0001127602-13-008363.txt : 20130227 0001127602-13-008363.hdr.sgml : 20130227 20130227180307 ACCESSION NUMBER: 0001127602-13-008363 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130225 FILED AS OF DATE: 20130227 DATE AS OF CHANGE: 20130227 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: 13648268 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 2013-02-25 0000877860 NATIONAL HEALTH INVESTORS INC NHI 0001012853 ADAMS W ANDREW 222 ROBERT ROSE DRIVE MURFREESBORO TN 37129 1 Common Stock - held by Spouse 9707 I Common Stock held by Spouse Common Stock By Amk, L.p. 732784 D Common Stock By Springland Ventures, L.p. 44000 D Common Stock by W. Andrew Adams Non Exempt Trust 34140 D Common Stock by W. Andrew Adams Exempt Trust 7411 D Common Stock By Adams Family Foundation II 222307 I Trustee Common Stock by EMA, L.P. 341802 I Trustee Common Stock by JMA Grandchildren's Trust 12635 I Trustee Stock Options (Right to Buy) 64.49 2013-02-25 4 A 0 15000 64.49 A 2013-02-25 2018-02-25 Common Stock 15000 15000 D Stock Options (Right to Buy) 45.58 2011-02-22 2016-02-22 Common Stock 15000 15000 D Stock Options (Right to Buy) 47.52 2012-02-21 2017-02-21 Common Stock 15000 15000 D Shares previously held in W. Andrew Adams Exempt & Non Exempt Trust divided into two separate accounts - W. Andrew Adams Exempt Trust and W. Andrew Adams Non Exempt Trust. The total remains the same. /s/W. Andrew Adams 2013-02-26