SEC Form 4 · accession 0001209191-18-001203
Diversicare Healthcare Services, Inc. · DVCR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert Z Hensley
Director
Period of report
Dec 31, 2017
Accepted (ET)
Jan 3, 2018 · 5:51 pm EST
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 | — | — | — | 41,694 | 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 | — | Dec 31, 2017 | A | 1 | A | — | — | Common Stock | 1 | 9 | D |
| Dividend Equivalent Rights on 2016 Restricted SharesF2 | — | Dec 31, 2017 | A | 8 | A | — | — | Common Stock | 8 | 62 | D |
| Dividend Equivalent Rights on 2017 Restricted SharesF3 | — | Dec 31, 2017 | A | 11 | A | — | — | Common Stock | 11 | 43 | D |
| Stock Settled Stock Appreciation RightF4 | $5.45 | holding | — | — | — | — | Jun 18, 2020 | Common Stock | 1,000 | 1,000 | D |
| Stock Settled Stock Appreciation RightF4 | $2.37 | holding | — | — | — | — | Mar 13, 2019 | Common Stock | 1,000 | 1,000 | D |
| Stock Settled Stock Appreciation RightF4 | $10.88 | holding | — | — | — | — | Mar 14, 2018 | Common Stock | 1,000 | 1,000 | 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.
- F4Vests 1/3 on 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.
Remarks
Exhibit List Exhibit 24 - Power of Attorney