-----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, JRWiU6lWa+p3hq8/P/xjuFwOwelWXmjzvAhqIamlo+EhOjEZR4VQbkFdxA/TusYV aEJJ8yHVKtqcUiiWQRfSEw== 0001046311-00-000013.txt : 20000215 0001046311-00-000013.hdr.sgml : 20000215 ACCESSION NUMBER: 0001046311-00-000013 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: 541963 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/ CENTRAL INDEX KEY: 0000903871 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR IRS NUMBER: 213445874 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O MANOR CARE INC STREET 2: 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 FORMER COMPANY: FORMER CONFORMED NAME: BAINUM STEWART DATE OF NAME CHANGE: 19930506 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, 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) ( ) Form filed by One Reporting Person (X) 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)| | ___________________________________________________________________________________________________________________________________| Common Stock |3-15-9|G (6|37,000 |D | |5,505,869 |I |Note 1 | |9 |) | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |798,711 |I |Note 2 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |81,711 |I |Note 3 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |100,000 |I |Note 4 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |76,386 |I |Note 5 | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | |296 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ 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 Declaration of Trust dated May 23, 1995 (the "SB Trust"), the sole trustee of which is Mr. Bainum. Note 2: Shares owned by the Jane L. Bainum Declaration of Trust dated May 23, 1995 (the "JLB Trust"), the sole trustee of which is Mr. Bainum's wife. Note 3: The proportionate interest of the JLB trust in shares (1,779,628) owned by Mid Pines Associates, L.P., in which the JLB Trust is a limited partner, and shares (3,567,869) owned by Realty Investment Company, Inc., a real estate investment and management company, in which the JLB Trust is a noncontrolling shareholder. Note 4: The proportionate interest of the Edelblut Partners, L.P., in which the SB Trust and the JLB Trust are the sole partners, in shares (1,779,628) owned by Mid Pines Associates, L.P. Note 5: The proportionate interest of the SB Trust in shares (1,779,628) owned by Mid Pines Associates, L.P., in which the SB Trust is a limited partner, and shares (3,567,869) owned by Realty Investment Company, Inc., in which the SB Trust is a noncontrolling shareholder. Note 6: On March 15,1999, Mr. Bainum gifted 37,000 shares to Commonweal Foundation, a private family charitable foundation. -----END PRIVACY-ENHANCED MESSAGE-----