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NATIONAL HEALTHCARE CORP

For the period ended Mar 31, 2025. Filed May 8, 2025.

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About this filing

A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.

Mar 31, 2025 · Filed May 8, 2025

NHC$209.74+0.4%Stored close · as of Nov 9, 2026

Extracted filing text, with the paragraph anchors used by the comparison.

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Item 1. Financial Statements

Interim Condensed Consolidated Statements of Operations

20252024
Revenues:
Net patient revenues$361,607$285,823
Other revenues12,09011,353
Net operating revenues373,697297,176
Cost and expenses:
Salaries, wages, and benefits228,130183,138
Other operating92,45777,429
Facility rent11,36510,348
Depreciation and amortization10,97810,586
Total costs and expenses342,930281,501
Income from operations30,76715,675
Other income (expense):
Non–operating income4,0795,685
Interest expense(2,106)(46)
Unrealized gains on marketable equity securities10,98214,399
Income before income taxes43,72235,713
Income tax provision(11,432)(9,462)
Net income32,29026,251
Net income attributable to noncontrolling interest(85)(38)
Net income attributable to National HealthCare Corporation$32,205$26,213
Earnings per share attributable to National HealthCare Corporation stockholders:
Basic$2.09$1.71
Diluted$2.07$1.69
Weighted average common shares outstanding:
Basic15,438,30615,350,240
Diluted15,575,75215,505,096

Interim Condensed Consolidated Statements of Comprehensive Income

(unaudited–* in thousands)*

20252024
Net income$32,290$26,251
Other comprehensive income/(loss):
Unrealized gains/(losses) on investments in marketable debt securities1,594(472)
Reclassification adjustment for realized gains on sales of marketable debt securities–(10)
Income tax (expense)/benefit related to items of other comprehensive income(204)45
Other comprehensive income/(loss), net of tax1,390(437)
Net income attributable to noncontrolling interest(85)(38)
Comprehensive income attributable to National HealthCare Corporation$33,595$25,776

Interim Condensed Consolidated Balance Sheets

(in thousands)

March 31, 2025December 31, 2024
unaudited
Assets
Current Assets:
Cash and cash equivalents$90,386$76,121
Restricted cash and cash equivalents, current portion24,58919,568
Marketable equity securities152,785140,064
Restricted marketable equity securities21,69723,190
Restricted marketable debt securities, current portion6,48311,529
Accounts receivable141,741135,325
Inventories8,0799,039
Prepaid expenses and other assets8,9399,060
Notes receivable505512
Total current assets455,204424,408
Property and Equipment:
Property and equipment, at cost1,287,8251,281,736
Accumulated depreciation and amortization(608,377)(597,447)
Net property and equipment679,448684,289
Other Assets:
Restricted cash and cash equivalents, less current portion1,1861,233
Restricted marketable debt securities, less current portion113,684108,275
Deposits and other assets8,5138,837
Operating lease right-of-use assets70,14779,167
Goodwill170,478170,478
Intangible assets19,86419,864
Investments in unconsolidated companies30,29727,878
Total other assets414,169415,732
Total assets$1,548,821$1,524,429

Interim Condensed Consolidated Balance Sheets (continued)

March 31, 2025December 31, 2024
unaudited
Liabilities and Stockholders’ Equity
Current Liabilities:
Trade accounts payable$21,646$25,493
Operating lease liabilities, current portion32,10931,841
Accrued payroll96,26092,719
Amounts due to third party payors13,89715,351
Accrued risk reserves, current portion31,07331,096
Other current liabilities27,29621,377
Dividends payable9,4449,420
Long-term debt due within one year7,5007,500
Total current liabilities239,225234,797
Long-term debt126,500129,500
Operating lease liabilities, less current portion36,81245,925
Accrued risk reserves, less current portion77,12472,520
Refundable entrance fees6,2346,063
Deferred income taxes37,11035,550
Other noncurrent liabilities17,83416,911
Total liabilities540,839541,266
Equity:
Common stock, $.01 par value; 45,000,000 shares authorized; 15,464,856 and 15,450,003 shares, respectively, issued and outstanding154154
Capital in excess of par value233,113232,530
Retained earnings774,954752,193
Accumulated other comprehensive loss(3,326)(4,716)
Total National HealthCare Corporation stockholders’ equity1,004,895980,161
Noncontrolling interest3,0873,002
Total equity1,007,982983,163
Total liabilities and equity$1,548,821$1,524,429

Interim Condensed Consolidated Statements of Cash Flows

(unaudited–* in thousands)*

20252024
Cash Flows From Operating Activities:
Net income$32,290$26,251
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization10,97810,586
Equity in earnings of unconsolidated investments–(67)
Unrealized gains on marketable equity securities(10,982)(14,399)
Gains on sale of marketable securities(241)(344)
Gain on sale of unconsolidated company–(1,024)
Deferred income taxes1,3562,484
Stock–based compensation1,027793
Changes in operating assets and liabilities:
Accounts receivable(6,416)(17,119)
Inventories960623
Prepaid expenses and other assets4453,153
Operating lease obligations17555
Trade accounts payable(3,847)1,503
Accrued payroll3,541(19,954)
Amounts due to third party payors(1,454)1,619
Accrued risk reserves4,5814,978
Contract liabilities–7,667
Other current liabilities5,9191,311
Other noncurrent liabilities9231,530
Net cash provided by operating activities39,2559,646
Cash Flows From Investing Activities:
Purchases of property and equipment(6,137)(5,955)
Proceeds from sale of unconsolidated company–2,100
Investments in unconsolidated companies(2,419)(1,488)
Collections of notes receivable716
Purchases of marketable securities(11,062)(8,703)
Proceeds from sale of marketable securities12,28811,615
Net cash used in investing activities(7,323)(2,415)
Cash Flows From Financing Activities:
Repayments under credit facility(3,000)–
Principal payments under finance lease obligations–(860)
Dividends paid to common stockholders(9,420)(9,051)
Issuance of common stock1,2788,412
Repurchase of common shares(1,722)(9,900)
Entrance fee deposits (refunds)171(668)
Net cash used in financing activities(12,693)(12,067)
Net Increase/(Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents19,239(4,836)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period96,922125,968
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period$116,161$121,132
Balance Sheet Classifications:
Cash and cash equivalents$90,386$93,982
Restricted cash and cash equivalents25,77527,150
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents$116,161$121,132

Interim Condensed Consolidated Statements of Stockholders’** Equity**

For the three months ended March 31, 2025:

Common Stock · Capital in Excess of · Retained · Accumulated Other Comprehensive · Non- controlling · Total Stockholders’
SharesAmountPar ValueEarningsLossInterestEquity
Balance at January 1, 202515,450,003$154$232,530$752,193$(4,716)$3,002$983,163
Net income–––32,205–8532,290
Other comprehensive income––––1,390–1,390
Stock–based compensation––1,027–––1,027
Shares sold – options exercised32,262–1,278–––1,278
Repurchase of common shares(17,409)–(1,722)–––(1,722)
Dividends declared to common stockholders ($0.61 per share)–––(9,444)––(9,444)
Balance at March 31, 202515,464,856$154$233,113$774,954$(3,326)$3,087$1,007,982

For the three months ended March 31, 2024:

Common Stock · Capital in Excess of · Retained · Accumulated Other Comprehensive · Non- controlling · Total Stockholders’
SharesAmountPar ValueEarningsLossInterestEquity
Balance at January 1, 202415,350,661$153$227,604$687,599$(6,604)$1,728$910,480
Net income–––26,213–3826,251
Other comprehensive loss––––(437)–(437)
Stock–based compensation––793–––793
Shares sold – options exercised150,19418,412–––8,413
Repurchase of common shares(101,131)–(9,900)–––(9,900)
Dividends declared to common stockholders ($0.59 per share)–––(9,086)––(9,086)
Balance at March 31, 202415,399,724$154$226,909$704,726$(7,041)$1,766$926,514

The accompanying notes to interim condensed consolidated financial statements are an integral part of these consolidated statements.

Notes to Interim Condensed Consolidated Financial Statements

March 31, 2025

Note1 – Description of Business

National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. As of* March 31, 2025,we operate or manage, through certain affiliates,80 skilled nursing facilities with a total of 10,329 licensed beds,26 assisted living facilities with1,413* units, nine independent living facilities, three behavioral health hospitals,34 homecare agencies, and 33 hospice agencies. We operate specialized care units within certain of our healthcare centers such as Alzheimer's disease care units and sub-acute nursing units. In addition, we provide insurance services, management and accounting services, and we lease properties to operators of skilled nursing and assisted living facilities. We operate in 9 states and are located primarily in the southeastern United States.

Note2 – Summary of Significant Accounting Policies

The listing below isnot intended to be a comprehensive list of all our significant accounting policies. In many cases, the accounting treatment of a particular transaction is specifically dictated by U.S. generally accepted accounting principles (“GAAP”), with limited need for management’s judgment in their application. There are also areas in which management’s judgment in selecting any available alternative wouldnot produce a materially different result. See our audited* December 31, 2024consolidated financial statements and notes thereto which contain accounting policies and other disclosures required by U.S. GAAP. Our audited December 31, 2024*consolidated financial statements are available at our web site: www.nhccare.com.

Basis of Presentation

The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. The consolidated financial statements include the accounts of all entities controlled by NHC. The Company presents noncontrolling interest within the equity section of its consolidated balance sheets. The Company presents the amount of consolidated net income that is attributable to NHC and the noncontrolling interest in its consolidated statements of operations.

We assume that users of these interim financial statements have read or have access to the audited* December 31, 2024consolidated financial statements and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, maybe determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information isnot* necessarily indicative of the results that* may*be expected for a full year for a variety of reasons.

Estimates and Assumptions

The preparation of financial statements in conformity with U.S. GAAP requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.

Net Patient Revenues and Accounts Receivable

Net patient revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, assisted living and independent living, home health care services, hospice services, and behavioral health services. Net patient revenue is reported at the amount that reflects the consideration to which the Company expects to be entitled in exchange for providing patient services. These amounts are due from patients, governmental programs, and otherthird-party payors, and include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations.

The Company recognizes revenue as its performance obligations are completed. Routine services are treated as a single performance obligation satisfied over time as services are rendered. These routine services represent a bundle of services that arenot capable of being distinct. The performance obligations are satisfied over time as the patient simultaneously receives and consumes the benefits of the healthcare services provided. Additionally, there* maybe ancillary services which arenot* included in the daily rates for routine services, but instead are treated as separate performance obligations satisfied at a point in time when those services are rendered.

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The Company determines the transaction price based on established billing rates reduced by explicit price concessions provided tothird party payors. Explicit price concessions are based on contractual agreements and historical experience. The Company considers the patient's ability and intent to pay the amount of consideration upon admission. Credit losses are recorded as bad debt expense, which is included as a component of other operating expenses in the interim condensed consolidated statements of operations. Bad debt expense was $2,661,000 and $2,471,000 for thethree months ended* March 31, 2025and2024,* respectively. As of* March 31, 2025,and December 31, 2024,*the Company has recorded allowance for doubtful accounts of $10,926,000 and $9,702,000, respectively, as our best estimate of expected losses inherent in the accounts receivable balance.

Other Revenues

Other revenues include revenues from the provision of insurance services to other healthcare providers, management and accounting services to other healthcare providers, and rental income. Our insurance revenues consist of premiums that are generally paid in advance and then amortized into income over the policy period. We charge for management services based on a percentage of net revenues. We charge for accounting services based on a monthly fee or a fixed fee per bed of the healthcare center under contract. We record other revenues as the performance obligations are satisfied based on the terms of our contractual arrangements.

We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive variable rent, which is based on the increase in revenues of a lessee over a base year. We recognize variable rent annually or monthly, as applicable, when, based on the actual revenue of the lessee is earned.

Segment Reporting

In accordance with the provisions of Accounting Standards Codification ("ASC")280, Segment Reporting, the Company is required to report financial and descriptive information about its reportable operating segments. The Company hastwo reportable operating segments: (1) inpatient services, which includes the operation of skilled nursing facilities, assisted and independent living facilities, and behavioral health hospitals, and (2) homecare and hospice services. The Company also reports an "all other" category that includes revenues from rental income, management and accounting services fees, insurance services, and cost of the corporate office. See Note6 for further disclosure of the Company’s operating segments.

Other Operating Expenses

Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance.

General and Administrative Costs

With the Company being a healthcare provider, the majority of our expenses are "cost of revenue" items. Costs that could be classified as "general and administrative" by the Company would include its corporate office costs, excluding stock-based compensation, which were $6,632,000 and $6,164,000 for thethree months ended* March 31, 2025and2024,* respectively.

Long-Term Leases

The Company’s lease portfolio primarily consists of operating real estate leases for certain skilled nursing facilities, assisted and independent living facilities, homecare and hospice offices, and pharmacy warehouses. The original terms of the leases typically range fromtwo tofifteen years. Several of the real estate leases include renewal options which vary in length and* may**not* include specific rent renewal amounts. We determine if an arrangement is a lease at inception of a contract. We determine the lease term by assuming exercise of renewal options that are reasonably certain.

The Company records right-of-use assets and liabilities for non-cancelable real estate operating leases with original or remaining lease terms in excess ofone year. Leases with a lease term of12 months or less at inception arenot recorded and are expensed on a straight-line basis over the lease term. We recognize lease components and non-lease components together andnot as separate parts of a lease for real estate leases.

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Operating lease right-of-use assets and liabilities are recorded at the present value of the lease payments over the lease term. The present value of the lease payments are discounted using the incremental borrowing rate associated with each lease. The variable components of the lease payment that fluctuate with the operations of a health facility arenot included in determining the right-of-use assets and lease liabilities. Rather, these variable components are expensed as incurred.

Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements,20-40 years and equipment and furniture,3-15 years. Leasehold improvements are amortized over periods that donot exceed the non-cancelable respective lease terms using the straight-line method.

Business Combinations

We account for transactions that represent business combinations using the acquisition method of accounting in accordance with ASC805, *Business Combinations.*Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Assets acquired and liabilities assumed, if any, are measured at fair value on the acquisition date using the appropriate valuation method. Goodwill generated from acquisitions is recognized for the excess of the purchase price over the fair value of tangible and identifiable intangible assets acquired and liabilities assumed. In determining the fair value of identifiable assets, we use various valuation techniques. These valuation methods require us to make estimates and assumptions surrounding projected revenues and costs, future growth, and discount rates.

Goodwill and Other Intangible Assets

Goodwill represents the excess of the purchase price over the fair value of identifiable net assets acquired in business combinations. Goodwill isnot amortized but is subject to an annual impairment test. We perform our annual goodwill impairment assessment on thefirst day of thefourth quarter. Tests are performed more frequently if events occur, or circumstances change that would more likely thannot reduce the fair value of the reporting unit below its carrying amount.

The Company’s indefinite-lived intangible assets consist of trade names and certificates of need and licenses. The Company reviews indefinite-lived intangible assets for impairment on an annual basis or more frequently if events or changes in circumstances indicate that the carrying amount of the intangible asset is below its carrying amount.

We are self–insured for risks related to workers’ compensation and general and professional liability insurance. We havetwo wholly–owned limited purpose insurance companies that insure these risks. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to engage an external, independent actuary to assist in estimating our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis.

Professional liability remains an area of particular concern to us. The long-term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by skilled nursing facilities and their employees in providing care to residents. The Company has been, and continues to be, subject to claims and legal actions that arise in the ordinary course of business, including potential claims related to patient care and treatment. A significant increase in the number of these claims, or an increase in the amounts due as a result of these claims could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.

We are principally self-insured for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.

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Continuing Care Contracts

We have continuing care retirement centers (“CCRC”) within our operations. Residents* may*enter into continuing care contracts with us.

Non-refundable fees are included as a component of the transaction price and are amortized into revenue over the actuarily determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees arenot included as part of the transaction price and are classified as noncurrent liabilities in our consolidated balance sheets.

We also annually estimate the present value of the cost of future services and the use of facilities to be provided to the current CCRC residents and compare that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the cost of future services exceeds the related anticipated revenues, a liability is recorded with a corresponding charge to income. As of* March 31, 2025,and December 31, 2024,*we have recorded a future service obligation liability in the amount of $1,474,000. This obligation is reflected within other noncurrent liabilities in the interim condensed consolidated balance sheets.

Other Noncurrent Liabilities

Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions, deferred revenue, and obligations to provide future services to our CCRC residents. Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”) and the non-refundable portion of CCRC entrance fees being amortized over the remaining life expectancies of the residents.

Noncontrolling Interest

The noncontrolling interest in a subsidiary is presented within total equity in the Company's interim condensed consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income attributable to NHC in its interim condensed consolidated statements of operations. The Company’s earnings per share is calculated based on net income attributable to NHC’s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of the subsidiary earnings, contributions, and distributions.

Recently Adopted Accounting Guidance

In* December 2023,the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU")2023-09 "Income Taxes (Topic740): Improvements to Income Tax Disclosures,"which requires companies to disclosed disaggregated jurisdictional and categorical information for the tax rate reconciliation, income taxes paid and other income tax related amounts. ASU2023*-09 is effective for annual periods beginning with the Company's fiscal year2025. The Company has adopted the ASU and will include the required disclosures in our annual report.

Recent Accounting GuidanceNot* Yet Adopted*

In* October**2023,* the FASB issued ASU2023-06, "Codification Amendments in Response to the SEC's Disclosure Update and Simplification Initiative," which amends U.S. GAAP to include certain disclosure requirements that are currently required under SEC Regulation S-X or Regulation S-K. Each amendment will be effective on the date on which the SEC removes the related disclosure requirement from SEC Regulation S-X or Regulation S-K. The adoption isnot expected to have a material impact on the Company's financial statements as these requirements were previously incorporated under the SEC Regulations.

In* November 2024,the FASB issued ASU2024*-03 "Disaggregation of Income Statement Expenses," which requires the Company to disaggregate key expense categories such as employee compensation and depreciation within its financial statements. ASU2024-03 is effective for annual periods beginning with the Company's fiscal year2027, and interim periods with the Company's fiscal year2028, with early adoption permitted. We are currently evaluating the impact this ASU will have on the company's financial statements and related disclosures.

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Note3 – Net Patient Revenues

The Company disaggregates revenue from contracts with customers by service type and by payor.

Revenue by Service Type

The Company’s net patient services can generally be classified into the followingtwo categories: (1) inpatient services, which includes the operation of skilled nursing facilities, assisted and independent living facilities, and behavioral health hospitals, and (2) homecare and hospice services*(in thousands)*.

20252024
Net patient revenues:
Inpatient services$325,478$252,254
Homecare and hospice services36,12933,569
Total net patient revenues$361,607$285,823

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For inpatient and hospice services, revenue is recognized on a daily basis as each day represents a separate contract and performance obligation. For homecare, revenue is recognized when services are provided based on the number of days of service rendered in the period of care or on a per-visit basis. Typically, patients andthird-party payors are billed monthly after services are performed or the patient is discharged, and payments are due based on contract terms.

As our performance obligations relate to contracts with a duration ofone year or less, the Company isnot required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The Company has minimal unsatisfied performance obligations at the end of the reporting period as our patients are typically underno obligation to remain admitted in our facilities or under our care. As the period between the time of service and time of payment is typicallyone year or less, the Company didnot adjust for the effects of a significant financing component.

Revenue by Payor

Certain groups of patients receive funds to pay the cost of their care from a common source. The following table sets forth sources of net patient revenues for the periods indicated:

Source20252024
Medicare31%34%
Managed Care11%10%
Medicaid31%28%
Private Pay and Other27%28%
Total100%100%

Medicare covers skilled nursing services for beneficiaries who require nursing care and/or rehabilitation services following a hospitalization of at leastthree consecutive days. For each eligible day a Medicare beneficiary is in a skilled nursing facility, Medicare pays the facility a daily payment, subject to adjustment for certain factors such as a wage index in the geographic area. The payment covers all services provided by the skilled nursing facility for the beneficiary that day, including room and board, nursing, therapy and drugs, as well as an estimate of capital–related costs to deliver those services.

For homecare services, Medicare pays based on the acuity level of the patient and based on periods of care. A period of care is defined as a length of care up to30 days with multiple continuous periods allowed. The services covered by the payment include all disciplines of care, in addition to medical supplies, within the scope of the home health benefit.

For hospice services, Medicare pays a daily rate to cover the hospice’s costs for providing services included in the patient care plan. Medicare makes daily payments based on1 of4 levels of hospice care. All hospice care and services offered to patients and their families must follow an individualized written plan of care that meets the patient’s needs.

Our hospice service revenue is subject to certain limitations on payments from Medicare. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. If applicable, we record these cap adjustments as a reduction to revenue.

Medicaid is operated by individual states with the financial participation of the federal government. The states in which we operate currently use prospective cost–based reimbursement systems. Under cost–based reimbursement systems, the skilled nursing facility is reimbursed for the reasonable direct and indirect allowable costs it incurred in a base year in providing routine resident care services as defined by the program.

Private pay, managed care, and other payment sources include commercial insurance, individual patient funds, managed care plans and the Veterans Administration. Private paying patients, private insurance carriers and the Veterans Administration generally pay based on the healthcare center's charges or specifically negotiated contracts. For private pay patients in skilled nursing, assisted living and independent living facilities, the Company bills for room and board charges, with the remittance being due on receipt of the statement and generally by the10th day of the month the services are performed.

Certain managed care payors for homecare services pay on a per-visit basis. This revenue is recorded on an accrual basis based upon the date of services at amounts equal to its established or estimated per-visit rates.

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State Relief Supplemental Funding

The Company received supplemental Medicaid payments from various states. The funding generally incorporates specific use requirements primarily for direct patient care including labor related expenses or various patient care related expenses. We have recorded $1,872,000 and $3,462,000 in net patient revenues for these supplemental Medicaid payments for thethree months ended* March 31, 2025and2024,* respectively.

Third Party Payors

Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Noncompliance with such laws and regulations can be subject to regulatory actions including fines, penalties, and exclusion from the Medicare and Medicaid programs. We believe that we are following all applicable laws and regulations.

Medicare and Medicaid program revenues, as well as certain Managed Care program revenues, are subject to audit and retroactive adjustment by government representatives or their agents. Settlements withthird-party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and the Company’s historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized willnot occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known, or as years are settled or areno longer subject to such audits, reviews, and investigations. We believe that any differences between the net revenues recorded, and final determination willnot materially affect the consolidated financial statements. We have made provisions of approximately $13,897,000 and $15,351,000 as of* March 31, 2025and December 31, 2024,*respectively, for various Medicare, Medicaid, and Managed Care claims reviews and current and prior year cost reports.

Note4 – Other Revenues

Other revenues are outlined in the table below. Revenues from rental income include health care real estate properties owned by us and leased tothird party operators. Revenues from management and accounting services include fees provided to manage and provide accounting services to other healthcare operators. Revenues from insurance services include premiums for workers’ compensation and professional liability insurance policies that our wholly owned insurance subsidiaries have written for certain healthcare operators to which we provide management or accounting services. "Other" revenues include miscellaneous health care related earnings*(in thousands)*.

20252024
Rental income$6,450$5,959
Management and accounting services fees4,4234,438
Insurance services814872
Other40384
Total other revenues$12,090$11,353

Rental Income

The Company leases real estate assets consisting of skilled nursing facilities and assisted living facilities tothird party operators. Additionally, we sublease four Florida skilled nursing facilities included in our lease from National Health Investors (“NHI”), who is a related party, as noted in Note7 – Long Term Leases. NHI is a publicly-traded real estate investment trust. Mr. Robert G. Adams, non-executive Chairman of the NHC Board, also serves on the Board of Directors of NHI.

Management Fees from National Health Corporation

We manage five skilled nursing facilities owned by National Health Corporation (“National”). For thethree months ended* March 31, 2025and2024,* we recognized management fees and interest on management fees of $1,408,000 and $1,320,000, respectively, for these centers.

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Insurance Services

For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for thethree months ended* March 31, 2025and2024* were $525,000 and $582,000, respectively. Associated losses and expenses including those for self-insurance are included in the interim condensed consolidated statements of operations as "Salaries, wages and benefits."

For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for thethree months ended* March 31, 2025and2024* were $289,000 and $290,000, respectively. Associated losses and expenses including those for self–insurance are included in the interim condensed consolidated statements of operations as "Other operating costs and expenses".

Note5 – Non–Operating Income

Non–operating income is comprised of the following*(in thousands)*:

20252024
Dividends and net realized gains and losses on sales of securities$1,954$2,056
Interest income2,1252,538
Equity in earnings of unconsolidated investments-67
Gain on sale of unconsolidated company-1,024
Total non-operating income$4,079$5,685

Gain on sale of unconsolidated company

In* January 2024,*the Company sold its ownership interest in a homecare agency located in Nashville, Tennessee. The total consideration paid to the company was $2,100,000, which resulted in a gain of $1,024,000.

Note6 – Business Segments

The Company hastwo reportable operating segments: (1) inpatient services, which includes the operation of skilled nursing facilities, assisted and independent living facilities, and behavioral health hospitals; and (2) homecare and hospice services. These reportable operating segments are consistent with information used by the Company’s Chief Executive Officer, as chief operating decision maker (“CODM”), to assess performance and allocate resources. The Company also reports an "all other" category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office.

The Company’s CODM evaluates performance including pretax earnings and allocates capital resources to each segment based on an operating model that is designed to improve the quality of patient care and profitability of the Company while enhancing long-term shareholder value. The CODM doesnot review assets by segment in his resource allocation and therefore, assets by segment arenot disclosed below.

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The following tables set forth the Company’s unaudited interim condensed consolidated statements of operations by business segment*(in thousands*):

Inpatient Services · Homecare and Hospice · All Other · Total
Revenues:
Net patient revenues$325,478$36,129$-$361,607
Other revenues373-11,71712,090
Net operating revenues325,85136,12911,717373,697
Costs and expenses:
Salaries, wages, and benefits192,43722,40413,289228,130
Other operating81,8707,2583,32992,457
Rent8,8346081,92311,365
Depreciation and amortization10,06213078610,978
Total costs and expenses293,20330,40019,327342,930
Income/(loss) from operations32,6485,729(7,610)30,767
Non-operating income--4,0794,079
Interest expense(2,106)--(2,106)
Unrealized gains on marketable equity securities--10,98210,982
Income/(loss) before income taxes$30,542$5,729$7,451$43,722
Inpatient Services · Homecare and Hospice · All Other · Total
Revenues:
Net patient revenues$252,254$33,569$-$285,823
Other revenues15-11,33811,353
Net operating revenues252,26933,56911,338297,176
Costs and expenses:
Salaries, wages, and benefits150,89021,00911,239183,138
Other operating68,6835,9722,77477,429
Rent8,1125661,67010,348
Depreciation and amortization9,63018776910,586
Total costs and expenses237,31527,73416,452281,501
Income/(loss) from operations14,9545,835(5,114)15,675
Non-operating income--5,6855,685
Interest expense(46)--(46)
Unrealized gains on marketable equity securities--14,39914,399
Income before income taxes$14,908$5,835$14,970$35,713

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Note7 – Long-Term Leases

Operating Leases

At* March 31, 2025,we lease from NHI the real property of 28 skilled nursing facilities, five assisted living centers andthree independent living centers underone* lease agreement. As part of the lease agreement, we sublease four Florida skilled nursing facilities to athird-party operator. The lease includes base rent plus a percentage rent. The annual base rent is $32,225,000 in2025 and $31,975,000 in2026 with the lease term expiring in2026. The percentage rent is based on a quarterly calculation of revenue increases and is payable on a quarterly basis. Total facility rent expense to NHI was $9,911,000 and $9,472,000 for thethree months ended* March 31, 2025and2024,* respectively.

Minimum Lease Payments

The following table summarizes the maturity of our operating lease liabilities as of* March 31, 2025 (*in thousands):

Operating Leases
2026$35,718
202727,047
20282,193
20291,748
20301,539
Thereafter11,416
Total minimum lease payments79,661
Less: amounts representing interest(10,740)
Present value of future minimum lease payments68,921
Less: current portion(32,109)
Noncurrent lease liabilities$36,812

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Note8 – Earnings per Share

Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings.

The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share (in thousands, except for share and per share amounts):

20252024
Basic:
Weighted average common shares outstanding15,438,30615,350,240
Net income attributable to National HealthCare Corporation$32,205$26,213
Earnings per common share, basic$2.09$1.71
Diluted:
Weighted average common shares outstanding15,438,30615,350,240
Effects of dilutive instruments137,446154,856
Weighted average common shares outstanding15,575,75215,505,096
Net income attributable to National HealthCare Corporation$32,205$26,213
Earnings per common share, diluted$2.07$1.69

For thethree months ended* March 31, 2025and2024,* 493,249 and 245,726 stock options, respectively, were excluded from the calculation of diluted weighted average shares of common stock outstanding because the inclusion of these securities would have an anti-dilutive impact.

Note9 – Investments in Marketable Securities

Our investments in marketable equity securities are carried at fair value with the changes in unrealized gains and losses recognized in our results of operations at each measurement date. Our investments in marketable debt securities are classified as available for sale securities and carried at fair value with the unrealized gains and losses recognized through accumulated other comprehensive income at each measurement date. Any credit-related decline in fair market values below the amortized cost of our available for sale debt securities are recorded in our results of operations through an allowance for credit losses. Realized gains and losses from securities sales are recognized in results of operations upon disposition of the securities using the specific identification method on a trade date basis. Refer to Note10 for a description of the Company's methodology for determining the fair value of marketable securities.

Marketable securities consist of the following*(in thousands)*:

March 31, 2025December 31, 2024
Book ValueFair ValueBook ValueFair Value
Investments available for sale:
Marketable equity securities$30,176$152,785$30,176$140,064
Restricted investments available for sale:
Marketable equity securities18,77921,69718,53423,190
Corporate debt securities58,00657,22358,92757,471
Asset-based securities15,30614,26315,59314,410
U.S. Treasury securities46,81444,95246,81144,186
State and municipal securities3,7623,7293,7873,737
$172,843$294,649$173,828283,058

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Included in the marketable equity securities are the following*(in thousands, except share amounts):*

March 31, 2025December 31, 2024
SharesCostFair ValueSharesCostFair Value
NHI Common Stock1,630,642$24,734$120,4391,630,642$24,734$113,003

The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows*(in thousands)*:

March 31, 2025December 31, 2024
CostFair ValueCostFair Value
Maturities:
Within 1 year$24,655$24,424$25,707$25,317
1 to 5 years66,45564,28066,11763,379
6 to 10 years32,20831,01932,64830,606
Over 10 years570444646502
$123,888$120,167$125,118$119,804

Gross unrealized gains related to marketable equity securities are $126,575,000 and $115,259,000 as of* March 31, 2025and December 31, 2024,respectively. Gross unrealized losses related to marketable equity securities are $1,049,000 and $715,000 as of March 31, 2025and December 31, 2024,respectively. For thethree* months ended* March 31, 2025and2024,* the Company recognized net unrealized gains of $10,982,000 and $14,399,000, respectively, for the changes in fair market value of the marketable equity securities in the interim condensed consolidated statements of operations.

Gross unrealized gains related to available for sale marketable debt securities are $494,000 and $135,000 as of* March 31, 2025and December 31, 2024,respectively. Gross unrealized losses related to available for sale marketable debt securities are $4,215,000 and $5,449,000 as of March 31, 2025and December 31, 2024,*respectively.

The Company’s unrealized losses in our available for sale marketable debt securities were determined to be non-credit related. The Company hasnot recognized any credit related impairments for thethree months ended* March 31, 2025and2024.*

For the marketable securities in gross unrealized loss positions, (a) it is more likely thannot that the Company willnot be required to sell the investment securities before recovery of the unrealized losses, and (b) the Company expects that the contractual principal and interest will be received on the investment securities.

Proceeds from the sale of available for sale marketable securities during thethree months ended* March 31, 2025and2024* were $12,288,000 and $11,615,000, respectively. Investment gains of $241,000 and $344,000 were realized on these sales during thethree months ended* March 31, 2025and2024,* respectively.

Note10 – Fair Value Measurements

The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes thethree levels of inputs that* may*be used to measure fair value:

Level 1 – The valuation is based on quoted prices in active markets for identical instruments.

Level 2 – The valuation is based on observable inputs such as quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model–based valuation techniques for which all significant assumptions are observable in the market.

Level 3 – The valuation is based on unobservable inputs that are supported by minimal or no market activity and that are significant to the fair value of the instrument. Level 3 valuations are typically performed using pricing models, discounted cash flow methodologies, or similar techniques that incorporate management’s own estimates of assumptions that market participants would use in pricing the instrument, or valuations that require significant management judgment or estimation.

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A financial instrument’s level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement.

The following table summarizes fair value measurements by level at* March 31, 2025and December 31, 2024for assets and liabilities measured at fair value on a recurring basis(in thousands)*:

Fair Value Measurements Using
March 31, 2025Fair ValueQuoted Prices in Active Markets For Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash and cash equivalents$90,386$90,386$–$–
Restricted cash and cash equivalents25,77525,775––
Marketable equity securities174,482174,482––
Corporate debt securities57,22340,85516,368–
Asset–backed securities14,263–14,263–
U.S. Treasury securities44,95244,952––
State and municipal securities3,7298042,925–
Total financial assets$410,810$377,254$33,556$–
Fair Value Measurements Using
December 31, 2024Fair ValueQuoted Prices in Active Markets For Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash and cash equivalents$76,121$76,121$–$–
Restricted cash and cash equivalents20,80120,801––
Marketable equity securities163,254163,254––
Corporate debt securities57,47143,65613,815–
Asset–backed securities14,410–14,410–
U.S. Treasury securities44,18644,186––
State and municipal securities3,7378062,931–
Total financial assets$379,980$348,824$31,156$–

Note11 – Goodwill and Other Intangible Assets

At* March 31, 2025,we evaluated potential triggering events that might be indicators that our goodwill and indefinite lived intangibles were impaired. As a result of the review, there wereno impairment indicators regarding the Company’s goodwill that required a quantitative test to be performed. However, our accounting estimates could materially change from period to period due to changing market factors. We will continue to monitor future events, changes in circumstances, and the potential impact thereof. If actual results arenot* consistent with our assumptions and estimates, we* may*be exposed to future goodwill impairment losses.

At* March 31, 2025,*the following table represents the activity related to our goodwill by segment (in thousands):

Inpatient ServicesHomecare and HospiceAll OtherTotal
January 1, 2025$5,924$164,554$–$170,478
Additions––––
March 31, 2025$5,924$164,554$–$170,478

Indefinite-lived intangible assets consist of the following*(in thousands)*:

March 31, 2025December 31, 2024
Trade names$15,896$15,896
Certificates of need1,7561,756
Licenses2,2122,212
Total$19,864$19,864

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Note12 - Stock Repurchase Program

During thethree months ended* March 31, 2025,the Company repurchased 17,409 shares of its common stock for a total cost of $1,722,000. During thethree* months ended* March 31, 2024,*the Company repurchased 101,131 shares of its common stock for a total cost of $9,900,000. The shares were funded from cash on hand and were cancelled and returned to the status of authorized but unissued.

Note13 – Stock–Based Compensation

NHC recognizes stock–based compensation expense for all stock options granted over the requisite service period using the fair value at the date of grant using the Black–Scholes pricing model. Stock–based compensation totaled $1,027,000 and $793,000 for thethree months ended* March 31, 2025and2024,* respectively. Stock–based compensation is included in “Salaries, wages and benefits” in the interim condensed consolidated statements of operations.

At* March 31, 2025,*the Company had $9,077,000 of unrecognized compensation cost related to unvested stock–based compensation awards. This unrecognized compensation cost will be amortized over an approximate three-year period.

Stock Options

The following table summarizes the significant assumptions used to value the options granted for thethree months ended* March 31, 2025and for the year ended December 31, 2024.*

March 31, 2025December 31, 2024
Risk–free interest rate4.17%4.40%
Expected volatility26.9%24.1%
Expected life, in years2.92.9
Expected dividend yield2.81%2.63%

The following table summarizes our outstanding stock options for thethree months ended* March 31, 2025and for the year ended December 31, 2024.*

Number of SharesWeighted Average Exercise PriceAggregate Intrinsic Value
Options outstanding at January 1, 2024588,534$61.30$–
Options granted297,78394.42–
Options exercised(219,973)64.73–
Options cancelled(35,102)79.20–
Options outstanding at December 31, 2024631,24274.73–
Options granted269,89991.03–
Options exercised(20,981)60.93–
Options cancelled(3,999)75.69–
Options outstanding at March 31, 2025876,161$80.08$11,675,000
Options exercisable at March 31, 2025342,716$68.58$8,396,000
Options Outstanding March 31, 2025 · Exercise Prices · Weighted Average Exercise Price · Weighted Average Remaining Contractual Life in Years
337,912$53.94-$71.64$59.952.3
538,249$90.62-$106.4892.724.4
876,161$80.083.6

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Note14 – Income Taxes

The Company's income tax provision as a percentage of our income before income taxes was 26.1% and 26.5% for thethree months ended* March 31, 2025and2024,* respectively.

Typically, these percentages vary from the U.S. federal statutory income tax rate of 21% primarily due to state income taxes, excess tax benefits from stock-based compensation, benefits resulting from the lapsing of statute of limitations of items in our tax contingency reserve, and non-deductible expenses. For thethree months ended* March 31, 2025and2024,* the accrual of state income tax was the most significant reconciling item.

Our quarterly income tax provision, and our estimate of our annual effective income tax rate, is subject to variation due to several factors, including volatility based on the amount of pre-tax income or loss.

The Company isno longer subject to U.S. federal and state examinations by tax authorities for years before2021 (with certain state exceptions).

Note15 – Long-Term Debt

Long–term debt consists of the following (dollars in thousands):

Interest rate at March 31, 2025MaturityMarch 31, 2025December 31, 2024
Credit facility, interest payable monthlyVariable, 5.9%2029$134,000$137,000
Less current portion(7,500)(7,500)
Total long-term debt, less current portion$126,500$129,500

On* August 1, 2024,the Company entered into a $200,000,000 senior credit facility with afive-year term consisting of a $150,000,000 term facility and a $50,000,000 revolving line of credit (the “Credit Facility”). The Credit Facility is for general corporate purposes, including working capital and acquisitions. The loans bear interest at either (i) Term Secured Overnight Financing Rate (“SOFR”) for interest periods of one,three orsix* months, plus the applicable margin or, at NHC’s option, (ii) the Base Rate plus the applicable margin. The applicable margin is an interest rate per annum between 1.30% and 1.65% for Term SOFR loans and between.30% and.65% for Base Rate loans, depending upon the Company meeting certain conditions. The revolving line of credit contains a commitment fee equal to 0.25% of the unused borrowing capacity. There areno amounts outstanding on the revolving line of credit at* March 31, 2025.*

NHC’s obligations under the Credit Facility are unsecured. The Credit Facility contains customary representations and warranties, financial covenants, and other customary affirmative and negative covenants. The Credit Facility also contains customary events of default. As of* March 31, 2025,the Company is compliant with all financial covenants. Based on level2* inputs, the carrying value of the Company's long-term debt is considered to approximate the fair value of such debt based upon the interest rates that the Company believes it can currently obtain for similar debt.

The aggregate maturities of long–term debt for thefive years subsequent to* March 31, 2025are as follows(in thousands)*:

Long–Term Debt
2025$5,625
20267,500
20277,500
20287,500
2029105,875
Total$134,000

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Note16 – Contingencies and Commitments

We have wholly-owned limited purpose insurance companies that insure risks related to workers’ compensation and professional liability insurance claims both for our owned and leased entities and certain of the entities to which we provide management or accounting services. The liability we have recognized for reported claims and estimates for incurred but unreported claims totals $108,197,000 and $103,616,000 at* March 31, 2025and December 31, 2024,*respectively. The liability is included in accrued risk reserves in the interim condensed consolidated balance sheets and is subject to adjustment for actual claims incurred. It is possible that these claims plus unasserted claims could exceed our insurance coverages and our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows.

As a result of the terms of our insurance policies and our use of wholly owned limited purpose insurance companies, we have retained significant insurance risk with respect to workers’ compensation and general and professional liability. We consider the professional services of independent actuaries to assist us in estimating our exposures for claims obligations (for both asserted and unasserted claims) related to deductibles and exposures in excess of coverage limits, and we maintain reserves for these obligations. Such estimates are based on many variables including historical and statistical information and other factors.

Workers’* Compensation*

For workers’ compensation, we utilize a wholly–owned Tennessee domiciled property/casualty insurance company to write coverage for NHC affiliates and for third–party customers. Policies are written for a duration oftwelve months and cover only risks related to workers’ compensation losses. All customers are companies which operate in the senior care industry. Business is written on a direct basis.

General and Professional Liability Insurance and Lawsuits

The senior care industry has experienced significant increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by skilled nursing facilities and their employees in providing care to residents. The Company has been, and continues to be, subject to claims and legal actions that arise in the ordinary course of business, including potential claims related to patient care and treatment. The defense of these lawsuits* mayresult in significant legal costs, regardless of the outcome, and can result in large settlement amounts or damage awards. Additional insurance is purchased throughthird* party providers that serve to supplement the coverage provided through our wholly owned captive insurance company.

There is certain additional litigation incidental to our business,none of which, based upon information available to date, would be material to our financial position, results of operations, or cash flows. In addition, the long–term care industry is continuously subject to scrutiny by governmental regulators, which could result in litigation or claims related to regulatory compliance matters.

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Civil Investigative Demand

On or about* May 21, 2024,Caris Healthcare, L.P. (“Caris”) received a Civil Investigative Demand (“CID”) from the U.S. Attorney’s Office for the Eastern District of Tennessee. The CID requests the production of certain medical records for patients at Caris’ Nashville office and other documents related to the billing for hospice services for the period of January 1, 2019,*through the date of the CID. The Company is cooperating with respect to the requests and remains in the process of responding to the CID.

Governmental Regulations

Laws and regulations governing Medicare, Medicaid and other federal healthcare programs are complex and subject to interpretation. Management believes that it is following all applicable laws and regulations in all material respects. However, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusions from the Medicare, Medicaid and other federal healthcare programs.

Indemnities

From time to time, the Company enters into certain types of contracts that contingently require it to indemnify parties againstthird-party claims. These contracts primarily include (i) certain real estate leases, under which the Company* maybe required to indemnify property owners or prior facility operators for post-transfer liabilities and other claims arising from the Company’s use of the applicable premises, (ii) operations transfer agreements, in which the Company agrees to indemnify past operators of facilities against certain liabilities arising from the transfer of the operation and/or the operation thereof after the transfer to the Company or its subsidiary, (iii) certain lending agreements, under which the Company maybe required to indemnify the lender against various claims and liabilities, (iv) certain agreements by and between the Company and/or its subsidiaries or affiliates, and (v) certain agreements with the Company officers, directors and others, under which the Company maybe required to indemnify such persons for liabilities arising out of the nature of their relationship to the Company and/or its subsidiaries and affiliates. The terms of such obligations vary by contract and, in most instances, donot* expressly state or include a specific or maximum dollar amount. Generally, amounts under these contracts cannot be reasonably estimated until a specific claim is asserted. Consequently, becauseno specific indemnity claims have been asserted,no liabilities have been recorded for these obligations on the consolidated balance sheets for any of the periods presented.

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