5 1 NYSE0001190374 Officer Beverly Enterprises, Inc. 000104044162-1691861 12/31/02 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) SUSIENKA, CINDY H One Thousand Beverly Way Fort Smith Arkansas 72919 2. Issuer Name and Ticker or Trading Symbol Beverly Enterprises, Inc. (BEV) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/02 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) PRES. AEGIS THERAPIES 7. 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 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I ------------------------------------------------------------------------------------------------------------------------------------ $.10 Par Value Common Stock - ESPP (1) 06/11/02 T 65.7586 A $7.8697 D Direct $.10 Par Value Common Stock - ESPP (1) 07/05/02 T 44.4783 A $7.7566 D Direct $.10 Par Value Common Stock - ESPP (1) 08/01/02 T 105.7948 A $3.2610 777.3986 D Direct Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration ------------------------------------------------------------------------------------------------------------------------------------ Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Employee Stock Purchase Plan SIGNATURE OF REPORTING PERSON /S/ SUSIENKA, CINDY H DATE 01/16/03