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Pay vs Performance Disclosure - USD ($) | 12 Months Ended
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Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Pay vs Performance Disclosure |  |  |  |
Pay vs Performance Disclosure, Table | PAY VERSUS PERFORMANCE
Year | ​ | ​ | Summary Compensation Table Total to PEO(1) ($) | ​ | ​ | 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) |  |  |

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