0001004724-14-000161.txt : 20141222 0001004724-14-000161.hdr.sgml : 20141222 20141222175031 ACCESSION NUMBER: 0001004724-14-000161 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141217 FILED AS OF DATE: 20141222 DATE AS OF CHANGE: 20141222 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: Morrison Brent CENTRAL INDEX KEY: 0001623063 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33135 FILM NUMBER: 141304041 MAIL ADDRESS: STREET 1: 1145 HEMBREE ROAD CITY: ROSWELL STATE: GA ZIP: 30076 4 1 wf-form4_141928862054563.xml FORM 4 X0306 4 2014-12-17 0 0001004724 ADCARE HEALTH SYSTEMS, INC ADK 0001623063 Morrison Brent 1145 HEMBREE ROAD ROSWELL GA 30076 1 0 0 0 Common Stock 3.9 2014-12-17 4 A 0 17288 0 A 2015-12-17 2024-12-17 Common Stock 17288.0 17288 D Common Stock 3.9 2014-12-17 4 A 0 17288 0 A 2016-12-17 2024-12-17 Common Stock 17288.0 34576 D Common Stock 3.9 2014-12-17 4 A 0 17289 0 A 2017-12-17 2024-12-17 Common Stock 17289.0 51865 D Stock options issued to Reporting Person pursuant to the AdCare Health Systems, Inc. 2011 Stock Option Plan and in respect of 2015 compensation /s/Nicole Parker, Attorney-in-fact 2014-12-23