NATIONAL HEALTHCARE CORP
For the period ended Jun 30, 2025. Filed Aug 7, 2025.
View on SEC.govAbout 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.
Jun 30, 2025 · Filed Aug 7, 2025
NHC$208.85+0.6%Stored close · as of Nov 6, 2026
What changed in Management’s Discussion and Analysis?
Read the current filingPrevious report: 10-Q
Period ended 2025-03-31; filed 2025-05-08.
0001437749-25-015499
Item 2. Management's Discussion and Analysis of Financial Condition and Results of OperationsCurrent report: 10-Q
Period ended 2025-06-30; filed 2025-08-07.
0001437749-25-025500
Item 2. Management's Discussion and Analysis of Financial Condition and Results of OperationsThe baseline is this issuer’s latest earlier reporting period of the same form that was filed before the current report. A previous 10-Q is a different quarter, not a year-over-year comparison. Amendments are excluded.
Compared 87 previous paragraphs and 103 current paragraphs.
52 unchanged; 28 reworded; 14 added; 7 removed; 0 previous and 9 current paragraphs rearranged.
Tables are not compared: 10 previous and 21 current tables excluded. Dates, whitespace, punctuation and numbering changes are ignored; changes to financial figures remain significant.
A changed paragraph is not evidence that risk increased or decreased. An unchanged paragraph does not establish that risk stayed the same.
Added paragraphs (14)
Current report
In June 2025, CMS released its proposed rule outlining fiscal year 2026 Medicare payment rates. CMS projects payments to home health agencies in fiscal year 2026 will decrease by 6.4% or $1.1 billion, relative to the prior year. This update includes a 3.2% market basket update, reduced by a 0.8 percentage point cut for productivity. The rule also includes several reductions that CMS proposes as necessary to achieve budget neutral implementation of PDGM, including a 4.1% permanent reduction to the standard payment rate to prevent future overpayments, as well as a temporary but indefinite 5.0% reduction to recoup past overpayments. CMS also proposes a 0.5% reduction related to high-cost outlier payments.
Current report
Net operating revenues and grant income
Current report
Net patient revenues increased $83,431,000, or 29.8%, compared to the same period last year.
Current report
During the second quarter of 2025, we contributed land to a newly-formed limited liability company resulting in an equity interest in the new entity. The fair value of the land contributed to the new entity was $5,625,000. The related cost basis of the contributed land was $2,019,000, which resulted in a gain of $3,606,000. This gain was netted with other operating expenses resulting in a decrease of $3,606,000 in other operating expenses as compared to the same period in the prior year.
Current report
Non–operating income increased by $176,000 compared to the same period last year, as further detailed in Note 5 to our interim condensed consolidated financial statements.
Current report
Six Months Ended June 30, 2025 Compared to Six Months Ended June 30, 2024
Current report
Net operating revenues and grant income
Current report
Net patient revenues increased $159,215,000, or 28.1%, compared to the same period last year.
Current report
Other revenues increased $1,003,000, or 4.4%, compared to the same period last year, as further detailed in Note 4 to our interim condensed consolidated financial statements.
Current report
Total costs and expenses
Current report
Total costs and expenses for the six months ended June 30, 2025 compared to the same period of 2024 increased $124,111,000, or 22.2% to $683,750,000 from $559,639,000.
Current report
During the second quarter of 2025, we contributed land to a newly-formed limited liability company resulting in an equity interest in the new entity. The fair value of the land contributed to the new entity was $5,625,000. The related cost basis of the contributed land was $2,019,000, which resulted in a gain of $3,606,000. This gain was netted with other operating expenses resulting in a decrease of $3,606,000 in other operating expenses as compared to the same period in the prior year.
Current report
Other income
Removed paragraphs (7)
Previous report
Centers for Medicare and Medicaid Services Minimum Staffing Standards
Previous report
On April 22, 2024, the Centers for Medicare and Medicaid Services (“CMS”) issued the Minimum Staffing Standards for Long-Term Care (“LTC”) Facilities and Medicaid Institutional Payment Transparency Reporting final rule. Included in this final rule are new comprehensive minimum nurse staffing requirements, which aim to significantly reduce the risk of residents receiving unsafe and low-quality care within LTC facilities. CMS is finalizing a total nurse staffing standard of 3.48 hours per resident day (“HPRD”), which must include at least 0.55 HPRD of direct registered nurse (“RN”) care and 2.45 HPRD of direct nurse aide care. Facilities may use any combination of nurse staff (RN, licensed practical nurse and licensed vocational nurse, or nurse aide) to account for the additional 0.48 HPRD needed to comply with the total nurse staffing standard.
Previous report
CMS is also finalizing enhanced facility assessment requirements and a requirement to have an RN onsite 24 hours a day, seven days a week (“24/7”), to provide skilled nursing care. The 24/7 RN onsite can be the Director of Nursing; however, they must be available to provide direct resident care.
Previous report
This final rule provides a staggered implementation timeframe of the minimum nurse staffing standards and a 24/7 RN requirement based on geographic location, as well as possible exemptions for qualifying facilities for some parts of these requirements based on workforce unavailability and other factors.
Previous report
Congress is currently considering major cuts to federal spending on Medicaid. One of the options under consideration is to limit the amount of federal Medicaid funding they receive by levying taxes on providers and thereby increasing their reimbursement rates. Restricting these “provider taxes” would create financing gaps for states which could result in higher state taxes, reductions in Medicaid eligibility, lower provider payment rates, and fewer covered benefits.
Previous report
Net operating revenues
Previous report
Net patient revenues increased $75,784,000, or 26.5%, compared to the same period last year.
Reworded paragraphs (28)
Previous wording
A primary area of management focus continues to be the rates of occupancy within our skilled nursing facilities. The overall census in owned and leased skilled nursing facilities for the three months ending March 31, 2025 was 89.3% compared to 88.5% for the same period a year ago.
Current wording
A primary area of management focus continues to be the rates of occupancy within our skilled nursing facilities. The overall census in owned and leased skilled nursing facilities for the three months ending June 30, 2025 was 89.4% compared to 89.0% for the same period a year ago. For the six months ended June 30, 2025, overall census in our owned and leased skilled nursing facilities was 89.3% compared to 88.7% for the same period a year ago.
Previous wording
Our accrued professional liability and workers’ compensation reserves totaled $108,197,000 at March 31, 2025 and are a primary area of management focus. We have set aside restricted cash and cash equivalents and marketable securities to fund our estimated professional liability and workers’ compensation liabilities.
Current wording
Our accrued professional liability and workers’ compensation reserves totaled $108,982,000 at June 30, 2025 and are a primary area of management focus. We have set aside restricted cash and cash equivalents and marketable securities to fund our estimated professional liability and workers’ compensation liabilities.
Previous wording
In April 2025, CMS released its proposed rule outlining fiscal year 2026 Medicare payment rates and policy changes for skilled nursing facilities, which will begin on October 1, 2025. The fiscal year 2026 proposal equates to a net 2.8% increase in Medicare Part A payments to SNFs in fiscal year 2026 compared to 2025 levels. The rule includes a market basket increase of 3.0%, an increase of 0.6% to the market basket forecast error adjustment, and a negative 0.8% productivity adjustment. These figures do not incorporate the SNF Value Based Purchasing (“VBP”) reduction for certain SNFs subject to the net reduction in payments under the SNF VBP; those adjustments are estimated to total $196.5 million in fiscal year 2025.
Current wording
In July 2025, CMS released its final rule outlining fiscal year 2026 Medicare payment rates and policy changes for skilled nursing facilities, which will begin on October 1, 2025. The fiscal year 2026 rule equates to a net 3.2% increase in Medicare Part A payments to SNFs in fiscal year 2026 compared to 2025 levels. The rule includes a market basket increase of 3.3%, an increase of 0.6% to the market basket forecast error adjustment, and a negative 0.7% productivity adjustment. These figures do not incorporate the SNF Value Based Purchasing (“VBP”) reduction for certain SNFs subject to the net reduction in payments under the SNF VBP; those adjustments are estimated to total $208.4 million in fiscal year 2026.
Previous wording
For the first three months of 2025, our average Medicare per diem rate for skilled nursing facilities increased 5.2% as compared to the same period in 2024.
Current wording
For the first six months of 2025, our average Medicare per diem rate for skilled nursing facilities increased 5.8% as compared to the same period in 2024.
Previous wording
Effective July 1, 2024 and for the fiscal year 2025, the state of Missouri has approved specific individual nursing facility increases. We estimate the resulting increase in revenue for the 2025 fiscal year will be approximately $6,600,000 annually, or $1,650,000 per quarter.
Current wording
Effective July 1, 2025 and for the fiscal year 2026, the state of Tennessee implemented specific individual nursing facility increases. We estimate the resulting increase in revenue for the 2026 fiscal year will be approximately $3,000,000 annually, or $750,000 per quarter.
Previous wording
Effective July 1, 2024 and for the fiscal year 2025, the state of Tennessee implemented specific individual nursing facility increases. We estimate the resulting increase in revenue for the 2025 fiscal year will be approximately $11,000,000 annually, or $2,750,000 per quarter. Additionally, the state of Tennessee implemented supplemental Medicaid payments for fiscal year 2025 for continued stabilization payments and Medicaid rate rebasing. These supplemental payments will result in an increase in revenue for the 2025 fiscal year of approximately $7,500,000 annually, or $1,875,000 per quarter.
Current wording
Effective October 1, 2025 and for the fiscal year 2026, the state of South Carolina implemented specific individual nursing facility increases. We estimate the resulting increase in revenue for the 2026 fiscal year will be approximately $4,200,000 annually, or $1,050,000 per quarter.
Previous wording
For the first three months of 2025, our average Medicaid per diem increased 6.2% compared to the same period in 2024.
Current wording
For the first six months of 2025, our average Medicaid per diem increased 7.2% compared to the same period in 2024.
Previous wording
In April 2025, CMS released its proposed rule outlining fiscal year 2026 Medicare payment rates. CMS issued a rate increase of 2.4%, or $695 million, effective October 1, 2025. This increase is the result of a 3.2% market basket increase reduced by a 0.8% productivity adjustment. The FY2026 hospice payment update also includes an update to the statutory aggregate cap amount, which limits the overall payments per patient that are made annually. The proposed cap amount for FY2026 is $35,293.
Current wording
In April 2025, CMS released its proposed rule outlining fiscal year 2026 Medicare payment rates. CMS issued a rate increase of 2.4%, or $695 million, effective October 1, 2025. This increase results from the proposed 3.2% inpatient hospital market basket percentage increase reduced by a proposed 0.8% point productivity adjustment, required by law. The FY2026 hospice payment update also includes an update to the statutory aggregate cap amount, which limits the overall payments per patient that are made annually. The proposed hospice cap amount for FY2026 is $35,293.
Previous wording
The following table and discussion set forth items from the interim condensed consolidated statements of operations as a percentage of net operating revenues for the three months ended March 31, 2025 and 2024.
Current wording
The following table and discussion set forth items from the interim condensed consolidated statements of operations as a percentage of net operating revenues and grant income for the three and six months ended June 30, 2025 and 2024.
Previous wording
Results for the quarter ended March 31, 2025 compared to the first quarter of 2024 include a 25.7% increase in net operating revenues. The net operating revenues increase was due to an 8.5% increase in same-facility net operating revenues, as well as the August 1, 2024 acquisition of White Oak.
Current wording
Results for the quarter ended June 30, 2025 compared to the second quarter of 2024 include a 24.7% increase in net operating revenues and grant income. The net operating revenues increase was due to a 9.6% increase in same-facility net operating revenues, as well as the August 1, 2024 acquisition of White Oak.
Previous wording
For the quarter ended March 31, 2025, GAAP net income attributable to NHC was $32,205,000 compared to net income of $26,213,000 for the same period in 2024. Excluding the unrealized gains in our marketable equity securities portfolio and other non-GAAP adjustments, adjusted net income for the quarter ended March 31, 2025 was $24,838,000 compared to $15,386,000 for the same period in 2024, an increase of 61.4%. The increase in non-GAAP earnings for the three months ended March 31, 2025 compared to the same period in 2024 was primarily due to the continued increase in skilled nursing census, skilled nursing per diem increases from some of our government payors, the continued reduction of agency staffing expense, and the White Oak operations being accretive to earnings.
Current wording
For the quarter ended June 30, 2025, GAAP net income attributable to NHC was $23,722,000 compared to net income of $26,844,000 for the same period in 2024. Excluding the unrealized gains and losses in our marketable equity securities portfolio and other non-GAAP adjustments, adjusted net income for the quarter ended June 30, 2025 was $25,710,000 compared to $15,612,000 for the same period in 2024, an increase of 64.7%. The increase in non-GAAP earnings for the three months ended June 30, 2025 compared to the same period in 2024 was primarily due to the continued increase in skilled nursing census, skilled nursing per diem increases from some of our government payors, the continued reduction of agency staffing expense, and the White Oak operations being accretive to earnings.
Previous wording
The total census at owned and leased skilled nursing facilities for the quarter averaged 89.3%, compared to an average of 88.5% for the same quarter a year ago. Overall, the composite skilled nursing facility per diem increased 4.9% compared to the same quarter a year ago. Our Medicare per diem rates increased 5.2% and managed care per diem rates increased 4.6% compared to the same quarter a year ago. Medicaid and private pay per diem rates increased 6.2% and 9.5%, respectively, compared to the same quarter a year ago. For the three months ended March 31, 2025 and 2024, respectively, $1,872,000 and $3,462,000 have been included in our net patient revenues for supplemental Medicaid payments.
Current wording
The total census at owned and leased skilled nursing facilities for the quarter averaged 89.4%, compared to an average of 89.0% for the same quarter a year ago. Overall, the composite skilled nursing facility per diem increased 6.7% compared to the same quarter a year ago. Our Medicare per diem rates increased 6.4% and managed care per diem rates increased 8.5% compared to the same quarter a year ago. Medicaid and private pay per diem rates increased 8.3% and 9.1%, respectively, compared to the same quarter a year ago. For the three months ended June 30, 2025 and 2024, respectively, $1,812,000 and $2,585,000 have been included in our net patient revenues for supplemental Medicaid payments.
Previous wording
Other revenues increased $737,000, or 6.5%, compared to the same quarter last year, as further detailed in Note 4 to our interim condensed consolidated financial statements.
Current wording
Other revenues increased $266,000, or 2.4%, compared to the same quarter last year, as further detailed in Note 4 to our interim condensed consolidated financial statements.
Previous wording
Total costs and expenses for the three months ended March 31, 2025 compared to the same period of 2024 increased $61,429,000, or 21.8% to $342,930,000 from $281,501,000.
Current wording
Total costs and expenses for the three months ended June 30, 2025 compared to the same period of 2024 increased $62,682,000, or 22.5% to $340,820,000 from $278,138,000.
Previous wording
Salaries, wages, and benefits increased $44,992,000, or 24.6%, to $228,130,000 from $183,138,000. Salaries, wages, and benefits as a percentage of net operating revenues was 61.0% compared to 61.6% for the three months ended March 31, 2025 and 2024, respectively. Although we continue to face workforce and labor shortages within all of our operations, we are working diligently to find solutions to reduce and eliminate agency nurse staffing expense within our healthcare operations. For the first quarter of 2025, our agency nurse staffing expense was $1,487,000 compared to $5,286,000 for the first quarter of 2024.
Current wording
Salaries, wages, and benefits increased $46,458,000, or 25.8%, to $226,534,000 from $180,076,000. Salaries, wages, and benefits as a percentage of net operating revenues was 60.4% compared to 59.9% for the three months ended June 30, 2025 and 2024, respectively. Although we continue to face workforce and labor shortages within all of our operations, we are working diligently to find solutions to reduce and eliminate agency nurse staffing expense within our healthcare operations. For the second quarter of 2025, our agency nurse staffing expense was $981,000 compared to $4,098,000 for the second quarter of 2024.
Previous wording
The income tax provision for the three months ended March 31, 2025 is $11,432,000 (an effective income tax rate of 26.1%).
Current wording
The income tax provision for the three months ended June 30, 2025 is $8,055,000 (an effective income tax rate of 25.0%).
Previous wording
The White Oak operations attributed to an increase of $56,726,000 in net patient revenues for the quarter ended March 31, 2025 compared to the same period in 2024. On March 1, 2024, the Company exited a lease and transferred the operations of two skilled nursing facilities and one memory care facility located in Missouri. The exiting of these operations resulted in net patient revenues decreasing $5,579,000 for the quarter ended March 31, 2025 compared to the first quarter of 2024.
Current wording
The White Oak operations attributed to an increase of $113,580,000 in net patient revenues for the six months ended June 30, 2025 compared to the same period in 2024. On March 1, 2024, the Company exited a lease and transferred the operations of two skilled nursing facilities and one memory care facility located in Missouri. The exiting of these operations in 2024 resulted in net patient revenues decreasing $5,579,000 for the six months ended June 30, 2025 compared to the same period a year ago.
Previous wording
The White Oak operations attributed to an increase of $37,018,000 in salaries, wages, and benefits for the three months ended March 31, 2025 compared to the same period in the prior year. On March 1, 2024, the Company exited a lease and transferred the operations of two skilled nursing facilities and one memory care facility located in Missouri. The exiting of these operations resulted in salaries, wages and benefits decreasing $4,009,000 for the quarter ended March 31, 2025 compared to the first quarter of 2024.
Current wording
The White Oak operations attributed to an increase of $74,583,000 in salaries, wages, and benefits for the six months ended June 30, 2025 compared to the same period in the prior year. On March 1, 2024, the Company exited a lease and transferred the operations of two skilled nursing facilities and one memory care facility located in Missouri. The exiting of these operations in 2024 resulted in salaries, wages and benefits decreasing $4,009,000 for the six months ended June 30, 2025 compared to the same period of 2024.
Previous wording
Other operating expenses increased $15,028,000, or 19.4%, to $92,457,000 for the 2025 period compared to $77,429,000 for the 2024 period. Other operating expenses as a percentage of net operating revenues was 24.7% and 26.1% for the three months ended March 31, 2025 and 2024, respectively. The White Oak operations attributed to an increase of $12,769,000 in other operating expenses for the three months ended March 31, 2025 as compared to the same period in the prior year. The three exited Missouri operations during the first quarter of 2024 resulted in other operating expenses decreasing $2,281,000 for the quarter ended March 31, 2025 compared to the same period last year.
Current wording
Other operating expenses increased $28,817,000, or 18.5%, to $184,400,000 for the 2025 period compared to $155,583,000 for the 2024 period. Other operating expenses as a percentage of net operating revenues was 24.6% and 26.0% for the six months ended June 30, 2025 and 2024, respectively. The White Oak operations attributed to an increase of $25,584,000 in other operating expenses for the six months ended June 30, 2025 as compared to the same period in the prior year. The three exited Missouri operations during the first quarter of 2024 resulted in other operating expenses decreasing $2,281,000 for the six months ended June 30, 2025 compared to the same period last year.
Previous wording
Non–operating income decreased by $1,606,000 compared to the same period last year, as further detailed in Note 5 to our interim condensed consolidated financial statements. 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.
Current wording
Non–operating income decreased by $1,430,000 compared to the same period last year, as further detailed in Note 5 to our interim condensed consolidated financial statements. 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
Previous wording
Specifically, the Company believes the presentation of non-GAAP financial information that excludes the unrealized gains or losses on our marketable equity securities, gains on sale of unconsolidated companies, and share-based compensation expense is helpful in allowing investors to assess the Company’s operations more accurately.
Current wording
Specifically, the Company believes the presentation of non-GAAP financial information that excludes the unrealized gains or losses on our marketable equity securities, gains on sale of unconsolidated companies, gains on sale of property and equipment, and share-based compensation expense is helpful in allowing investors to assess the Company’s operations more accurately.
Previous wording
Net cash provided by operating activities for the three months ended March 31, 2025 was $39,255,000 as compared to $9,646,000 in the same period last year. Cash provided by operating activities consisted of net income of $32,290,000 and adjustments for non–cash items of $2,379,000. There was cash provided by working capital in the amount of $4,827,000 for the three months ended March 31, 2025 compared to cash used for working capital needs in the amount of $14,634,000 for the same period a year ago.
Current wording
Net cash provided by operating activities for the six months ended June 30, 2025 was $102,074,000 as compared to $60,307,000 in the same period last year. Cash provided by operating activities consisted of net income of $56,403,000 and adjustments for non–cash items of $12,704,000. There was cash provided by working capital in the amount of $32,831,000 for the six months ended June 30, 2025 compared to $4,052,000 for the same period a year ago.
Previous wording
Included in the adjustments for non-cash items are depreciation expense, equity in earnings of unconsolidated investments, unrealized gains on our marketable equity securities, gain on sale of an unconsolidated company, deferred taxes, and stock compensation.
Current wording
Included in the adjustments for non-cash items are depreciation expense, equity in earnings of unconsolidated investments, unrealized gains on our marketable equity securities, gain on sale of an unconsolidated company, gain on sale of property and equipment, deferred taxes, and stock compensation.
Previous wording
Net cash used in investing activities totaled $7,323,000 for the three months ended March 31, 2025, compared to $2,415,000 for the three months ended March 31, 2024. Cash used for property and equipment additions was $6,137,000 and $5,955,000 for the three months ended March 31, 2025, and 2024, respectively. Proceeds from the sale of marketable securities, net of purchases, resulted in cash provided by investing activities of $1,226,000 and $2,912,000 for the three months ended March 31, 2025 and 2024, respectively. For the three months ended March 31, 2025, we contributed capital of $2,419,000 to a joint venture, multi-family development that is under construction in Franklin, Tennessee. In January 2024, the Company sold its ownership interest in a homecare agency resulting in proceeds from the sale of $2,100,000.
Current wording
Net cash used in investing activities totaled $22,902,000 for the six months ended June 30, 2025, compared to $990,000 for the six months ended June 30, 2024. Cash used for property and equipment additions was $16,341,000 and $13,788,000 for the six months ended June 30, 2025, and 2024, respectively. Purchases, net of proceeds from sales, of marketable securities resulted in cash used in investing activities of $3,821,000 for the six months ended June 30, 2025. Proceeds from the sale of marketable securities, net of purchases, resulted in cash provided by investing activities of $15,764,000 for the six months ended June 30, 2024.
Previous wording
Net cash used in financing activities totaled $12,693,000 for the three months ended March 31, 2025 compared to $12,067,000 for the three months ended March 31, 2024. During the first quarter of 2025, cash of $3,000,000 was used to pay down the outstanding principal balance of the long-term debt. Cash used for dividend payments to common stockholders totaled $9,420,000 in the current year period compared to $9,051,000 for the same period a year ago. Proceeds from the issuance of common stock totaled $1,278,000 and $8,412,000 for the three months ended March 31, 2025 and 2024, respectively. We repurchased common shares outstanding in the amount of $1,722,000 and $9,900,000 for the three months ended March 31, 2025 and 2024, respectively.
Current wording
Net cash used in financing activities totaled $45,732,000 for the six months ended June 30, 2025 compared to $19,680,000 for the six months ended June 30, 2024. During the first six months of 2025, cash of $27,000,000 was used to pay down the outstanding principal balance of the long-term debt. Cash used for dividend payments to common stockholders totaled $18,854,000 in the current year period compared to $18,137,000 for the same period a year ago. Proceeds from the issuance of common stock totaled $6,462,000 and $11,239,000 for the six months ended June 30, 2025 and 2024, respectively. We repurchased common shares outstanding in the amount of $6,384,000 and $11,402,000 for the six months ended June 30, 2025 and 2024, respectively.
Previous wording
We expect to meet our short-term liquidity requirements primarily from our cash flows from operating activities. In addition to cash flows from operations, we have current cash on hand of $90,386,000 and unrestricted marketable equity securities of $152,785,000. We also have unencumbered real estate and the borrowing capacity on our $50 million available line of credit. We believe these various resources are adequate to meet our contractual obligations and growth and development plans in the next twelve months.
Current wording
We expect to meet our short-term liquidity requirements primarily from our cash flows from operating activities. In addition to cash flows from operations, we have current cash on hand of $110,992,000 and unrestricted marketable equity securities of $146,636,000. We also have unencumbered real estate and the borrowing capacity on our $50 million available line of credit. We believe these various resources are adequate to meet our contractual obligations and growth and development plans in the next twelve months.
Previous wording
We expect to meet our long-term liquidity requirements primarily from our cash flows from operating activities, our current cash on hand of $90,386,000, our unrestricted marketable equity securities of $152,785,000, and our borrowing capacity on the $50 million available line of credit. We also have substantial value in our unencumbered real estate assets, which could potentially be used as collateral in future borrowing opportunities.
Current wording
We expect to meet our long-term liquidity requirements primarily from our cash flows from operating activities, our current cash on hand of $110,992,000, our unrestricted marketable equity securities of $146,636,000, and our borrowing capacity on the $50 million available line of credit. We also have substantial value in our unencumbered real estate assets, which could potentially be used as collateral in future borrowing opportunities.
Previous wording
Laws and regulations governing the 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.
Current wording
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.
Rearranged current paragraphs (9)
Current report — wording carried from elsewhere
The White Oak operations attributed to an increase of $56,855,000 in net patient revenues for the quarter ended June 30, 2025 compared to the same period in 2024.
Current report — wording carried from elsewhere
The White Oak operations attributed to an increase of $37,564,000 in salaries, wages, and benefits for the three months ended June 30, 2025 compared to the same period in the prior year.
Current report — wording carried from elsewhere
Other operating expenses increased $13,789,000, or 17.6%, to $91,943,000 for the 2025 period compared to $78,154,000 for the 2024 period. Other operating expenses as a percentage of net operating revenues was 24.5% and 26.0% for the three months ended June 30, 2025 and 2024, respectively. The White Oak operations attributed to an increase of $12,815,000 in other operating expenses for the three months ended June 30, 2025 as compared to the same period in the prior year.
Current report — wording carried from elsewhere
Results for the six months ended June 30, 2025 compared to the same period of 2024 include a 25.2% increase in net operating revenues and grant income. The net operating revenues increase was due to a 9.5% increase in same-facility net operating revenues, as well as the August 1, 2024 acquisition of White Oak.
Current report — wording carried from elsewhere
For the six months ended June 30, 2025, GAAP net income attributable to NHC was $55,927,000 compared to net income of $53,057,000 for the same period in 2024. Excluding the unrealized gains in our marketable equity securities portfolio and other non-GAAP adjustments, adjusted net income for the six months ended June 30, 2025 was $50,549,000 compared to $30,998,000 for the same period in 2024, an increase of 63.1%. The increase in non-GAAP earnings for the six months ended June 30, 2025 compared to the same period in 2024 was primarily due to the continued increase in skilled nursing census, skilled nursing per diem increases from some of our government payors, the continued reduction of agency staffing expense, and the White Oak operations being accretive to earnings.
Current report — wording carried from elsewhere
The total census at owned and leased skilled nursing facilities for the six months ended June 30, 2025 averaged 89.3%, compared to an average of 88.7% for the same period a year ago. Overall, the composite skilled nursing facility per diem increased 5.7% compared to the same period a year ago. Our Medicare per diem rates increased 5.8% and managed care per diem rates increased 6.5% compared to the same period a year ago. Medicaid and private pay per diem rates increased 7.2% and 9.3%, respectively, compared to the same period a year ago. For the six months ended June 30, 2025 and 2024, respectively, $3,684,000 and $6,047,000 have been included in our net patient revenues for supplemental Medicaid payments.
Current report — wording carried from elsewhere
Salaries, wages, and benefits increased $91,450,000, or 25.2%, to $454,664,000 from $363,214,000. Salaries, wages, and benefits as a percentage of net operating revenues was 60.7% compared to 60.8% for the six months ended June 30, 2025 and 2024, respectively. Although we continue to face workforce and labor shortages within all of our operations, we are working diligently to find solutions to reduce and eliminate agency nurse staffing expense within our healthcare operations. For the six months ended June 30, 2025, our agency nurse staffing expense was $2,468,000 compared to $9,384,000 for the same period of 2024.
Current report — wording carried from elsewhere
The income tax provision for the six months ended June 30, 2025 is $19,487,000 (an effective income tax rate of 25.7%).
Current report — wording carried from elsewhere
For the six months ended June 30, 2025, we contributed capital of $2,419,000 to a joint venture, multi-family development that is under construction in Franklin, Tennessee compared to $4,856,000 for the same period in the prior year. We also contributed capital of $786,000 to a joint venture, multi-family development in Hermitage, Tennessee during the second quarter of 2025. In January 2024, the Company sold its ownership interest in a homecare agency resulting in proceeds from the sale of $2,100,000.