare Corporation Stockholders:
Basic (in dollars per share)	$ 0.75	$ 0.73	$ 2.29	$ 2.42
Diluted (in dollars per share)	$ 0.75	$ 0.73	$ 2.28	$ 2.41
Weighted Average Common Shares Outstanding:
Basic (in shares)	15,195,394	15,198,696	15,186,315	15,128,728
Diluted (in shares)	15,220,567	15,222,648	15,217,797	15,216,838
Dividends Declared Per Common Share (in dollars per share)	$ 0.48	$ 0.45	$ 1.41	$ 1.30

XML

Interim Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Net income	$ 11,184	$ 11,110	$ 34,386	$ 36,675
Other Comprehensive Income (Loss):
Unrealized gains (loss) on investments in marketable securities	(3,976)	5,458	8,380	36,085
Reclassification adjustment for realized gains on sale of securities	(17)	(264)	(255)	(804)
Income tax (expense) benefit related to items of other comprehensive income	1,572	(2,028)	(3,074)	(13,582)
Other Comprehensive Income (Loss), net of tax	(2,421)	3,166	5,051	21,699
Loss Attributable to Noncontrolling Interest	168		349
Comprehensive Income Attributable to National HealthCare Corporation	$ 8,931	$ 14,276	$ 39,786	$ 58,374

XML

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Sep. 30, 2017	Dec. 31, 2016
Current Assets:
Cash and cash equivalents	$ 69,790,000	$ 26,335,000
Restricted cash and cash equivalents	9,783,000	3,125,000
Marketable securities	143,763,000	138,013,000
Restricted marketable securities	15,627,000	22,773,000
Accounts receivable, less allowance for doubtful accounts of $7,999 and $5,743, respectively	80,258,000	82,531,000
Inventories	7,113,000	7,508,000
Prepaid expenses and other assets	2,582,000	2,648,000
Notes receivable, current portion	1,267,000	3,259,000
Federal income tax receivable	5,913,000	4,665,000
Total current assets	336,096,000	290,857,000
Property and Equipment:
Property and equipment, at cost	954,739,000	933,140,000
Accumulated depreciation and amortization	(402,396,000)	(373,516,000)
Net property and equipment	552,343,000	559,624,000
Other Assets:
Restricted cash and cash equivalents	2,167,000	2,129,000
Restricted marketable securities	148,983,000	160,931,000
Deposits and other assets	6,228,000	5,244,000
Goodwill	17,600,000	17,600,000
Notes receivable, less current portion	11,989,000	13,820,000
Investments in limited liability companies	35,431,000	37,242,000
Total other assets	222,398,000	236,966,000
Total assets	1,110,837,000	1,087,447,000
Current Liabilities:
Trade accounts payable	14,736,000	18,593,000
Capital lease obligations, current portion	3,641,000	3,481,000
Accrued payroll	55,586,000	65,912,000
Amounts due to third party payors	20,649,000	17,019,000
Accrued risk reserves, current portion	25,410,000	25,898,000
Other current liabilities	20,293,000	13,207,000
Dividends payable	7,294,000	6,818,000
Total current liabilities	147,609,000	150,928,000
Long–term debt	120,000,000	120,000,000
Capital lease obligations, less current portion	23,997,000	26,748,000
Accrued risk reserves, less current portion	70,103,000	65,264,000
Refundable entrance fees	8,827,000	9,924,000
Obligation to provide future services	3,236,000	3,236,000
Deferred income taxes	26,027,000	22,072,000
Other noncurrent liabilities	15,542,000	16,302,000
Deferred revenue	4,007,000	3,362,000
Total liabilities	419,348,000	417,836,000
Stockholders’ Equity:
Common stock, $.01 par value; 45,000,000 shares authorized; 15,196,855 and 15,162,938 shares, respectively, issued and outstanding	152,000	152,000
Capital in excess of par value	214,347,000	211,457,000
Retained earnings	405,250,000	391,934,000
Accumulated other comprehensive income	71,119,000	66,068,000
Total National HealthCare Corporation stockholders’ equity	690,868,000	669,611,000
Noncontrolling interest	621,000
Total stockholders' equity	691,489,000	669,611,000
Total liabilities and stockholders’ equity	$ 1,110,837,000	$ 1,087,447,000

XML

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	45,000,000	45,000,000
Common stock, shares issued (in shares)	15,196,855	15,162,938
Common stock, shares outstanding (in shares)	15,196,855	15,162,938
Accounts receivable, allowance for doubtful accounts	$ 7,999	$ 5,743

XML

Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash Flows From Operating Activities:
Net income	$ 34,386	$ 36,675
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	31,609	28,847
Provision for doubtful accounts receivable	5,612	5,774
Equity in earnings of unconsolidated investments	(5,908)	(4,926)
Distributions from unconsolidated investments	7,748	7,163
Gains on sale of restricted marketable securities	(255)	(804)
Deferred income taxes	881	909
Stock–based compensation	1,263	502
Changes in operating assets and liabilities, net of the effect of acquisitions:
Accounts receivable	(3,339)	1,667
Income tax receivable	(1,248)	(1,003)
Inventories	395	122
Prepaid expenses and other assets	(942)	(704)
Trade accounts payable	(3,857)	(2,769)
Accrued payroll	(10,326)	(14,759)
Amounts due to third party payors	3,630	2,353
Accrued risk reserves	4,375	(899)
Other current liabilities	7,086	5,880
Other noncurrent liabilities	(760)	(84)
Deferred revenue	645	837
Net cash provided by operating activities	70,995	64,781
Cash Flows From Investing Activities:
Additions to property and equipment	(24,328)	(50,466)
Investments in unconsolidated companies	(176)	(1,282)
Investments in notes receivable		(2,419)
Collections of notes receivable	3,970	845
Purchases of restricted marketable securities	(24,874)	(34,747)
Sales of restricted marketable securities	46,598	30,963
Net cash provided by (used in) investing activities	1,190	(57,106)
Cash Flows From Financing Activities:
Tax expense from stock–based compensation		(1,134)
Principal payments under capital lease obligations	(2,591)	(2,440)
Dividends paid to common stockholders	(20,943)	(18,977)
Issuance of common shares	1,627	10,070
Repurchase of common shares		(8,195)
Equity attributable to noncontrolling interest	970
Entrance fee refunds	(1,097)	(196)
Change in deposits		253
Net cash used in financing activities	(22,034)	(20,619)
Net Increase (Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	50,151	(12,944)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	31,589	49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	81,740	36,370
Balance Sheet Classifications:
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	$ 31,589	$ 49,314

XML

Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Noncontrolling Interest [Member]	Total
Balance (in shares) at Dec. 31, 2015	15,000,616
Balance at Dec. 31, 2015	$ 150	$ 209,469	$ 368,013	$ 53,364		$ 630,996
Net income attributable to National HealthCare Corporation			36,675			36,675
Other comprehensive income				21,699		21,699
Stock–based compensation		502				502
Tax expense from exercise of stock options		(1,134)				(1,134)
Shares sold – options exercised (in shares)	278,623
Shares sold – options exercised	$ 3	10,067				10,070
Repurchase of common stock (in shares)	(130,000)
Repurchase of common stock	$ (1)	(8,194)				(8,195)
Dividends declared to common stockholders			(19,798)			(19,798)
Net loss attributable to noncontrolling interest
Balance (in shares) at Sep. 30, 2016	15,149,239
Balance at Sep. 30, 2016	$ 152	210,710	384,890	75,063		670,815
Balance (in shares) at Dec. 31, 2015	15,000,616
Balance at Dec. 31, 2015	$ 150	209,469	368,013	53,364		$ 630,996
Shares sold – options exercised (in shares)						499,066
Balance (in shares) at Dec. 31, 2016	15,162,938
Balance at Dec. 31, 2016	$ 152	211,457	391,934	66,068		$ 669,611
Net income attributable to National HealthCare Corporation			34,735			34,735
Other comprehensive income				5,051		5,051
Stock–based compensation		1,263				$ 1,263
Shares sold – options exercised (in shares)	33,917					33,717
Shares sold – options exercised		1,627				$ 1,627
Dividends declared to common stockholders			(21,419)			(21,419)
Net loss attributable to noncontrolling interest					(349)	(349)
Equity contributed by noncontrolling interest					970	970
Balance (in shares) at Sep. 30, 2017	15,196,855
Balance at Sep. 30, 2017	$ 152	$ 214,347	$ 405,250	$ 71,119	$ 621	$ 691,489

XML

Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) (Parentheticals) - $ / shares	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Common Stock [Member]
Dividends declared to common stockholders (in dollars per share)	$ 1.41	$ 1.30
Dividends declared to common stockholders (in dollars per share)	$ 1.41	$ 1.30

XML

Note 1 - Description of Business

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]

Note

1

–

Description of Business

National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. As of

September 30, 2017,

we operate or manage, through certain affiliates,

76

skilled nursing facilities with a total of

9,597

licensed beds,

24

 assisted living facilities,

five

independent living facilities, and

36

homecare programs. We operate specialized care units within certain of our healthcare centers such as Alzheimer's disease care units and sub-acute nursing units. We also have a noncontrolling ownership interest in a hospice care business that services NHC owned skilled nursing facilities and others. In addition, we provide insurance services, management and accounting services, and we lease properties to operators of skilled nursing facilities. We operate in

10

states and are located primarily in the southeastern United States.

XML

Note 2 - Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Significant Accounting Policies [Text Block]

Note

2

–

Summary of Significant Accounting Policies

The listing below is

not

intended to be a comprehensive list of all our significant accounting policies. In many cases, the accounting treatment of a particular transaction is specifically dictated by generally accepted accounting principles, with limited need for management’s judgment in their application. There are also areas in which management’s judgment in selecting any available alternative would

not

produce a materially different result. See our audited

December 31, 2016

consolidated financial statements and notes thereto which contain accounting policies and other disclosures required by generally accepted accounting principles. Our audited

December 31, 2016

consolidated financial statements are available at our web site: www.nhccare.com.

Basis of Presentation

The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. The consolidated financial statements include the accounts of all entities controlled by NHC. The Company presents noncontrolling interest within the equity section of its consolidated balance sheets. The Company presents the amount of consolidated net income (loss) that is attributable to NHC and the noncontrolling interest in its consolidated statements of income.

We assume that users of these interim financial statements have read or have access to the audited

December 31, 2016

consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies,

may

be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is

not

necessarily indicative of the results that

may

be expected for a full year for a variety of reasons.

Estimates and Assumptions

The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.

Change in Accounting Principle

Effective

December 31, 2016,

the Company retrospectively adopted a change in accounting principle related to the early adoption of Accounting Standards Update (“ASU”)

No.

2016–18,

Statement of Cash Flows (Topic

230

)—Restricted Cash—a consensus of the FASB Emerging Issues Task Force

. The updated guidance requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash and restricted cash equivalents. As such, amounts generally described as restricted cash and restricted cash equivalents should be included in the “beginning–of–period” and “end–of–period” total amounts shown on the statements of cash flows.

As described in the guidance for accounting changes under ASC Topic

250,

the comparative consolidated statement of cash flows of prior periods are adjusted to apply the new accounting method retrospectively. The following table presents the effect on the interim condensed consolidated statement of cash flows for the

nine

months ending

September 30, 2016

for the accounting change that was retrospectively adopted on

December 31, 2016:

Consolidated Statement

of Cash Flows

(

in thousands

)

	Nine Months Ended September 30, 2016
	As Previously Reported			Effect of Accounting Change			As Adjusted
Cash Flows from Operating Activities:
Restricted cash and cash equivalents	$	(15,507	)	$	15,507		$	–
Net cash provided by operating activities		49,274			15,507			64,781
Cash Flows from Investing Activities:
Change in restricted cash and cash equivalents		9,455			(9,455	)		–
Net cash used in investing activities		(47,651	)		(9,455	)		(57,106	)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		(18,996	)		6,052			(12,944	)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period		38,208			11,106			49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents,  End of Period	$	19,212		$	17,158		$	36,370

Recently Adopted Accounting Guidance

In

November 2016,

the Financial Accounting Standards Board ("FASB") issued ASU

No.

2016–18,

“Statement of Cash Flows (Topic

230

)—Restricted Cash—a consensus of the FASB Emerging Issues Task Force”. This revised standard is an effort by the FASB to reduce diversification in practice by providing specific guidance on the presentation of restricted cash or restricted cash equivalents in the statement of cash flows. The updated guidance requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash and restricted cash equivalents. As such, amounts generally described as restricted cash and restricted cash equivalents should be included in the “beginning–of–period” and “end–of–period” total amounts shown on the statement of cash flows. The effective date for this standard is for years beginning after

December 15, 2017,

with early adoption permitted. Effective

December 31, 2016,

the Company elected to early adopt this standard. The adoption of this standard represented a change in accounting principle which was applied retrospectively; see the paragraphs above under “

Change in Accounting Principle

” for further discussion on the adoption of ASU

No.

2016–18.

In

March 2016,

the FASB issued ASU

2016

-

09,

“

Compensation – Stock Compensation (Topic

718

): Improvements to Employee Share-Based Payment Accounting.” ASU

2016

-

09

simplifies the accounting for share-based payment award transactions including: income tax consequences, classification of awards as either equity or liabilities and classification on the statement of cash flows. ASU

2016

-

09

is effective for fiscal years beginning after

December 

15,

2016,

including interim periods within those fiscal years. On

January 1, 2017,

the Company adopted the provisions of ASU

2016

-

09.

 As a result of the adoption, the Company has recognized 

$0

and

$235,000

 of excess tax benefits related to share-based payments in our provision for income taxes for the

three

and

nine

months ended 

September 30, 2017,

respectively. These items were historically recorded in additional paid-in capital. In addition, cash flows related to excess tax benefits are now classified as an operating activity along with other income tax related cash flows. The Company elected to apply the change in presentation of excess tax benefits in the statements of cash flows on a prospective basis.

Recent Accounting Guidance

Not

Yet Adopted

In

February 2016,

the FASB issued ASU

2016

-

02,

"Leases (Topic

842

)." The objective of this update is to increase transparency and comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and disclosing key information about leasing arrangements. This ASU is effective for fiscal years beginning after

December 15, 2018,

including interim periods within those annual periods and is to be applied utilizing a modified retrospective approach. We anticipate this standard will have a material impact on our consolidated financial statements. Additionally, we are currently evaluating the impact this standard will have on our policies and procedures and internal control framework.

In

January 2016,

the FASB issued ASU

No.

2016

-

01,

 “Financial Instruments - Recognition and Measurement of Financial Assets and Financial Liabilities

(Topic

825

)”. ASU

No.

2016

-

01

revises the classification and measurement of investments in certain equity investments and the presentation of certain fair value changes for certain financial liabilities measured at fair value. ASU

No.

2016

-

01

requires the change in fair value of many equity investments to be recognized in net income.  ASU

No.

2016

-

01

is effective for interim and annual periods beginning after

December 15, 2017,

with early adoption permitted.   Adopting ASU

No.

2016

-

01

may

result in a cumulative effect adjustment to the Company’s retained earnings as of the beginning of the year of adoption. We are currently evaluating the potential effects of adopting the provisions of ASU

No.

2016

-

01.

In

May 2014,

the FASB issued ASU

No.

2014–09

“Revenue from Contracts with Customers”, also known as the “New Revenue Standard”. This update is the result of a collaborative effort by the FASB and the International Accounting Standards Board to simplify revenue recognition guidance, remove inconsistencies in the application of revenue recognition, and to improve comparability of revenue recognition practices across entities, industries, jurisdictions, and capital markets. The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to receive for those goods or services. The New Revenue Standard is applied through the following

five

-step process:

1.

Identify the contract(s) with a customer.

2.

Identify the performance obligation in the contract.

3.

Determine the transaction price.

4.

Allocate the transaction price to the performance obligations in the contract.

5.

Recognize revenue when (or as) the entity satisfies a performance obligation.

For a public entity, this update is effective for annual reporting periods beginning after

December 15, 2017,

including interim periods within that reporting period by applying either the full retrospective method or the cumulative catch-up transition method. The full retrospective method requires application of the provisions of the New Revenue Standard for all periods presented while the cumulative catch-up transition method requires the application of the provisions of the New Revenue Standard as of the date of adoption with the cumulative effect of the retrospective application of the provisions as an adjustment through retained earnings. Currently, the Company is evaluating which method to apply.

As we continue to progress with our implementation efforts to adopt the New Revenue Standard, management continues to evaluate and refine its estimates of the anticipated impacts it will have on our revenue recognition policies, procedures, financial position, results of operations, cash flows, financial disclosures and control framework.  In addition, the Company is monitoring specific developments for the senior living industry and evaluating potential changes to our business processes, systems, and controls to support the recognition disclosure under the new standard. Specifically, the Company is continuing to evaluate revenue sources to determine the potential effects the New Revenue Standard will have on the amount or timing of certain industry-specific healthcare revenue sources, which at this time, includes revenue recorded from our continuing care retirement community (“CCRC”), timing of revenue recorded from our homecare operations, and settlements with

third

party payors. At this time, we do

not

expect any significant impacts. 

Revenue Recognition

– Third Party Payors

Approximately

65%

of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that

may

result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment

no

longer being subject to audit or review. We have recorded liabilities of approximately

$20,649,000

and

$17,019,000

as of

September 30, 2017

and

December 31, 2016,

respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.

Revenue Recognition

–

Private P

ay

For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.

Revenue Recognition

–

Subordination of Fees and Uncert

ain Collections

We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge

6%

to

7%

of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the healthcare facility being managed. Furthermore, for certain of the

third

parties with whom we have contracted to provide services and which we have determined that collection is

not

reasonably assured; our policy is to recognize income only in the period in which the amounts are realized. We

may

receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be

no

assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.

We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We

may

continue to provide services to certain managed centers despite

not

being fully paid currently so that we

may

be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center

may

be small compared to the potential benefit. Also, we

may

benefit from providing other ancillary services to the managed center.

Segment Reporting

In accordance with the provisions of ASC

280,

“Segment Reporting”, the Company is required to report financial and descriptive information about its reportable operating segments. Beginning in the

first

quarter of

2017

with the leadership change of the Company’s Chief Executive Officer, we reassessed and realigned our reportable operating segments to coincide with the way our new leadership and chief operating decision maker ("CODM") measures Company performance and allocates resources. T

he Company now has

two

reportable operating segments: (

1

) inpatient services, which includes the operation of skilled nursing facilities and assisted and independent living facilities, and (

2

) homecare services. The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. See Note

5

for further disclosure of the Company’s operating segments.

Other Operating Expenses

Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance.

General and Administrative Costs

With the Company being a healthcare provider, the majority of our expenses are "cost of revenue" items. Costs that could be classified as "general and administrative" by the Company would include its corporate office costs, which were

$22,442,000

and

$21,222,000

for the

nine

months ended

September 30, 2017

and

2016,

respectively.

Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements,

20

-

40

years and equipment and furniture,

3

-

15

years. Leasehold improvements are amortized over periods that do

not

exceed the non-cancelable respective lease terms using the straight-line method.

Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic

840

-

30,

Leases – Capital Leases

. Amortization of capital lease assets is included in depreciation and amortization expense.

Accrued Risk Reserves

We are self–

insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to engage an external, independent actuary to assist in estimating our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis.

Professional liability remains an area of particular concern to us. The long-term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by skilled nursing facilities and their employees in providing care to residents. As of

September 30, 2017,

we and/or our managed healthcare facilities are defendants in

60

such claims. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.

We are principally self-insured for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.

Continuing Care Contracts and Refundable Entrance Fee

We have

one

CCRC within our operations.

Residents at this retirement center

may

enter into continuing care contracts with us. The contracts provide that

10%

of the resident entry fee becomes non-refundable upon occupancy, and the remaining refundable portion of the entry fee is calculated using the lessor of the price at which the apartment is re-assigned or

90%

of the original entry fee, plus

40%

of any appreciation if the apartment exceeds the original resident’s entry fee. In each case, we amortize the non-refundable part of these fees into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of

September 30, 2017

and

December 31, 2016

were

$8,827,000

and

$9,924,000,

respectively.

Obligation to Provide Future Services

W

e annually estimate the present value of the cost of future services and the use of facilities to be provided to the current CCRC residents and compare that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of

September 30, 2017,

and

December 31, 2016,

we have recorded a future service obligation in the amount of

$3,236,000.

Other Noncurrent Liabilities

Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions.

D

eferred Revenue

Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”), the non-refundable portion

(

10%

) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are

not

yet earned.

Noncontrolling Interest

The noncontrolling interest in a subsidiary is presented within total equity in the Company's interim condensed consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income attributable to NHC in its interim condensed consolidated statements of income. The Company’s earnings per share is calculated based on net income attributable to NHC’s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest.

Variable Interest Entities

We have equity interests in unconsolidated limited liability companies that operate various post-acute and senior healthcare businesses. We analyze our investments in these limited liability companies to determine if the company is considered a VIE and would require consolidation. To the extent that we own interests in a VIE and we (i) are the sole entity that has the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary.

The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and

may

or

may

not

be limited to its investment in the unconsolidated VIE. The investments in unconsolidated VIEs are classified as “investments in limited liability companies” in the consolidated balance sheets.

XML

Note 3 - Other Revenues

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Other Revenues [Text Block]

N

ote

3

–

Other Revenues

Other revenues are outlined in the table below. Revenues from management and accounting services include management and accounting fees provided to managed healthcare facilities and other health care centers. Revenues from rental income include health care real estate properties owned by us and leased to

third

party operators. Revenues from insurance services include premiums for workers’ compensation and professional liability insurance policies that our wholly–owned limited purpose insurance subsidiaries have written for certain health care centers to which we provide management or accounting services. "Other" revenues include miscellaneous health care related earnings.

Other revenues include the following:

	Three Months Ended September 30				Nine Months Ended September 30
(in thousands)	2017		2016		2017		2016
Rental Income	$	5,500	$	5,434	$	16,501	$	16,439
Management and accounting services fees		4,130		5,061		11,741		12,316
Insurance services		2,077		1,729		5,721		5,468
Other		230		410		868		1,174
	$	11,937	$	12,634	$	34,831	$	35,397

Management Fees from National

We manage

five

skilled nursing facilities owned by National. For the

three

months and

nine

months ended

September 30, 2017,

we recognized management fees and interest on management fees of

$977,000

and

$2,902,000

from these centers, respectively. For the

three

months and

nine

months ended

September 30, 2016,

we recognized management fees and interest on management fees of

$939,000

and

$2,834,000

from these centers.

Because the amount collectable cannot be reasonably determined when the management services are provided, and because we cannot estimate the timing or amount of expected future collections, the unpaid fees from the

five

centers owned by National will be recognized as revenues only when the collectability of these fees can be reasonably assured.

  Under the terms of our management agreement with National, the payment of these fees to us

may

be subordinated to other expenditures of the

five

long–term care centers.  We continue to manage these centers so that we

may

be able to collect our fees in the future and because the incremental savings from discontinuing services to a center

may

be small compared to the potential benefit.  We

may

receive payment for the unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the

five

centers or the proceeds from the sale of the centers are sufficient to pay the fees.  There can be

no

assurance that such future improved cash flows will occur. 

Insurance Services

For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the

three

months and

nine

months ended

September 30, 2017

were

$1,399,000

and

$4,087,000.

For the

three

months and

nine

months ended

September 30, 2016,

the workers' compensation premium revenues reflected in the interim condensed consolidated statements of income were

$1,064,000

and

$3,447,000,

respectively. Associated losses and expenses are reflected in the interim condensed consolidated statements of income as "Salaries, wages and benefits."

For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the

three

months and

nine

months ended

September 30, 2017

were

$678,000

and

$1,634,000,

respectively. For the

three

months and

nine

months ended

September 30, 2016,

the professional liability insurance premium revenues reflected in the interim condensed consolidated statements of income were

$665,000

and

$2,021,000,

respectively. Associated losses and expenses including those for self–insurance are included in the interim condensed consolidated statements of income as "Other operating costs and expenses".

XML

Note 4 - Non-operating Income

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Other Nonoperating Income and Expense [Text Block]

N

ote

4

–

Non

–

Operating Income

Non–operating income is outlined in the table below. Non–operating income includes equity in earnings of unconsolidated investments, dividends and other realized gains and losses on marketable securities, and interest income. Our most significant equity method investment is a

75.1%

non–controlling ownership interest in Caris HealthCare L.P. (“Caris”), a business that specializes in hospice care services.

	Three Months Ended September 30				Nine Months Ended September 30
(in thousands)	2017		2016		2017		2016
Equity in earnings of unconsolidated investments	$	2,528	$	1,806	$	5,908	$	4,926
Dividends and other net realized gains and losses on sales of securities		1,696		1,892		5,319		5,654
Interest income		1,866		1,393		4,820		4,209
	$	6,090	$	5,091	$	16,047	$	14,789

XML

Note 5 - Business Segments

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Segment Reporting Disclosure [Text Block]

Note

5

– Business Segments

The Company has

two

reportable operating segments: (

1

) inpatient services, which includes the operation of skilled nursing facilities and assisted and independent living facilities, and (

2

) homecare services. These reportable operating segments are consistent with information used by the Company

’s Chief Executive Officer, as CODM, to assess performance and allocate resources.

The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and

costs of the corporate office. The Company has presented the financial information for the

three

months and

nine

months ended

September 30, 2016

on a comparative basis to conform with the current year segment presentation. For additional information on these reportable segments see Note

1

- “

Description of Business”.

The Company

’s CODM evaluates performance and allocates capital resources to each segment based on an operating model that is designed to improve the quality of patient care and profitability of the Company while enhancing long-term shareholder value. The CODM does

not

review assets by segment in his resource allocation and therefore, assets by segment are

not

disclosed below.

The following table sets forth

the Company’s unaudited interim condensed consolidated statements of income by business segment

(in thousands

):

	Three Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	214,360	$	15,688	$	-		$	230,048
Other revenues		181		-		11,756			11,937
Net operating revenues		214,541		15,688		11,756			241,985
Costs and Expenses:
Salaries, wages and benefits		127,050		8,317		10,533			145,900
Other Operating		56,851		5,291		1,897			64,039
Rent		8,128		502		1,476			10,106
Depreciation and Amortization		9,756		41		1,036			10,833
Interest		423		-		899			1,322
Total costs and expenses		202,208		14,151		15,841			232,200
Income (Loss) Before Non-Operating Income		12,333		1,537		(4,085	)		9,785
Non-Operating Income		-		-		6,090			6,090
Income Before Income Taxes	$	12,333	$	1,537	$	2,005		$	15,875

	Three Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	202,925	$	15,722	$	-		$	218,647
Other revenues		-		-		12,634			12,634
Net operating revenues		202,925		15,722		12,634			231,281
Costs and Expenses:
Salaries, wages and benefits		122,496		8,103		9,804			140,403
Other Operating		51,717		5,108		2,131			58,956
Rent		8,028		476		1,810			10,314
Depreciation and Amortization		8,862		46		1,090			9,998
Interest		474		-		546			1,020
Total costs and expenses		191,577		13,733		15,381			220,691
Income (Loss) Before Non-Operating Income		11,348		1,989		(2,747	)		10,590
Non-Operating Income		-		-		5,091			5,091
Income Before Income Taxes	$	11,348	$	1,989	$	2,344		$	15,681

	Nine Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	638,550	$	47,304	$	-		$	685,854
Other revenues		632		-		34,199			34,831
Net operating revenues		639,182		47,304		34,199			720,685
Costs and Expenses:
Salaries, wages and benefits		369,585		24,760		32,294			426,639
Other Operating		169,710		15,484		5,584			190,778
Rent		24,552		1,490		4,231			30,273
Depreciation and Amortization		28,362		120		3,127			31,609
Interest		1,309		-		2,290			3,599
Total costs and expenses		593,518		41,854		47,526			682,898
Income (Loss) Before Non-Operating Income		45,664		5,450		(13,327	)		37,787
Non-Operating Income		-		-		16,047			16,047
Income Before Income Taxes	$	45,664	$	5,450	$	2,720		$	53,834

	Nine Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	605,626	$	47,614	$	-		$	653,240
Other revenues		250		-		35,147			35,397
Net operating revenues		605,876		47,614		35,147			688,637
Costs and Expenses:
Salaries, wages and benefits		350,166		24,300		31,025			405,491
Other Operating		156,068		15,494		6,009			177,571
Rent		24,838		1,443		4,679			30,960
Depreciation and Amortization		25,435		139		3,273			28,847
Interest		1,459		-		1,454			2,913
Total costs and expenses		557,966		41,376		46,440			645,782
Income (Loss) Before Non-Operating Income		47,910		6,238		(11,293	)		42,855
Non-Operating Income		-		-		14,789			14,789
Income Before Income Taxes	$	47,910	$	6,238	$	3,496		$	57,644

XML

Note 6 - Long-term Leases

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Leases of Lessee Disclosure [Text Block]

Note

6

– Long-Term Leases

Capital Leases

Fixed assets recorded under the capital leases, which are included in property and equipment in the interim condensed consolidated balance sheets, are as follows:

	September 30, 2017			December 31, 2016
	(in thousands)
Buildings and personal property	$	39,032		$	39,032
Accumulated amortization		(14,064	)		(11,120	)
	$	24,968		$	27,912

Operating Leases

At

September 30, 2017,

NHC leases from National Health Investors, Inc. (“NHI”) the real property of

35

skilled nursing facilities,

seven

assisted living facilities and

three

independent living facilities under

two

separate lease agreements. Base rent expense under both lease agreements totals

$34,200,000

annually with rent thereafter escalating by

4%

of the increase in facility revenue over the base year. Total facility rent expense to NHI was

$9,314,000

and

$9,480,000

for the

three

months ended

September 30, 2017

and

2016,

respectively. Total facility rent expense to NHI was

$27,942,000

and

$28,440,000

for the

nine

months ended

September 30, 2017

and

2016,

respectively.

Minimum Lease Payments

The approximate future minimum lease payments required under all leases that have remaining non-cancelable lease terms at

September 30, 2017

are as follows:

	Operating Leases		Capital Leases
	(in thousands)
201 8	$	34,200	$	5,200
201 9		34,200		5,200
20 20		34,200		5,200
20 21		34,200		5,200
20 22		34,200		5,200
Thereafter		151,100		7,367
Total minimum lease payments	$	322,100	$	33,367
Less: Amounts representing interest				(5,729	)
Present value of minimum lease payments				27,638
Less: Current portion				(3,641	)
Long-term capital lease obligations			$	23,997

XML

Note 7 - Earnings Per Share

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Earnings Per Share [Text Block]

Note

7

–

Earnings per Share

Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings.

The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share

(in thousands, except for share and per share amounts)

:

	Three Months Ended Sept.30				Nine Months Ended Sept. 30
	2017		2016		2017		2016
Basic:
Weighted average common shares outstanding		15,195,394		15,198,696		15,186,315		15,128,728
Net income attributable to National Health Care Corporation	$	11,352	$	11,110	$	34,735	$	36,675
Earnings per common share, basic	$	0.75	$	0.73	$	2.29	$	2.42
Diluted:
Weighted average common shares outstanding		15,195,394		15,198,696		15,186,315		15,128,728
Dilutive effect of stock options		25,173		23,952		31,482		23,588
Dilutive effect of contingent issuable stock		-		-		-		64,522
Weighted a verage common shares outstanding		15,220,567		15,222,648		15,217,797		15,216,838
Net income attributable to National Health Care Corporation	$	11,352	$	11,110	$	34,735	$	36,675
Earnings per common share, diluted	$	0.75	$	0.73	$	2.28	$	2.41

In the above table, options to purchase

1,122,585

shares of our common stock have been excluded for the

three

months and

nine

months ended

September 30, 2017

due to their anti–dilutive impact. Options to purchase

11,592

shares of our common stock have been excluded for the

three

months and

nine

months ended

September 30, 2016

due to their anti–dilutive impact.

XML

Note 8 - Investments in Marketable Securities

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]

Note

8

–

Inve

stments in Marketable Securities

Our investments in marketable securities are classified as available for sale securities. Realized gains and losses from securities sales are recognized in results of operations upon disposition of the securities using the specific identification method on a trade date basis. Refer to Note

9

for a description of the Company's methodology for determining the fair value of marketable securities.

Marketable securities and restricted marketable securities consist of the following

(in thousands)

:

	September 30, 2017				December 31, 2016
	Amortized Cost		Fair Value		Amortized Cost		Fair Value
Investments a vailable for sale:
Marketable equity securities	$	30,176	$	143,763	$	30,176	$	138,013
Restricted investments available for sale:
Corporate debt securities		68,538		69,311		71,311		71,100
Commercial mortgage –backed securities		50,762		50,517		56,889		56,168
U.S. Treasury securities		21,297		20,926		25,748		25,181
State and municipal securities		23,903		23,856		32,020		31,255
	$	194,676	$	308,373	$	216,144	$	321,717

Included in the available for sale marketable equity securities are the following

(in thousands, except share amounts)

:

	September 30, 2017						December 31, 2016
	Shares		Cost		Fair Value		Shares		Cost		Fair Value
NHI Common Stock		1,630,642	$	24,734	$	126,032		1,630,642	$	24,734	$	120,945

The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows

(in thousands)

:

	September 30, 2017				December 31, 2016
	Cost		Fair Value		Cost		Fair Value
Maturities:
Within 1 year	$	11,060	$	11,081	$	14,181	$	14,216
1 to 5 years		68,297		68,620		79,827		79,502
6 to 10 years		80,290		80,073		91,211		89,269
Over 10 years		4,853		4,836		749		717
	$	164,500	$	164,610	$	185,968	$	183,704

Gross unrealized gains related to available for sale securities are

$114,891,000

and

$108,730,000

as of

September 30, 2017

and

December 31, 2016,

respectively. Gross unrealized losses related to available for sale securities are

$1,194,000

and

$3,157,000

as of

September 30, 2017

and

December 31, 2016,

respectively. For the marketable securities in gross unrealized loss positions, (a) it is more likely than

not

that the Company will

not

be required to sell the investment securities before recovery of the unrealized losses, and (b) the Company expects that the contractual principal and interest will be received on the investment securities. As a result, the Company recognized

no

other-than-temporary impairment during the

nine

months ended

September 30, 2017

or for the year ended

December 31, 2016.

Proceeds from the sale of securities during the

nine

months ended

September 30, 2017

and

2016

were

$46,598,000

and

$30,963,000,

respectively. Investment gains of

$255,000

and

$804,000

were realized on these sales during the

nine

months ended

September 30, 2017

and

2016,

respectively.

XML

Note 9 - Fair Value Measurements

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Fair Value Disclosures [Text Block]

Note

9

–

Fair Value Measurements

The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes the

three

levels of inputs that

may

be used to measure fair value:

Level

1

– The valuation is based on quoted prices in active markets for identical instruments.

Level

2

– The valuation is based on observable inputs such as quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are

not

active, and model–based valuation techniques for which all significant assumptions are observable in the market.

Level

3

– The valuation is based on unobservable inputs that are supported by minimal or

no

market activity and that are significant to the fair value of the instrument. Level

3

valuations are typically performed using pricing models, discounted cash flow methodologies, or similar techniques that incorporate management’s own estimates of assumptions that market participants would use in pricing the instrument, or valuations that require significant management judgment or estimation.

A financial instrument’s level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement.

Valuation of Marketable Securities

The Company determines fair value for marketable securities with Level

1

inputs through quoted market prices. The Company determines fair value for marketable securities with Level

2

inputs through broker or dealer quotations or alternative pricing sources with reasonable levels of price transparency. Our Level

2

marketable securities have been initially valued at the transaction price and subsequently valued, at the end of each month, typically utilizing

third

party pricing services or other market observable data. The pricing services utilize industry standard valuation models, including both income and market based approaches and observable market inputs to determine value. These observable market inputs include reportable trades, benchmark yields, credit spreads, broker/dealer quotes, bids, offers, and other industry and economic events.

We validated the prices provided by our broker by reviewing their pricing methods, obtaining market values from other pricing sources, analyzing pricing data in certain instances and confirming that the relevant markets are active. After completing our validation procedures, we did

not

adjust or override any fair value measurements provided by our broker as of

September 30, 2017.

We did

not

have any transfers of assets between Level

1

and Level

2

of the fair value measurement hierarchy during the

nine

months ended

September 30, 2017.

Other

The carrying amounts of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, and accounts payable approximate fair value due to their short–term nature. The estimated fair value of notes receivable approximates the carrying value based principally on their underlying interest rates and terms, maturities, collateral and credit status of the receivables. Our long–term debt approximates fair value due to variable interest rates, but fair value is also determined using Level

2

inputs through alternative pricing sources. At

September 30, 2017,

there were

no

material differences between the carrying amounts and fair values of NHC’s financial instruments.

The following table summarizes fair value measurements by level at

September 30, 2017

and

December 31, 2016

for assets and liabilities measured at fair value on a recurring basis

(in thousands)

:

	Fair Value Measurements Using
September 30, 2017	Fair Value		Quoted Prices in Active Markets For Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Cash and cash equivalents	$	69,790	$	69,790	$	–	$	–
Restricted cash and cash equivalents		11,950		11,950		–		–
Marketable equity securities		143,763		143,763		–		–
Corporate debt securities		69,311		48,929		20,382		–
M ortgage–backed securities		50,517		–		50,517		–
U.S. Treasury securities		20,926		20,926		–		–
State and municipal securities		23,856		–		23,856		–
Total financial assets	$	390,113	$	295,358	$	94,755	$	–

	Fair Value Measurements Using
December 31, 2016	Fair Value		Quoted Prices in Active Markets For Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Cash and cash equivalents	$	26,335	$	26,335	$	–	$	–
Restricted cash and cash equivalents		5,254		5,254		–		–
Marketable equity securities		138,013		138,013		–		–
Corporate debt securities		71,100		42,323		28,777		–
M ortgage-backed securities		56,168		–		56,168		–
U.S. Treasury securities		25,181		25,181		–		–
State and municipal securities		31,255		–		31,255		–
Total financial assets	$	353,306	$	237,106	$	116,200	$	–

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Note 10 - Long-term Debt

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Debt Disclosure [Text Block]

Note

10

–

Long

–

Term Debt

Long–term debt consists of the following:

	Weighted Average Interest Rate			Maturities		September 30, 2017		December 31, 2016
	Variable					(dollars in thousands)
Revolving Credit Facility, interest payable monthly		2.6	%		2020	$	110,000	$	110,000
Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		3.6	%		2018		10,000		10,000
							120,000		120,000
Less current portion							–		–
						$	120,000	$	120,000

The

$10

million unsecured term note payable to National is due

January 1, 2018.

The Company intends to extend the note payable beyond the current due date. If the Company is

not

able to extend the note payable with National,

the Company’s 

$175

million credit facility is available to provide financing.

$175,000,000

Credit Facility

In

October 2015,

we entered into a

$175

million credit facility that has a

five

year maturity date (

October 2020).

Loans bear interest at either (i) LIBOR plus

1.40%

or (ii) the base rate plus

0.40%.

The base rate is defined as the highest of (a) the Federal Funds Rate plus ½ of

1%,

(b) the Bank of America prime rate, and (c) LIBOR plus

1.00%.

The credit facility is available for general corporate purposes, including working capital and acquisitions. NHC is permitted, upon required notice to the lender, to prepay the loans outstanding under the credit facility at any time, without penalty.

The Credit Agreement contains customary representations and financial covenants, including covenants that restrict, among other things, asset dispositions, mergers and acquisitions, dividends, restricted payments, debt, liens, investments and affiliate transactions. The Credit Agreement contains customary events of default.

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Note 11 - Stock Repurchase Program

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Treasury Stock [Text Block]

Note

1

1

- Stock Repurchase Program

In

August 2017,

the Board of Directors authorized a new common stock purchase program. The program will allow for repurchases of up to

$25

million of its common stock. The new stock repurchase plan began on

September 1, 2017

and will expire on

August 31, 2018.

No

repurchases of common stock have been executed under this current program.

XML

Note 12 - Stock-based Compensation

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Disclosure of Compensation Related Costs, Share-based Payments [Text Block]

Note

1

2

–

S

tock

–

Based Compensation

NHC recognizes stock–based compensation expense for all stock options and restricted stock granted over the requisite service period using the fair value for these grants as estimated at the date of grant either using the Black–Scholes pricing model for stock options or the quoted market price for restricted stock.

The Compensation Committee of the Board of Directors (“the Committee”) has the authority to select the participants to be granted options; to designate whether the option granted is an incentive stock option (“ISO”), a non–qualified option, or a stock appreciation right; to establish the number of shares of common stock that

may

be issued upon exercise of the option; to establish the vesting provision for any award; and to establish the term any award

may

be outstanding. The exercise price of any ISO’s granted will

not

be less than the fair market value of the shares of common stock on the date granted and the term of an ISO

may

not

be any more than

ten

years. The exercise price of any non–qualified options granted will

not

be less than the fair market value of the shares of common stock on the date granted unless so determined by the Committee.

In

May 2015,

our stockholders voted to amend the

2010

Omnibus Equity Incentive Plan (“the

2010

Plan”) to increase the number of shares of our common stock authorized under the Plan from the original

1,200,000

shares to

2,575,000

shares. The shares granted during the

nine

months ended

September 30, 2017

consisted of

1,062,500

shares to employees of the Company,

52,500

shares to the Directors of the Company, and

9,310

shares for the Employee Stock Purchase Plan. At

September 30, 2017,

568,744

shares were available for future grants under the amended

2010

Plan.

Compensation expense is recognized only for the awards that ultimately vest. Stock–based compensation totaled

$430,000

and

$9,000

for the

three

months ended

September 30, 2017

and

2016,

respectively. Stock–based compensation totaled

$1,263,000

and

$502,000

for the

nine

months ended

September 30, 2017

and

2016,

respectively. Stock–based compensation is included in “Salaries, wages and benefits” in the interim condensed consolidated statements of income.

At

September 30, 2017,

the Company had

$7,520,000

of unrecognized compensation cost related to unvested stock–based compensation awards. This unrecognized compensation cost will be amortized over an approximate

four

year period.

Stock Options

The following table summarizes the significant assumptions used to value the options granted for the

nine

months ended

September 30, 2017

and for the year ended

December 31, 2016.

	201 7			201 6
Risk –free interest rate		2.08	%		0.89	%
Expected volatility		16.6	%		15.8	%
Expected life, in years		4.8			2.2
Expected dividend yield		3.10	%		3.09	%

The following table summarizes our outstanding stock options for the

nine

months ended

September 30, 2017

and for the year ended

December 31, 2016.

	Number of Shares			Weighted Average Exercise Price		Aggregate Intrinsic Value
Options outstanding at January 1, 201 6		621,390		$	48.15	$	–
Options granted		56,291			62.54		–
Options exercised		(499,066	)		47.16		–
Options cancelled		(656	)		46.69		–
Options outstanding at December 31, 2016		177,959			55.48		–
Options granted		1,124,310			72.96		–
Options exercised		(33,717	)		47.89		–
Options cancelled		–			–		–
Options outstanding at September 30, 2017		1,268,552		$	71.17	$	758,000
Options exercisable at September 30, 2017		196,742		$	61.44	$	758,000

Options Outstanding September 30, 2017	Exercise Prices			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life in Years
60,000	$47.45	-	$52.93	$	50.88		1.2
1,208,552	$61.25	-	$75.45		72.18		4.3
1,268,552				$	71.17		4.2

XML

Note 13 - Income Taxes

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Income Tax Disclosure [Text Block]

Note

13

– Income Taxes

The income tax provision for the

three

months ended

September 30, 2017

is

$4,691,000

(an effective income tax rate of

29.5%

). The income tax provision and effective tax rate for the

three

months ended

September 30, 2017

were favorably impacted by statute of limitations expirations resulting in a benefit to the provision of

$1,753,000

or

11.0%

of income before taxes for the quarter. The income tax provision for the

three

months ended

September 30, 2016

was

$4,571,000

(an effective income tax rate of

29.1%

). The income tax provision and effective tax rate for the

three

months ended

September 30, 2016

were favorably impacted by statute of limitation expirations resulting in a benefit to the provision of

$1,306,000

or

8.3%

of income before taxes for the quarter.

The income tax provision for the

nine

months ended

September 30, 2017

is

$19,448,000

(an effective income tax rate of

36.1%

). The income tax provision and effective tax rate for the

nine

months ended

September 30, 2017

were favorably impacted by the statute of limitations expirations resulting in a benefit to the provision of

$1,753,000

or

3.3%

of income before taxes in

2017.

The income tax provision for the

nine

months ended

September 30, 2016

was

$20,969,000

(an effective income tax rate of

36.4%

). The income tax provision and effective tax rate for the

nine

months ended

September 30, 2016

were favorably impacted by the statute of limitation expirations resulting in a benefit to the provision of

$1,306,000

or

2.3%

of income before taxes in

2016.

Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense.

The Company is

no

longer subject to U.S. federal and state examinations by tax authorities for years before

2014

(with certain state exceptions).

XML

Note 14 - Contingencies and Commitments

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Commitments and Contingencies Disclosure [Text Block]

Note

1

4

– Contingencies

and Commitments

Accrued Risk Reserves

We are self–

insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims both for our owned or leased entities and certain of the entities to which we provide management or accounting services. The liability we have recognized for reported claims and estimates for incurred but unreported claims totals

$95,513,000

and

$91,162,000

at

September 30, 2017

and

December 31, 2016,

respectively. The liability is included in accrued risk reserves in the interim condensed consolidated balance sheets and is subject to adjustment for actual claims incurred. It is possible that these claims plus unasserted claims could exceed our insurance coverages and our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

As a result of the terms of our insurance policies and our use of wholly–owned limited purpose insurance companies, we have retained significant insurance risk with respect to workers’ compensation and general and professional liability. We consider the professional services of independent actuaries to assist us in estimating our exposures for claims obligations (for both asserted and unasserted claims) related to deductibles and exposures in excess of coverage limits, and we maintain reserves for these obligations. Such estimates are based on many variables including historical and statistical information and other factors.

Workers

’

Compensation

For workers’ compensation, we utilize a wholly–owned Tennessee domiciled property/casualty insurance company to write coverage for NHC affiliates and for third–party customers. Policies are written for a duration of

twelve

months and cover only risks related to workers’ compensation losses. All customers are companies which operate in the senior care industry. Business is written on a direct basis. Direct business coverage is written for statutory limits and the insurance company’s losses in excess of

$1,000,000

per claim are covered by reinsurance.

General and Professional Liability Lawsuits and Insurance

The senior care industry has experienced increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by nursing facilities and their employees in providing care to residents. As of

September 30, 2017,

we and/or our managed centers are currently defendants in

60

such claims.

Insurance coverage for both periods includes both primary policies and excess policies. The primary coverage is in the amount of

$1.0

million per incident,

$3.0

million per location with an annual primary policy aggregate limit that is adjusted on an annual basis. For

2016

and

2017,

the excess coverage is

$

9.0

million per occurrence. Additional insurance is purchased through

third

party providers that serve to supplement the coverage provided through our wholly–owned captive insurance company.

Civil Investigative Demand

On

December 19, 2013,

the Company was served with a civil investigative demand (“CID”) from the U.S. Department of Justice and the Office of the U.S. Attorney for the Eastern District of Tennessee (“DOJ Investigation”) requesting the production of documents and interrogatory responses regarding the billing for and medical necessity of certain rehabilitative therapy services. Based upon our review, the CID appears to relate to services provided at our facilities based in Knoxville, Tennessee.

On

October 7, 2014,

the Company received a subpoena from the Office of Inspector General of the United Department of Health and Human Services (“OIG Subpoena”) related to the current DOJ Investigation.  The OIG Subpoena requests certain financial and organizational documents from the Company and certain of its subsidiaries and SNFs and medical records from certain of the Company’s Tennessee–based SNFs. 

The Company is cooperating fully with these requests. We are unable to evaluate the outcome of this investigation at this time.  It is possible that this investigation could lead to a claim that could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

Caris HealthCare, L.P. Investigation

On

December 9, 2014,

Caris Healthcare, L.P., a business that specializes in hospice care services in Company–owned health care centers and in other settings, received notice from the U.S. Attorney’s Office for the Eastern District of Tennessee and the Attorney Generals’ Offices for the State of Tennessee and State of Virginia that those government entities were conducting an investigation regarding patient eligibility for hospice services provided by Caris precipitated by a

qui tam

lawsuit.  We have a

75.1%

non–controlling ownership interest in Caris.

A

qui tam

lawsuit was filed on

May 22, 2014,

in the U.S. District Court for the Eastern District of Tennessee by a former Caris employee, Barbara Hinkle, and is captioned

United States of America, State of Tennessee, and State of Virginia ex rel. Barbara Hinkle v. Caris Healthcare, L.P.

,

No.

3:14–cv–212

(E.D. Tenn.).

On

June 16, 2016,

the State of Tennessee and the State of Virginia declined to intervene in the

qui tam

lawsuit.  On

June 20, 2016,

the Court ordered that the complaint be unsealed.  On

October 11, 2016,

the United States filed a Complaint in Intervention against Caris Healthcare, L.P. and Caris Healthcare, LLC, a wholly owned subsidiary of Caris Healthcare, L.P. The United States' complaint alleges that Caris billed the government for ineligible hospice patients between

June 2013

and

December 2013

and retained overpayments regarding ineligible hospice patients from

April 2010

through

June 2013.

It seeks treble damages and civil penalties under the Federal False Claims Act and asserts claims for payment under mistake of fact, unjust enrichment, and conversion. The relator has filed a notice of voluntary dismissal without prejudice of the non–intervened claims asserted in her

qui tam

complaint. On

May 30, 2017,

the district court denied Caris’ motion to dismiss, and the parties are engaged in discovery. This matter is set for trial in

March 2019.

Caris denies the allegations in the United States' complaint and intends to defend itself vigorously. Given the early stage of this action, we are unable to assess the probable outcome or potential liability, if any, arising from this action.  It is possible that this claim could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

Financing Commitments

In conjunction with our management contract with National, we have entered into a line of credit arrangement whereby we

may

have amounts due from National from time to time. The maximum loan commitment under the line of credit is

$2,000,000.

At

September 30, 2017,

National did

not

have an outstanding balance on the line of credit.

Governmental Regulations

Laws and regulations governing the Medicare, Medicaid and other federal healthcare programs are complex and subject to interpretation. Management believes that it is in compliance with all applicable laws and regulations in all material respects. However, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusions from the Medicare, Medicaid and other federal healthcare programs.

XML

Note 15 - Common Stock Authorized

9 Months Ended

Sep. 30, 2017

Notes to Financial Statements

Stockholders' Equity Note Disclosure [Text Block]

Note

15

– Common Stock Authorized

On

May 9, 2017,

our Board of Directors and shareholders approved to increase our authorized common stock by

15,000,000

shares, from

30,000,000

shares to

45,000,000

shares, par value

$0.01.

The additional shares of common stock available for issue are part of the existing class of common stock. These shares have the same rights and privileges as the shares of common stock previously outstanding.

XML

Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2017

Accounting Policies [Abstract]

Basis of Accounting, Policy [Policy Text Block]

Basis of Presentation

The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. The consolidated financial statements include the accounts of all entities controlled by NHC. The Company presents noncontrolling interest within the equity section of its consolidated balance sheets. The Company presents the amount of consolidated net income (loss) that is attributable to NHC and the noncontrolling interest in its consolidated statements of income.

We assume that users of these interim financial statements have read or have access to the audited

December 31, 2016

consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies,

may

be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is

not

necessarily indicative of the results that

may

be expected for a full year for a variety of reasons.

Use of Estimates, Policy [Policy Text Block]

Estimates and Assumptions

The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.

Change in Accounting Principle, Policy [Policy Text Block]

Change in Accounting Principle

Effective

December 31, 2016,

the Company retrospectively adopted a change in accounting principle related to the early adoption of Accounting Standards Update (“ASU”)

No.

2016–18,

Statement of Cash Flows (Topic

230

)—Restricted Cash—a consensus of the FASB Emerging Issues Task Force

. The updated guidance requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash and restricted cash equivalents. As such, amounts generally described as restricted cash and restricted cash equivalents should be included in the “beginning–of–period” and “end–of–period” total amounts shown on the statements of cash flows.

As described in the guidance for accounting changes under ASC Topic

250,

the comparative consolidated statement of cash flows of prior periods are adjusted to apply the new accounting method retrospectively. The following table presents the effect on the interim condensed consolidated statement of cash flows for the

nine

months ending

September 30, 2016

for the accounting change that was retrospectively adopted on

December 31, 2016:

Consolidated Statement

of Cash Flows

(

in thousands

)

	Nine Months Ended September 30, 2016
	As Previously Reported			Effect of Accounting Change			As Adjusted
Cash Flows from Operating Activities:
Restricted cash and cash equivalents	$	(15,507	)	$	15,507		$	–
Net cash provided by operating activities		49,274			15,507			64,781
Cash Flows from Investing Activities:
Change in restricted cash and cash equivalents		9,455			(9,455	)		–
Net cash used in investing activities		(47,651	)		(9,455	)		(57,106	)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		(18,996	)		6,052			(12,944	)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period		38,208			11,106			49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents,  End of Period	$	19,212		$	17,158		$	36,370

New Accounting Pronouncements, Policy [Policy Text Block]

Recently Adopted Accounting Guidance

In

November 2016,

the Financial Accounting Standards Board ("FASB") issued ASU

No.

2016–18,

“Statement of Cash Flows (Topic

230

)—Restricted Cash—a consensus of the FASB Emerging Issues Task Force”. This revised standard is an effort by the FASB to reduce diversification in practice by providing specific guidance on the presentation of restricted cash or restricted cash equivalents in the statement of cash flows. The updated guidance requires that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash and restricted cash equivalents. As such, amounts generally described as restricted cash and restricted cash equivalents should be included in the “beginning–of–period” and “end–of–period” total amounts shown on the statement of cash flows. The effective date for this standard is for years beginning after

December 15, 2017,

with early adoption permitted. Effective

December 31, 2016,

the Company elected to early adopt this standard. The adoption of this standard represented a change in accounting principle which was applied retrospectively; see the paragraphs above under “

Change in Accounting Principle

” for further discussion on the adoption of ASU

No.

2016–18.

In

March 2016,

the FASB issued ASU

2016

-

09,

“

Compensation – Stock Compensation (Topic

718

): Improvements to Employee Share-Based Payment Accounting.” ASU

2016

-

09

simplifies the accounting for share-based payment award transactions including: income tax consequences, classification of awards as either equity or liabilities and classification on the statement of cash flows. ASU

2016

-

09

is effective for fiscal years beginning after

December 

15,

2016,

including interim periods within those fiscal years. On

January 1, 2017,

the Company adopted the provisions of ASU

2016

-

09.

 As a result of the adoption, the Company has recognized 

$0

and

$235,000

 of excess tax benefits related to share-based payments in our provision for income taxes for the

three

and

nine

months ended 

September 30, 2017,

respectively. These items were historically recorded in additional paid-in capital. In addition, cash flows related to excess tax benefits are now classified as an operating activity along with other income tax related cash flows. The Company elected to apply the change in presentation of excess tax benefits in the statements of cash flows on a prospective basis.

Recent Accounting Guidance

Not

Yet Adopted

In

February 2016,

the FASB issued ASU

2016

-

02,

"Leases (Topic

842

)." The objective of this update is to increase transparency and comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and disclosing key information about leasing arrangements. This ASU is effective for fiscal years beginning after

December 15, 2018,

including interim periods within those annual periods and is to be applied utilizing a modified retrospective approach. We anticipate this standard will have a material impact on our consolidated financial statements. Additionally, we are currently evaluating the impact this standard will have on our policies and procedures and internal control framework.

In

January 2016,

the FASB issued ASU

No.

2016

-

01,

 “Financial Instruments - Recognition and Measurement of Financial Assets and Financial Liabilities

(Topic

825

)”. ASU

No.

2016

-

01

revises the classification and measurement of investments in certain equity investments and the presentation of certain fair value changes for certain financial liabilities measured at fair value. ASU

No.

2016

-

01

requires the change in fair value of many equity investments to be recognized in net income.  ASU

No.

2016

-

01

is effective for interim and annual periods beginning after

December 15, 2017,

with early adoption permitted.   Adopting ASU

No.

2016

-

01

may

result in a cumulative effect adjustment to the Company’s retained earnings as of the beginning of the year of adoption. We are currently evaluating the potential effects of adopting the provisions of ASU

No.

2016

-

01.

In

May 2014,

the FASB issued ASU

No.

2014–09

“Revenue from Contracts with Customers”, also known as the “New Revenue Standard”. This update is the result of a collaborative effort by the FASB and the International Accounting Standards Board to simplify revenue recognition guidance, remove inconsistencies in the application of revenue recognition, and to improve comparability of revenue recognition practices across entities, industries, jurisdictions, and capital markets. The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to receive for those goods or services. The New Revenue Standard is applied through the following

five

-step process:

1.

Identify the contract(s) with a customer.

2.

Identify the performance obligation in the contract.

3.

Determine the transaction price.

4.

Allocate the transaction price to the performance obligations in the contract.

5.

Recognize revenue when (or as) the entity satisfies a performance obligation.

For a public entity, this update is effective for annual reporting periods beginning after

December 15, 2017,

including interim periods within that reporting period by applying either the full retrospective method or the cumulative catch-up transition method. The full retrospective method requires application of the provisions of the New Revenue Standard for all periods presented while the cumulative catch-up transition method requires the application of the provisions of the New Revenue Standard as of the date of adoption with the cumulative effect of the retrospective application of the provisions as an adjustment through retained earnings. Currently, the Company is evaluating which method to apply.

As we continue to progress with our implementation efforts to adopt the New Revenue Standard, management continues to evaluate and refine its estimates of the anticipated impacts it will have on our revenue recognition policies, procedures, financial position, results of operations, cash flows, financial disclosures and control framework.  In addition, the Company is monitoring specific developments for the senior living industry and evaluating potential changes to our business processes, systems, and controls to support the recognition disclosure under the new standard. Specifically, the Company is continuing to evaluate revenue sources to determine the potential effects the New Revenue Standard will have on the amount or timing of certain industry-specific healthcare revenue sources, which at this time, includes revenue recorded from our continuing care retirement community (“CCRC”), timing of revenue recorded from our homecare operations, and settlements with

third

party payors. At this time, we do

not

expect any significant impacts. 

Contractual Adjustments and Third Party Settlements, Policy [Policy Text Block]

Revenue Recognition

– Third Party Payors

Approximately

65%

of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that

may

result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment

no

longer being subject to audit or review. We have recorded liabilities of approximately

$20,649,000

and

$17,019,000

as of

September 30, 2017

and

December 31, 2016,

respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.

Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block]

Revenue Recognition

–

Private P

ay

For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.

Premiums Receivable, Allowance for Doubtful Accounts, Estimation Methodology, Policy [Policy Text Block]

Revenue Recognition

–

Subordination of Fees and Uncert

ain Collections

We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge

6%

to

7%

of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the healthcare facility being managed. Furthermore, for certain of the

third

parties with whom we have contracted to provide services and which we have determined that collection is

not

reasonably assured; our policy is to recognize income only in the period in which the amounts are realized. We

may

receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be

no

assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.

We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We

may

continue to provide services to certain managed centers despite

not

being fully paid currently so that we

may

be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center

may

be small compared to the potential benefit. Also, we

may

benefit from providing other ancillary services to the managed center.

Segment Reporting, Policy [Policy Text Block]

Segment Reporting

In accordance with the provisions of ASC

280,

“Segment Reporting”, the Company is required to report financial and descriptive information about its reportable operating segments. Beginning in the

first

quarter of

2017

with the leadership change of the Company’s Chief Executive Officer, we reassessed and realigned our reportable operating segments to coincide with the way our new leadership and chief operating decision maker ("CODM") measures Company performance and allocates resources. T

he Company now has

two

reportable operating segments: (

1

) inpatient services, which includes the operation of skilled nursing facilities and assisted and independent living facilities, and (

2

) homecare services. The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. See Note

5

for further disclosure of the Company’s operating segments.

Other Operating Expenses Policy [Policy Text Block]

Other Operating Expenses

Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance.

Selling, General and Administrative Expenses, Policy [Policy Text Block]

General and Administrative Costs

With the Company being a healthcare provider, the majority of our expenses are "cost of revenue" items. Costs that could be classified as "general and administrative" by the Company would include its corporate office costs, which were

$22,442,000

and

$21,222,000

for the

nine

months ended

September 30, 2017

and

2016,

respectively.

Property, Plant and Equipment, Policy [Policy Text Block]

Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements,

20

-

40

years and equipment and furniture,

3

-

15

years. Leasehold improvements are amortized over periods that do

not

exceed the non-cancelable respective lease terms using the straight-line method.

Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic

840

-

30,

Leases – Capital Leases

. Amortization of capital lease assets is included in depreciation and amortization expense.

Liability Reserve Estimate, Policy [Policy Text Block]

Accrued Risk Reserves

We are self–

insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to engage an external, independent actuary to assist in estimating our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis.

Professional liability remains an area of particular concern to us. The long-term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by skilled nursing facilities and their employees in providing care to residents. As of

September 30, 2017,

we and/or our managed healthcare facilities are defendants in

60

such claims. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.

We are principally self-insured for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.

Continuing Care Retirement Communities, Advance Fees, Policy [Policy Text Block]

Continuing Care Contracts and Refundable Entrance Fee

We have

one

CCRC within our operations.

Residents at this retirement center

may

enter into continuing care contracts with us. The contracts provide that

10%

of the resident entry fee becomes non-refundable upon occupancy, and the remaining refundable portion of the entry fee is calculated using the lessor of the price at which the apartment is re-assigned or

90%

of the original entry fee, plus

40%

of any appreciation if the apartment exceeds the original resident’s entry fee. In each case, we amortize the non-refundable part of these fees into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of

September 30, 2017

and

December 31, 2016

were

$8,827,000

and

$9,924,000,

respectively.

Obligation to Provide Future Services

W

e annually estimate the present value of the cost of future services and the use of facilities to be provided to the current CCRC residents and compare that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of

September 30, 2017,

and

December 31, 2016,

we have recorded a future service obligation in the amount of

$3,236,000.

Other Noncurrent Liabilities [Policy Text Block]

Other Noncurrent Liabilities

Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions.

Revenue Recognition, Deferred Revenue [Policy Text Block]

D

eferred Revenue

Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”), the non-refundable portion

(

10%

) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are

not

yet earned.

Noncontrolling Interest, Policy [Policy Text Block]

Noncontrolling Interest

The noncontrolling interest in a subsidiary is presented within total equity in the Company's interim condensed consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income attributable to NHC in its interim condensed consolidated statements of income. The Company’s earnings per share is calculated based on net income attributable to NHC’s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest.

Consolidation, Variable Interest Entity, Policy [Policy Text Block]

Variable Interest Entities

We have equity interests in unconsolidated limited liability companies that operate various post-acute and senior healthcare businesses. We analyze our investments in these limited liability companies to determine if the company is considered a VIE and would require consolidation. To the extent that we own interests in a VIE and we (i) are the sole entity that has the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary.

The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and

may

or

may

not

be limited to its investment in the unconsolidated VIE. The investments in unconsolidated VIEs are classified as “investments in limited liability companies” in the consolidated balance sheets.

XML

Note 2 - Summary of Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

New Accounting Pronouncement, Early Adoption [Table Text Block]

	Nine Months Ended September 30, 2016
	As Previously Reported			Effect of Accounting Change			As Adjusted
Cash Flows from Operating Activities:
Restricted cash and cash equivalents	$	(15,507	)	$	15,507		$	–
Net cash provided by operating activities		49,274			15,507			64,781
Cash Flows from Investing Activities:
Change in restricted cash and cash equivalents		9,455			(9,455	)		–
Net cash used in investing activities		(47,651	)		(9,455	)		(57,106	)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		(18,996	)		6,052			(12,944	)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period		38,208			11,106			49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents,  End of Period	$	19,212		$	17,158		$	36,370

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Note 3 - Other Revenues (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Other Revenues [Table Text Block]

	Three Months Ended September 30				Nine Months Ended September 30
(in thousands)	2017		2016		2017		2016
Rental Income	$	5,500	$	5,434	$	16,501	$	16,439
Management and accounting services fees		4,130		5,061		11,741		12,316
Insurance services		2,077		1,729		5,721		5,468
Other		230		410		868		1,174
	$	11,937	$	12,634	$	34,831	$	35,397

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Note 4 - Non-operating Income (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Other Nonoperating Income, by Component [Table Text Block]

	Three Months Ended September 30				Nine Months Ended September 30
(in thousands)	2017		2016		2017		2016
Equity in earnings of unconsolidated investments	$	2,528	$	1,806	$	5,908	$	4,926
Dividends and other net realized gains and losses on sales of securities		1,696		1,892		5,319		5,654
Interest income		1,866		1,393		4,820		4,209
	$	6,090	$	5,091	$	16,047	$	14,789

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Note 5 - Business Segments (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Segment Reporting Information, by Segment [Table Text Block]

	Three Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	214,360	$	15,688	$	-		$	230,048
Other revenues		181		-		11,756			11,937
Net operating revenues		214,541		15,688		11,756			241,985
Costs and Expenses:
Salaries, wages and benefits		127,050		8,317		10,533			145,900
Other Operating		56,851		5,291		1,897			64,039
Rent		8,128		502		1,476			10,106
Depreciation and Amortization		9,756		41		1,036			10,833
Interest		423		-		899			1,322
Total costs and expenses		202,208		14,151		15,841			232,200
Income (Loss) Before Non-Operating Income		12,333		1,537		(4,085	)		9,785
Non-Operating Income		-		-		6,090			6,090
Income Before Income Taxes	$	12,333	$	1,537	$	2,005		$	15,875

	Three Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	202,925	$	15,722	$	-		$	218,647
Other revenues		-		-		12,634			12,634
Net operating revenues		202,925		15,722		12,634			231,281
Costs and Expenses:
Salaries, wages and benefits		122,496		8,103		9,804			140,403
Other Operating		51,717		5,108		2,131			58,956
Rent		8,028		476		1,810			10,314
Depreciation and Amortization		8,862		46		1,090			9,998
Interest		474		-		546			1,020
Total costs and expenses		191,577		13,733		15,381			220,691
Income (Loss) Before Non-Operating Income		11,348		1,989		(2,747	)		10,590
Non-Operating Income		-		-		5,091			5,091
Income Before Income Taxes	$	11,348	$	1,989	$	2,344		$	15,681

	Nine Months Ended September 30, 2017
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	638,550	$	47,304	$	-		$	685,854
Other revenues		632		-		34,199			34,831
Net operating revenues		639,182		47,304		34,199			720,685
Costs and Expenses:
Salaries, wages and benefits		369,585		24,760		32,294			426,639
Other Operating		169,710		15,484		5,584			190,778
Rent		24,552		1,490		4,231			30,273
Depreciation and Amortization		28,362		120		3,127			31,609
Interest		1,309		-		2,290			3,599
Total costs and expenses		593,518		41,854		47,526			682,898
Income (Loss) Before Non-Operating Income		45,664		5,450		(13,327	)		37,787
Non-Operating Income		-		-		16,047			16,047
Income Before Income Taxes	$	45,664	$	5,450	$	2,720		$	53,834

	Nine Months Ended September 30, 2016
	Inpatient Services		Homecare		All Other			Total
Revenues:
Net patient revenues	$	605,626	$	47,614	$	-		$	653,240
Other revenues		250		-		35,147			35,397
Net operating revenues		605,876		47,614		35,147			688,637
Costs and Expenses:
Salaries, wages and benefits		350,166		24,300		31,025			405,491
Other Operating		156,068		15,494		6,009			177,571
Rent		24,838		1,443		4,679			30,960
Depreciation and Amortization		25,435		139		3,273			28,847
Interest		1,459		-		1,454			2,913
Total costs and expenses		557,966		41,376		46,440			645,782
Income (Loss) Before Non-Operating Income		47,910		6,238		(11,293	)		42,855
Non-Operating Income		-		-		14,789			14,789
Income Before Income Taxes	$	47,910	$	6,238	$	3,496		$	57,644

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Note 6 - Long-term Leases (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Capital Leased Assets [Table Text Block]

	September 30, 2017			December 31, 2016
	(in thousands)
Buildings and personal property	$	39,032		$	39,032
Accumulated amortization		(14,064	)		(11,120	)
	$	24,968		$	27,912

Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block]

	Operating Leases		Capital Leases
	(in thousands)
201 8	$	34,200	$	5,200
201 9		34,200		5,200
20 20		34,200		5,200
20 21		34,200		5,200
20 22		34,200		5,200
Thereafter		151,100		7,367
Total minimum lease payments	$	322,100	$	33,367
Less: Amounts representing interest				(5,729	)
Present value of minimum lease payments				27,638
Less: Current portion				(3,641	)
Long-term capital lease obligations			$	23,997

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Note 7 - Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]

	Three Months Ended Sept.30				Nine Months Ended Sept. 30
	2017		2016		2017		2016
Basic:
Weighted average common shares outstanding		15,195,394		15,198,696		15,186,315		15,128,728
Net income attributable to National Health Care Corporation	$	11,352	$	11,110	$	34,735	$	36,675
Earnings per common share, basic	$	0.75	$	0.73	$	2.29	$	2.42
Diluted:
Weighted average common shares outstanding		15,195,394		15,198,696		15,186,315		15,128,728
Dilutive effect of stock options		25,173		23,952		31,482		23,588
Dilutive effect of contingent issuable stock		-		-		-		64,522
Weighted a verage common shares outstanding		15,220,567		15,222,648		15,217,797		15,216,838
Net income attributable to National Health Care Corporation	$	11,352	$	11,110	$	34,735	$	36,675
Earnings per common share, diluted	$	0.75	$	0.73	$	2.28	$	2.41

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Note 8 - Investments in Marketable Securities (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Available-for-sale Securities [Table Text Block]

	September 30, 2017				December 31, 2016
	Amortized Cost		Fair Value		Amortized Cost		Fair Value
Investments a vailable for sale:
Marketable equity securities	$	30,176	$	143,763	$	30,176	$	138,013
Restricted investments available for sale:
Corporate debt securities		68,538		69,311		71,311		71,100
Commercial mortgage –backed securities		50,762		50,517		56,889		56,168
U.S. Treasury securities		21,297		20,926		25,748		25,181
State and municipal securities		23,903		23,856		32,020		31,255
	$	194,676	$	308,373	$	216,144	$	321,717

Schedule of Available-for-sale Securities Reconciliation [Table Text Block]

	September 30, 2017						December 31, 2016
	Shares		Cost		Fair Value		Shares		Cost		Fair Value
NHI Common Stock		1,630,642	$	24,734	$	126,032		1,630,642	$	24,734	$	120,945

Investments Classified by Contractual Maturity Date [Table Text Block]

	September 30, 2017				December 31, 2016
	Cost		Fair Value		Cost		Fair Value
Maturities:
Within 1 year	$	11,060	$	11,081	$	14,181	$	14,216
1 to 5 years		68,297		68,620		79,827		79,502
6 to 10 years		80,290		80,073		91,211		89,269
Over 10 years		4,853		4,836		749		717
	$	164,500	$	164,610	$	185,968	$	183,704

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Note 9 - Fair Value Measurements (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]

	Fair Value Measurements Using
September 30, 2017	Fair Value		Quoted Prices in Active Markets For Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Cash and cash equivalents	$	69,790	$	69,790	$	–	$	–
Restricted cash and cash equivalents		11,950		11,950		–		–
Marketable equity securities		143,763		143,763		–		–
Corporate debt securities		69,311		48,929		20,382		–
M ortgage–backed securities		50,517		–		50,517		–
U.S. Treasury securities		20,926		20,926		–		–
State and municipal securities		23,856		–		23,856		–
Total financial assets	$	390,113	$	295,358	$	94,755	$	–

	Fair Value Measurements Using
December 31, 2016	Fair Value		Quoted Prices in Active Markets For Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Cash and cash equivalents	$	26,335	$	26,335	$	–	$	–
Restricted cash and cash equivalents		5,254		5,254		–		–
Marketable equity securities		138,013		138,013		–		–
Corporate debt securities		71,100		42,323		28,777		–
M ortgage-backed securities		56,168		–		56,168		–
U.S. Treasury securities		25,181		25,181		–		–
State and municipal securities		31,255		–		31,255		–
Total financial assets	$	353,306	$	237,106	$	116,200	$	–

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Note 10 - Long-term Debt (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Debt [Table Text Block]

	Weighted Average Interest Rate			Maturities		September 30, 2017		December 31, 2016
	Variable					(dollars in thousands)
Revolving Credit Facility, interest payable monthly		2.6	%		2020	$	110,000	$	110,000
Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		3.6	%		2018		10,000		10,000
							120,000		120,000
Less current portion							–		–
						$	120,000	$	120,000

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Note 12 - Stock-based Compensation (Tables)

9 Months Ended

Sep. 30, 2017

Notes Tables

Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]

	201 7			201 6
Risk –free interest rate		2.08	%		0.89	%
Expected volatility		16.6	%		15.8	%
Expected life, in years		4.8			2.2
Expected dividend yield		3.10	%		3.09	%

Share-based Compensation, Stock Options, Activity [Table Text Block]

	Number of Shares			Weighted Average Exercise Price		Aggregate Intrinsic Value
Options outstanding at January 1, 201 6		621,390		$	48.15	$	–
Options granted		56,291			62.54		–
Options exercised		(499,066	)		47.16		–
Options cancelled		(656	)		46.69		–
Options outstanding at December 31, 2016		177,959			55.48		–
Options granted		1,124,310			72.96		–
Options exercised		(33,717	)		47.89		–
Options cancelled		–			–		–
Options outstanding at September 30, 2017		1,268,552		$	71.17	$	758,000
Options exercisable at September 30, 2017		196,742		$	61.44	$	758,000

Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range [Table Text Block]

Options Outstanding September 30, 2017	Exercise Prices			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life in Years
60,000	$47.45	-	$52.93	$	50.88		1.2
1,208,552	$61.25	-	$75.45		72.18		4.3
1,268,552				$	71.17		4.2

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Note 1 - Description of Business (Details Textual)	Sep. 30, 2017
Number of Skilled Nursing Centers	76
Number of Beds	9,597
Number of Assisted Living Facilities	24
Number of Independent Living Facilities	5
Number of Homecare Programs	36
Number of States in which Entity Operates	10

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Note 2 - Summary of Significant Accounting Policies (Details Textual)	3 Months Ended		9 Months Ended
	Sep. 30, 2017 USD ($)	Sep. 30, 2016 USD ($)	Sep. 30, 2017 USD ($)	Sep. 30, 2016 USD ($)	Dec. 31, 2016 USD ($)
Income Tax Expense (Benefit)	$ 4,691,000	$ 4,571,000	$ 19,448,000	$ 20,969,000
Number of Reportable Segments			2
Malpractice Loss Contingency, Number of Claims	60		60
Customer Refundable Fees	$ 8,827,000		$ 8,827,000		$ 9,924,000
Continuing Care Retirement Communities Advance Fees, Obligation for Future Services, Amount	$ 3,236,000		$ 3,236,000		3,236,000
Number of Operating Segments			2
Appreciation [Member]
Malpractice Loss Contingency, Number of Claims	60		60
Appreciation of Apartment Over Original Residents Entry Fee Percentage			40.00%
Refundable Advance Fees [Member]
Nonrefundable Resident Entry Fee Percentage			10.00%
Customer Refundable Fees	$ 8,827,000		$ 8,827,000		9,924,000
Original Entry Fee [Member]
Refundable Resident Entry Fee Percentage			90.00%
Corporate Office Costs [Member]
General and Administrative Expense			$ 22,442,000	$ 21,222,000
Minimum [Member]
Management Services Fees			6.00%
Minimum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life			20 years
Minimum [Member] | Equipment and Furniture [Member]
Property, Plant and Equipment, Useful Life			3 years
Maximum [Member]
Management Services Fees			7.00%
Maximum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life			40 years
Maximum [Member] | Equipment and Furniture [Member]
Property, Plant and Equipment, Useful Life			15 years
Medicare and Medicaid [Member]
Allowance for Doubtful Accounts Receivable	20,649,000		$ 20,649,000		$ 17,019,000
Percent of Revenues Derived from Medicare, Medicaid and Other Government Programs [Member]
Concentration Risk, Percentage			65.00%
Accounting Standards Update 2016-09 [Member]
Income Tax Expense (Benefit)	$ 0		$ (235,000)

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Note 2 - Summary of Significant Accounting Policies - Effect of Accounting Change on the Statement of Cash Flows (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Net cash provided by operating activities	$ 70,995	$ 64,781
Net cash used in investing activities	1,190	(57,106)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	50,151	(12,944)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	31,589	49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	$ 81,740	36,370
New Accounting Pronouncement, Early Adoption, Effect [Member]
Restricted cash and cash equivalents
Net cash provided by operating activities		64,781
Change in restricted cash and cash equivalents
Net cash used in investing activities		(57,106)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		(12,944)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period		36,370
New Accounting Pronouncement, Early Adoption, Effect [Member] | Scenario, Previously Reported [Member]
Restricted cash and cash equivalents		(15,507)
Net cash provided by operating activities		49,274
Change in restricted cash and cash equivalents		9,455
Net cash used in investing activities		(47,651)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		(18,996)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		38,208
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period		19,212
New Accounting Pronouncement, Early Adoption, Effect [Member] | Restatement Adjustment [Member]
Restricted cash and cash equivalents		15,507
Net cash provided by operating activities		15,507
Change in restricted cash and cash equivalents		(9,455)
Net cash used in investing activities		(9,455)
Net (Decrease) Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		6,052
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		11,106
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period		$ 17,158

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Note 3 - Other Revenues (Details Textual) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Workers Compensation Premium Revenue [Member]
Health Care Organization, Premium Revenue	$ 1,399,000	$ 1,064,000	$ 4,087,000	$ 3,447,000
Professional Liability Insurance [Member]
Health Care Organization, Premium Revenue	678,000	665,000	1,634,000	2,021,000
National [Member]
Management Fees Revenue	$ 977,000	$ 939,000	$ 2,902,000	$ 2,834,000

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Note 3 - Other Revenues - Summary of Other Revenues (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Other Revenues	$ 11,937	$ 12,634	$ 34,831	$ 35,397
Other Income [Member]
Other Revenues	230	410	868	1,174
Rental Income [Member]
Other Revenues	5,500	5,434	16,501	16,439
Management and Accounting Services Fees [Member]
Other Revenues	4,130	5,061	11,741	12,316
Insurance Services [Member]
Other Revenues	$ 2,077	$ 1,729	$ 5,721	$ 5,468

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Note 4 - Non-operating Income (Details Textual)	Sep. 30, 2017
Caris [Member]
Equity Method Investment, Ownership Percentage	75.10%

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Note 4 - Non-operating Income - Summary of Non-operating Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Equity in earnings of unconsolidated investments	$ 2,528	$ 1,806	$ 5,908	$ 4,926
Dividends and other net realized gains and losses on sales of securities	1,696	1,892	5,319	5,654
Interest income	1,866	1,393	4,820	4,209
	$ 6,090	$ 5,091	$ 16,047	$ 14,789

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Note 5 - Business Segments (Details Textual)	9 Months Ended
	Sep. 30, 2017
Number of Operating Segments	2
Number of Reportable Segments	2

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Note 5 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Revenues:
Net patient revenues	$ 230,048	$ 218,647	$ 685,854	$ 653,240
Other revenues	11,937	12,634	34,831	35,397
Net operating revenues	241,985	231,281	720,685	688,637
Cost and Expenses:
Salaries, wages and benefits	145,900	140,403	426,639	405,491
Other operating	64,039	58,956	190,778	177,571
Rent	10,106	10,314	30,273	30,960
Depreciation and amortization	10,833	9,998	31,609	28,847
Interest	1,322	1,020	3,599	2,913
Total costs and expenses	232,200	220,691	682,898	645,782
Income (Loss) Before Non-Operating Income	9,785	10,590	37,787	42,855
Non–Operating Income	6,090	5,091	16,047	14,789
Income Before Income Taxes	15,875	15,681	53,834	57,644
Inpatient Services Segment [Member]
Revenues:
Net patient revenues	214,360	202,925	638,550	605,626
Other revenues	181		632	250
Net operating revenues	214,541	202,925	639,182	605,876
Cost and Expenses:
Salaries, wages and benefits	127,050	122,496	369,585	350,166
Other operating	56,851	51,717	169,710	156,068
Rent	8,128	8,028	24,552	24,838
Depreciation and amortization	9,756	8,862	28,362	25,435
Interest	423	474	1,309	1,459
Total costs and expenses	202,208	191,577	593,518	557,966
Income (Loss) Before Non-Operating Income	12,333	11,348	45,664	47,910
Non–Operating Income
Income Before Income Taxes	12,333	11,348	45,664	47,910
Homecare Services Segment [Member]
Revenues:
Net patient revenues	15,688	15,722	47,304	47,614
Other revenues
Net operating revenues	15,688	15,722	47,304	47,614
Cost and Expenses:
Salaries, wages and benefits	8,317	8,103	24,760	24,300
Other operating	5,291	5,108	15,484	15,494
Rent	502	476	1,490	1,443
Depreciation and amortization	41	46	120	139
Interest
Total costs and expenses	14,151	13,733	41,854	41,376
Income (Loss) Before Non-Operating Income	1,537	1,989	5,450	6,238
Non–Operating Income
Income Before Income Taxes	1,537	1,989	5,450	6,238
Other Segments [Member]
Revenues:
Net patient revenues
Other revenues	11,756	12,634	34,199	35,147
Net operating revenues	11,756	12,634	34,199	35,147
Cost and Expenses:
Salaries, wages and benefits	10,533	9,804	32,294	31,025
Other operating	1,897	2,131	5,584	6,009
Rent	1,476	1,810	4,231	4,679
Depreciation and amortization	1,036	1,090	3,127	3,273
Interest	899	546	2,290	1,454
Total costs and expenses	15,841	15,381	47,526	46,440
Income (Loss) Before Non-Operating Income	(4,085)	(2,747)	(13,327)	(11,293)
Non–Operating Income	6,090	5,091	16,047	14,789
Income Before Income Taxes	$ 2,005	$ 2,344	$ 2,720	$ 3,496

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Note 6 - Long-term Leases (Details Textual)	3 Months Ended		9 Months Ended
	Sep. 30, 2017 USD ($)	Sep. 30, 2016 USD ($)	Sep. 30, 2017 USD ($)	Sep. 30, 2016 USD ($)
Operating Leases, Rent Expense	$ 10,106,000	$ 10,314,000	$ 30,273,000	$ 30,960,000
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	35		35
Number of Assisted Living Centers Leased from NHI	7		7
Number of Independent Living Centers Leased from NHI	3		3
Number of Lease Agreements with NHI	2		2
Operating Leases, Rent Expense, Minimum Rentals			$ 34,200,000
Operating Lease Additional Percentage Rent Percentage			4.00%
Operating Leases, Rent Expense	$ 9,314,000	$ 9,480,000	$ 27,942,000	$ 28,440,000

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Note 6 - Long-term Leases - Fixed Assets Recorded Under Capital Leases (Details) - Buildings and Personal Property [Member] - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Buildings and personal property	$ 39,032	$ 39,032
Accumulated amortization	(14,064)	(11,120)
Total capital leases	$ 24,968	$ 27,912

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Note 6 - Long-term Leases - Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
2018, operating leases	$ 34,200
2018, capital leases	5,200
2019, operating leases	34,200
2019, capital leases	5,200
2020, operating leases	34,200
2020, capital leases	5,200
2021, operating leases	34,200
2021, capital leases	5,200
2022, operating leases	34,200
2022, capital leases	5,200
Thereafter, operating leases	151,100
Thereafter, capital leases	7,367
Total minimum lease payments, operating leases	322,100
Total minimum lease payments, capital leases	33,367
Less: Amounts representing interest, capital leases	(5,729)
Present value of minimum lease payments, capital leases	27,638
Less: Current portion, capital leases	(3,641)	$ (3,481)
Long-term capital lease obligations, capital leases	$ 23,997	$ 26,748

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Note 7 - Earnings Per Share (Details Textual) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Incentive Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	1,122,585	11,592	1,122,585	11,592

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Note 7 - Earnings Per Share - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Weighted average common shares outstanding (in shares)	15,195,394	15,198,696	15,186,315	15,128,728
Net income attributable to National HealthCare Corporation	$ 11,352	$ 11,110	$ 34,735	$ 36,675
Earnings per common share, basic (in dollars per share)	$ 0.75	$ 0.73	$ 2.29	$ 2.42
Dilutive effect of contingent issuable stock (in shares)				64,522
Weighted average common shares outstanding (in shares)	15,220,567	15,222,648	15,217,797	15,216,838
Earnings per common share, diluted (in dollars per share)	$ 0.75	$ 0.73	$ 2.28	$ 2.41
Employee Stock Option [Member]
Dilutive effect of stock options (in shares)	25,173	23,952	31,482	23,588

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Note 8 - Investments in Marketable Securities (Details Textual) - USD ($)	9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Available-for-sale Securities, Accumulated Gross Unrealized Gain, before Tax	$ 114,891,000		$ 108,730,000
Available-for-sale Securities, Accumulated Gross Unrealized Loss, before Tax	1,194,000		3,157,000
Other than Temporary Impairment Losses, Investments, Available-for-sale Securities	0		$ 0
Proceeds from Sale and Maturity of Marketable Securities	46,598,000	$ 30,963,000
Realized Investment Gains (Losses)	$ 255,000	$ 804,000

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Note 8 - Investments in Marketable Securities - Marketable Securities and Restricted Marketable Securities (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Restricted investments available for sale, amortized cost	$ 164,500	$ 185,968
Investments available for sale, amortized cost	194,676	216,144
Investments available for sale, fair value	308,373	321,717
Equity Securities [Member]
Unrestricted investments available for sale, amortized cost	30,176	30,176
Unrestricted investments available for sale, fair value	143,763	138,013
Corporate Debt Securities [Member]
Restricted investments available for sale, amortized cost	68,538	71,311
Restricted investments available for sale, fair value	69,311	71,100
Commercial Mortgage Backed Securities [Member]
Restricted investments available for sale, amortized cost	50,762	56,889
Restricted investments available for sale, fair value	50,517	56,168
US Government Corporations and Agencies Securities [Member]
Restricted investments available for sale, amortized cost	21,297	25,748
Restricted investments available for sale, fair value	20,926	25,181
US States and Political Subdivisions Debt Securities [Member]
Restricted investments available for sale, amortized cost	23,903	32,020
Restricted investments available for sale, fair value	$ 23,856	$ 31,255

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Note 8 - Investments in Marketable Securities - Available for Sale Marketable Equity Securities (Details) - NHI Common Stock [Member] - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
NHI Common Stock, Shares (in shares)	1,630,642	1,630,642
NHI Common Stock, Cost	$ 24,734	$ 24,734
NHI Common Stock, Fair Value	$ 126,032	$ 120,945

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Note 8 - Investments in Marketable Securities - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Within 1 year, cost	$ 11,060	$ 14,181
Within 1 year, fair value	11,081	14,216
1 to 5 years, cost	68,297	79,827
1 to 5 years, fair value	68,620	79,502
6 to 10 years, cost	80,290	91,211
6 to 10 years, fair value	80,073	89,269
Over 10 years, cost	4,853	749
Over 10 years, fair value	4,836	717
Cost	164,500	185,968
Fair Value	$ 164,610	$ 183,704

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Note 9 - Fair Value Measurements - Summary of Fair Value Measurements by Level (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016	Sep. 30, 2016
Restricted cash and cash equivalents	$ 11,950		$ 17,158
Available-for-sale securities	308,373	$ 321,717
Fair Value, Measurements, Recurring [Member]
Cash and cash equivalents	69,790	26,335
Restricted cash and cash equivalents	11,950	5,254
Total financial assets	390,113	353,306
Fair Value, Measurements, Recurring [Member] | Equity Securities [Member]
Available-for-sale securities	143,763	138,013
Fair Value, Measurements, Recurring [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	69,311	71,100
Fair Value, Measurements, Recurring [Member] | Commercial Mortgage Backed Securities [Member]
Available-for-sale securities	50,517	56,168
Fair Value, Measurements, Recurring [Member] | US Treasury Securities [Member]
Available-for-sale securities	20,926	25,181
Fair Value, Measurements, Recurring [Member] | US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities	23,856	31,255
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Cash and cash equivalents	69,790	26,335
Restricted cash and cash equivalents	11,950	5,254
Total financial assets	295,358	237,106
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Equity Securities [Member]
Available-for-sale securities	143,763	138,013
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	48,929	42,323
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Commercial Mortgage Backed Securities [Member]
Available-for-sale securities
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | US Treasury Securities [Member]
Available-for-sale securities	20,926	25,181
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member]
Cash and cash equivalents
Restricted cash and cash equivalents
Total financial assets	94,755	116,200
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Equity Securities [Member]
Available-for-sale securities
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	20,382	28,777
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Commercial Mortgage Backed Securities [Member]
Available-for-sale securities	50,517	56,168
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | US Treasury Securities [Member]
Available-for-sale securities
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities	$ 23,856	$ 31,255

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Note 10 - Long-term Debt (Details Textual) - USD ($) $ in Millions	1 Months Ended
	Oct. 31, 2015	Sep. 30, 2017	Dec. 31, 2016
Long-term Debt		$ 120	$ 120
Bank of America [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 175
Debt Instrument, Term	5 years
Bank of America [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	1.40%
Debt Instrument, Basis Spread on Base Rate	1.00%
Bank of America [Member] | Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.40%
Bank of America [Member] | Federal Funds Effective Swap Rate [Member]
Debt Instrument, Basis Spread on Base Rate	0.50%
Unsecured Term Note Payable [Member]
Long-term Debt		$ 10	$ 10

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Note 10 - Long-term Debt - Summary of Long-term Debt (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Long-term debt	$ 120	$ 120
Less current portion
Long-term debt, noncurrent	$ 120	120
Unsecured Term Note Payable [Member]
Long-term debt, weighted average interest rate	3.60%
Long-term debt, maturities	2018
Long-term debt	$ 10	10
Revolving Credit Facility [Member]
Long-term debt, weighted average interest rate	2.60%
Long-term debt, maturities	2020
Long-term debt	$ 110	$ 110

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Note 11 - Stock Repurchase Program (Details Textual) - Common Stock [Member] - USD ($) shares in Thousands, $ in Millions	1 Months Ended
	Sep. 30, 2017	Aug. 31, 2017
Stock Repurchase Program, Authorized Amount		$ 25
Stock Repurchased and Retired During Period, Shares	0

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Note 12 - Stock-based Compensation (Details Textual) - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016	May 31, 2015	May 30, 2015
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross			1,124,310		56,291
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized	$ 7,520,000		$ 7,520,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition			4 years
Salaries, Wages, and Benefits [Member]
Allocated Share-based Compensation Expense	$ 430,000	$ 9,000	$ 1,263,000	$ 502,000
The 2010 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized						2,575,000	1,200,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross			1,062,500
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant	568,744		568,744
The 2010 Plan [Member] | Director [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross			52,500
Employee Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross			9,310
Incentive Stock Option [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period			10 years

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Note 12 - Stock-based Compensation - Summary of Assumptions Used to Value Options Granted (Details)	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Risk–free interest rate	2.08%	0.89%
Expected volatility	16.60%	15.80%
Expected life (Year)	4 years 292 days	2 years 73 days
Expected dividend yield	3.10%	3.09%

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Note 12 - Stock-based Compensation - Summary of Options Outstanding (Details) - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Options outstanding, shares (in shares)	177,959	621,390
Options outstanding, weighted average exercise price (in dollars per share)	$ 55.48	$ 48.15
Options granted, shares (in shares)	1,124,310	56,291
Options granted, weighted average exercise price (in dollars per share)	$ 72.96	$ 62.54
Options exercised, shares (in shares)	(33,717)	(499,066)
Options exercised, weighted average exercise price (in dollars per share)	$ 47.89	$ 47.16
Options cancelled, shares (in shares)		(656)
Options cancelled, weighted average exercise price (in dollars per share)		$ 46.69
Options outstanding, shares (in shares)	1,268,552	177,959
Options outstanding, weighted average exercise price (in dollars per share)	$ 71.17	$ 55.48
Options outstanding, aggregate intrinsic value	$ 758,000
Options exercisable (in shares)	196,742
Options exercisable, weighted average exercise price (in dollars per share)	$ 61.44
Options exercisable, aggregate intrinsic value	$ 758,000

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Note 12 - Stock-based Compensation - Options Outstanding by Exercise Price Range (Details)	9 Months Ended
	Sep. 30, 2017 $ / shares shares
Options outstanding (in shares) | shares	1,268,552
Weighted Average Exercise Price (in dollars per share)	$ 71.17
Weighted Average Remaining Contractual Life in Years (Year)	4 years 73 days
Exercise Price Range 1 [Member]
Options outstanding (in shares) | shares	60,000
Exercise Price, Lower Range (in dollars per share)	$ 47.45
Exercise Price, Upper Range (in dollars per share)	52.93
Weighted Average Exercise Price (in dollars per share)	$ 50.88
Weighted Average Remaining Contractual Life in Years (Year)	1 year 73 days
Exercise Price Range 2 [Member]
Options outstanding (in shares) | shares	1,208,552
Exercise Price, Lower Range (in dollars per share)	$ 61.25
Exercise Price, Upper Range (in dollars per share)	75.45
Weighted Average Exercise Price (in dollars per share)	$ 72.18
Weighted Average Remaining Contractual Life in Years (Year)	4 years 109 days

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Note 13 - Income Taxes (Details Textual) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Income Tax Expense (Benefit)	$ 4,691,000	$ 4,571,000	$ 19,448,000	$ 20,969,000
Effective Income Tax Rate Reconciliation, Percent	29.50%	29.10%	36.10%	36.40%
Effective Income Tax Rate Reconciliation, Tax Contingency, Amount	$ 1,753,000	$ 1,306,000	$ 1,753,000	$ 1,306,000
Effective Income Tax Rate Reconciliation, Tax Contingency, Percent	11.00%	8.30%	3.30%	2.30%
Earliest Tax Year [Member]
Open Tax Year			2014

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Note 14 - Contingencies and Commitments (Details Textual) - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Self Insurance Reserve	$ 95,513,000	$ 91,162,000
Direct Business Coverage Statutory Limits	$ 1,000,000
Malpractice Loss Contingency, Number of Claims	60
Annual Excess Coverage	$ 9,000,000	$ 9,000,000
Line of Credit [Member] | National Health Care [Member]
Line of Credit Facility, Maximum Borrowing Capacity	2,000,000
Long-term Line of Credit	$ 0
Caris [Member]
Equity Method Investment, Ownership Percentage	75.10%
Coverage Amount Per Incident [Member]
Primary Insurance Coverage Amount Per Incident	$ 1,000,000
Primary Insurance Coverage, Amount Per Location	$ 3,000,000

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Note 15 - Common Stock Authorized (Details Textual) - $ / shares	May 09, 2017	Sep. 30, 2017	May 08, 2017	Dec. 31, 2016
Common Stock, Increase, Shares Authorized	15,000,000
Common Stock, Shares Authorized	45,000,000	45,000,000	30,000,000	45,000,000
Common Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01		$ 0.01