0001104659-12-025035.txt : 20120412 0001104659-12-025035.hdr.sgml : 20120412 20120412170112 ACCESSION NUMBER: 0001104659-12-025035 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120412 DATE AS OF CHANGE: 20120412 EFFECTIVENESS DATE: 20120412 FILER: 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 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-176644 FILM NUMBER: 12756908 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 D 1 primary_doc.xml X0705 D LIVE 0001004724 ADCARE HEALTH SYSTEMS INC 5057 Troy Road Springfield OH OHIO 45502-9032 937-964-8974 OHIO None None Corporation true David A. Tenwick 5057 Troy Road Springfield OH OHIO 45502-9032 Director Christopher F. Brogdon 5057 Troy Road Springfield OH OHIO 45502-9032 Executive Officer Director Boyd P. Gentry 5057 Troy Road Springfield OH OHIO 45502-9032 Executive Officer Director Gary L. Wade 5057 Troy Road Springfield OH OHIO 45502-9032 Director Peter J. Hackett 5057 Troy Road Springfield OH OHIO 45502-9032 Director Jeffrey Levine 5057 Troy Road Springfield OH OHIO 45502-9032 Director Joshua J. McClellan 5057 Troy Road Springfield OH OHIO 45502-9032 Director Philip S. Radcliffe 5057 Troy Road Springfield OH OHIO 45502-9032 Director Laurence E. Sturtz 5057 Troy Road Springfield OH OHIO 45502-9032 Director Martin D. Brew 5057 Troy Road Springfield OH OHIO 45502-9032 Executive Officer David Rubenstein 5057 Troy Road Springfield OH OHIO 45502-9032 Executive Officer Other Health Care Decline to Disclose 06 false 2012-03-30 false true true true false 0 1200000 1200000 0 Represents a warrant to purchase 300,000 shares of common stock at an exercise price of $4.00, which was issued in connection with a financing transaction. Warrant has not been exercised; amounts above reflect the total exercise price. false 1 0 0 0 false ADCARE HEALTH SYSTEMS INC /s/ Martin D. Brew Martin D. Brew Chief Financial Officer 2012-04-12