0001209191-12-053555.txt : 20121116 0001209191-12-053555.hdr.sgml : 20121116 20121116170139 ACCESSION NUMBER: 0001209191-12-053555 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121115 FILED AS OF DATE: 20121116 DATE AS OF CHANGE: 20121116 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: 121212303 MAIL ADDRESS: STREET 1: 593 ATLANTA STREET CITY: ROSWELL STATE: GA ZIP: 30075 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: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5057 TROY RD CITY: SPRINGFEILD STATE: OH ZIP: 45502 BUSINESS PHONE: 937-964-8974 MAIL ADDRESS: STREET 1: 5057 TROY RD CITY: SPRINGFIELD STATE: OH ZIP: 45502 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-11-15 0 0001004724 ADCARE HEALTH SYSTEMS INC ADK 0001431870 Brogdon Christopher F 2 BUCKHEAD PLAZA 3050 PEACHTREE ROAD, SUITE 570 ATLANTA GA 30305 1 1 1 0 Chief Acquisition Officer Common Stock 2012-11-15 4 P 0 1000 3.978 A 938035 I By spouse Common Stock 221296 D Christopher F. Brogdon 2012-11-16