Revenue growth has moderated significantly from a 28.7% peak in 2025Q2 to just 1.7% in 2026Q1, while gross margins compressed to 30.5% from the 38-39% range maintained throughout 2025.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 | Dec'99 | Dec'98 | Dec'97 | Dec'96 |
|---|
| Sales/Revenue | 1.52B | 1.51B | 1.3B | 1.14B | 1.07B | 1.01B | 980.71M | 996.38M | 980.35M | 963.89M | 923.58M | 906.62M | 871.68M | 788.96M | 761M | 773.24M | 720.65M | 668.22M | 633.21M | 598.03M | 562.96M | 542.38M | 521.83M | 472.86M | 458.25M | 419.97M | 462.42M | 440.14M | 441.2M | 463.48M | 386.3M |
| Revenue Growth % | 10.89% | 16.38% | 13.7% | 6.26% | 6.27% | 3.08% | -1.57% | 1.64% | 1.71% | 4.37% | 1.87% | 4.01% | 10.49% | 3.67% | -1.58% | 7.3% | 7.85% | 5.53% | 5.88% | 6.23% | 3.79% | 3.94% | 10.36% | 3.19% | 9.12% | -9.18% | 5.06% | -0.24% | -4.81% | 19.98% | 10.56% |
| Cost of Goods Sold | 957.05M | 485.77M | 810.93M | 712.34M | 686.17M | 666.06M | 609.31M | 592.83M | 582.72M | 572.04M | 548.01M | 532.74M | 510.25M | 453.56M | 426.93M | 428.67M | 400.27M | 558.85M | 538.51M | 502.09M | 157.66M | 150.16M | 149.56M | 129.72M | 127.05M | 111.72M | 119.59M | 121.35M | 163.5M | 140M | 123.3M |
| COGS % of Revenue | - | 32.16% | 62.48% | 62.4% | 63.87% | 65.89% | 62.13% | 59.5% | 59.44% | 59.35% | 59.34% | 58.76% | 58.54% | 57.49% | 56.1% | 55.44% | 55.54% | 83.63% | 85.05% | 83.96% | 28.01% | 27.69% | 28.66% | 27.43% | 27.72% | 26.6% | 25.86% | 27.57% | 37.06% | 30.21% | 31.92% |
| Gross Profit | 567.07M | 1.02B | 487.01M | 429.2M | 388.11M | 344.88M | 371.41M | 403.55M | 397.63M | 391.85M | 375.57M | 373.89M | 361.43M | 335.4M | 334.07M | 344.57M | 320.38M | 109.37M | 94.7M | 95.94M | 405.29M | 392.22M | 372.27M | 343.15M | 331.21M | 308.25M | 342.83M | 318.8M | 277.7M | 323.48M | 263M |
| Gross Margin % | 37.21% | 67.84% | 37.52% | 37.6% | 36.13% | 34.11% | 37.87% | 40.5% | 40.56% | 40.65% | 40.66% | 41.24% | 41.46% | 42.51% | 43.9% | 44.56% | 44.46% | 16.37% | 14.95% | 16.04% | 71.99% | 72.31% | 71.34% | 72.57% | 72.28% | 73.4% | 74.14% | 72.43% | 62.94% | 69.79% | 68.08% |
| Gross Profit Growth % | - | 110.42% | 13.47% | 10.59% | 12.54% | -7.14% | -7.97% | 1.49% | 1.47% | 4.33% | 0.45% | 3.45% | 7.76% | 0.4% | -3.05% | 7.55% | 192.94% | 15.49% | -1.3% | -76.33% | 3.33% | 5.36% | 8.49% | 3.61% | 7.45% | -10.09% | 7.54% | 14.8% | -14.15% | 23% | 8.5% |
| Operating Expenses | 573.78M | 881.31M | 401.25M | 372.07M | 356.22M | 293.95M | 323.25M | 354.51M | 341.55M | 337.74M | 315.03M | 306.76M | 293.42M | 263.32M | 265.83M | 265.72M | 262.76M | 58.5M | 57.14M | 57.21M | 357.34M | 343M | 330.91M | 307.78M | 292.32M | 280.93M | 318.79M | 299.41M | 255.4M | 273.3M | 222.8M |
| OpEx % of Revenue | - | 58.34% | 30.91% | 32.59% | 33.16% | 29.08% | 32.96% | 35.58% | 34.84% | 35.04% | 34.11% | 33.84% | 33.66% | 33.38% | 34.93% | 34.36% | 36.46% | 8.75% | 9.02% | 9.57% | 63.48% | 63.24% | 63.41% | 65.09% | 63.79% | 66.89% | 68.94% | 68.02% | 57.89% | 58.97% | 57.68% |
| Selling, General & Admin | 34.86M | 0 | 43.18M | 41.52M | 40.98M | 40.82M | 40.49M | 40.52M | 40.92M | 40.37M | 41.29M | 39.97M | 39.73M | 39.45M | 39.35M | 39.74M | 38.09M | 32.35M | 31.45M | 40.2M | 343.17M | 327.54M | 317.15M | 295.4M | 279.95M | 268.2M | 304.35M | 289.02M | 243.3M | 258.3M | 209.6M |
| SG&A % of Revenue | - | - | 3.33% | 3.64% | 3.81% | 4.04% | 4.13% | 4.07% | 4.17% | 4.19% | 4.47% | 4.41% | 4.56% | 5% | 5.17% | 5.14% | 5.28% | 4.84% | 4.97% | 6.72% | 60.96% | 60.39% | 60.78% | 62.47% | 61.09% | 63.86% | 65.82% | 65.67% | 55.15% | 55.73% | 54.26% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 4M | 881.31M | 358.06M | 330.54M | 315.24M | 253.14M | 282.76M | 314M | 300.63M | 297.38M | 273.74M | 266.79M | 253.69M | 223.87M | 226.48M | 225.98M | 224.67M | 26.14M | 25.69M | 17.01M | 14.17M | 15.46M | 13.77M | 12.38M | 12.37M | 12.73M | 14.44M | 10.38M | 12.1M | 15M | 13.2M |
| Operating Income | -6.71M | 143.45M | 85.76M | 57.13M | 31.9M | 50.92M | 48.16M | 49.04M | 56.08M | 54.11M | 60.54M | 67.13M | 68.01M | 72.08M | 68.24M | 78.85M | 57.63M | 50.87M | 37.55M | 38.73M | 47.95M | 49.22M | 41.35M | 35.37M | 38.89M | 27.32M | 24.04M | 19.39M | 22.3M | 50.18M | 40.2M |
| Operating Margin % | -0.44% | 9.5% | 6.61% | 5% | 2.97% | 5.04% | 4.91% | 4.92% | 5.72% | 5.61% | 6.56% | 7.4% | 7.8% | 9.14% | 8.97% | 10.2% | 8% | 7.61% | 5.93% | 6.48% | 8.52% | 9.07% | 7.92% | 7.48% | 8.49% | 6.5% | 5.2% | 4.4% | 5.05% | 10.83% | 10.41% |
| Operating Income Growth % | - | 67.27% | 50.1% | 79.13% | -37.37% | 5.75% | -1.8% | -12.55% | 3.63% | -10.62% | -9.81% | -1.3% | -5.65% | 5.63% | -13.46% | 36.83% | 13.28% | 35.47% | -3.03% | -19.23% | -2.58% | 19.02% | 16.93% | -9.05% | 42.35% | 13.64% | 23.99% | -13.06% | -55.56% | 24.82% | 5.79% |
| EBITDA | 38.85M | 188.37M | 127.75M | 99.17M | 72.39M | 91.6M | 90.17M | 91.46M | 97.97M | 96.76M | 99.56M | 104.24M | 102.39M | 100.63M | 98.03M | 107.75M | 84.77M | 76.3M | 62.37M | 55.73M | 60.66M | 63.37M | 53.79M | 46.57M | 50.03M | 39.18M | 38.48M | 29.77M | 34.4M | 65.18M | 53.4M |
| EBITDA Margin % | 2.55% | 12.47% | 9.84% | 8.69% | 6.74% | 9.06% | 9.19% | 9.18% | 9.99% | 10.04% | 10.78% | 11.5% | 11.75% | 12.75% | 12.88% | 13.94% | 11.76% | 11.42% | 9.85% | 9.32% | 10.78% | 11.68% | 10.31% | 9.85% | 10.92% | 9.33% | 8.32% | 6.76% | 7.8% | 14.06% | 13.82% |
| EBITDA Growth % | -72.89% | 47.46% | 28.82% | 37% | -20.97% | 1.58% | -1.4% | -6.65% | 1.25% | -2.82% | -4.48% | 1.8% | 1.76% | 2.65% | -9.02% | 27.11% | 11.1% | 22.34% | 11.9% | -8.12% | -4.27% | 17.81% | 15.49% | -6.92% | 27.69% | 1.82% | 29.25% | -13.45% | -47.22% | 22.05% | 0% |
| D&A (Non-Cash Add-back) | 45.56M | 44.92M | 41.98M | 42.03M | 40.49M | 40.67M | 42.02M | 42.42M | 41.89M | 42.65M | 39.02M | 37.11M | 34.38M | 28.55M | 29.79M | 28.9M | 27.14M | 25.43M | 24.82M | 17.01M | 12.71M | 14.15M | 12.44M | 11.21M | 11.15M | 11.87M | 14.44M | 10.38M | 12.1M | 15M | 13.2M |
| EBIT | 168.06M | 168.8M | 140.54M | 89.06M | 27.79M | 150.88M | 53.82M | 91.15M | 79.58M | 79.44M | 84.15M | 87.88M | 87.36M | 102.51M | 93.94M | 99.83M | 81.48M | 68.37M | 54.16M | 73.41M | 47.95M | 49.22M | 41.35M | 35.37M | 38.89M | 27.32M | 24.04M | 19.39M | 22.3M | 50.18M | 40.2M |
| Net Interest Income | 7.37M | 3.47M | 5.97M | 8.06M | 4.57M | 3.82M | 4.4M | 4.05M | 2.49M | 1.28M | 1.54M | 2.89M | 2.38M | 4.91M | 4.17M | 4.54M | 4.87M | -716K | -873K | -1.17M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Income | 9.91M | 9.84M | 10.1M | 8.38M | 5.13M | 4.67M | 5.79M | 7.19M | 7.18M | 6.17M | 5.48M | 5.49M | 4.55M | 5.24M | 4.62M | 4.98M | 5.38M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Expense | 2.54M | 6.37M | 4.13M | 324K | 563K | 845K | 1.4M | 3.13M | 4.7M | 4.89M | 3.94M | 2.61M | 2.17M | 331K | 455K | 443K | 513K | 716K | 873K | 1.17M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Income/Expense | 170.23M | 18.98M | 50.65M | 31.6M | -4.67M | 99.11M | 4.27M | 38.98M | 18.81M | 20.44M | 19.66M | 18.15M | 17.18M | 30.09M | 25.25M | 20.53M | 23.34M | 16.78M | 15.73M | 33.51M | 6.33M | -2.53M | -1.3M | -2.08M | -11.44M | -5.16M | -6.88M | -5.35M | -32.4M | -12.98M | -40.2M |
| Pretax Income | 163.53M | 162.43M | 136.41M | 88.74M | 27.23M | 150.04M | 52.42M | 88.02M | 74.88M | 74.55M | 80.21M | 85.27M | 85.19M | 102.18M | 93.48M | 99.38M | 80.97M | 67.66M | 53.29M | 72.23M | 54.28M | 46.69M | 40.05M | 33.29M | 27.45M | 22.16M | 17.16M | 14.04M | -10.1M | 37.2M | 0 |
| Pretax Margin % | 10.73% | 10.75% | 10.51% | 7.77% | 2.53% | 14.84% | 5.35% | 8.83% | 7.64% | 7.73% | 8.68% | 9.41% | 9.77% | 12.95% | 12.28% | 12.85% | 11.24% | 10.12% | 8.42% | 12.08% | 9.64% | 8.61% | 7.68% | 7.04% | 5.99% | 5.28% | 3.71% | 3.19% | -2.29% | 8.03% | - |
| Income Tax | 37.11M | 39.83M | 34.32M | 23.45M | 7.25M | 10.95M | 10.43M | 20.04M | 16.18M | 18.87M | 29.67M | 32.13M | 31.82M | 37.56M | 34.18M | 34.39M | 28.27M | 27.61M | 16.92M | 26.79M | 17.54M | 18.05M | 16.08M | 13.34M | 11.01M | 8.96M | 6.94M | 5.65M | -3.7M | 200K | 0 |
| Effective Tax Rate % | 22.69% | 24.52% | 25.16% | 26.43% | 26.64% | 7.3% | 19.9% | 22.77% | 21.61% | 25.31% | 36.99% | 37.68% | 37.36% | 36.76% | 36.56% | 34.61% | 34.92% | 40.8% | 31.75% | 37.08% | 32.31% | 38.67% | 40.15% | 40.06% | 40.11% | 40.44% | 40.45% | 40.27% | 36.63% | 0.54% | - |
| Net Income | 123.67M | 120.02M | 101.93M | 66.8M | 22.45M | 138.59M | 41.87M | 68.21M | 58.96M | 56.2M | 50.54M | 53.14M | 53.37M | 64.61M | 59.3M | 64.99M | 52.7M | 40.05M | 36.37M | 45.45M | 36.74M | 28.64M | 23.97M | 19.95M | 16.44M | 13.2M | 10.22M | 8.38M | -6.4M | 37M | 29.3M |
| Net Margin % | 8.11% | 7.95% | 7.85% | 5.85% | 2.09% | 13.71% | 4.27% | 6.85% | 6.01% | 5.83% | 5.47% | 5.86% | 6.12% | 8.19% | 7.79% | 8.4% | 7.31% | 5.99% | 5.74% | 7.6% | 6.53% | 5.28% | 4.59% | 4.22% | 3.59% | 3.14% | 2.21% | 1.9% | -1.45% | 7.98% | 7.58% |
| Net Income Growth % | 14.59% | 17.75% | 52.59% | 197.61% | -83.8% | 230.99% | -38.62% | 15.68% | 4.91% | 11.21% | -4.9% | -0.42% | -17.4% | 8.96% | -8.76% | 23.33% | 31.58% | 10.11% | -19.97% | 23.7% | 28.3% | 19.45% | 20.15% | 21.38% | 24.52% | 29.18% | 21.89% | 230.98% | -117.3% | 26.28% | 38.86% |
| Net Income (Continuing) | 126.42M | 122.61M | 102.09M | 65.29M | 19.98M | 139.09M | 41.99M | 67.98M | 58.7M | 55.68M | 50.54M | 53.14M | 53.37M | 64.61M | 59.3M | 64.99M | 52.7M | 40.05M | 36.37M | 45.45M | 36.74M | 28.64M | 23.97M | 19.95M | 16.44M | 13.2M | 10.22M | 8.38M | -6.4M | 37M | 29.3M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 5.67M | 5.74M | 3M | 1.73M | 3.24M | 5.46M | 3.08M | 476K | 1.18M | 694K | -40.02M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1.19M | 874K | 812K | 750K | 0 | 0 | 0 | 700K | 800K | 800K |
| EPS (Diluted) | 7.84 | 7.67 | 6.53 | 4.34 | 1.45 | 8.99 | 2.72 | 4.44 | 3.87 | 3.69 | 3.32 | 3.20 | 3.14 | 3.87 | 3.57 | 3.96 | 3.22 | 2.31 | 2.11 | 3.36 | 2.85 | 0.24 | 1.95 | 1.65 | 1.37 | 1.13 | 0.89 | 0.73 | -0.58 | 3.58 | 2.97 |
| EPS Growth % | 13.73% | 17.46% | 50.46% | 199.31% | -83.87% | 230.51% | -38.74% | 14.73% | 4.88% | 11.14% | 3.75% | 1.91% | -18.86% | 8.4% | -9.85% | 22.98% | 39.39% | 9.48% | -37.2% | 17.89% | 1087.5% | -87.69% | 18.18% | 20.44% | 21.24% | 26.97% | 21.92% | 225.86% | -116.2% | 20.54% | 28.02% |
| EPS (Basic) | - | 7.76 | 6.62 | 4.36 | 1.46 | 9.03 | 2.74 | 4.47 | 3.87 | 3.70 | 3.34 | 3.34 | 3.24 | 4.05 | 3.65 | 4.09 | 3.22 | 2.31 | 2.16 | 3.47 | 2.99 | 0.34 | 2.05 | 1.72 | 1.43 | 1.17 | 0.89 | 0.73 | -0.58 | 4.17 | 3.48 |
| Diluted Shares Outstanding | 15.77M | 15.65M | 15.6M | 15.38M | 15.45M | 15.42M | 15.37M | 15.36M | 15.24M | 15.22M | 15.21M | 14.49M | 14.22M | 16.7M | 16.6M | 16.41M | 13.68M | 13.58M | 13.13M | 12.99M | 12.89M | 12.79M | 12.29M | 12.06M | 11.97M | 11.68M | 11.47M | 11.42M | 11.12M | 10.34M | 9.87M |
| Basic Shares Outstanding | 15.54M | 15.47M | 15.39M | 15.31M | 15.41M | 15.35M | 15.31M | 15.27M | 15.22M | 15.19M | 15.13M | 13.89M | 13.82M | 13.83M | 13.85M | 13.77M | 13.67M | 13.56M | 12.83M | 12.56M | 12.29M | 12.24M | 11.69M | 11.61M | 11.51M | 11.27M | 11.45M | 11.42M | 11.12M | 8.87M | 8.42M |
| Dividend Payout Ratio | - | 32.25% | 36.27% | 53.24% | 154.17% | 23.11% | 76.24% | 45.75% | 50.59% | 50.24% | 51.04% | 39.68% | 35.05% | 27.04% | 52.02% | 24.55% | 28.05% | 33.73% | 31.74% | 21.49% | 22.07% | 23.47% | - | - | - | - | - | - | - | 56.76% | 59.73% |
Labor cost inflation volatility
According to the latest quarterly filings, NHC's revenue growth has moderated significantly from the 28.7% peak observed in 2025Q2 to a modest 1.7% in 2026Q1, suggesting that the post-pandemic census recovery tailwinds may be normalizing as the company faces a more challenging year-over-year comparison base.
The sharp deceleration in top-line expansion indicates that the initial surge in patient volume is likely plateauing. Investors should monitor whether the company can sustain organic growth through its behavioral health initiatives or if the core skilled nursing segment is reaching a capacity ceiling in its primary Tennessee market.
As reported in recent financial statements, NHC experienced a notable contraction in gross margin to 30.5% in 2026Q1, a significant departure from the 38-39% range maintained throughout 2025, which may reflect rising clinical labor costs or shifts in the underlying payer mix toward lower-reimbursement Medicaid residents.
The sudden drop in gross profitability suggests that the company's ability to pass through cost increases to payers is currently lagging behind inflationary pressures. This margin volatility highlights the sensitivity of the business model to labor market tightness and the potential for regulatory reimbursement changes to impact facility-level profitability.
Based on NHC's reported figures, the company's operating income turned negative in 2026Q1 at -$104.3M, marking a stark reversal from the consistent positive operating margins seen in previous quarters and indicating that fixed costs are currently outpacing the company's ability to generate sufficient operating leverage.
The inability to maintain positive operating income suggests that the company's cost structure is becoming increasingly rigid, potentially due to staffing mandates or non-recurring operational expenses. This trend warrants further investigation into whether the current operating loss is a temporary anomaly or a structural shift in the company's cost-to-revenue efficiency.
Data from recent SEC filings reveals that NHC reported a net income of $35.9M in 2026Q1 despite a significant operating loss, suggesting that non-operating items or investment gains are currently masking the underlying weakness in core healthcare service delivery and distorting the quality of reported earnings.
The reliance on non-operating income to bolster the bottom line raises concerns regarding the sustainability of current EPS levels. Analysts should strip out these volatile investment-related gains to assess the true operational health of the company's care facilities and determine if the core business remains fundamentally profitable.
Quick answers to the most common questions about buying NHC stock.
For fiscal year 2025, National HealthCare Corporation (NHC) reported total revenue of $1.51B. This represents a 291.0% increase compared to $386.3M in 1996.
National HealthCare Corporation (NHC) is profitable, generating $120.0M in net income for the fiscal year ending 2025 with a net profit margin of 7.9%.
National HealthCare Corporation (NHC) reported an operating income of $143.4M, resulting in an operating profit margin of 9.5%. This margin reflects the operational efficiency of the business before interest and taxes.
National HealthCare Corporation (NHC) generated $1.02B in gross profit for the year, representing a gross profit margin of 67.8%. This demonstrates the company's core pricing power and production efficiency.