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Pay vs Performance Disclosure - USD ($)
 12 Months Ended
Dec. 31, 2024
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)
($)
 
2024
 
 
2,154,574
 
 
2,650,982
 
 
1,323,467
 
 
1,696,113
 
 
145.07
 
 
146.89
 
 
101,927,000
 
 
105,289,000
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:
2024, 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 2024. 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
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2024
 
 
2,154,574
 
 
686,180
 
 
287,502
 
 
25,354
 
 
—
 
 
12,844
 
 
(272,051)
 
 
(243,420)
 
 
2,650,982
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Average for Other NEO’s
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2024
 
 
1,323,467
 
 
489,322
 
 
214,340
 
 
20,664
 
 
—
 
 
7,328
 
 
(157,802)
 
 
(201,207)
 
 
1,696,113
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(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:
2024, 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 $ 2,154,574 $ 1,609,695 $ 1,159,207 $ 2,249,445 $ 1,278,366
PEO Actually Paid Compensation Amount $ 2,650,982 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 2024. 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
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2024
 
 
2,154,574
 
 
686,180
 
 
287,502
 
 
25,354
 
 
—
 
 
12,844
 
 
(272,051)
 
 
(243,420)
 
 
2,650,982
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Average for Other NEO’s
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2024
 
 
1,323,467
 
 
489,322
 
 
214,340
 
 
20,664
 
 
—
 
 
7,328
 
 
(157,802)
 
 
(201,207)
 
 
1,696,113
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
        
Non-PEO NEO Average Total Compensation Amount $ 1,323,467 971,183 696,866 1,288,949 760,448
Non-PEO NEO Average Compensation Actually Paid Amount $ 1,696,113 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 2024. 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
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2024
 
 
2,154,574
 
 
686,180
 
 
287,502
 
 
25,354
 
 
—
 
 
12,844
 
 
(272,051)
 
 
(243,420)
 
 
2,650,982
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Average for Other NEO’s
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2024
 
 
1,323,467
 
 
489,322
 
 
214,340
 
 
20,664
 
 
—
 
 
7,328
 
 
(157,802)
 
 
(201,207)
 
 
1,696,113
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
        
Compensation Actually Paid vs. Total Shareholder Return        
Compensation Actually Paid vs. Net Income        
Compensation Actually Paid vs. Company Selected Measure        
Total Shareholder Return Vs Peer Group        
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, 2024 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 $ 145.07 121.89 75.58 83.43 79.2
Peer Group Total Shareholder Return Amount 146.89 143.19 140.3 143.09 113.45
Net Income (Loss) $ 101,927,000 $ 66,798,000 $ 22,445,000 $ 138,590,000 $ 41,871,000
Company Selected Measure Amount 105,289,000 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 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 | Year-end Fair Value of Equity Awards Granted in Covered Year that are Outstanding and Unvested          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount $ 686,180        
PEO | Year-over-Year Change in Fair Value of Equity Awards Granted in Prior Years That are Outstanding and Unvested          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 287,502        
PEO | Change in Fair Value as of Vesting Date of Prior Year Equity Awards Vested in Covered Year          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 25,354        
PEO | Prior Year End Fair Value of Equity Awards Granted in Any Prior Year that Fail to Meet Applicable Vesting Conditions During Covered Year          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 0        
PEO | Dividends or Other Earnings Paid on Equity Awards not Otherwise Reflected in Total Compensation for Covered Year          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 12,844        
PEO | Stock Awards Reported in SCT [Member]          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount (272,051)        
PEO | Option Awards Reported in SCT [Member]          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount (243,420)        
Non-PEO NEO | Year-end Fair Value of Equity Awards Granted in Covered Year that are Outstanding and Unvested          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 489,322        
Non-PEO NEO | Year-over-Year Change in Fair Value of Equity Awards Granted in Prior Years That are Outstanding and Unvested          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 214,340        
Non-PEO NEO | Change in Fair Value as of Vesting Date of Prior Year Equity Awards Vested in Covered Year          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 20,664        
Non-PEO NEO | Prior Year End Fair Value of Equity Awards Granted in Any Prior Year that Fail to Meet Applicable Vesting Conditions During Covered Year          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 0        
Non-PEO NEO | Dividends or Other Earnings Paid on Equity Awards not Otherwise Reflected in Total Compensation for Covered Year          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount 7,328        
Non-PEO NEO | Stock Awards Reported in SCT [Member]          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount (157,802)        
Non-PEO NEO | Option Awards Reported in SCT [Member]          
Pay vs Performance Disclosure          
Adjustment to Compensation, Amount $ (201,207)