SEC Form 4 · accession 0001209191-17-054945
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, 2017
Accepted (ET)
Oct 3, 2017 · 3:35 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 | — | — | — | 230,149 | 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 2015 Restricted SharesF1 | — | Sep 30, 2017 | A | 42 | A | — | — | Common Stock | 42 | 518 | D |
| Dividend Equivalent Rights on 2016 Restricted SharesF2 | — | Sep 30, 2017 | A | 83 | A | — | — | Common Stock | 83 | 675 | D |
| Dividend Equivalent Rights on 2017 Restricted SharesF3 | — | Sep 30, 2017 | A | 121 | A | — | — | Common Stock | 121 | 401 | D |
| 2017 Restricted Stock UnitsF4,F5 | — | Sep 30, 2017 | A | 52 | A | — | — | Common Stock | 52 | 10,891 | D |
| 2016 Restricted Stock UnitsF4,F6 | — | Sep 30, 2017 | A | 31 | A | — | — | Common Stock | 31 | 6,417 | D |
| Stock Options (right to buy)F7 | $5.60 | holding | — | — | — | Nov 10, 2011 | Nov 10, 2021 | Common Stock | 50,000 | 50,000 | D |
| Stock Settled Stock Appreciation RightF7 | $6.21 | holding | — | — | — | Apr 5, 2010 | Apr 5, 2020 | Common Stock | 35,000 | 35,000 | D |
| Stock Settled Stock Appreciation RightF7 | $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 10, 2015 and will vest as the underlying shares vest.
- F2These dividend equivalent rights accrued on shares of restricted stock granted on March 11, 2016 and will vest as the underlying shares vest.
- F3These dividend equivalent rights accrued on shares of restricted stock granted on March 13, 2017 and will vest as the underlying shares vest.
- F4Each Restricted Stock Unit is equal to one share. These are dividend equivalent rights accruing on restricted stock units.
- F5The 2017 Restricted Stock Units shall vest and be exercisable in full on the 2nd anniversary of the original Grant Date (03/13/2017).
- F6The 2016 Restricted Stock Units shall vest and be exercisable in full on the 2nd anniversary of their original Grant Date (03/11/2016).
- F7Vests 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.