0001104659-22-006139.txt : 20220120 0001104659-22-006139.hdr.sgml : 20220120 20220120214511 ACCESSION NUMBER: 0001104659-22-006139 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220118 FILED AS OF DATE: 20220120 DATE AS OF CHANGE: 20220120 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cody Lauren C. CENTRAL INDEX KEY: 0001905168 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-16817 FILM NUMBER: 22543990 MAIL ADDRESS: STREET 1: C/O FIVE STAR SENIOR LIVING INC. STREET 2: 400 CENTRE STREET CITY: NEWTON STATE: MA ZIP: 02458 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIVE STAR SENIOR LIVING INC. CENTRAL INDEX KEY: 0001159281 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 043516029 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 CENTRE STREET CITY: NEWTON STATE: MA ZIP: 02458 BUSINESS PHONE: (617) 796 8387 MAIL ADDRESS: STREET 1: 400 CENTRE STREET CITY: NEWTON STATE: MA ZIP: 02458 FORMER COMPANY: FORMER CONFORMED NAME: FIVE STAR QUALITY CARE, INC. DATE OF NAME CHANGE: 20161006 FORMER COMPANY: FORMER CONFORMED NAME: FIVE STAR QUALITY CARE INC DATE OF NAME CHANGE: 20010918 3 1 tm223066-1_3seq1.xml OWNERSHIP DOCUMENT X0206 3 2022-01-18 1 0001159281 FIVE STAR SENIOR LIVING INC. NASDAQ:FVE 0001905168 Cody Lauren C. C/O FIVE STAR SENIOR LIVING INC., 400 CENTRE STREET NEWTON MA 02458 0 1 0 0 EVP & CCO /s/ Lauren C. Cody 2022-01-20