0000950170-24-008337.txt : 20240129 0000950170-24-008337.hdr.sgml : 20240129 20240129163006 ACCESSION NUMBER: 0000950170-24-008337 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20240126 FILED AS OF DATE: 20240129 DATE AS OF CHANGE: 20240129 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROUSSEAU JON B CENTRAL INDEX KEY: 0001579775 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41938 FILM NUMBER: 24574093 MAIL ADDRESS: STREET 1: 805 N. WHITTINGTON PARKWAY CITY: LOUISVILLE STATE: KY ZIP: 40222 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BrightSpring Health Services, Inc. CENTRAL INDEX KEY: 0001865782 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 822956404 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 805 N. WHITTINGTON PARKWAY CITY: LOUISVILLE STATE: KY ZIP: 40222 BUSINESS PHONE: 502-394-2100 MAIL ADDRESS: STREET 1: 805 N. WHITTINGTON PARKWAY CITY: LOUISVILLE STATE: KY ZIP: 40222 3 1 ownership.xml 3 X0206 3 2024-01-26 0 0001865782 BrightSpring Health Services, Inc. BTSG 0001579775 ROUSSEAU JON B C/O BRIGHTSPRING HEALTH SERVICES, INC. 805 N. WHITTINGTON PARKWAY LOUISVILLE KY 40222 true true false false See Remarks Common Stock 1947 D Common Stock 351363 I By Rousseau Family Trust Stock Options (Right to Buy) 6.37 2029-10-16 Common Stock 1327081 D Stock Options (Right to Buy) 6.37 2029-10-16 Common Stock 534676 I By The Margaret Rousseau Children Trust Stock Options (Right to Buy) 6.37 2029-10-16 Common Stock 377602 I By Rousseau Family Trust Stock Options (Right to Buy) 22.29 2033-11-22 Common Stock 628108 D Stock Options (Right to Buy) 13.00 2034-01-25 Common Stock 320086 D Options granted on October 16, 2019, of which 955,823 vested on January 25, 2024 in connection with the pricing of the Issuer's initial public offering, with the remaining options subject to a time-based vesting schedule, of which, the remaining 46,803 unvested options will fully vest on March 5, 2024. Reflects a 15.7027-for-1 forward stock split of the Issuer's common stock, which became effective on January 25, 2024 (the "Stock Split"). Does not include unvested performance-based options which will be reported when earned upon achievement of certain performance criteria. These options are fully vested. Reflects the Stock Split. Options granted on November 22, 2023 which vest one-third on May 22, 2024, and the remaining two-thirds to vest in equal monthly installments over the two years subsequent to the grant date. Reflects the Stock Split. Options granted on January 25, 2024 which vest in twelve equal quarterly installments commencing on April 25, 2024. Title: Chairman, President and Chief Executive Officer. The Reporting Person states that this filing shall not be an admission that the Reporting Person is the beneficial owner of any of the securities reported herein as indirectly owned, and the Reporting Person disclaims beneficial ownership of such securities except to the extent of the Reporting Person's pecuniary interest therein. Exhibit List: Exhibit 24 - Power of Attorney. /s/ Steven S. Reed, as Attorney-in-Fact 2024-01-29 EX-24 2 btsg-ex24.htm EX-24 EX-24

Exhibit 24

 

POWER OF ATTORNEY

 

Know all by these presents that the undersigned, does hereby make, constitute and appoint each of Steven S. Reed and Allison L. Brown, or any one of them, as a true and lawful attorney-in-fact of the undersigned with full powers of substitution and revocation, for and in the name, place and stead of the undersigned (in the undersigned's individual capacity), to execute and deliver such forms that the undersigned may be required to file with the U.S. Securities and Exchange Commission as a result of the undersigned's ownership of or transactions in securities of BrightSpring Health Services, Inc. (the “Company”) (i) pursuant to Section 16(a) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), including, without limitation, statements on Form 3, Form 4 and Form 5 (including any amendments thereto), (ii) pursuant to Rule 144 under the Securities Act of 1933, as amended (the “Securities Act”), including, without limitation, notices on Form 144 (including any amendments thereto), and (iii) in connection with any applications for EDGAR access codes or any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the Securities and Exchange Commission, including without limitation the Form ID.

 

The Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, 5 and 144 with regard to his or her ownership of or transactions in securities of the Company, unless earlier revoked in writing. The undersigned acknowledges that Steven S. Reed and Allison L. Brown are not assuming any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act or Rule 144 under the Securities Act.

 

 

By:

/s/ Jon B. Rousseau

 

Name:

Jon B. Rousseau

 

 

Date: October 10, 2023