CONCENTRA MANAGED CARE INC
424B3, 1998-12-02
SPECIALTY OUTPATIENT FACILITIES, NEC
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                                      FILED PURSUANT TO RULE 424(B)(3) AND (C)
                                                         FILE NUMBER 333-52585

                     SUPPLEMENT NO. 4 DATED DECEMBER 2, 1998
                     TO PROSPECTUS DATED SEPTEMBER 10, 1998
           RELATING TO $230,000,000 PRINCIPAL AMOUNT 4.50% CONVERTIBLE
        SUBORDINATED NOTES DUE 2003 AND 5,575,757 SHARES OF COMMON STOCK,
                          $.01 PAR VALUE PER SHARE, OF
                          CONCENTRA MANAGED CARE, INC.

All  capitalized  terms used but not  defined  herein  shall  have the  meanings
ascribed to them in the Prospectus  dated September 10, 1998,  forming a part of
the Registration Statement on Form S-3, File No. 333-52585. Any cross references
in this supplement refer to portions of the Prospectus.

The purpose of this supplement is to provide  additional  information  regarding
the Selling Securityholders. In addition to the Selling Securityholders named in
the  Prospectus,  the  following  table sets  forth the name of each  additional
Selling  Securityholder  and relationship,  if any, with the Company and (i) the
amount of Notes owned by each additional  Selling  Securityholder as of December
2, 1998 (subject to the qualifications set forth below), (ii) the maximum amount
of Notes which may be offered for the account of such Selling  Securityholder as
of December 2, 1998 and (iii) the  maximum  amount of Common  Stock which may be
offered for the account of such Selling Securityholder under the Prospectus.

<TABLE>

                                                   PRINCIPAL      PRINCIPAL          COMMON STOCK    COMMON STOCK
                                                   AMOUNT OF      AMOUNT OF          OWNED PRIOR TO     OFFERED
                                                   NOTES OWNED    OFFERED HEREBY       OFFERING (1)     HEREBY (2)
<S>                                               <C>             <C>               <C>             <C>   


Alta Partners Holdings, LDC                      $ 1,000,000      $ 1,000,000        24,242          24,242
BT Alex.Brown Inc.                                 2,000,000        2,000,000        48,484          48,484
BT Holdings (New York) Inc.                        2,500,000        2,500,000        60,606          60,606
Morgan Stanley Dean Witter Convertible 
   Securities Trust                                3,000,000        3,000,000        72,727          72,727
Morgan Stanley Dean Witter Income 
   Builder Fund                                    4,400,000        4,400,000       106,666         106,666
Morgan Stanley Dean Witter Variable 
   Income Builder                                    800,000          800,000        19,393          19,393

Total.                                           $13,700,000      $13,700,000       332,118         332,118

</TABLE>

(1)  Comprises  the  shares of Common  Stock  into  which the Notes held by such
     Selling  Securityholder are convertible at the initial conversion rate. The
     Conversion  Rate and the  number of shares of Common  Stock  issuable  upon
     conversion   of  the  Notes  are  subject  to   adjustment   under  certain
     circumstances.   See   "Description   of  Notes  --   Conversion   Rights."
     Accordingly,  the number of shares of Common Stock issuable upon conversion
     of the Notes may increase or decrease from time to time.

(2)  Assumes  conversion  into Common  Stock of the full amount of Notes held by
     the Selling  Securityholder at the initial conversion rate and the offering
     of such shares by such Selling Securityholder  pursuant to this Prospectus.
     The Conversion  Rate and the number of shares of Common Stock issuable upon
     conversion   of  the  Notes  is  subject  to   adjustment   under   certain
     circumstances.   See   "Description   of  Notes  --   Conversion   Rights."
     Accordingly,  the number of shares of Common Stock issuable upon conversion
     of the Notes may increase or decrease from time to time.  Fractional shares
     will not be issued upon conversion of the Notes;  rather, cash will be paid
     in lieu of fractional shares, if any.

Because the Selling Securityholders may, pursuant to this Prospectus,  offer all
or some  portion of the Notes and  Common  Stock they  presently  hold or,  with
respect to Common  Stock,  have the right to  acquire  upon  conversion  of such
Notes,  no estimate  can be given as to the amount of the Notes and Common Stock
that will be held by the Selling  Securityholders  upon  termination of any such
sales. In addition, the Selling Securityholders  identified above may have sold,
transferred or otherwise  disposed of all or a portion of their Notes and Common
Stock since the date on which they  provided  the  information  regarding  their
Notes  and  Common  Stock,   in  transactions   exempt  from  the   registration
requirements of the Securities Act. See "Plan of Distribution."



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