0001104659-12-048389.txt : 20120711 0001104659-12-048389.hdr.sgml : 20120711 20120711091558 ACCESSION NUMBER: 0001104659-12-048389 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120711 DATE AS OF CHANGE: 20120711 EFFECTIVENESS DATE: 20120711 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 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-181009 FILM NUMBER: 12956990 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 X0706 D LIVE 0001004724 ADCARE HEALTH SYSTEMS INC 1145 Hembree Road Roswell GA GEORGIA 30076 678-869-5116 OHIO None None Corporation true David A. Tenwick 1145 Hembree Road Roswell GA GEORGIA 30076 Director Christopher F. Brogdon 1145 Hembree Road Roswell GA GEORGIA 30076 Executive Officer Director Boyd P. Gentry 1145 Hembree Road Roswell GA GEORGIA 30076 Executive Officer Director Gary L. Wade 1145 Hembree Road Roswell GA GEORGIA 30076 Director Peter J. Hackett 1145 Hembree Road Roswell GA GEORGIA 30076 Director Jeffrey Levine 1145 Hembree Road Roswell GA GEORGIA 30076 Director Joshua J. McClellan 1145 Hembree Road Roswell GA GEORGIA 30076 Director Philip S. Radcliffe 1145 Hembree Road Roswell GA GEORGIA 30076 Director Laurence E. Sturtz 1145 Hembree Road Roswell GA GEORGIA 30076 Director Martin D. Brew 1145 Hembree Road Roswell GA GEORGIA 30076 Executive Officer David Rubenstein 1145 Hembree Road Roswell GA GEORGIA 30076 Executive Officer Other Health Care Decline to Disclose 06 false 2012-06-28 false true true true true false 0 Cantone Research, Inc. 26314 None None 766 Shrewsbury Avenue Tinton Falls NJ NEW JERSEY 07724 AR ARKANSAS CA CALIFORNIA CO COLORADO CT CONNECTICUT DC DISTRICT OF COLUMBIA FL FLORIDA ID IDAHO IL ILLINOIS IA IOWA KS KANSAS MA MASSACHUSETTS MI MICHIGAN NV NEVADA NJ NEW JERSEY NY NEW YORK NC NORTH CAROLINA OH OHIO PA PENNSYLVANIA RI RHODE ISLAND TN TENNESSEE TX TEXAS UT UTAH 8000000 7500000 500000 Represents sale of subordinated promissory notes, convertible into shares of common stock at a conversion price per share of $4.17. false 29 600000 true 0 Assumes offering is fully subscribed and excludes 1% expense reimbursement and equity compensation to placement agent of 50,000 shares of restricted common stock and three-year warrant to purchase 250,000 shares at $4.00 per share exercise price. 0 true AdCare Health Systems Inc /s/ Martin D. Brew Martin D. Brew Chief Financial Officer 2012-07-11