Pay vs Performance Disclosure - USD ($)

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Dec. 31, 2020

Pay vs Performance Disclosure

Pay vs Performance Disclosure, Table

PAY VERSUS PERFORMANCE

Year	Summary Compensation Table Total to PEO(1) ($)	Compensation Actually Paid to PEO(3) ($)	Average Summary Compensation Table Total for Non-PEO NEOs(2) ($)	Average Compensation Actually Paid to Non-PEO NEOs (2)(3) ($)	Value of Initial Fixed $100 Investment Based on:		Net Income ($)	Adjusted Income Before Income Taxes(5) ($)
					Total Share- holder Return(4) ($)	S&P Healthcare Index Total Shareholder Return(4) ($)
2023	1,609,695	2,416,165	971,183	1,579,389	121.89	143.19	66,798,000	75,304,000
2022	1,159,207	1,048,455	696,866	600,179	75.58	140.30	22,445,000	45,505,000
2021	2,249,445	2,132,097	1,288,949	1,157,347	83.43	143.09	138,590,000	163,404,000
2020	1,278,366	786,671	760,448	370,710	79.20	113.45	41,871,000	76,270,000

(1)
The principal executive officer (“PEO”) for each of the covered fiscal years is Stephen F. Flatt, who began serving as our Chief Executive Officer (“CEO”) in January 2017.

(2)
The non-PEO Named Executive Officers (“NEO's”) represent the following individuals for each of the years shown:

2023 and 2022 - B. Anderson Flatt, Senior Vice President and Chief Information Officer; Brian F. Kidd, Senior Vice President and Chief Financial Officer; Josh A. McCreary, Senior Vice President, General Counsel, and Secretary; R. Michael Ussery, President and Chief Operating Officer.

2021 and 2020 - B. Anderson Flatt, Senior Vice President and Chief Information Officer; Brian F. Kidd, Senior Vice President, Controller, and Principal Accounting Officer; Jeffrey R. Smith, Senior Vice President and Treasurer; R. Michael Ussery, President and Chief Operating Officer.

(3)
To calculate Compensation Actually Paid (“CAP”) to the Chief Executive Officer and the average CAP to the other NEO’s, the following adjustments were made to Summary Compensation Table (“SCT”) total compensation for 2023. The fair value of stock awards includes the value of both restricted stock awards and stock option awards (in $’s):

		Additions					Deductions
Year	Summary Compensation Table ($)	Fair Value of Stock Awards Granted During the Year, Outstanding and Unvested at Year-End ($)	Change in Value of Stock Awards Granted in Any Prior Year, Outstanding and Unvested at Year-End ($)	Change in Value of Stock Awards Granted in Any Prior Year, Vested During the Year ($)	Fair Value of Awards Forfeited in Fiscal Year ($)	Dividends Paid in Fiscal Year on Unvested Awards ($)	Stock Awards Reported in SCT ($)	Option Awards Reported in SCT ($)	Compensation Actually Paid ($)
Principal Executive Officer
2023	1,609,695	835,305	400,577	(30,055)	—	12,913	(261,880)	(150,390)	2,416,165
Average for Other NEO’s
2023	971,183	621,394	281,490	(24,498)	—	7,104	(154,936)	(122,349)	1,579,389

(4)
The comparison of total shareholder returns (“TSR”) assumes that $100 was invested on December 31, 2019, in NHC and the S&P Healthcare Index, and that dividends were reinvested when and as paid. The selected peer group is the S&P Healthcare Index.

(5)
Our company-selected measure, which is the measure we believe represents the most important financial performance not otherwise presented in the table above that we use to link CAP to our Company's performance is adjusted income before income taxes, a non-GAAP measure. This measure takes income before income taxes and adds or subtracts the unrealized gain or losses on marketable equity securities, plus adds or subtracts the net income or loss attributable to noncontrolling interest.

Company Selected Measure Name

adjusted income before income taxes

Named Executive Officers, Footnote

(1)
The principal executive officer (“PEO”) for each of the covered fiscal years is Stephen F. Flatt, who began serving as our Chief Executive Officer (“CEO”) in January 2017.

(2)
The non-PEO Named Executive Officers (“NEO's”) represent the following individuals for each of the years shown:

2023 and 2022 - B. Anderson Flatt, Senior Vice President and Chief Information Officer; Brian F. Kidd, Senior Vice President and Chief Financial Officer; Josh A. McCreary, Senior Vice President, General Counsel, and Secretary; R. Michael Ussery, President and Chief Operating Officer.

2021 and 2020 - B. Anderson Flatt, Senior Vice President and Chief Information Officer; Brian F. Kidd, Senior Vice President, Controller, and Principal Accounting Officer; Jeffrey R. Smith, Senior Vice President and Treasurer; R. Michael Ussery, President and Chief Operating Officer.

Peer Group Issuers, Footnote

(4)
The comparison of total shareholder returns (“TSR”) assumes that $100 was invested on December 31, 2019, in NHC and the S&P Healthcare Index, and that dividends were reinvested when and as paid. The selected peer group is the S&P Healthcare Index.

PEO Total Compensation Amount

$ 1,609,695

$ 1,159,207

$ 2,249,445

$ 1,278,366

PEO Actually Paid Compensation Amount

$ 2,416,165

1,048,455

2,132,097

786,671

Adjustment To PEO Compensation, Footnote

(3)
To calculate Compensation Actually Paid (“CAP”) to the Chief Executive Officer and the average CAP to the other NEO’s, the following adjustments were made to Summary Compensation Table (“SCT”) total compensation for 2023. The fair value of stock awards includes the value of both restricted stock awards and stock option awards (in $’s):

		Additions					Deductions
Year	Summary Compensation Table ($)	Fair Value of Stock Awards Granted During the Year, Outstanding and Unvested at Year-End ($)	Change in Value of Stock Awards Granted in Any Prior Year, Outstanding and Unvested at Year-End ($)	Change in Value of Stock Awards Granted in Any Prior Year, Vested During the Year ($)	Fair Value of Awards Forfeited in Fiscal Year ($)	Dividends Paid in Fiscal Year on Unvested Awards ($)	Stock Awards Reported in SCT ($)	Option Awards Reported in SCT ($)	Compensation Actually Paid ($)
Principal Executive Officer
2023	1,609,695	835,305	400,577	(30,055)	—	12,913	(261,880)	(150,390)	2,416,165
Average for Other NEO’s
2023	971,183	621,394	281,490	(24,498)	—	7,104	(154,936)	(122,349)	1,579,389

Non-PEO NEO Average Total Compensation Amount

$ 971,183

696,866

1,288,949

760,448

Non-PEO NEO Average Compensation Actually Paid Amount

$ 1,579,389

600,179

1,157,347

370,710

Adjustment to Non-PEO NEO Compensation Footnote

(3)
To calculate Compensation Actually Paid (“CAP”) to the Chief Executive Officer and the average CAP to the other NEO’s, the following adjustments were made to Summary Compensation Table (“SCT”) total compensation for 2023. The fair value of stock awards includes the value of both restricted stock awards and stock option awards (in $’s):

		Additions					Deductions
Year	Summary Compensation Table ($)	Fair Value of Stock Awards Granted During the Year, Outstanding and Unvested at Year-End ($)	Change in Value of Stock Awards Granted in Any Prior Year, Outstanding and Unvested at Year-End ($)	Change in Value of Stock Awards Granted in Any Prior Year, Vested During the Year ($)	Fair Value of Awards Forfeited in Fiscal Year ($)	Dividends Paid in Fiscal Year on Unvested Awards ($)	Stock Awards Reported in SCT ($)	Option Awards Reported in SCT ($)	Compensation Actually Paid ($)
Principal Executive Officer
2023	1,609,695	835,305	400,577	(30,055)	—	12,913	(261,880)	(150,390)	2,416,165
Average for Other NEO’s
2023	971,183	621,394	281,490	(24,498)	—	7,104	(154,936)	(122,349)	1,579,389

Compensation Actually Paid vs. Total Shareholder Return

COMPENSATION ACTUALLY PAID VERSUS COMPANY PERFORMANCE

The graphs below depict the relationship between each of the financial performance measures in the pay versus performance table above and CAP to our CEO and, on average, to our other NEO’s, for each of the four years ended December 31, 2023.

Compensation Actually Paid vs. Net Income

COMPENSATION ACTUALLY PAID VERSUS COMPANY PERFORMANCE

The graphs below depict the relationship between each of the financial performance measures in the pay versus performance table above and CAP to our CEO and, on average, to our other NEO’s, for each of the four years ended December 31, 2023.

Compensation Actually Paid vs. Company Selected Measure

COMPENSATION ACTUALLY PAID VERSUS COMPANY PERFORMANCE

The graphs below depict the relationship between each of the financial performance measures in the pay versus performance table above and CAP to our CEO and, on average, to our other NEO’s, for each of the four years ended December 31, 2023.

Total Shareholder Return Vs Peer Group

COMPENSATION ACTUALLY PAID VERSUS COMPANY PERFORMANCE

The graphs below depict the relationship between each of the financial performance measures in the pay versus performance table above and CAP to our CEO and, on average, to our other NEO’s, for each of the four years ended December 31, 2023.

Tabular List, Table

Performance Measures

The financial performance measures which we believe are most important to link compensation actually paid to each of our Named Executive Officers for the fiscal year ended December 31, 2023 to our performance and the only ones used by the Company are:

Net Income

Adjusted Income Before Income Taxes

Adjusted Income Before Income Taxes is calculated by beginning with the income before income taxes line item in the consolidated statements of operations and adding: (i) the unrealized gains or losses on marketable equity securities and (ii) net income or loss attributable to noncontrolling interest.

Total Shareholder Return Amount

$ 121.89

75.58

83.43

79.2

Peer Group Total Shareholder Return Amount

143.19

140.3

143.09

113.45

Net Income (Loss)

$ 66,798,000

$ 22,445,000

$ 138,590,000

$ 41,871,000

Company Selected Measure Amount

75,304,000

45,505,000

163,404,000

76,270,000

PEO Name

Stephen F. Flatt

Stephen F. Flatt

Stephen F. Flatt

Stephen F. Flatt

Measure:: 1

Pay vs Performance Disclosure

Name

Net Income

Measure:: 2

Pay vs Performance Disclosure

Name

Adjusted Income Before Income Taxes

Non-GAAP Measure Description

(5)
Our company-selected measure, which is the measure we believe represents the most important financial performance not otherwise presented in the table above that we use to link CAP to our Company's performance is adjusted income before income taxes, a non-GAAP measure. This measure takes income before income taxes and adds or subtracts the unrealized gain or losses on marketable equity securities, plus adds or subtracts the net income or loss attributable to noncontrolling interest.

PEO | Fair Value of Stock Awards Granted During the Year, Outstanding and Unvested at Year-End [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

$ 835,305

PEO | Change in Value of Stock Awards Granted in Any Prior Year, Outstanding and Unvested at Year-End [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

400,577

PEO | Change in Value of Stock Awards Granted in Any Prior Year, Vested During the Year [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(30,055)

PEO | Fair Value of Awards Forfeited in Fiscal Year [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

PEO | Dividends Paid in Fiscal Year on Unvested Awards [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

12,913

PEO | Stock Awards Reported in SCT [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(261,880)

PEO | Option Awards Reported in SCT [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(150,390)

Non-PEO NEO | Fair Value of Stock Awards Granted During the Year, Outstanding and Unvested at Year-End [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

621,394

Non-PEO NEO | Change in Value of Stock Awards Granted in Any Prior Year, Outstanding and Unvested at Year-End [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

281,490

Non-PEO NEO | Change in Value of Stock Awards Granted in Any Prior Year, Vested During the Year [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(24,498)

Non-PEO NEO | Fair Value of Awards Forfeited in Fiscal Year [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

0

Non-PEO NEO | Dividends Paid in Fiscal Year on Unvested Awards [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

7,104

Non-PEO NEO | Stock Awards Reported in SCT [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

(154,936)

Non-PEO NEO | Option Awards Reported in SCT [Member]

Pay vs Performance Disclosure

Adjustment to Compensation, Amount

$ (122,349)