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FORM 8-A
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(B) OR (G) OF THE
SECURITIES EXCHANGE ACT OF 1934
BEVERLY ENTERPRISES, INC.
(Exact name of registrant as specified in its charter)
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DELAWARE 95-4100309
(State of incorporation or organization) (I.R.S. Employer Identification No.)
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5111 ROGERS AVENUE, SUITE 40-A, FORT SMITH, ARKANSAS 72919-0155
(Address of registrant's principal executive offices)
________________________________
See Table of Additional Co-Registrants Included Herewith
________________________________
ROBERT W. POMMERVILLE
Senior Vice President, General Counsel, and Secretary
Beverly Enterprises, Inc.
5111 Rogers Avenue, Suite 40-A
Fort Smith, Arkansas 72919-0155
(501) 452-6712
(Name, address, including zip code, and telephone number,
including area code, of agent for service)
Send copies of all communications to:
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GARY OLSON, ESQ. MARK C. SMITH, ESQ.
Latham & Watkins Skadden, Arps, Slate, Meagher & Flom
633 West Fifth Street, Suite 4000 919 Third Avenue
Los Angeles, CA 90071 New York, New York 10022
(213) 485-1234 (213) 735-3000
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_______________________________
APPROXIMATE DATE OF COMMENCEMENT OF PROPOSED SALE TO THE PUBLIC:
As soon as practicable after the effective date of the Registration Statement
______________________________
If this Form relates to the registration of a class of debt securities and is
effective upon filing pursuant to General Instruction A(c)(1), please check the
following box. [ ]
If this Form relates to the registration of a class of debt securities and is
to become effective simultaneously with the effectiveness of a concurrent
registration statement under the Securities Act of 1933 pursuant to General
Instruction A(c)(2), please check the following box. [x]
Securities to be registered pursuant to Section 12(b) of the Act.
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Name of each exchange on which
Title of each class to be so registered each class is to be registered
--------------------------------------- ------------------------------
$150,000,000 AGGREGATE PRINCIPAL AMOUNT NEW YORK STOCK EXCHANGE
OF ___% SENIOR NOTES
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Securities to be registered pursuant to Section 12(g) of the Act:
NONE
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TABLE OF ADDITIONAL CO-REGISTRANTS
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(Exact name of Co-Registrant (State or other (I.R.S. Employer
---------------------------- --------------- -------------------
as specified in its charter) jurisdiction of Identification No.)
---------------------------- --------------- -------------------
incorporation or
----------------
organization)
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A.B.C. Health Equipment Corp. New York 13-3043192
AdviNet, Inc. Delaware 71-0758986
AGI-Camelot, Inc. Missouri 43-1253376
AGI-McDonald County Health Care, Inc. Missouri 43-1253385
Alliance Health Services, Inc. Delaware 22-3226432
Alliance Home Health Care, inc. Connecticut 06-1341698
Amco Medical Service, Inc. Texas 75-1288363
American Transitional Care Centers of Texas, Inc. Texas 76-0298534
American Transitional Care Dallas - Ft. Worth, Inc. Texas 76-0322331
American Transitional Health Care, Inc. Delaware 76-0292237
American Transitional Hospitals, Inc. Delaware 76-0232151
American Transitional Hospitals of Indiana, Inc. Indiana 35-1903972
American Transitional Hospitals of Oklahoma, Inc. Oklahoma 74-2689039
American Transitional Hospitals of Tennessee, Inc. Tennessee 62-1562740
American Transitional Hospitals - Texas Medical
Center, Inc. Delaware 71-0779078
ATH - Clear Lake, Inc. Delaware 71-0776296
ATH Columbus, Inc. Delaware 71-0776295
ATH Del Oro, Inc. Texas 62-1578954
ATH Heights, Inc. Texas 76-0442017
ATH Oklahoma City, Inc. Oklahoma 73-1465199
ATH Tucson, Inc. Arizona 71-0767043
Beverly Acquisition Corporation Delaware 71-0765364
Beverly Assisted Living, Inc. Delaware 71-0777901
Beverly Health and Rehabilitation Services, Inc. California 95-2301514
Beverly Enterprises - Alabama, Inc. California 95-3742145
Beverly Enterprises - Arizona, Inc. California 95-3750871
Beverly Enterprises - Arkansas, Inc. California 95-3751272
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(Exact name of Co-Registrant (State or other (I.R.S. Employer
---------------------------- --------------- -------------------
as specified in its charter) jurisdiction of Identification No.)
---------------------------- --------------- -------------------
incorporation or
----------------
organization)
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Beverly Enterprises - California, Inc. California 95-3750879
Beverly Enterprises - Colorado, Inc. California 95-3750882
Beverly Enterprises - Connecticut, Inc. California 95-3849642
Beverly Enterprises - Delaware, Inc. California 95-3849628
Beverly Enterprises - Distribution Services, Inc. California 95-4081567
Beverly Enterprises - District of Columbia, Inc. California 95-3750889
Beverly Enterprises - Florida, Inc. California 95-3742251
Beverly Enterprises - Garden Terrace, Inc. California 95-3849648
Beverly Enterprises - Georgia, Inc. California 95-3750880
Beverly Enterprises - Hawaii, Inc. California 95-3750890
Beverly Enterprises - Idaho, Inc. California 95-3750886
Beverly Enterprises - Illinois, Inc. California 95-3750883
Beverly Enterprises - Indiana, Inc. California 95-3744258
Beverly Enterprises - Iowa, Inc. California 95-3751271
Beverly Enterprises - Kansas, Inc. California 95-3751269
Beverly Enterprises - Kentucky, Inc. California 95-3750894
Beverly Enterprises - Louisiana, Inc. California 95-3849633
Beverly Enterprises - Maine, Inc. California 95-3849627
Beverly Enterprises - Maryland, Inc. California 95-3750892
Beverly Enterprises - Massachusetts, Inc. California 95-3750893
Beverly Enterprises - Michigan, Inc. California 95-3898661
Beverly Enterprises - Minnesota, Inc. California 95-3742698
Beverly Enterprises - Mississippi, Inc. California 95-3742144
Beverly Enterprises - Missouri, Inc. California 95-3750895
Beverly Enterprises - Montana, Inc. California 95-3849636
Beverly Enterprises - Nebraska, Inc. California 95-3750873
Beverly Enterprises - Nevada, Inc. California 95-3750896
Beverly Enterprises - New Hampshire, Inc. California 95-3849630
Beverly Enterprises - New Jersey, Inc. California 95-3750884
Beverly Enterprises - New Mexico, Inc. California 95-3750869
Beverly Enterprises - North Carolina, Inc. California 95-3742257
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(Exact name of Co-Registrant (State or other (I.R.S. Employer
---------------------------- --------------- -------------------
as specified in its charter) jurisdiction of Identification No.)
---------------------------- --------------- -------------------
incorporation or
----------------
organization)
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Beverly Enterprises - North Dakota, Inc. California 95-3751270
Beverly Enterprises - Ohio, Inc. California 95-3750867
Beverly Enterprises - Oklahoma, Inc. California 95-3849624
Beverly Enterprises - Oregon, Inc. California 95-3750881
Beverly Enterprises - Pennsylvania, Inc. California 95-3750870
Beverly Enterprises - Rhode Island, Inc. California 95-3849621
Beverly Enterprises - South Carolina, Inc. California 95-3750866
Beverly Enterprises - Tennessee, Inc. California 95-3742261
Beverly Enterprises - Texas, Inc. California 95-3744256
Beverly Enterprises - Utah, Inc. California 95-3751089
Beverly Enterprises - Vermont, Inc. California 95-3750885
Beverly Enterprises - Virginia, Inc. California 95-3742694
Beverly Enterprises - Washington, Inc. California 95-3750868
Beverly Enterprises - West Virginia, Inc. California 95-3750888
Beverly Enterprises - Wisconsin, Inc. California 95-3742696
Beverly Enterprises - Wyoming, Inc. California 95-3849638
Beverly Enterprises Japan Limited California 95-3982125
Beverly Enterprises Medical Equipment Corporation California 95-3849617
Beverly Enterprises Rehabilitation Corporation California 95-3849619
Beverly Holdings I, Inc. Delaware 71-0768985
Beverly Manor Inc. of Hawaii California 99-0144750
Beverly Real Estate Holdings, Inc. Delaware 71-0768984
Beverly REMIC Depositor, Inc. California 95-4183372
Beverly Savana Cay Manor, Inc. California 95-4217381
Brownstone Pharmacy, Inc. Connecticut 06-0760884
Columbia-Valley Nursing Home, Inc. Ohio 34-1262298
Commercial Management, Inc. Iowa 42-0891358
Computran Systems, Inc. Oregon 93-0675109
Continental Care Centers of Council Bluffs, Inc. Iowa 41-1413442
DD Wholesale, Inc. Massachusetts 04-3133621
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(Exact name of Co-Registrant (State or other (I.R.S. Employer
---------------------------- --------------- -------------------
as specified in its charter) jurisdiction of Identification No.)
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incorporation or
----------------
organization)
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Dunnington Drug, Inc. Delaware 22-3122469
Dunnington Rx Services of Rhode Island, Inc. Rhode Island 05-0460848
Dunnington Rx Services of Massachusetts, Inc. Massachusetts 04-3128047
Forest City Building Ltd. Missouri 43-1102460
Hallmark Convalescent Homes, Inc. Michigan 41-1413478
Healthcare Prescription Services, Inc. Indiana 35-1868731
Home Medical Systems, Inc. Delaware 23-2271050
Hospice Preferred Choice, Inc. Delaware 71-0761314
Hospital Facilities Corporation California 95-2499218
Insta-Care Holdings, Inc. Florida 59-2213553
Insta-Care Pharmacy Services Corporation Texas 59-1817412
Insurance Software Packages, Inc. Florida 59-3090233
Kenwood View Nursing Home, Inc. Kansas 48-6111286
Liberty Nursing Homes, Incorporated Virginia 54-0784334
Medical Arts Health Facility of Lawrenceville, Inc. Georgia 58-1329700
Medical Health Industries, Inc. Delaware 39-1140633
MedView Services, Incorporated Florida 59-3090223
Moderncare of Lumberton, Inc. North Carolina 56-1217025
Nebraska City S-C-H, Inc. Nebraska 41-1413481
Nursing Home Operators, Inc. Ohio 34-0949279
Omni Med B, Inc. Connecticut 06-1303450
Petersen Health Care, Inc. Florida 59-2043392
Pharmacy Corporation of America California 95-3849613
Pharmacy Corporation of America-Massachusetts, Inc. Delaware 71-0776297
Pharmacy Dynamics Group, Inc. Florida 65-0166808
Phymedsco, Inc. West Virginia 55-0582953
Resource Opportunities, Inc. Florida 58-1930884
Salem No. 1, Inc. Missouri 43-1130257
South Alabama Nursing Home, Inc. Alabama 95-3809397
South Dakota - Beverly Enterprises, Inc. California 95-3750887
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(Exact name of Co-Registrant (State or other (I.R.S. Employer
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as specified in its charter) jurisdiction of Identification No.)
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incorporation or
----------------
organization)
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Spectra Rehab Alliance, Inc. Delaware 71-0759298
Synergos, Inc. California 33-0203515
Synergos - North Hollywood, Inc. California 33-0242556
Synergos - Pleasant Hill, Inc. California 33-0256657
Synergos - Scottsdale, Inc. Arizona 94-3085083
Taylor County Health Facility, Inc. Florida 59-1779865
TMD Disposition Company Florida 59-3151568
Vantage Healthcare Corporation Delaware 35-1572998
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ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED.
Reference is made to the information contained under
the caption "Description of Senior Notes" on pages 35-54 of
Amendment No. 1 to the Registration Statement on Form S-3
(File No. 33-64111) (the "Registration Statement"), as filed
with the Securities and Exchange Commission, pursuant to the
Securities Act of 1933, as amended, on November 21, 1995.
Reference is also made to any information which may be
included in any additional form of prospectus filed pursuant
to Rule 424(b) under the Securities Act, is incorporated
herein by reference and is being filed herewith pursuant to
Rule 12b-23 under the Securities Exchange Act of 1934, as
amended.
ITEM 2. EXHIBITS
1. Form of specimen Senior Note (incorporated by reference to
Exhibit 4.2 to the Registration Statement).
2. Form of Indenture for Senior Notes (incorporated by reference
to Exhibit 4.1 to the Registration Statement).
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SIGNATURE
Pursuant to the requirements of Section 12 of the Securities
Exchange Act of 1934, the Registrant has duly caused this registration
statement to be signed on its behalf by the undersigned, thereto duly
authorized.
For the Registrants set forth in the facing page
and on the table of additional Co-Registrants
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Dated: November 30, 1995 By: /s/ John W. MacKenzie
-------------------------------------
John W. MacKenzie
Vice President, Deputy General Counsel
and Assistant Secretary of
Beverly Enterprises, Inc.
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