SEC Form 4 · accession 0001209191-18-053310

Diversicare Healthcare Services, Inc. · DVCR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Sep 30, 2018

Accepted (ET)

Oct 2, 2018 · 5:24 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000919956

Table I — non-derivative securities

Security	Date	Code	Shares	A/D	Owned after	D/I	Nature of ownership
Common Stock	holding	—	—	—	46,664	D
Common Stock^F1	holding	—	—	—	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

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Dividend Equivalent Rights on 2018 Restricted Shares^F2	—	Sep 30, 2018	A	20	A	—	—	Common Stock	20	57	D
Dividend Equivalent Rights on 2017 Restricted Shares^F3	—	Sep 30, 2018	A	12	A	—	—	Common Stock	12	61	D
Dividend Equivalent Rights on 2016 Restricted Shares^F4	—	Sep 30, 2018	A	6	A	—	—	Common Stock	6	49	D

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.
F2These dividend equivalent rights accrued on shares of restricted stock granted on March 13, 2018 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.
F4These dividend equivalent rights accrued on shares of restricted stock granted on March 11, 2016 and will vest as the underlying shares vest.

Exhibit List Exhibit 24 - Power of Attorney