National Healthcare
National Healthcare's revenue rose 16.1% to $1.5 billion in fiscal 2025. Its operating margin was 8.5%, up from 6.9% a year earlier. Free cash flow was $149 million, up 86.5%. It paid out $53 million in dividends and buybacks, 36% of free cash flow. The diluted share count rose 0.3%.
NATIONAL HEALTHCARE CORP
Latest fiscal year ended December 31, 2025
10-K filed February 26, 2026 · 0001437749-26-005910
Updated
Revenue
$1.5B
16.1%
Operating margin
8.5%
1.6 pts
Net income
$120M
17.8%
Free cash flow
$149M
86.5%
Return on capital
9.4%
2.1 pts
Market cap
$3.3B
Nov 6 close
P/E
28.9x
On $7.23 EPS, 4 qtrs
Operating margin is operating income as a share of revenue. Free cash flow is cash from operations minus capital spending. Return on capital is after-tax operating income as a share of the money invested in the business: debt plus equity, minus cash. Market cap is the last closing share price times the latest diluted share count, so it is approximate. P/E is the last close divided by diluted earnings per share over the last four quarters, or the latest fiscal year where the quarters aren't available; there is none when the company made a loss.
Charts show fiscal years, from the 10-K filings.
Income statement
Revenue and net income
US$ billions, fiscal years; net losses in red. Revenue on the left axis, net income on the right; zero is the same line on both.
Revenue (left axis)Net income (right axis)
Gross profit, R&D and operating income
US$ billions, fiscal years. Gross profit is revenue minus the cost of what was sold; research and development is one of the costs paid from it; what remains after all operating costs is operating income. Losses in red.
Gross profitResearch and developmentOperating income
Margins
Percent of revenue
GrossOperatingNetFree cash flow
From fiscal 2016 to 2025, earnings per share grew 9.8% a year and net income 10.1% a year, as new shares raised the share count by 3% and diluted each share's earnings.
Diluted earnings per share
US$ per share, fiscal years, restated for any stock splits; loss years in red.
Returns on capital
Return on capital and on equity
Percent. Return on capital is after-tax operating income over the money invested in the business (debt plus equity, minus cash); return on equity is net income over shareholders' equity. Both use the average of opening and closing balances.
Return on capitalReturn on equity
Balance sheet
Cash and debt
US$ billions, at each fiscal year end. Debt includes finance leases.
Cash and short-term investmentsDebt
Assets, liabilities and equity
US$ billions, at each fiscal year end. Assets equal liabilities plus equity; negative equity in red.
Total assetsTotal liabilitiesShareholders' equity
Debt and liquidity ratios
Times. Debt to equity, current assets over current liabilities, and net debt over EBITDA (a full year's).
Debt to equityCurrent ratioNet debt to EBITDA
Five years at a glance
| Fiscal year end | FY21 | FY22 | FY23 | FY24 | FY25 |
|---|---|---|---|---|---|
| Cash and short-term investments | 108 | 59 | 107 | 76 | 93 |
| Debt incl. finance leases | 10 | 6 | 1 | 137 | 40 |
| Net debt (negative means net cash) | −97 | −53 | −106 | 61 | −53 |
| Net debt to EBITDA | −1.1x | −0.7x | −1.1x | 0.5x | −0.3x |
| Debt to equity | 0.0x | 0.0x | 0.0x | 0.1x | 0.0x |
| Interest coverage | 60.3x | 56.6x | 177.3x | 21.7x | 20.1x |
| Current ratio | 1.6x | 1.8x | 1.9x | 1.8x | 1.8x |
| Quick ratio | 1.6x | 1.8x | 1.9x | 1.8x | 1.8x |
US$ millions unless stated, at each fiscal year end. Net debt to EBITDA is debt minus cash, divided by operating income before depreciation and amortization: roughly how many years of those earnings the net debt equals. Debt to equity is debt as a multiple of shareholders' equity. Interest coverage is operating income divided by interest expense. The current ratio is current assets over current liabilities; the quick ratio leaves out inventory.
Cash flow
Cash from operations, capital spending and free cash flow
US$ billions, fiscal years. Free cash flow is cash from operations minus capital spending; negative years in red.
Cash from operationsCapital spendingFree cash flow
Stock-based compensation and buybacks
US$ billions, fiscal years. Shares paid to employees (stock-based compensation, a cost that uses no cash) against cash spent buying shares back. Buybacks that only match it leave the share count roughly where it was.
Stock-based compensationShare buybacks
Dividends and buybacks
US$ billions, cash paid in each fiscal year
DividendsShare buybacks
Diluted share count
Weighted-average diluted shares, millions
Projections
Project National Healthcare's revenue, net income and earnings per share five years ahead in a bull, a base and a bear case with your own figures, and see the share prices your P/E estimates give them, or value it with a discounted cash flow model. Every projected figure is yours: it is not a forecast of ours.
Insider trades
Over the 12 months between November 7, 2025 and November 6, 2026, 1 insider bought $174,863 of National Healthcare shares on the open market, and 9 insiders sold $11.2 million.
Buys and sells by month
US$ millions, open-market purchases (up) and sales (down) by officers, directors and 10% owners in each month.
BoughtSold
| Date | Insider | Trade | Shares | Price | Value | Filing |
|---|---|---|---|---|---|---|
| Sep 22, 2026 | Vicki L DodsonSr.VP Patient Srvcs | Sold | 4,834 | $225.00 | $1.1 million | Form 4 |
| Sep 11, 2026 | Brian F KiddSVP, CFO | Sold | 6,813 | $225.70 | $1.5 million | Form 4 |
| Sep 10, 2026 | Josh A McCrearySenior VP & General Counsel | Sold | 2,719 | $224.23 | $609,673 | Form 4 |
| Aug 28, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $222.50 | $222,500 | Form 4 |
| Aug 25, 2026 | David R. GiffordDirector | Sold | 1,779 | $225.42 | $401,022 | Form 4 |
| Aug 25, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $227.00 | $227,000 | Form 4 |
| Aug 20, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $237.00 | $237,000 | Form 4 |
| Aug 19, 2026 | Stephen Fowler FlattCEO, Director | Sold | 1,500 | $237.08 | $355,620 | Form 4 |
| Aug 19, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $237.18 | $237,180 | Form 4 |
| Aug 17, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $226.00 | $226,000 | Form 4 |
| Aug 14, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $222.11 | $222,110 | Form 4 |
| Aug 12, 2026 | Ben Anderson Flatt SrSenior VP & CIO | Sold | 1,000 | $221.21 | $221,210 | Form 4 |
The latest 12 of 21 trades. Open-market purchases and sales by officers, directors and 10% owners, from their Form 4 filings with the SEC: one row per person, day and filing, at the day's average price. Grants, option exercises and shares withheld for tax aren't counted. Insiders buy and sell for many reasons, such as taxes, spreading their savings or a plan set up months earlier, so a trade on its own says little about where a company is heading. For information only, not investment advice. Insider trades at all companies
Indicators
Four widely used measures, worked out from the company's filings. The cutoffs are the ones their authors or users go by, not a verdict of ours.
| Indicator | FY23 | FY24 | FY25 |
|---|---|---|---|
| Piotroski F-score | 7 of 8 | 5 of 8 | 6 of 8 |
| Rule of 40 | 12.4% | 20.6% | 25.9% |
| Altman Z'' | 5.35 | 4.73 | 5.74 |
| Accruals ratio | −3.4% | −0.4% | −4.3% |
Piotroski F-score: how many of nine simple tests of profitability, funding and efficiency the company passed in the year (Piotroski, 2000); 8 or 9 is strong, 0 to 2 weak. Rule of 40: revenue growth plus free cash flow margin; software investors treat 40% or more as the bar. Altman Z'': working capital, retained earnings, operating income and equity weighed against assets and liabilities (Altman, 1995); Altman puts above 2.6 in the safe zone and below 1.1 in the distress zone. Accruals ratio: net income minus cash from operations, over average total assets; lower means profit is backed by cash.
The nine F-score tests
| Test | FY23 | FY24 | FY25 |
|---|---|---|---|
| Net income is positive | Pass | Pass | Pass |
| Cash from operations is positive | Pass | Pass | Pass |
| Return on assets rose | Pass | Pass | Pass |
| Cash from operations exceeds net income | Pass | Pass | Pass |
| Debt fell relative to assets | Fail | Fail | Pass |
| Current ratio rose | Pass | Fail | Pass |
| Share count didn't rise | Pass | Fail | Fail |
| Gross margin rose | — | — | — |
| Revenue rose relative to assets | Pass | Pass | Fail |
| F-score | 7 of 8 | 5 of 8 | 6 of 8 |
Companies that report no gross profit are scored on the other eight.
Compare
Put National Healthcare side by side with any other company we cover: revenue, growth, margins, cash flow and returns, with ten years of charts.
Similar companies
| Company | Year | Revenue growth | Operating margin | Free cash flow margin | Return on capital | Net debt to EBITDA | F-score | Compare |
|---|---|---|---|---|---|---|---|---|
| National Healthcare | FY25 | 16.1% | 8.5% | 9.8% | 9.4% | −0.3x | 6 | |
| U.S. Physical Therapy | FY25 | 16.3% | 11.1% | 7.8% | 10.7% | 1.2x | 6 | Compare |
| Astrana Health | FY25 | 56.4% | 2.5% | 3.3% | 4.2% | 4.9x | 4 | Compare |
| Acadia Healthcare | FY25 | 5.0% | — | −13.3% | −16.0% | — | 4 | Compare |
| Ensign Group | FY25 | 18.7% | 8.4% | — | 19.7% | −0.8x | 6 | Compare |
Each company's latest fiscal year. Fiscal years end in different months, so the periods don't line up exactly. Free cash flow margin is free cash flow as a share of revenue. Net debt to EBITDA is explained under the balance sheet, and the F-score under Indicators.
10 years of figures
| Fiscal year | FY16 | FY17 | FY18 | FY19 | FY20 | FY21 | FY22 | FY23 | FY24 | FY25 |
|---|---|---|---|---|---|---|---|---|---|---|
| Income statement | ||||||||||
| Revenue | 924 | 964 | 980 | 996 | 1,028 | 1,074 | 1,086 | 1,142 | 1,307 | 1,518 |
| Revenue growth | — | 4.4% | 1.7% | 1.6% | 3.2% | 4.5% | 1.1% | 5.1% | 14.5% | 16.1% |
| Gross profit | — | — | — | — | — | — | — | — | — | — |
| Research and development | — | — | — | — | — | — | — | — | — | — |
| Operating income | 60 | 54 | 56 | 49 | 48 | 51 | 32 | 58 | 90 | 128 |
| Net income | 50 | 56 | 59 | 68 | 42 | 139 | 22 | 67 | 102 | 120 |
| Diluted EPS (US$) | 3.32 | 3.69 | 3.87 | 4.44 | 2.72 | 8.99 | 1.45 | 4.34 | 6.53 | 7.67 |
| Diluted shares (millions) | 15 | 15 | 15 | 15 | 15 | 15 | 15 | 15 | 16 | 16 |
| Cash flow | ||||||||||
| Cash from operations | 91 | 94 | 98 | 100 | 203 | 62 | 9 | 111 | 107 | 185 |
| Capital expenditure | 63 | 32 | 30 | 26 | 22 | 39 | 30 | 28 | 28 | 36 |
| Free cash flow | 28 | 62 | 69 | 74 | 181 | 23 | −21 | 83 | 80 | 149 |
| Dividends paid | 26 | 28 | 30 | 31 | 32 | 32 | 35 | 36 | 37 | 39 |
| Share buybacks | 8 | 0 | 1 | 1 | 0 | 1 | 10 | 2 | 14 | 15 |
| Acquisitions | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 0 | 0 |
| Stock-based compensation | 0 | 2 | 2 | 2 | 2 | 3 | 3 | 3 | 4 | 4 |
| Balance sheet at fiscal year end | ||||||||||
| Cash and short-term investments | 164 | 198 | 184 | 203 | — | 108 | 59 | 107 | 76 | 93 |
| Debt incl. finance leases | 120 | 100 | 78 | 29 | 15 | 10 | 6 | 1 | 137 | 40 |
| Total assets | 1,087 | 1,096 | 1,081 | 1,287 | 1,362 | 1,403 | 1,276 | 1,311 | 1,524 | 1,526 |
| Total liabilities | 418 | 393 | 346 | 508 | 564 | 495 | 398 | 400 | 541 | 452 |
| Shareholders' equity | 670 | 703 | 733 | 779 | 795 | 903 | 874 | 909 | 980 | 1,069 |
| Margins and ratios | ||||||||||
| Gross margin | — | — | — | — | — | — | — | — | — | — |
| Operating margin | 6.6% | 5.6% | 5.7% | 4.9% | 4.7% | 4.7% | 2.9% | 5.0% | 6.9% | 8.5% |
| Net margin | 5.5% | 5.8% | 6.0% | 6.8% | 4.1% | 12.9% | 2.1% | 5.8% | 7.8% | 7.9% |
| Free cash flow margin | 3.1% | 6.4% | 7.0% | 7.4% | 17.6% | 2.1% | −2.0% | 7.3% | 6.1% | 9.8% |
| Rule of 40 (growth + FCF margin) | — | 10.8% | 8.7% | 9.0% | 20.8% | 6.6% | −0.9% | 12.4% | 20.6% | 25.9% |
| Return on capital | 6.2% | 6.6% | 7.1% | 6.1% | — | — | 2.9% | 5.2% | 7.3% | 9.4% |
| Return on equity | 7.8% | 8.2% | 8.2% | 9.0% | 5.3% | 16.3% | 2.5% | 7.5% | 10.8% | 11.7% |
| Return on assets | 4.7% | 5.2% | 5.4% | 5.8% | 3.2% | 10.0% | 1.7% | 5.2% | 7.2% | 7.9% |
| Net debt to EBITDA | −0.5x | −1.0x | −1.1x | −1.9x | — | −1.1x | −0.7x | −1.1x | 0.5x | −0.3x |
US$ millions unless stated. Where a later 10-K restated a year, the latest filed figure is shown. Download all figures (CSV, US$ millions)
Source: National Healthcare's Form 10-K filings, from SEC EDGAR. For information only, not investment advice. The Filing Desk is not affiliated with National Healthcare.