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>
<CAPTION>
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Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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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)| |
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock |3-15-9|G (6|37,000 |D | |5,505,869 |I |Note 1 |
|9 |) | | | | | | |
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| | | | | |798,711 |I |Note 2 |
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| | | | | |81,711 |I |Note 3 |
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| | | | | |100,000 |I |Note 4 |
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| | | | | |76,386 |I |Note 5 |
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| | | | | |296 |D | |
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<CAPTION>
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Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned |
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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)| |
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock Options | | | | | | | | | | |9,000 | | |
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</TABLE>
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.