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Note 8 - 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 | 6 Months Ended
--- | --- | ---
Jun. 30, 2024 | Jun. 30, 2023 | Jun. 30, 2024 | Jun. 30, 2023
Basic: |  |  |  |
Weighted average common shares outstanding (in shares) | 15,391,535 | 15,297,435 | 15,371,150 | 15,317,319
Net income attributable to National HealthCare Corporation | $ 26,844 | $ 16,281 | $ 53,057 | $ 28,004
Earnings per common share, basic (in dollars per share) | $ 1.74 | $ 1.06 | $ 3.45 | $ 1.83
Diluted: |  |  |  |
Weighted average common shares outstanding (in shares) | 15,391,535 | 15,297,435 | 15,371,150 | 15,317,319
Effects of dilutive instruments (in shares) | 164,077 | 24,909 | 159,474 | 21,921
Weighted average common shares outstanding (in shares) | 15,555,612 | 15,322,344 | 15,530,624 | 15,339,240
Net income attributable to National HealthCare Corporation | $ 26,844 | $ 16,281 | $ 53,057 | $ 28,004
Earnings per common share, diluted (in dollars per share) | $ 1.73 | $ 1.06 | $ 3.42 | $ 1.83

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- Definition Number of [basic] shares or units, after adjustment for contingently issuable shares or units and other shares or units not deemed outstanding, determined by relating the portion of time within a reporting period that common shares or units have been outstanding to the total time in that period. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 260 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 1 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org/1943274/2147482662/260-10-50-1 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 260 -SubTopic 10 -Name Accounting Standards Codification -Section 45 -Paragraph 10 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482689/260-10-45-10 + Details
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Namespace Prefix: | us-gaap_
Data Type: | xbrli:sharesItemType
Balance Type: | na
Period Type: | duration