SEC Form 4 · accession 0001209191-18-001209
Diversicare Healthcare Services, Inc. · DVCR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard M Brame
Director
Period of report
Feb 15, 2015
Accepted (ET)
Jan 3, 2018 · 5:53 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 StockF1 | Feb 15, 2015 | W | 250 | $0.00 | A | 250 | I | Held in Grandson's Trust |
| Common Stock | holding | — | — | — | 1,450 | I | Spouse | |
| Common Stock | holding | — | — | — | 1,000 | I | Held In Spouse's IRA | |
| Common StockF2 | holding | — | — | — | 44,260 | 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 SharesF3 | — | Dec 31, 2017 | A | 1 | A | — | — | Common Stock | 1 | 9 | D |
| Dividend Equivalent Rights on 2016 Restricted SharesF4 | — | Dec 31, 2017 | A | 8 | A | — | — | Common Stock | 8 | 62 | D |
| Dividend Equivalent Rights on 2017 Restricted SharesF5 | — | Dec 31, 2017 | A | 11 | A | — | — | Common Stock | 11 | 43 | D |
| Stock Settled Stock Appreciation RightF6 | $10.88 | holding | — | — | — | — | Mar 14, 2018 | Common Stock | 1,000 | 1,000 | D |
Explanation of responses
- F1The Reporting Person is the trustee of a trust holding 250 shares of common stock for the benefit of his grandson and may therefore be deemed to be the beneficial owner of the shares of common stock held by this trust. However, the Reporting Person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein.
- F2Total includes 2,450 shares that were inadvertently excluded from the Reporting Person's prior Form 4.
- F3These dividend equivalent rights accrued on shares of restricted stock granted on March 10, 2015 and will vest as the underlying shares vest.
- F4These dividend equivalent rights accrued on shares of restricted stock granted on March 11, 2016 and will vest as the underlying shares vest.
- F5These dividend equivalent rights accrued on shares of restricted stock granted on March 13, 2017 and will vest as the underlying shares vest.
- F6Vests 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