4 1 ghvi4021002jal.txt OCTOBER 2, 2002 - JOSEPH A. LANASA, III UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 [ ] 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* Lanasa, III Joseph A. -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Goldman, Sachs & Co. 85 Broad Street -------------------------------------------------------------------------------- (Street) New York New York 10004 -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol Genesis Health Ventures, Inc. (GHVI) ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) ================================================================================ 4. Statement for Month/Day/Year October 2, 2002 ================================================================================ 5. If Amendment, Date of Original (Month/Day/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ X ] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ------------------------------------------- ================================================================================ 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 | ==================================================================================================================================== | | | | |5. |6. | | | | | | 4. |Amount of |Owner- | | | | | | Securities Acquired (A) or |Securities |ship | | | |2A. |3. | Disposed of (D) |Beneficially |Form: |7. | |2. |Deemed |Transaction| (Instr. 3, 4 and 5) |Owned |Direct |Nature of | |Transaction |Execution |Code | -------------------------------|Following |(D) or |Indirect | 1. |Date |Date, if |(Instr. 8) | | (A) | |Reported |Indirect |Beneficial| Title of Security |(Month/Day/ |any(Month/|-----------| Amount | or | Price |Transactions |(I) |Ownership | (Instr. 3) |Year) |Day/Year) | Code | V | | (D) | |(Instr. 3 & 4)|(Instr.4)|(Instr. 4)| -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | Common Stock | | | | | | | | 6,220,613 | I | 01,02 | ====================================================================================================================================
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). FORM 4 (continued)
==================================================================================================================================== Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned | (e.g., puts, calls, warrants, options, convertible securities) | ==================================================================================================================================== | | | | | | | | |9. |10. | | |2. | | | | | | | |Number |Owner-| | |Con- | | | | | | | |of |ship | | |ver- | |3A. | | | | | |Deriv- |of | | |sion | |De- | |5. | |7. | |ative |Deriv-|11. | |or | |emed| |Number of | |Title and Amount | |Secur- |ative |Nature| |Exer- | |Exe-| |Derivative |6. |of Underlying |8. |ities |Secur-|of | |cise | |cu- |4. |Securities |Date |Securities |Price |Bene- |ity: |In- | |Price |3. |tion|Trans-|Acquired (A)|Exercisable and |(Instr. 3 and 4) |of |ficially |Direct|direct| |of |Trans- |Date|action|or Disposed |Expiration Date |-----------------------|Deriv- |Owned |(D) or|Bene- | 1. |Der- |action |if |Code |of (D) |(Month/Day/Year) | |Amount |ative |Following|In- |ficial| Title of |iva- |Date |any,|(Instr|(Instr. 3, |-----------------| |or |Secur- |Reported |direct|Owner-| Derivative |tive |(Month/ |(MM/|8) |4 and 5) |Date |Expira- | |Number |ity |Trans- |(I) |ship | Security |Secu- |Day/ |DD/ |------|------------|Exer- |tion | |of |(Instr. |action(s)|(Instr|(Instr| (Instr. 3) |rity |Year) |YY) |Code|V| (A) | (D) |cisable |Date |Title |Shares |5) |(Instr.4)|4) |4) | -----------------------------------------------------------------------------------------------------------------------------------| Stock Option | | | | | | | | | | | | | | | | (right to buy) |$16.80|10/02/02| | A | | 2,500| | Immed. |10/02/12|Common Stock | 2,500 | | 2,500 | 01,03|01,03 | -----------------------------------------------------------------------------------------------------------------------------------| Stock Option | | | | | | | | | | | | | | | | (right to buy) |$20.33| | | | | | | Immed. |10/02/11|Common Stock | 25,000 | | 25,000 | 01,03|01,03 | -----------------------------------------------------------------------------------------------------------------------------------| Series A | | | | | | | | | | | | | | | | Convertible | | | | | | | | | | | | | | | | Preferred | | | | | | | | | | | | | | | | Stock |$20.33| | | | | | | Immed. | 04 |Common Stock | 353,167 | | 71,799 | I |01,04 | ====================================================================================================================================
Explanation of Responses: 01: The Reporting Person is a managing director of Goldman, Sachs & Co. ("Goldman Sachs"). Goldman Sachs is an indirect wholly-owned subsidiary of The Goldman Sachs Group, Inc. ("GS Group"). The Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of his pecuniary interest therein, if any. 02: Goldman Sachs beneficially owns directly and GS Group may be deemed to beneficially own indirectly 6,220,613 shares of common stock of Genesis Health Ventures, Inc. 03: These options were granted pursuant to the Genesis Health Ventures, Inc. 2001 Stock Option Plan to the Reporting Person. The Reporting Person has an understanding with GS Group pursuant to which he holds such options for the benefit of GS Group. 04: Goldman Sachs beneficially owns directly and GS Group may be deemed to beneficially own indirectly 71,799 shares of Series A convertible preferred stock of Genesis Health Ventures, Inc. ("Series A Preferred"). The conversion rate is $20.33 of liquidation preference for each share of common stock. The Series A Preferred has a liquidation preference of $42,600,000 and accrues dividends at the annual rate of 6% payable in additional shares of Series A Preferred. The Series A Preferred are subject to mandatory redemption on October 2, 2010. By: s/ Edward T. Joel January 24, 2003 --------------------------------------------- ----------------------- **Signature of Reporting Person Date Attorney-in-fact ** 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 procedures. Alternatively, this Form is permitted to be submitted to the Commission in electronic format at the option of the reporting person pursuant to Rule 101(b)(4) of Regulation S-T. POWER OF ATTORNEY The undersigned does hereby appoint Roger S. Begelman, Edward T. Joel, Saskia Brookfield Martin and Susan P. Goddard, (and any other employee of The Goldman Sachs Group, Inc. or one of its affiliates designated in writing by one of the attorneys-in-fact), his true and lawful attorneys, and each of them his true and lawful attorney, with power to act without the other, and with full power of substitution and resubstitution, to execute and file for him and in his name any Initial Statement of Beneficial Ownership of Securities on Form 3, any Statement of Changes in Beneficial Ownership on Form 4 and any Annual Statement of Changes in Beneficial Ownership on Form 5, or any similar or successor form, which may be required to be filed by him with the Securities and Exchange Commission pursuant to Section 16 of the Securities Exchange Act of 1934, as amended, and any and all instruments necessary or incidental therewith, hereby granting unto said attorneys and each of them full power and authority to do and perform in the name and on behalf of the undersigned, and in any and all capacities, every act and thing whatsoever required or necessary to be done in and about the premises, as fully and to all intents and purposes as the undersigned might or could do in person, hereby ratifying and approving the act of said attorneys and each of them. This power of attorney shall not be affected by the subsequent disability or incompetence of the principal. This power of attorney shall remain in full force and effect until either revoked in writing by the undersigned or until such time as the person or persons to whom power of attorney has been hereby granted cease(s) to be an employee of The Goldman Sachs Group, Inc. or one of its affiliates. In witness thereof the undersigned hereunto signed his name this 17th day of January, 2003. s/ Joseph A. Lanasa III ----------------------- JOSEPH A. LANASA III