National HealthCare Corporation (NHC): History, Ownership, Mission, How It Works & Makes Money

As a seasoned financial analyst, I have to ask: do you really understand how National HealthCare Corporation (NHC) continues to grow its footprint in the complex US senior care market? This provider of a full continuum of care-from skilled nursing to home health-reported a trailing twelve months (TTM) revenue of approximately $1.50 billion as of Q3 2025, a robust 22.67% growth, largely fueled by strategic acquisitions like White Oak Management, Inc. That kind of top-line expansion, even with Q2 2025 GAAP net income at $23.72 million, demands a closer look at the underlying business model, the near-term risks in cost management, and the long-term value proposition. We need to map out the history and ownership structure of this 50-year-old company to see how it keeps generating such strong operational momentum in a highly regulated industry.

National HealthCare Corporation (NHC) History

You're looking for the bedrock of National HealthCare Corporation (NHC), and the story is one of steady, calculated expansion in senior care. The core takeaway is that NHC didn't start as a sprawling conglomerate; it began with a focused, campus-style vision in 1971, which has since evolved into a diversified, multi-billion-dollar continuum of care, largely driven by strategic acquisitions like the $221 million White Oak purchase in 2024.

National HealthCare Corporation's Founding Timeline

Year established

The company was established in 1971, a time when the long-term care landscape was just beginning to professionalize.

Original location

NHC's original location and current headquarters is in Murfreesboro, Tennessee.

Founding team members

The primary founder was Dr. Carl E. Adams, whose initial vision was to create a high-quality, campus-style concept for seniors, starting with 14 skilled nursing centers.

Initial capital/funding

Specific details on the initial capital and funding are not publicly available, but the company's immediate start with 14 skilled nursing centers suggests a significant, though unstated, initial investment to launch the vision.

National HealthCare Corporation's Evolution Milestones

National HealthCare Corporation's Transformative Moments

The company's trajectory has been shaped by two key factors: an unwavering focus on an integrated care model and calculated, large-scale acquisitions that immediately move the needle on revenue.

The most recent and defintely transformative moment was the August 2024 acquisition of White Oak Management, Inc. for $221 million. Here's the quick math on the impact:

• Revenue Growth: This deal was the primary catalyst for the strong top-line performance in 2025. The company's TTM revenue as of Q3 2025 hit a robust $1.50 billion, up 22.67% year-over-year.
• Operational Momentum: Even without the acquisition, same-facility net operating revenue grew by a healthy 8.7% in Q3 2025, showing existing operations are performing well too.
• Profitability Signal: While Q3 2025 GAAP net income saw a slight dip, the adjusted diluted earnings per share (EPS), which strips out volatile investment gains, rose to $1.58, a clear sign that the core operational strategy is working despite cost pressures.

This expansion into new facilities and services directly supports the company's long-term strategy, which you can read more about in their Mission Statement, Vision, & Core Values of National HealthCare Corporation (NHC).

The consistent dividend, set at an annual rate of $2.56 per share in 2025, also signals management's confidence in the sustained cash flow generated by this diversified, post-acquisition portfolio.

National HealthCare Corporation (NHC) Ownership Structure

National HealthCare Corporation's (NHC) ownership is primarily a mix of institutional investors and individual retail shareholders, but a significant block is held by company insiders, which concentrates voting power. This structure means that while the stock is publicly traded, key strategic decisions often reflect the interests of a relatively small group of long-term stakeholders.

National HealthCare Corporation's Current Status

NHC is a publicly traded entity, which means its shares are available for purchase on an open market, specifically the NYSE American under the ticker symbol NHC. Being public mandates a high degree of transparency through regular filings with the Securities and Exchange Commission (SEC), giving you a clear view of its financial health and governance. The company's market capitalization reflects its long-standing position in the US healthcare services sector.

National HealthCare Corporation's Ownership Breakdown

The company's control is distributed across three main shareholder types, with institutional money holding the largest stake. This is typical for a seasoned, dividend-paying stock like NHC, but the insider position is notably high for a publicly traded firm, which can defintely influence long-term strategy.

For a deeper dive into who is buying and selling, you should check out Exploring National HealthCare Corporation (NHC) Investor Profile: Who's Buying and Why?

National HealthCare Corporation's Leadership

The executive team is steering the company through a planned leadership transition as of late 2025, which investors should watch closely. The current structure is set to change at the end of the fiscal year, consolidating power at the top. The board also recently added a new, experienced voice.

Key executive and board changes effective near the end of 2025 include:

• Stephen F. Flatt: Currently Chief Executive Officer (CEO), he will assume the additional role of President effective December 31, 2025, upon the retirement of R. Michael Ussery.
• R. Michael Ussery: President and Chief Operating Officer (COO) until his retirement on December 31, 2025.
• Timothy J. Shelly: Senior Vice President of Operations, he will become the principal operating officer following Mr. Ussery's retirement.
• Dr. Lisa Piercey: Appointed as a new independent director to the Board on November 6, 2025, bringing strong public health and healthcare administration experience.

The Board is chaired by Robert G. Adams, and other senior leaders include Brian Kidd, Senior Vice President & Chief Financial Officer, and Josh McCreary, Senior Vice President, General Counsel & Secretary. This team's decisions on capital allocation and expansion will directly impact your returns.

National HealthCare Corporation (NHC) Mission and Values

National HealthCare Corporation's (NHC) mission is a clear three-way commitment: prioritizing satisfaction for their customers, partners (employees), and investors, which drives their financial stability and operational excellence. This focus on all stakeholders shows their cultural DNA is built on a foundation of ethical care and sustainable business practice.

You're looking at a company that measures its success not just on the bottom line, but on how well they treat everyone involved. Honestly, that balance is what makes their financial position so resilient; for the first nine months of 2025, their total revenue was over $1.131 billion, and that kind of top-line growth doesn't happen without a strong, values-driven culture.

National HealthCare Corporation's Core Purpose

The company's core purpose goes beyond simply providing services; it's about setting the standard for senior care. This commitment is defintely reflected in their performance metrics, like the fact that their skilled nursing facilities (SNFs) had an average Net Promoter Score (NPS) of 60.0 in 2024, which is significantly higher than the national healthcare average of 38.0.

Official Mission Statement

NHC's mission statement is a great example of a for-profit entity tying its financial success directly to its service quality and employee engagement. It's a smart way to ensure all internal decisions are aligned.

• NHC is committed to being the senior care leader in customer, partner, and investor satisfaction.

Vision Statement

Their vision statement is a simple, actionable phrase that guides the day-to-day work of their thousands of partners across their facilities. It emphasizes continuous, incremental improvement in patient experience.

Here's the quick math: if you have 57% of your SNFs rated 4- or 5-Star by the Centers for Medicare & Medicaid Services (CMS)-compared to a national average of only 35%-you're proving that vision works. A better way, day by day, really adds up. Breaking Down National HealthCare Corporation (NHC) Financial Health: Key Insights for Investors

• Caring in a Better Way, Day by Day.

National HealthCare Corporation's Core Values (C.A.R.E.)

NHC uses the acronym C.A.R.E. to define its core values, which act as the ethical framework for all operations, from patient intake to financial reporting. This structure gives employees a clear, memorable guide for conduct.

• Commit to Godly Excellence.
• Act with Compassion and Integrity.
• Respect and Value People.
• Enhance Quality of life.

National HealthCare Corporation slogan/tagline

While the vision statement often doubles as the tagline, their simple, direct motto cuts straight to the heart of their business model.

• Care is our business.

National HealthCare Corporation (NHC) How It Works

National HealthCare Corporation (NHC) works by operating an integrated, post-acute care ecosystem, generating the vast majority of its revenue-about 96.8% in Q1 2025-from direct patient services across a continuum of care settings. The company's financial strength is clear, with trailing twelve months (TTM) revenue as of Q3 2025 hitting a robust $1.50 billion. You can defintely see the power of that diversified model in their results.

National HealthCare Corporation's Product/Service Portfolio

NHC's portfolio is built to capture patients at various stages of their health journey, moving them seamlessly between facilities as their needs change. This integrated model is the core of their value proposition, keeping patients within the NHC system longer. As of November 1, 2025, the company operates a substantial network across the Southeastern U.S.

National HealthCare Corporation's Operational Framework

The operational success of NHC in 2025 stems from two core drivers: maximizing facility utilization and aggressively managing labor costs. The Q3 2025 net operating revenues were $382,661,000, a 12.5% increase year-over-year, which shows this framework is working. Here's the quick math on their efficiency.

• Census Improvement: Skilled Nursing Facility (SNF) occupancy improved to 89.3% in Q1 2025, which directly drives revenue per facility.
• Labor Cost Control: Agency nurse staffing expense fell significantly in Q1 2025 compared to the prior year, boosting the operating margin.
• Margin Expansion: The Operating Margin for the nine months ending September 30, 2025, was a robust 8.42%, dramatically higher than the industry median, which analysts forecast between 1% and 2%.
• Strategic Acquisitions: The August 2024 White Oak acquisition continues to be accretive, contributing to the 8.7% same-facility net operating revenue growth in Q3 2025.

If you're looking for deeper analysis on who is buying into this operational story, you should read Exploring National HealthCare Corporation (NHC) Investor Profile: Who's Buying and Why?

National HealthCare Corporation's Strategic Advantages

NHC's competitive moat isn't just about the number of beds; it's about quality and integration, which are hard for competitors to replicate quickly. They've built a strong reputation over decades, especially in the Southeast U.S. markets where they operate.

• Continuum of Care: The integrated service model allows NHC to capture patients from high-acuity SNFs and transition them to lower-cost, higher-margin homecare or assisted living, maximizing the lifetime value of each patient.
• Superior Quality Ratings: As of 2024, 57% of NHC's SNFs held a 4- or 5-Star rating from the Centers for Medicare & Medicaid Services (CMS), far outpacing the national average of 35%.
• Exceptional Customer Satisfaction: The average Net Promoter Score (NPS) for NHC's SNFs was 60.0 in 2024, significantly higher than the national healthcare average of 38.0, which helps drive patient preference and referrals.
• Financial Discipline: The company reported a robust free cash flow of over $100 million, demonstrating operational efficiency and the ability to self-fund growth and maintain a sustainable dividend.

National HealthCare Corporation (NHC) How It Makes Money

National HealthCare Corporation generates the vast majority of its revenue by providing a comprehensive suite of patient services, primarily through its skilled nursing facilities, assisted living, and home care programs. This core business is supplemented by a smaller, but still important, stream from managing and providing ancillary services to third-party healthcare operators.

National HealthCare Corporation's Revenue Breakdown

You need to know where the money is coming from. National HealthCare Corporation's trailing twelve months (TTM) revenue, as of the third quarter of 2025, hit a robust $1.50 billion, marking a strong 22.67% year-over-year growth. This growth is a clear mix of organic expansion-what we call same-facility growth-and strategic acquisitions, like the White Oak Management, Inc. deal in 2024.

Here's the quick math on the breakdown, based on the most recent granular data from early 2025, which remains consistent with the company's operational focus:

The overwhelming majority of the business-nearly 97 cents of every dollar-is driven by direct patient care. Same-facility net operating revenue grew 8.7% in Q3 2025, showing the core business is defintely executing well.

Business Economics

The economics of National HealthCare Corporation are governed by a few key factors: patient volume, government reimbursement rates, and labor costs. It's a volume and rate business, but still, cost management is everything.

• Reimbursement Rate Tailwinds: The company benefits from supportive regulatory environments, such as the Medicare Skilled Nursing Facility (SNF) rate increase of +4.2% for the 2025 fiscal year, which directly boosts the per diem (daily) rate they can charge.
• Managed Care Growth: Medicare Advantage (MA) is a growing payer source. Excluding a timing delay on quality incentive payments, the average MA per diem increased 2.7% year-over-year in Q3 2025, showing rate strength in this critical segment.
• Volume is Up: Patient volumes are robust. Total skilled nursing patient days increased to 740,373 in the third quarter of 2025, which is a clear sign of strong demand for their services.
• Labor Cost Pressure: The biggest risk is labor. Salaries, wages, and benefits were up 25.8% in Q2 2025 compared to the prior year, though the company has successfully reduced expensive agency nurse staffing expense to just $1.5 million in Q1 2025 from $5.3 million a year earlier. This is a massive operational win.

National HealthCare Corporation's Financial Performance

When you strip out the noise, National HealthCare Corporation's operational performance in 2025 is strong, even with a mixed GAAP (Generally Accepted Accounting Principles) result. You should focus on the adjusted figures, which give a clearer picture of the core business health.

• Adjusted Earnings Power: Adjusted diluted earnings per share (EPS) for Q3 2025 was $1.58, a jump of 24.3% compared to the same quarter last year. This non-GAAP number excludes volatile items like unrealized gains and losses in their marketable securities portfolio.
• Profitability Metrics: For the nine months ending September 30, 2025, the Operating Profit Margin was a healthy 8.42%. This tells you that the company is effectively managing the costs directly related to providing care.
• Liquidity is Solid: The company's liquidity is a green light. As of Q3 2025, the Current Ratio was 1.75, meaning National HealthCare Corporation holds $1.75 in current assets for every $1.00 in current liabilities. Their working capital was approximately $211.5 million at the end of Q3 2025.
• Cash Generation: The change in working capital over the trailing twelve months ended September 2025 was a positive inflow of $30 million, indicating efficient conversion of operations into readily available cash.

For a deeper dive into the balance sheet and cash flow trends, check out Breaking Down National HealthCare Corporation (NHC) Financial Health: Key Insights for Investors.

National HealthCare Corporation (NHC) Market Position & Future Outlook

National HealthCare Corporation (NHC) is a stable, diversified player in a fragmented senior healthcare market, poised to capitalize on demographic tailwinds with a strong balance sheet. The company's future outlook hinges on successfully integrating recent acquisitions and managing labor costs, which pressured margins despite robust top-line growth. Trailing twelve months (TTM) revenue, as of the third quarter of 2025, hit a solid $1.50 billion, showing a 22.67% year-over-year increase, but you need to watch how much of that growth translates to net income given current operating expenses.

Competitive Landscape

The U.S. skilled nursing facility (SNF) market is massive but highly fragmented, estimated at $202.4 billion in 2025. NHC is a regional leader, but it holds a small national footprint, competing with larger national chains and private equity-backed operators. Here's the quick math on their relative size based on 2025 revenue projections and TTM figures.

Opportunities & Challenges

You're looking at a sector where demand is inelastic, but reimbursement is a political football. NHC's strategic initiatives focus on what they can control: expansion and operational efficiency. The Q3 2025 adjusted diluted earnings per share (EPS) of $1.58, up 24.3% year-over-year, defintely shows their core business is healthy, but the risk profile is clear.

Industry Position

National HealthCare Corporation holds a premium position in the post-acute and long-term care ecosystem, largely due to its commitment to an integrated care model. This means they can seamlessly transition patients from a Skilled Nursing Facility (SNF) to homecare or hospice, which is a major advantage for both patient outcomes and payer relations. They operate 80 skilled nursing facilities and 67 home care and hospice agencies as of November 2025. [cite: 10 in step 1, 5 in step 1]

• NHC's 9-month 2025 Operating Margin of 8.42% is dramatically higher than the industry median, which analysts forecast to be between 1% and 2% for the full year 2025. This gap underscores their strong cost management and pricing power relative to peers. [cite: 10 in step 1]
• The company's focus on owning and operating its properties, rather than relying solely on leasing, provides better control over capital expenditure and operational strategy.
• Their geographic concentration, primarily in the Southeast U.S., allows for regional densification and shared resources, which helps mitigate the impact of the national labor shortage.

To be fair, while the revenue is growing, the ongoing leadership transition and the need to manage wage inflation are key variables that could affect that 8.42% margin. For a deeper dive into who is betting on this stability, check out Exploring National HealthCare Corporation (NHC) Investor Profile: Who's Buying and Why?