<PAGE>
------------------------------
OMB APPROVAL
------------------------------
OMB Number: 3235-0362
Expires: October 31, 2001
Estimated average burden
hours per response...... 1.0
------------------------------
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
[_] Check box if no longer subject
to Section 16. Form 4 or Form 5
obligations may continue. See
Instruction 1(b).
[_] Form 3 Holdings Reported
[_] Form 4 Transactions Reported
ANNUAL 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(f) of the Investment Company Act of 1940
- --------------------------------------------------------------------------------
1. Name and Address of Reporting Person*
Cosgrove Barry C.
- --------------------------------------------------------------------------------
(Last) (First) (Middle)
21250 Hawthorne Boulevard
- --------------------------------------------------------------------------------
(Street)
Torrance CA 90503
- --------------------------------------------------------------------------------
(City) (State) (Zip)
- --------------------------------------------------------------------------------
2. Issuer Name and Ticker or Trading Symbol
Total Renal Care Holdings Inc. (TRL)
- --------------------------------------------------------------------------------
3. I.R.S. Identification Number of Reporting Person, if an entity
(Voluntary)
- --------------------------------------------------------------------------------
4. Statement for Month/Year
1999
- --------------------------------------------------------------------------------
5. If Amendment, Date of Original (Month/Year)
- --------------------------------------------------------------------------------
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
[ ] Director [ ] 10% Owner
[X] Officer [ ] Other (specify below)
(give title below)
7. Senior V.P. Secretary & General Counsel
---------------------------------------
- -------------------------------------------------------------------------------
Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) action action or Disposed of (D) Securities ship of In-
Date Code Beneficially Form: direct
(Instr. 8) Owned at the Direct Bene-
(Instr. 3, 4 and 5) end of (D) or ficial
(Month/ ----------------- Issuer's Indirect Owner-
Day/ Amount (A) or Price Fiscal Year (I) ship
Year) (D) (Instr. 3 and 4) (Instr. 4) (Instr. 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Remainder: Report on a separate line for each class of securities beneficially
owned directly or indirectly
(Print or Type Responses)
(over)
SEC 2270 (3/91)
- --------------------------------------------------------------------------------
Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
- -----------------------------------------------------------------------------------------------------------------------------
1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv-
Security (Instr. 3) sion or action tion Code ative Securities
Exercise Date (Instr. 8) Acquired (A) or
Price of (Month/ Disposed of (D)
Deriv- Day/ (Instr. 3, 4, and 5)
ative Year)
Security
---------------------------
(A) (D)
- -----------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C>
Options (16b-3 Plan;
right to buy) $32.1875 9/26/99 H 200,000
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------------------
6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na-
cisable and Underlying Securities of of Deriv- ship ture
Expiration (Instr. 3 and 4) Deriv- ative of De- of In-
Date ative Secur- rivative direct
(Month/Day/ Secur- ities Secu- Bene-
Year) ity Bene- rity: ficial
(Instr. 5) ficially Direct Owner-
-------------------------------------------- Owned (D) or ship
Date Expira- Amount or at End Indi- (Instr. 4)
Exer- tion Title Number of of Year rect (1)
cisable Date Shares (Instr. 4) (Instr. 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
(1) 2/27/08 Common Stock 200,000 O D
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Explanation of Responses:
(1) 25% of the options were to vest and become exercisable on each of the first
four anniversaries of February 27, 1998.
** Intentional misstatements or omissions of facts constitute Federal
Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Barry C. Cosgrove 2/14/2000
________________________________ _________________
**Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
Page 2
