SEC FORM 4

SEC Form 4

FORM 4

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

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

McCurdy Chad A.

(Last)

(First)

(Middle)

1621 GALLERIA BLVD

(Street)

BRENTWOOD

37027

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Diversicare Healthcare Services, Inc. [ DVCR ]

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

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
03/13/2019

4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	03/13/2019		M		30	A	$0.00⁽¹⁾	17,827	D
Common Stock	03/13/2019		M		56	A	$0.00⁽²⁾	17,883	D
Common Stock	03/13/2019		M		1,000	A	$2.37	18,883	D
Common Stock	03/13/2019		D		603	D	$3.93	18,280	D
Common Stock	03/13/2019		A		2,333	A	$0.00⁽³⁾	20,613	D
Common Stock								35,000	I	In IRA
Common Stock								185,000	I	Jointly held with Spouse
Common Stock								7,500	I	In Spouse's IRA
Common Stock								1,017,600	I	Owned by Marlin Capital Partners, LLC⁽⁴⁾
Common Stock								15,000	I	Owned by Dependent Children⁽⁵⁾

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Dividend Equivalent Rights on 2017 Restricted Shares	⁽⁶⁾	03/13/2019		M			30	⁽⁶⁾	⁽⁶⁾	Common Stock	30	$0.00⁽¹⁾	31.09	D
Dividend Equivalent Rights on 2018 Restricted Shares	⁽⁷⁾	03/13/2019		M			56	⁽⁷⁾	⁽⁷⁾	Common Stock	56	$0.00⁽²⁾	112.84	D
Stock Settled Stock Appreciation Right	$2.37	03/13/2019		M			1,000	⁽⁸⁾	03/13/2019	Common Stock	1,000	$2.37	0	D
Stock Settled Stock Appreciation Right	$5.45							⁽⁸⁾	06/18/2020	Common Stock	1,000		1,000	D

Explanation of Responses:

1. Represents vesting of Dividend Equivalent Rights on 2017 Restricted Stock.

2. Represents vesting of Dividend Equivalent Rights on 2018 Restricted Stock.

3. Restricted stock grant that will vest in equal parts over the first three anniversaries of the date of grant.

4. Mr. McCurdy is the Managing Partner of Marlin Capital Partners, LLC.

5. This reporting person disclaims beneficial ownership of shares held by his children except to the extent of his pecuniary interest therein.

6. These dividend equivalent rights accrued on shares of restricted stock granted on March 13, 2017 and will vest as the underlying shares vest.

7. These dividend equivalent rights accrued on shares of restricted stock granted on March 13, 2018 and will vest as the underlying shares vest.

8. Vests 1/3 on first anniversary of the date of grant, 1/3 on the second anniversary of the date of grant, and 1/3 on the third anniversary of the date of grant.

Remarks:

Exhibit List Exhibit 24 - Power of Attorney

	/s/ Susan V. Sidwell, Attorney-in-Fact for Chad A. McCurdy	03/15/2019
	** 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 4 (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).
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