-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Ifhm2nIIDb7GGoLmXfMeu4VbvJFILj4fTL4bfF0zbEs/sLT9AbgK/f8BNkfc9D8E o+zjGKuidPmNjMgt1Lq+KA== 0001040441-04-000108.txt : 20040706 0001040441-04-000108.hdr.sgml : 20040705 20040706162208 ACCESSION NUMBER: 0001040441-04-000108 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040520 FILED AS OF DATE: 20040706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GREENE JAMES R CENTRAL INDEX KEY: 0001190346 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09550-2B FILM NUMBER: 04902624 MAIL ADDRESS: STREET 1: 134 BUTTONWOOD DRIVE CITY: FAIR HAVEN STATE: NJ ZIP: 07701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BEVERLY ENTERPRISES INC CENTRAL INDEX KEY: 0001040441 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 621691861 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 BUSINESS PHONE: 5014526712 MAIL ADDRESS: STREET 1: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 FORMER COMPANY: FORMER CONFORMED NAME: NEW BEVERLY HOLDINGS INC DATE OF NAME CHANGE: 19970604 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-05-20 1 0001040441 BEVERLY ENTERPRISES INC BEV 0001190346 GREENE JAMES R ONE THOUSAND BEVERLY WAY FORT SMITH AR 72919 1 0 0 0 PHANTOM STOCK UNITS 2004-05-20 4 D 0 61205.2513 7.8 D 2004-05-20 $.10 Par Value Common Stock 61205.2513 0 D These units of phantom stock have been granted under the Non-Employee Director Deferred Compensation Plan and are credited to a deferred share unit account each month, together with a 25% Company match, to be paid to the director, or, in the case of his/her death prior to retirement from the Board, his/her beneficiary(ies), in stock (or, with the Board's approval, in cash) upon his/her retirement from the Board, death or disability. Each Deferred Share Unit has a value equal to one share of common stock of Beverly. Phantom stock units settled in cash upon retirement from the Board to be paid in five annual installments. Remaining cash balance will accrue interest at 4.00% prime rate for the remainder of 2004. Interest rate will be adjusted annually in January of each plan year based on the prime rate as determined by a major New York bank in effect on the first business day of the year. By: MONA BRANNON For: JAMES R GREENE 2004-07-06 -----END PRIVACY-ENHANCED MESSAGE-----