0001209191-16-131177.txt : 20160705
0001209191-16-131177.hdr.sgml : 20160705
20160705172127
ACCESSION NUMBER: 0001209191-16-131177
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20160630
FILED AS OF DATE: 20160705
DATE AS OF CHANGE: 20160705
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Diversicare Healthcare Services, Inc.
CENTRAL INDEX KEY: 0000919956
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051]
IRS NUMBER: 621559667
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1621 GALLERIA BLVD.
CITY: BRENTWOOD
STATE: TN
ZIP: 37027
BUSINESS PHONE: 6157717575
MAIL ADDRESS:
STREET 1: 1621 GALLERIA BLVD.
CITY: BRENTWOOD
STATE: TN
ZIP: 37027
FORMER COMPANY:
FORMER CONFORMED NAME: ADVOCAT INC
DATE OF NAME CHANGE: 19940309
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MCCABE ROBERT A JR
CENTRAL INDEX KEY: 0001079428
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12996
FILM NUMBER: 161751586
MAIL ADDRESS:
STREET 2: 500 CHURCH ST, STE 200
CITY: NASHVILLE
STATE: TN
ZIP: 37219
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-06-30
0
0000919956
Diversicare Healthcare Services, Inc.
DVCR
0001079428
MCCABE ROBERT A JR
150 THIRD AVENUE SOUTH
SUITE 800
NASHVILLE
TN
37201
1
0
0
0
Common Stock
3000
D
Option to purchase Common Stock
10.21
2015-10-06
2025-10-06
Common Stock
15000
15000
D
Dividend Equivalent Rights on 2016 Restricted Shares
2016-06-30
4
A
0
13.34
0.00
A
Common Stock
13.34
26.28
D
5,000 vest on the date of grant, 5,000 vest on October 6, 2016 and 5,000 vest on October 6, 2017
These dividend equivalent rights accrued on shares of restricted stock granted on March 11, 2016 and will vest as the underlying shares vest.
Represents vesting of Dividend Equivalent Rights on 2016 Restricted Stock.
/s/ Jonathan D. Stanley, Attorney-In-Fact for Robert A. McCabe, Jr.
2016-07-05
EX-24.4_665314
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby constitutes and
appoints each of Jonathan D. Stanley, James R. McKnight, Jr., Kelly J. Gill and
Susan V. Sidwell signing singly, the undersigned's true and lawful
attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of Diversicare Healthcare Services, Inc.
(the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the
Securities
Exchange Act of 1934 and the rules thereunder;
(2) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such Form 3, 4,
or 5, complete and execute any amendment or amendments thereto, and timely file
such form with the United States Securities and Exchange Commission and any
stock exchange or similar authority;
(3) execute for and on behalf of the undersigned a Form ID and any
subsequent filings, submissions or correspondence relating thereto; and
(4) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact. This Power of Attorney replaces and revokes any and
all
prior powers of attorney granted by the undersigned, in the undersigned's
capacity as an officer and/or director of the Company, relating to Section 16 of
the Securities Exchange Act of 1934.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 6th day of October, 2015.
/s/ Robert A. McCabe Jr.
_____________________________
Signature
Robert A. McCabe Jr.
_____________________________
Print Name