-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, UDsZLgTzEVgSb135TMUfJC5H7E6v73mhUuebEvaUzO46Xb0O5vWkT7bqG39+mhI8 mE+PP/HQq8gZ1n2zGJUa8w== 0001188112-10-003269.txt : 20101130 0001188112-10-003269.hdr.sgml : 20101130 20101130172917 ACCESSION NUMBER: 0001188112-10-003269 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20101130 DATE AS OF CHANGE: 20101130 GROUP MEMBERS: CONNIE B. BROGDON FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Brogdon Christopher F CENTRAL INDEX KEY: 0001431870 FILING VALUES: FORM TYPE: SC 13D/A MAIL ADDRESS: STREET 1: 593 ATLANTA STREET CITY: ROSWELL STATE: GA ZIP: 30075 SUBJECT COMPANY: 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: SC 13D/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-83967 FILM NUMBER: 101222622 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 SC 13D/A 1 t69349_sc13da.htm SC 13D AMENDMENT NO. 14 t69349_sc13da.htm


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
 
SCHEDULE 13D/A
(Amendment No. 14)
 
Under the Securities Exchange Act of 1934

 
AdCare Health Systems, Inc.
(Name of Issuer)

Common Stock, no par value

(Title of Class of Securities)

00650W300

(CUSIP Number)

Christopher F. Brogdon
Connie B. Brogdon
345 Heards Ferry Road NW
Atlanta, GA 30328-4716
(404) 386-9607
(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)

November 23, 2010

(Date of Event Which Requires Filing of this Statement)

If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box   ¨.

*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of  Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of the that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
 
 
 

 
Page  2  of  6  Pages
 
 
CUSIP No. 00650W300

1.
NAMES OF REPORTING PERSONS
 
Christopher F. Brogdon
 
2.
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
 
 
(a) o
(b) x
3.
SEC USE ONLY
 
 
 
4.
SOURCE OF FUNDS
 
PF, OO
 
5.
CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e)
 
 
o
6.
CITIZENSHIP OR PLACE OF ORGANIZATION
 
United States of America
 
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
7.
SOLE VOTING POWER
 
0
8.
SHARED VOTING POWER
 
1,493,334
9.
SOLE DISPOSITIVE POWER
 
0
10.
SHARED DISPOSITIVE POWER
 
1,493,334
11.
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
1,493,334
 
12.
CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
o
13.
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
 
16.7%
 
14.
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
IN
 

 
 

 
Page  3  of  6  Pages
 
CUSIP No. 00650W300

1.
NAMES OF REPORTING PERSONS
 
Connie B. Brogdon
 
2.
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
 
 
(a) o
(b) x
3.
SEC USE ONLY
 
 
 
4.
SOURCE OF FUNDS
 
PF, OO
 
5.
CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e)
 
 
o
6.
CITIZENSHIP OR PLACE OF ORGANIZATION
 
United States of America
 
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
7.
SOLE VOTING POWER
 
0
8.
SHARED VOTING POWER
 
1,493,334
9.
SOLE DISPOSITIVE POWER
 
0
10.
SHARED DISPOSITIVE POWER
 
1,493,334
11.
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
1,493,334
 
12.
CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
o
13.
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
 
16.7%
 
14.
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
IN
 

 
 

 
Page  4  of  6  Pages
 
 
Explanatory Note:

 
This Amendment No. 14 to Schedule 13D (this “Amendment”) amends and restates, where indicated, the statement on Schedule 13D relating to the Common Stock of the Issuer filed by the Reporting Persons with the Securities and Exchange Commission on April 16, 2008 (the “Initial Statement”), as amended by Amendment No. 1, Amendment No. 2, Amendment No. 3, Amendment No. 4, Amendment No. 5, Amendment No. 6, Amendment No. 7, Amendment No. 8 , Amendment No. 9, Amendment No. 10, Amendment No. 11, Amendment No. 12, and Amendment No. 13 to Schedule 13D filed by the Reporting Persons with the Securities and Exchange Commission on May 8, 2008, June 4, 2008, July 15, 2008, August 21, 2008, March 24, 2009, June 18, 2009, July 10, 2009, August 4, 2009, September 15, 2009, November 19, 2009, December 31, 2009, February 18, 2010, and July 19, 2010, respectively (together, the “Previously Filed Amendments”). This Amendment is being made to disclose acquisitions by the Reporting Persons of additional warrants to purchase Common Stock that were not previously reported on the Initial Statement or the Previously Filed Amendments. Capitalized terms used in this Amendment but not otherwise defined herein have the meanings ascribed to such terms in the Initial Statement.  Except as otherwise set forth herein, this Amendment does not modify any of the information previously reported by the Reporting Persons in the Initial Statement or the Pre viously Filed Amendments.
     
Item 3.
Source and Amount of Funds or Other Consideration.
     
 
The Reporting Persons reported the acquisition of beneficial ownership of 56,505 shares of Common Stock and warrants to purchase 24,100 shares of Common Stock for cash in an aggregate amount of $135,251.43 using personal funds available on hand.
     
Item 5.
Interest in Securities of the Issuer.
     
 
(a).-(b).
As of the date of this Amendment, the Reporting Persons held 494,442 shares of Common Stock and warrants to purchase 998,892 shares of Common Stock, which represents approximately 16.7% of the outstanding Common Stock as of November 2, 2010.  The calculation of this percentage is based on 7,959,415 shares of Common Stock outstanding as of November 2, 2010, as disclosed by the Issuer in its Quarterly Report on Form 10-Q for the quarter ended September 30, 2010.
     
   
Each of the Reporting Persons may be deemed to beneficially own an aggregate of 1,493,334 shares of Common Stock, comprised of (i) 82,489 shares of Common Stock held of record by Mr. Brogdon; (ii) 85,392 shares of Common Stock that may be acquired by Mr. Brogdon upon the exercise of presently exercisable warrants held by Mr. Brogdon at an exercise price of $2.50 per share; (iii) 100,000 shares of Common Stock that may be acquired by Mr. Brogdon upon the exercise of presently exercisable warrants held by Mr. Brogdon at an exercise price of $3.00 per share; (iv) 100,000 shares of Common Stock that may be acquired by Mr. Brogdon upon the exercise of warrants vesting on September 24, 2010 held by Mr. Brogdon at an exercise price of $4.00 per share; (v) 100,000 shares of Common Stock that may be acquired by Mr. Brogdon upon the exercise of warrants vesting on September 24, 2011 held by Mr. Brogdon at an exercise price of $5.00 per share; (vi) 394,628 shares of Common Stock held of record by Ms. Brogdon; (vii) 499,600 shares of Common Stock that may be acquired by Ms. Brogdon upon the exercise of presently exercisable warrants held by Ms. Brogdon at an exercise price of $2.50 per share; (viii) 17,325 shares of Common Stock held of record by Ms. Brogdon as custodian for the benefit of the Reporting Persons’ minor child under the Uniform Gift to Minors Act; and (ix) 113,900 shares of Common Stock that may be acquired by Ms. Brogdon upon the exercise of presently exercisable warrants held by Mr. Brogdon as custodian for the benefit of the Rep orting Persons’ minor child under the Uniform Gift to Minors Act at an exercise price of $2.50 per share.  The warrants referred to in subsections (iii), (iv) and (v) of this paragraph were issued to Mr. Brogdon in connection with his being appointed a director of the Issuer in September 2009.  The warrants referred to in subsections (ii), (vii) and (ix) of this paragraph were amended on December 21, 2009, reducing the exercise price of such warrants from $5.40 per share to $2.50 per share as disclosed in the Issuer’s Current Report on Form 8-K filed with the Securities and Exchange Commission on December 23, 2009.
     
   
The Cover Pages of this Amendment are incorporated herein by reference.
 
 
 

 
Page  5  of  6  Pages
 
 
 
(c).
The following table sets forth all transactions by the Reporting Persons with respect to the Common Stock  that were not previously reported in the Initial Statement or the Previously Filed Amendments.
 
Trade Date
Number of Shares
or Warrants
Purchased
Purchase
Price Per
Share or
Warrant
How Purchase
Effected
Reporting Person
07/16/2010
2,000
$3.500
Open market
Ms. Brogdon
07/22/2010
900
$3.450
Open market
Ms. Brogdon
07/23/2010
100
$3.450
Open market
Ms. Brogdon
07/27/2010
2,000
$3.450
Open market
Ms. Brogdon
07/27/2010*
5,000
$1.300
Open market
Ms. Brogdon
08/06/2010
1,900
$3.600
Open market
Ms. Brogdon
08/11/2010
2,000
$3.450
Open market
Ms. Brogdon
08/16/2010
2,000
$3.350
Open market
Ms. Brogdon
08/23/2010
2,000
$3.240
Open market
Ms. Brogdon
08/31/2010
2,200
$3.295
Open market
Ms. Brogdon
09/01/2010
2,000
$3.400
Open market
Ms. Brogdon
09/02/2010
3,000
$3.393
Open market
Ms. Brogdon
09/09/2010
800
$3.380
Open market
Ms. Brogdon
9/09/2010*
900
$1.400
Open market
Ms. Brogdon
09/10/2010
2,000
$3.400
Open market
Ms. Brogdon
09/13/2010*
200
$1.450
Open market
Ms. Brogdon
09/17/2010
3,000
$3.200
Open market
Ms. Brogdon
10/01/2010
1,070
$3.450
Open market
Ms. Brogdon
10/13/2010
2,000
$3.630
Open market
Ms. Brogdon
10/15/2010*
1,000
$1.350
Open market
Ms. Brogdon
10/15/2010**
18,437
$0.000
Stock Dividend
Ms. Brogdon
10/15/2010**
3,928
$0.000
Stock Dividend
Mr. Brogdon
10/15/2010***
825
$0.000
Stock Dividend
Ms. Brogdon
10/18/2010*
4,000
$1.230
Open market
Ms. Brogdon
10/22/2010*
10,000
$1.350
Open market
Ms. Brogdon
10/25/2010
345
$3.590
Open market
Ms. Brogdon
10/26/2010
2,000
$3.600
Open market
Ms. Brogdon
11/12/2010
2,000
$4.230
Open market
Ms. Brogdon
11/23/2010*
3,000
$2.000
Open market
Ms. Brogdon
 
____________
*
Represents purchase of warrants to purchase shares of Common Stock.
   
**
Represents common stock issued to the Reporting Person as a result of a 5% stock dividend declared by the Issuer on August 11, 2010 with respect to all holders of the Issuer’s common stock as of September 30, 2010.
   
***
Represents common stock issued to Ms. Brogdon, as custodian for the benefit of the Reporting Persons’ minor child under the Uniform Gift to Minors Act, as a result of a 5% stock dividend declared by the Issuer on August 11, 2010 with respect to all holders of the Issuer’s common stock as of September 30, 2010.
 
 
(d).
Not applicable.
     
 
(e).
Not applicable.

 
 

 
Page  6  of  6  Pages
 
 
SIGNATURES

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

   
November 29, 2010
 
   
(Date)
 
       
   
/s/ Christopher F. Brogdon
 
   
(Signature)
 
       
   
Christopher F. Brogdon
 

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

   
November 29, 2010
 
   
(Date)
 
       
   
/s/ Connie B. Brogdon
 
   
(Signature)
 
       
   
Connie B. Brogdon
 
 
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