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Previous: LEXINGTON HEALTHCARE GROUP INC, 3, 1998-05-14 |
Next: LEXINGTON HEALTHCARE GROUP INC, 4/A, 1998-05-14 |
<TABLE>
<CAPTION>
FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
/ / Check this box if STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
no longer subject to
Section 16. Form 4 or
Form 5 obligations may Filed pusuant to Section 16(a) of the Securities Exchange Act of 1934,
continue. Section 17(a) of the Public Utility Holding Company Act of 1935
See Instruction 1(b). or Section 30(f) of the Investment Company Act of 1940
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading 6. Relationship of Reporting Person to
Symbol Issuer (Check all applicable)
<S> <C> <C> <C>
Dermer Harry Lexington Healthcare Group, Inc. (LEXI)
(Last) (First) (Middle) 3. IRS Identifi- 4. Statement for _X_ Director _X_ 10% Owner
cation Number of Month/Year
Reporting Person, March, 1998 _X_ Officer ___ Other
if an entity (give title (specify below)
725 Town Hill Road (Voluntary) below)
(Street) President and COO
New Hartford CT 06057
(City) (State) (Zip)
5. If Amendment, 7. Individual or Joint/Group Filing
Date of Original (Check Applicable Line)
Month/Year _X_ Form filed by One Reporting Person
April 9, 1998 ___ Form filed by More than One
Reporting Person
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<CAPTION>
Table 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security 2. Trans- 3. 4. Securities 5. Amount of 6. Owner- 7. Nature of
(Instr. 3) action Trans- Acquired (A) Securities ship Form: Indirect
Date action or Disposed of (D) Beneficially Direct Beneficial
Code (Instr. 3,4 and 5) Owned at End of (D) or Ownership
(Month (Instr.8) (A) Month Indirect
/Day/ or (I)
Year) Code V Amount (D) Price (Instr.3 and 4) (Instr. 4) (Instr. 4)
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 5/13/97 J(1) 615,500 A (1) D
Common Stock 5/22/97 J(2) 60,000 A (2) D
Common Stock 685,500 D
*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
(OVER)
(Print or Type Response)
</TABLE>
Page 1 of 3
<PAGE>
<TABLE>
<CAPTION>
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of 2.Con- 3.Tran- 4.Tran- 5. Number 6.Date 7.Title and 8.Price 9.Number 10.Own- 11.Na
Derivative version saction saction of Deriv- Exer- Amount of of of ship ture
Security or Date Code ative cisable and Underlying Deriv- Deriv- Form of In-
(Instr.3) Exercise (Month/ (Instr. Securities Expiration Securities ative ative of direct
Price Day/ 8) Acquired Date (Instr.3 and 4) Secur- Secur- Deriv- Bene-
of Year) (A) or (Month/Day ity ities ative ficial
Deriv- Disposed Year) (Instr.5) Bene- Secur- Own-
ative of (D) ficially ity: ship
Security (Inst.3,4, Owned Direct (Instr.
and 5) at End (D) or 4)
of Indirect
Month (I)
(Instr.4) (Instr.4)
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Code V (A) (D) Date Expir- Title Amount
Exer- ation or
cisable Date Number
of
Shares
Employee Stock
Option (right
to buy) $2.625 12/17/97 A 60,000 (3) 12/16/03Common 60,000 60,000 D
Stock
</TABLE>
Explanation of Responses: See Page 3.
<TABLE>
<CAPTION>
<S> <C> <C>
By: /s/ Harry Dermer 5/13/98
** Signature of Reporting Person Date
Name: Harry Dermer
** 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 provided is insufficient, see Instruction 6 for procedure.
</TABLE>
Page 2 of 3
<PAGE>
FORM 4
(continued)
Item 1: Harry Dermer
725 Town Hill Road
New Hartford, CT 06057
Item 2: Lexington Healthcare Group, Inc. (LEXI)
Item 4: March, 1998
Explanation of Responses:
(1) The reporting person acquired these shares of Common Stock from the
Issuer in exchange for a 25% interest in Lexington Health Care Group,
LLC.
(2) The reporting person acquired these shares of Common Stock from the
Issuer in exchange for a 20% interest in BALZ Medical Services, Inc.
(3) The option becomes exercisable in three equal annual installments
beginning on December 17, 1998.
Page 3 of 3
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