SEC Form 4 · accession 0001209191-16-143960
Diversicare Healthcare Services, Inc. · DVCR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kelly J. Gill
Officer — CEO & President · Director
Period of report
Sep 30, 2016
Accepted (ET)
Oct 4, 2016 · 2:15 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000919956
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 200,475 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Dividend Equivalent Rights on 2014 Restricted SharesF2,F1 | — | Sep 30, 2016 | A | 49 | A | — | — | Common Stock | 49 | 568 | D |
| Dividend Equivalent Rights on 2015 Restricted SharesF4,F3 | — | Sep 30, 2016 | A | 95 | A | — | — | Common Stock | 95 | 662 | D |
| Dividend Equivalent Rights on 2016 Restricted SharesF6,F5 | — | Sep 30, 2016 | A | 139 | A | — | — | Common Stock | 139 | 468 | D |
| 2015 Restricted Stock UnitsF7,F8 | — | Sep 30, 2016 | A | 86 | A | — | — | Common Stock | 86 | 15,635 | D |
| 2016 Restricted Stock UnitsF7,F9 | — | Sep 30, 2016 | A | 34 | A | — | — | Common Stock | 34 | 6,283 | D |
| Stock Options (right to buy)F10 | $5.60 | holding | — | — | — | Nov 10, 2011 | Nov 10, 2021 | Common Stock | 50,000 | 50,000 | D |
| Stock Settled Stock Appreciation RightF10 | $6.21 | holding | — | — | — | Apr 5, 2010 | Apr 5, 2020 | Common Stock | 35,000 | 35,000 | D |
| Stock Settled Stock Appreciation RightF10 | $5.45 | holding | — | — | — | Jun 18, 2010 | Jun 18, 2020 | Common Stock | 15,000 | 15,000 | D |
Explanation of responses
- F1These dividend equivalent rights accrued on shares of restricted stock granted on March 12, 2014 and will vest as the underlying shares vest.
- F10Vests 1/3 on the first anniversary of the date of grant, 1/3 on the second anniversary of the date of grant, and 1/3 on the third anniversary of the date of grant.
- F2Represents vesting of Dividend Equivalent Rights on 2014 Restricted Stock.
- F3These dividend equivalent rights accrued on shares of restricted stock granted on March 10, 2015 and will vest as the underlying shares vest.
- F4Represents vesting of Dividend Equivalent Rights on 2015 Restricted Stock.
- F5These dividend equivalent rights accrued on shares of restricted stock granted on March 11, 2016 and will vest as the underlying shares vest.
- F6Represents vesting of Dividend Equivalent Rights on 2016 Restricted Stock.
- F7Each Restricted Stock Unit is equal to one share.
- F8The 2015 Restricted Stock Units shall vest and be exercisable in full on the 2nd anniversary of their original Grant Date (03/10/2015).
- F9The 2016 Restricted Stock Units shall vest and be exercisable in full on the 2nd anniversary of their original Grant Date (03/11/2016).