0001437749-21-006747.txt : 20210322 0001437749-21-006747.hdr.sgml : 20210322 20210322155549 ACCESSION NUMBER: 0001437749-21-006747 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210318 FILED AS OF DATE: 20210322 DATE AS OF CHANGE: 20210322 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITH JEFFREY RUSSELL CENTRAL INDEX KEY: 0001694452 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13489 FILM NUMBER: 21761285 MAIL ADDRESS: STREET 1: 100 VINE ST. CITY: MURFREESBORO STATE: TN ZIP: 37130 FORMER NAME: FORMER CONFORMED NAME: SMITH JEFFREY R DATE OF NAME CHANGE: 20170111 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL HEALTHCARE CORP CENTRAL INDEX KEY: 0001047335 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 522057472 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 E. VINE ST CITY: MURFREESBORO STATE: TN ZIP: 37130 BUSINESS PHONE: 6158902020 MAIL ADDRESS: STREET 1: 100 E. VINE ST CITY: MURFREESBORO STATE: TN ZIP: 37130 4 1 rdgdoc.xml FORM 4 X0306 4 2021-03-18 0001047335 NATIONAL HEALTHCARE CORP NHC 0001694452 SMITH JEFFREY RUSSELL 100 VINE STREET MURFREESBORO TN 37130 1 SVP & Treasurer Shares of Common Stock held in my name 2021-03-18 4 M 0 46630 72.74 A 49897 D Shares of Common Stock held in my name 2021-03-18 4 F 0 43811 79.21 D 6086 D Option to Purchase Common Stock 72.94 2021-03-18 4 M 0 46630 0 D 2022-02-09 2022-03-11 Common Stock 48000 1370 D These stock options were granted pursuant to the 2010 Omnibus Equity Incentive Plan on May 9, 2017. On February 11, 2021, the Compensation Committee amended the option to grant the ability to exercise up to 100% of this option, with any shares issued upon exercise to be held as restricted stock until February 9, 2022, the original vesting date. The grant and exercise of these stock options are exempt from Section 16(b) pursuant to Rule 16b-3(d). Shares were withheld by the Company to pay the exercise price and withholding tax obligations. Total amount of shares beneficially owned following transactions reported on this form. /s/ Jeffrey Russell Smith 2021-03-22