0001127602-21-007678.txt : 20210224 0001127602-21-007678.hdr.sgml : 20210224 20210224171828 ACCESSION NUMBER: 0001127602-21-007678 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210222 FILED AS OF DATE: 20210224 DATE AS OF CHANGE: 20210224 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADAMS W ANDREW CENTRAL INDEX KEY: 0001012853 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10822 FILM NUMBER: 21674850 MAIL ADDRESS: STREET 1: P.O. BOX 1398 CITY: MURFREESBORO STATE: TN ZIP: 37133-1398 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL HEALTH INVESTORS INC CENTRAL INDEX KEY: 0000877860 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 621470956 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 222 ROBERT ROSE DRIVE CITY: MURFREESBORO STATE: TN ZIP: 37129 BUSINESS PHONE: 6158909100 MAIL ADDRESS: STREET 1: 222 ROBERT ROSE DRIVE CITY: MURFREESBORO STATE: TN ZIP: 37129 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2021-02-22 0000877860 NATIONAL HEALTH INVESTORS INC NHI 0001012853 ADAMS W ANDREW 222 ROBERT ROSE DRIVE MURFREESBORO TN 37129 1 Common Stock 2021-02-22 4 M 0 20000 60.52 A 36513 D Common Stock 2021-02-22 4 F 0 17344 69.79 D 19169 D Common Stock By Amk, L.p. 759784 D Common Stock By Adams Family Foundation II 222307 I Trustee Common Stock by JMA Grandchildren's Trust 12635 I Trustee Common Stock By Springland Ventures, L.p. 44000 D Common Stock by W. Andrew Adams Exempt Trust 7411 D Common Stock by W. Andrew Adams Non Exempt Trust 34140 D Common Stock - held by Spouse 11707 I Common Stock held by Spouse Stock Options (Right to Buy) 60.52 2021-02-22 4 M 0 20000 0 D 2016-02-22 2021-02-22 Common Stock 20000 0 D Stock Option Grant - 2-22-17 74.78 2017-02-22 2022-02-22 Common Stock 20000 20000 D Stock Options (Right to Buy) 2-20-18 64.33 2018-02-20 2023-02-20 Common Stock 20000 20000 D Stock Option Grant 2-21-19 79.96 2019-02-21 2024-02-21 Common Stock 25000 25000 D Stock Options (Right to Buy) 2-21-2020 90.79 2020-02-21 2025-02-21 Common Stock 25000 25000 D /s/Kimberly V. Ouimet, attorney-in-fact for Mr. Adams 2021-02-23