Exhibit 99.1

For release: February 21, 2019

Contact: Brian F. Kidd, SVP and Controller

Phone: (615) 890-2020

NHC Reports 2018 Year End Earnings

MURFREESBORO, Tenn. -- National HealthCare Corporation (NYSE American: NHC), the nation's oldest publicly traded senior health care company, announced today net operating revenues for the year ended December 31, 2018 totaled $980,349,000 compared to $963,895,000 for the year ended December 31, 2017, an increase of 1.7%. For the year ended December 31, 2018, reported GAAP net income attributable to NHC was $58,964,000 compared to $56,205,000 for the 2017 year, an increase of 4.9%. Excluding the unrealized gains in our marketable equity securities portfolio and other non-GAAP adjustments, adjusted net income for the year ended December 31, 2018 was $64,372,000 compared to $54,179,000 for the 2017 year, an increase of 18.8%⁽¹⁾.

GAAP diluted earnings per share were $3.87 and $3.69 for the years ended December 31, 2018 and 2017, respectively, an increase of 4.9%. Adjusted diluted earnings per share were $4.22 and $3.56 for the years ended December 31, 2018 and 2017, respectively, an increase of 18.5%⁽¹⁾.

Net operating revenues for the three months ended December 31, 2018 totaled $248,920,000 compared to $245,466,000 for the same three months in 2017, an increase of 1.4%. The fourth quarter of 2018 net income attributable to NHC was $18,152,000, or $1.19 per diluted share. In the fourth quarter of 2017, net income attributable to NHC was $21,470,000, or $1.41 per diluted share, which included a favorable $8.5 million adjustment due to the U.S. Tax Cuts and Jobs Act legislation that was passed in December 2017.

⁽¹⁾  See the tables below that provide a reconciliation of GAAP to non-GAAP items.

About NHC

NHC affiliates operate for themselves and third parties 75 skilled nursing facilities with 9,510 beds. NHC affiliates also operate 24 assisted living communities, five independent living communities, one behavioral health hospital, and 35 homecare programs. NHC’s other services include Alzheimer’s and memory care units, hospice services, pharmacy services, a rehabilitation services company, and providing management and accounting services to third party post-acute operators. Other information about the company can be found on our web site at www.nhccare.com.

Non-GAAP Financial Presentation

The Company is providing certain non-GAAP financial measures as the Company believes that these figures are helpful in allowing investors to more accurately assess the ongoing nature of the Company’s operations and measure the Company’s performance more consistently across periods. Therefore, the Company believes this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The presentation of this additional non-GAAP financial information is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.

Forward-Looking Statements

Statements in this press release that are not historical facts are forward-looking statements. NHC cautions investors that any forward-looking statements made involve risks and uncertainties and are not guarantees of future performance. The risks and uncertainties are detailed from time to time in reports filed by NHC with the S.E.C., including Forms 8-K, 10-Q and 10-K, and include, among others, the following: liabilities and other claims asserted against us and patient care liabilities, as well as the resolution of current litigation; availability of insurance and assets for indemnification; 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; and other factors referenced or incorporated by reference in the S.E.C. filings. The risks included here are not exhaustive. All forward-looking statements represent NHC’s best judgment as of the date of this release.

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Consolidated Statements of Income

(in thousands, except share and per share amounts) 

	Three Months Ended					Year Ended
	December 31					December 31
	2018			2017		2018			2017
				(as adjusted)					(as adjusted)
Revenues:	(unaudited)
Net patient revenues	$	235,601		$	233,144	$	932,774		$	916,742
Other revenues		13,319			12,322		47,575			47,153
Net operating revenues		248,920			245,466		980,349			963,895
Costs and expenses:
Salaries, wages and benefits		147,972			145,404		582,721			572,043
Other operating		61,770			61,311		254,038			249,833
Facility rent		10,232			10,094		40,923			40,367
Depreciation and amortization		10,718			11,043		41,894			42,652
Interest		1,034			1,291		4,697			4,890
Total costs and expenses		231,726			229,143		924,273			909,785
Income before non-operating income		17,194			16,323		56,076			54,110
Non-operating income		6,614			4,392		17,670			20,439
Unrealized gains on marketable securities		721			-		1,138			-
Income before income taxes		24,529			20,715		74,884			74,549
Income tax (provision)/benefit		(6,393	)		581		(16,185	)		(18,867	)
Net income		18,136			21,296		58,699			55,682
Loss attributable to noncontrolling interest		16			174		265			523
Net income attributable to National HealthCare Corporation	$	18,152		$	21,470	$	58,964		$	56,205
Earnings per common share
Basic	$	1.19		$	1.41	$	3.87		$	3.70
Diluted	$	1.19		$	1.41	$	3.87		$	3.69
Weighted average common shares outstanding
Basic		15,235,772			15,200,619		15,224,886			15,189,920
Diluted		15,255,107			15,222,343		15,236,826			15,218,962
Dividends declared per common share	$	0.50		$	0.48	$	1.98		$	1.89

Balance Sheet Data
(in thousands)	Dec. 31		Dec. 31
	2018		2017
Cash, cash equivalents and marketable securities	$	183,470	$	198,203
Restricted cash, cash equivalents and marketable securities		184,266		174,698
Current assets		322,009		329,311
Property and equipment, net		534,650		549,319
Total assets		1,080,948		1,096,526
Current liabilities		157,924		155,065
Long-term debt		55,000		100,000
NHC stockholders' equity		733,278		702,738

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Selected Operating Statistics

	Three Months Ended				Year Ended
	December 31				December 31
	2018		2017		2018		2017
	(unaudited)
Skilled Nursing Per Diems:
Medicare	$	463.12	$	459.14	$	462.24	$	460.82
Managed Care		389.51		400.91		397.75		405.67
Medicaid		197.89		187.07		191.88		186.53
Private Pay and Other		237.70		231.17		238.53		231.61
Average Skilled Nursing Per Diem	$	269.35	$	265.30	$	269.69	$	266.45
Skilled Nursing Patient Days:
Medicare		114,541		121,295		476,694		481,580
Managed Care		58,002		58,421		240,796		244,908
Medicaid		327,075		321,653		1,288,265		1,281,432
Private Pay and Other		182,872		183,633		718,121		725,460
Total Skilled Nursing Patient Days		682,490		685,002		2,723,876		2,733,380

The tables below provide reconciliations of GAAP to non-GAAP items (in thousands, except per share amounts):

	Three Months Ended						Year Ended
	December 31						December 31
	2018			2017			2018			2017
	(unaudited)
Net income attributable to National Healthcare Corporation	$	18,152		$	21,470		$	58,964		$	56,205
Non-GAAP adjustments:
Unrealized gains on marketable equity securities		(721	)		-			(1,138	)		-
Legal costs and charges related to Caris' legal investigation		-			1,650			8,364			2,889
Operating results for newly opened facilities not at full capacity (*)		1,604			1,335			3,562			7,332
Gain on acquisition of equity method investment		-			-			(2,050	)		-
Gain on sale of assets/healthcare facilities		(1,669	)		-			(1,669	)		(1,305	)
Stock-based compensation expense		240			415			1,778			1,678
Tax adjustments from the U.S. Tax Cuts and Jobs Act		-			(8,488	)		(1,434	)		(8,488	)
Provision of income taxes on non-GAAP adjustments		142			(1,326	)		(2,005	)		(4,132	)
Non-GAAP Net income	$	17,748		$	15,056		$	64,372		$	54,179
GAAP diluted earnings per share	$	1.19		$	1.41		$	3.87		$	3.69
Non-GAAP adjustments:
Unrealized gains on marketable equity securities		(0.03	)		-			(0.06	)		-
Legal costs and charges related to Caris' legal investigation		-			0.07			0.46			0.12
Operating results for newly opened facilities not at full capacity (*)		0.08			0.05			0.17			0.29
Gain on acquisition of equity method investment		-			-			(0.13	)		-
Gain on sale of assets/healthcare facilities		(0.09	)		-			(0.08	)		(0.05	)
Stock-based compensation expense		0.01			0.02			0.08			0.07
Tax adjustments from the U.S. Tax Cuts and Jobs Act		-			(0.56	)		(0.09	)		(0.56	)
Non-GAAP diluted earnings per share	$	1.16		$	0.99		$	4.22		$	3.56

(*) The newly opened facilities for the 2018 periods presented consist of facilities opened from 2016 through 2018 (two skilled nursing facilities, three assisted living facilities, and one memory care facility).  The newly opened facilities for the 2017 periods presented consist of facilities opened from 2015 through 2017 (three skilled nursing facilities and four assisted living facilities).

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