<PAGE> 1
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.
NEW BEVERLY HOLDINGS, INC.
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(Exact name of registrants as specified in their charters)
Delaware 95-4100309
Delaware 62-1691861
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(State of incorporation (I.R.S. Employer
or organization) Identification No.)
5111 Rogers Avenue, Suite 40-A
Fort Smith, Arkansas 72919
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(Address of principal executive offices) (zip code)
See Table of Additional Co-Registrants Attached
Securities to be registered pursuant to Section 12(b) of the Act:
Title of each class Name of each exchange on which
to be so registered each class is to be registered
9% Senior Notes due 2006 New York Stock Exchange
Securities to be registered pursuant to Section 12(g) of the Act:
None
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(Title of class)
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TABLE OF ADDITIONAL CO-REGISTRANTS
<TABLE>
<CAPTION>
(STATE OR OTHER
JURISDICTION OF
INCORPORATION OR (I.R.S. EMPLOYER
(EXACT NAME OF CO-REGISTRANT AS SPECIFIED IN ITS CHARTER) ORGANIZATION) IDENTIFICATION NO.)
--------------------------------------------------------- ---------------- -------------------
<S> <C> <C>
A-1 Home Health Services, Inc. ............................. Georgia 58-1935144
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
Amco Medical Service, Inc................................... Texas 75-1288363
American Transitional Care Dallas -- Ft. Worth, Inc......... Texas 76-0322331
American Transitional Hospitals of East Tennessee, Inc. .... Delaware 62-1704901
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 -- Little Rock, Inc. ................................... Delaware 62-1682209
ATH -- Memphis, Inc. ....................................... Delaware 62-1682212
ATH Oklahoma City, Inc...................................... Oklahoma 73-1465199
ATH Tucson, Inc............................................. Arizona 71-0765364
Beverly Assisted Living, Inc................................ Delaware 71-0777901
Beverly -- Bella Vista Holding, Inc. ....................... Delaware 71-0797481
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
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
</TABLE>
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<TABLE>
<CAPTION>
(STATE OR OTHER
JURISDICTION OF
INCORPORATION OR (I.R.S. EMPLOYER
(EXACT NAME OF CO-REGISTRANT AS SPECIFIED IN ITS CHARTER) ORGANIZATION) IDENTIFICATION NO.)
--------------------------------------------------------- ---------------- -------------------
<S> <C> <C>
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 95-3642257
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 International Limited................... California 95-3982125
Beverly Enterprises Medical Equipment Corporation........... California 95-3849617
Beverly Holdings I, Inc..................................... Delaware 71-0768985
Beverly Manor Inc. of Hawaii................................ California 99-0144750
Beverly -- Missouri Valley Holding, Inc. ................... Delaware 71-0797485
Beverly -- Rapid City Holding, Inc. ........................ Delaware 71-0797483
Beverly Real Estate Holdings, Inc........................... Delaware 71-0768984
Beverly Savana Cay Manor, Inc............................... California 95-4217381
Columbia-Valley Nursing Home, Inc........................... Ohio 34-1262298
Commercial Management, Inc.................................. Iowa 42-0891358
Continental Care Centers of Council Bluffs, Inc............. Iowa 41-1413442
Forest City Building Ltd.................................... Missouri 43-1102460
Hallmark Convalescent Homes, Inc............................ Michigan 41-1413478
Home Medical Systems, Inc................................... Delaware 23-2271050
HomeCare Preferred Choice, Inc. ............................ Delaware 62-1702864
Hospice Preferred Choice, Inc............................... Delaware 71-0761314
Hospital Facilities Corporation............................. California 95-2499218
Kenwood View Nursing Home, Inc. ............................ Kansas 48-6111286
Liberty Nursing Homes, Incorporated......................... Virginia 54-0784334
MATRIX HealthCare Network, Inc. ............................ Delaware 16-1702866
MATRIX Rehabilitation, Inc. ................................ Delaware 71-0783147
Medical Arts Health Facility of Lawrenceville, Inc. ........ Georgia 58-1329700
</TABLE>
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<TABLE>
<CAPTION>
(STATE OR OTHER
JURISDICTION OF
INCORPORATION OR (I.R.S. EMPLOYER
(EXACT NAME OF CO-REGISTRANT AS SPECIFIED IN ITS CHARTER) ORGANIZATION) IDENTIFICATION NO.)
--------------------------------------------------------- ---------------- -------------------
<S> <C> <C>
Moderncare of Lumberton, Inc. .............................. North Carolina 56-1217025
Nebraska City S-C-H, Inc. .................................. Nebraska 41-1413481
Nursing Home Operators, Inc. ............................... Ohio 34-0949279
Petersen Health Care, Inc. ................................. Florida 59-2043392
Salem No. 1, Inc. .......................................... Missouri 43-1130257
South Alabama Nursing Home, Inc. ........................... Alabama 95-3809397
South Dakota -- Beverly Enterprises, Inc. .................. California 95-3750887
Spectra Healthcare Alliance, Inc. .......................... Delaware 71-0759298
Synergos, Inc. ............................................. California 33-0203515
Synergos -- Scottsdale, Inc. ............................... Arizona 94-3085083
TMD Disposition Company..................................... Florida 59-3151568
Vantage Healthcare Corporation.............................. Delaware 35-1572998
</TABLE>
4
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Item 1: Description of Registrant's Securities to be Registered.
The description of such securities is hereby incorporated by reference
to the material set forth under the caption "Description of the Senior Notes"
in the Prospectus/Consent Solicitation Statement which constitutes a part of
the Registration Statement on Form S-4, File Nos. 333-35137 and 333-35137-01,
under the Securities Act of 1933, as amended (the "Registration Statement").
Item 2: Exhibits.
<TABLE>
<CAPTION>
Exhibit
Number Description
- - ------ -----------
<S> <C>
3.1 -- Certificate of Incorporation of New Beverly Holdings, Inc.
dated April 15, 1997 (incorporated by reference to Exhibit
3.1 to New Beverly Holdings, Inc.'s Registration Statement on
Form S-1 filed June 4, 1997 (File No. 333-28521)).
3.2 -- Amended Certificate of Incorporation of New Beverly Holdings,
Inc. dated May 29, 1997 (incorporated by reference to Exhibit
3.2 to New Beverly Holdings, Inc.'s Registration Statement on
Form S-1 filed June 4, 1997 (File No. 333-28521)).
3.3 -- Bylaws of New Beverly Holdings, Inc. (incorporated by
reference to Exhibit 3.4 to New Beverly Holdings, Inc.'s
Registration Statement on Form S-1 filed June 4, 1997 (File
No. 333-28521)).
4.1 -- Indenture dated as of February 1, 1996 between Beverly
Enterprises, Inc. and Chemical Bank, as Trustee, with respect
to Beverly Enterprises, Inc.'s 9% Senior Notes due February
15, 2006 (incorporated by reference to Exhibit 4.1 to Beverly
Enterprises, Inc.'s Annual Report on Form 10-K for the year
ended December 31, 1995).
4.2 -- Form of Second Supplemental Indenture dated , 1997
between Beverly Enterprises, Inc., New Beverly Holdings,
Inc., certain subsidiaries of Beverly Enterprises, Inc. as
guarantors and The Chase Manhattan Bank, as Trustee, with
respect to Beverly's 9% Senior Notes due February 15, 2006
(incorporated by reference to Exhibit 4.2 to Beverly
Enterprises, Inc.'s and New Beverly Holdings, Inc.'s (and
additional Co-Registrants') Registration Statement on Form S-4
filed on September 8, 1997 (File Nos. 333-25137 and
333-35137-01)).
4.3 -- Indenture dated as of March 15, 1983 between Beverly
Enterprises and Manufacturers Hanover Trust Company, Trustee
with respect to Beverly's 7 5/8% Convertible Subordinated
Debentures due March 15, 2003 (incorporated by reference to
Exhibit 4.2 to Beverly's Registration Statement on Form S-3
dated March 10, 1983 (File No. 2-82266)).
</TABLE>
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
By: /s/ Scott Tabakin
Name: Scott Tabakin
Title: Executive Vice President,
Chief Financial Officer and Director
Date: October 21, 1997
<PAGE> 6
INDEX TO EXHIBITS
<TABLE>
<CAPTION>
Exhibit
Number Description
- - ------ -----------
<S> <C>
3.1 -- Certificate of Incorporation of New Beverly Holdings, Inc.
dated April 15, 1997 (incorporated by reference to Exhibit
3.1 to New Beverly Holdings, Inc.'s Registration Statement on
Form S-1 filed June 4, 1997 (File No. 333-28521)).
3.2 -- Amended Certificate of Incorporation of New Beverly Holdings,
Inc. dated May 29, 1997 (incorporated by reference to Exhibit
3.2 to New Beverly Holdings, Inc.'s Registration Statement on
Form S-1 filed June 4, 1997 (File No. 333-28521)).
3.3 -- Bylaws of New Beverly Holdings, Inc. (incorporated by
reference to Exhibit 3.4 to New Beverly Holdings, Inc.'s
Registration Statement on Form S-1 filed June 4, 1997 (File
No. 333-28521)).
4.1 -- Indenture dated as of February 1, 1996 between Beverly
Enterprises, Inc. and Chemical Bank, as Trustee, with respect
to Beverly Enterprises, Inc.'s 9% Senior Notes due February
15, 2006 (incorporated by reference to Exhibit 4.1 to Beverly
Enterprises, Inc.'s Annual Report on Form 10-K for the year
ended December 31, 1995).
4.2 -- Form of Second Supplemental Indenture dated , 1997
between Beverly Enterprises, Inc., New Beverly Holdings,
Inc., certain subsidiaries of Beverly Enterprises, Inc. as
guarantors and The Chase Manhattan Bank, as Trustee, with
respect to Beverly's 9% Senior Notes due February 15, 2006
(incorporated by reference to Exhibit 4.2 to Beverly
Enterprises, Inc.'s and New Beverly Holdings, Inc.'s (and
additional Co-Registrants') Registration Statement on Form S-4
filed on September 8, 1997 (File Nos. 333-25137 and
333-35137-01)).
4.3 -- Indenture dated as of March 15, 1983 between Beverly
Enterprises and Manufacturers Hanover Trust Company, Trustee
with respect to Beverly's 7 5/8% Convertible Subordinated
Debentures due March 15, 2003 (incorporated by reference to
Exhibit 4.2 to Beverly's Registration Statement on Form S-3
dated March 10, 1983 (File No. 2-82266)).
</TABLE>
