-----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, KZ8ETZEXpqdJJ47BwkLeQ/YgWuCKtoX/+1zb7HdDPMGqPs3c2fzB4sYjfiYjym7I NuAXqZkutyI7cG0sykJJ9A== 0001040441-05-000192.txt : 20051220 0001040441-05-000192.hdr.sgml : 20051220 20051220113033 ACCESSION NUMBER: 0001040441-05-000192 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051201 FILED AS OF DATE: 20051220 DATE AS OF CHANGE: 20051220 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SABEL IVAN R CENTRAL INDEX KEY: 0001217563 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-09550-2B FILM NUMBER: 051274538 MAIL ADDRESS: STREET 1: TWO BETHESDA METRO CENTER SUITE 1200 CITY: BETHESDA STATE: MD ZIP: 20814 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/A 1 edgardoc.xml PRIMARY DOCUMENT X0202 4/A 2005-12-01 2005-12-05 0 0001040441 BEVERLY ENTERPRISES INC BEV 0001217563 SABEL IVAN R ONE THOUSAND BEVERLY WAY FORT SMITH AR 72919 1 0 0 0 PHANTOM STOCK UNITS 2005-12-01 4 A 0 1230.453 A 2005-12-01 $.10 Par Value Common Stock 1230.453 30851.4317 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, 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, 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. By: Brenda Boster, by Power of Attorney For: Ivan R. Sabel 2005-12-20 -----END PRIVACY-ENHANCED MESSAGE-----