0001004724-14-000141.txt : 20141202 0001004724-14-000141.hdr.sgml : 20141202 20141202163325 ACCESSION NUMBER: 0001004724-14-000141 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141125 FILED AS OF DATE: 20141202 DATE AS OF CHANGE: 20141202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ADCARE HEALTH SYSTEMS, INC CENTRAL INDEX KEY: 0001004724 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 311332119 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1145 HEMBREE ROAD CITY: ROSWELL STATE: GA ZIP: 30076 BUSINESS PHONE: 404-781-2895 MAIL ADDRESS: STREET 1: 1145 HEMBREE ROAD CITY: ROSWELL STATE: GA ZIP: 30076 FORMER COMPANY: FORMER CONFORMED NAME: ADCARE HEALTH SYSTEMS INC DATE OF NAME CHANGE: 19951208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brogdon Christopher F CENTRAL INDEX KEY: 0001431870 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33135 FILM NUMBER: 141260966 MAIL ADDRESS: STREET 1: 2 BUCKHEAD PLAZA, 3050 PEACHTREE ROAD STREET 2: SUITE 570 CITY: ATLANTA STATE: GA ZIP: 30305 4 1 wf-form4_141755599501678.xml FORM 4 X0306 4 2014-11-25 0 0001004724 ADCARE HEALTH SYSTEMS, INC ADK 0001431870 Brogdon Christopher F 2 BUCKHEAD PLAZA 3050 PEACHTREE ROAD, SUITE 570 ATLANTA GA 30305 1 0 0 1 Greater than 5% owner Common Stock 2014-11-25 4 S 0 5000 4.17 D 823568 I By spouse Common Stock 2014-11-25 4 S 0 5533 4.18 D 818035 I By spouse Common Stock 2014-11-25 4 S 0 30000 4.19 D 788035 I By spouse Common Stock 2014-11-25 4 S 0 3892 4.23 D 784143 I By spouse Common Stock 221296 D Christopher F. Brogdon 2014-12-02