-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, CPPEQM4NkpXWrIzpD45zvlPwcXPpJIkF65CukytU+SPCQooNDWW7P2zyRavwwOsH uyLyk++TG5Yjv8JCw+ICEg== 0001046311-00-000014.txt : 20000215 0001046311-00-000014.hdr.sgml : 20000215 ACCESSION NUMBER: 0001046311-00-000014 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991231 FILED AS OF DATE: 20000214 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MANOR CARE INC CENTRAL INDEX KEY: 0000878736 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 341687107 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 001-10858 FILM NUMBER: 542547 BUSINESS ADDRESS: STREET 1: 333 N. SUMMIT STREET CITY: TOLEDO STATE: OH ZIP: 43604-2617 BUSINESS PHONE: 4192525500 MAIL ADDRESS: STREET 1: P.O. BOX 10086 CITY: TOLEDO STATE: OH ZIP: 43699-0086 FORMER COMPANY: FORMER CONFORMED NAME: HCR MANOR CARE INC DATE OF NAME CHANGE: 19981001 FORMER COMPANY: FORMER CONFORMED NAME: HEALTH CARE & RETIREMENT CORP / DE DATE OF NAME CHANGE: 19930328 COMPANY DATA: COMPANY CONFORMED NAME: BAINUM STEWART JR CENTRAL INDEX KEY: 0001034261 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR IRS NUMBER: 213445874 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 11555 DARNESTOWN ROAD CITY: GAITHERSBURG STATE: MD ZIP: 20878 BUSINESS PHONE: 3019794400 MAIL ADDRESS: STREET 1: 11555 DARNESTOWN ROAD CITY: GAITHERSBURG STATE: MD ZIP: 20878 5 1 FORM 5 - 12-31-99 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. See Instructions 1(b). ( ) Form 3 Holdings Reported ( ) Form 4 Transactions Reported 1. Name and Address of Reporting Person Bainum, Jr., Stewart 10770 Columbia Pike, Suite 100 Silver Spring, MD 20901 USA 2. Issuer Name and Ticker or Trading Symbol HCR Manor Care HCR 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### 4. Statement for Month/Year 12-31-99 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director (X) 10% Owner ( ) Officer (give title below) ( ) Other (specify below) 7. Individual or Joint/Group Reporting (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. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | |Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership | |Date |Code| | Beneficially |(D)or | | | | | | A/| | Owned at |Indir | | | | | Amount | D | Price | End of Year |ect(I)| | ___________________________________________________________________________________________________________________________________| | | | | | |1,989,389 |I |NOTE 1 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |127,725 |I |NOTE 2 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |214,284 |I |NOTE 3 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |6,768 |I |NOTE 4 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |851,669 |I |NOTE 5 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |210,068 |I |NOTE 6 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |394,026 |I |NOTE 7 | - -----------------------------------------------------------------------------------------------------------------------------------| |3-31-9|J |381 |A | |381 |I |NOTE 8 | |9 | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| |3-31-9|J |821 |A | |821 |I |NOTE 9 | |9 | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity | | | Amount | |ble | | | |Year |(I)| | ___________________________________________________________________________________________________________________________________| Common Stock Options | | | | | | | | | | |9,000 | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: Note 1: Shares owned by the Stewart Bainum, Jr. Declaration of Trust ("Stewart Bainum, Jr. Trust") in which Mr. Bainum is the sole trustee. Note 2: The proportionate interest of the Stewart Bainum, Jr. Trust in shares (1,779,628) owned by Mid Pines Associates, L.P. Note 3: The proportionate interest of the Stewart Bainum, Jr. Grantor Retained Annuity Trust dated September 10, 1996, the sole trustee of which is Mr. Bainum, Jr., in shares (1,779,628) owned by Mid Pines Associates, L.P. Note 4: The proportionate interest of various trusts, the beneficiaries of which are Mr. Bainum, Jr.'s two minor children in shares (1,779,628) owned by the Mid Pines Associates, L.P. Note 5: The proportionate interest of the Stewart Bainum, Jr. Trust in shares (3,567,869) owned by Realty Investment Company, Inc., a real estate invesmtent and management company in which Mr. Bainum, Jr. is a non-controlling shareholder. Also includes 128,591 shares indirectly held through certain trusts for the benefit of Mr. Bainum, Jr.'s two minor children. Note 6: The proportionate interest of certain trusts in shares (1,779,628) owned by Mid Pines Associates, L.P. for the benefit of Mr. Bainum, Jr.'s nephews. Mr. Bainum is the trustee and his nephews are the sole beneficiaries. Beneficial ownership is disclaimed. Note 7: The proportionate interest of certain trusts in shares (3,567,869) owned by Realty Investment Company, Inc. for the benefit of Mr. Bainum, Jr.'s nephews. Mr. Bainum is the trustee and his nephews are the beneficiaries. Beneficial ownership is disclaimed. Note 8: Shares credited to Mr. Bainum, Jr.'s account in the Company's 401(K) plan. Note 9: Shares credited to Mr. Bainum, Jr.'s account in the Company's non-qualified retirement plan. -----END PRIVACY-ENHANCED MESSAGE-----