SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

STAFFIERI MICHAEL DAVID

(Last)

(First)

(Middle)

C/O DAVITA INC.

2000 16TH STREET

(Street)

DENVER

80202

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
10/04/2019

3. Issuer Name and Ticker or Trading Symbol
DAVITA INC. [ DVA ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	Chief Operating Officer, DKC

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	86,945⁽¹⁾	D
Common Stock	47,315	I	by 2012 Staffieri Family Trust

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Stock Appreciation Rights	⁽²⁾	06/02/2020	Common Stock	40,284	$83.82	D
Stock Appreciation Rights	⁽³⁾	05/13/2021	Common Stock	66,477	$75.42	D
Stock Appreciation Rights	⁽⁴⁾	06/06/2022	Common Stock	74,201	$65.48	D
Stock Appreciation Rights	⁽⁵⁾	05/15/2023	Common Stock	243,994	$66.29	D
Common Stock	⁽⁶⁾	06/20/2024	Common Stock	200,000	$52.41	D

Explanation of Responses:

1. Includes (i) 79,650 restricted stock units granted on May 15, 2019, which are scheduled to vest 50% each on May 15, 2022 and May 15, 2023, respectively, and (ii) 4,093 restricted stock units granted on December 24, 2016, which are scheduled to vest in full on May 15, 2020. Each of the foregoing vestings is subject to continued service through each applicable vesting date.

2. The Stock Appreciation Rights were granted on June 2, 2015, and are fully vested as of the date hereof.

3. The Stock Appreciation Rights were granted on May 13, 2016, with 50% having vested on May 13, 2019 and the remaining 50% scheduled to vest on May 13, 2020, subject to continued service through the applicable vesting date.

4. The Stock Appreciation Rights were granted on June 6, 2017, and are scheduled to vest 50% each on May 15, 2020 and May 15, 2021, respectively, subject to continued service through the applicable vesting date.

5. The Stock Appreciation Rights were granted on May 15, 2018, and are scheduled to vest 50% each on May 15, 2021 and May 15, 2022, respectively, subject to continued service through the applicable vesting date.

6. The Stock Appreciation Rights were granted on June 20, 2019, and are scheduled to vest 50% each on June 20, 2021 and June 20, 2023, respectively, subject to continued service through the applicable vesting date.

Remarks:

Exhibit List Exhibit 24 - Power of Attorney

	/s/ Stephanie N. Berberich, Attorney-in-Fact	10/15/2019
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.