X0304 4 2012-02-09 0 0000799231 ALMOST FAMILY INC AFAM 0001515378 Ralston Nancy 9510 ORMSBY STATION ROAD SUITE 300 LOUISVILLE KY 40223 0 1 0 0 Sr. VP Ops, Florida Common Stock 2012-02-09 4 F 0 276 20.05 D 3624 D Common Stock 6876 I Indirect by RSSY Home Healthcare Services, LLC Option (right to buy) 36.69 2021-03-10 Common Stock 1600 1600 D Option (right to buy) 24.94 2018-06-16 Common Stock 2500 2500 D Option (right to buy) 33.27 2019-02-08 Common Stock 1600 1600 D Option (right to buy) 40.13 2019-12-13 Common Stock 1100 1100 D The option becomes exercisable in four equal installments beginning on the first anniversary of the date of grant, March 11, 2011. Granted pursuant to the 2007 Stock & Incentive Compensation Plan. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, June 17, 2008. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, February 9, 2009. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, December 14, 2009. The Reporting Person is the managing partner of RSSY Home Healthcare Services, LLC. The reporting person disclaims beneficial ownership of the securities held by RSSY except to the extent of her pecuniary interest therein. Payment of tax liability by delivery of securities in connection with vesting of previously issued shares of restricted stock in accordance with Rule 16b-3. /s/ Nancy Ralston 2012-02-09