FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
MARINER HEALTH CARE INC [ MHCA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/09/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock, par value $0.01 per share | 810,210(1) | I(1) | See Note(1) | |||||||
Common Stock, par value $0.01 per share(2) | 02/09/2004 | J(2) | 933,386 | D | (2) | 0 | I(2) | See Note(2) | ||
Common Stock, par value $0.01 per share(3) | 02/09/2004 | J(3) | 103,707 | A | (3) | 103,707(4) | I(4) | See Note(4) | ||
Common Stock, par value $0.01 per share(3) | 02/09/2004 | J(3) | 4,574 | A | (3) | 4,574(5) | I(5) | See Note(5) | ||
Common Stock, par value $0.01 per share(3) | 02/09/2004 | J(3) | 383 | A | (3) | 383(6) | D(6) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Deferred Restricted Common Stock(7) | (8) | (9) | 05/15/2012 | Deferred Restricted Common Stock | 7,500 | 7,500 | I(7) | See Note(7) |
Explanation of Responses: |
1. Foothill Partners IV, L.P. ("Foothill IV") beneficially owns 810,210 shares of the common stock (the "Common Stock") of the issuer Mariner Health Care, Inc. (the "Company"). Mr. Stearns is a Managing Member of the General Partner of Foothill IV and, as such, may be deemed to beneficially own the Common Stock held by that entity. Mr. Stearns disclaims beneficial ownership of the Common Stock except to the extent of his pecuniary interest therein. |
2. Distribution of Common Stock held by Foothill III to all of its partners, including the Stearns Family Trust of 2001 (the "Stearns Family Trust"), Well Fargo Foothill, Inc. ("Wells Fargo Foothill") and The Foothill Group, Inc. (the "Foothill Group"). |
3. Represents shares acquired by entity pursuant to distribution described in Footnote 2 above. |
4. Wells Fargo Foothill beneficially owns 103,707 shares of the Common Stock of the Company. Mr. Stearns is a Senior Vice President of Wells Fargo Foothill and, as such, may be deemed to indirectly beneficially own the Common Stock held by that entity. Mr. Stearns disclaims beneficial ownership of the Common Stock. |
5. The Foothill Group beneficially owns 4,574 shares of the Common Stock of the Company. Mr. Stearns is a Senior Vice President of The Foothill Group and, as such, may be deemed to indirectly beneficially own the Common Stock held by that entity. Mr. Stearns disclaims beneficial ownership of the Common Stock. |
6. Held by the Stearns Family Trust of which Mr. Stearns is a Trustee. |
7. Pursuant to an agreement with Foothill IV, Mr. Stearns is required to assign or remit all compensation, including stock option grants and restricted stock, that he receives as a director of the Company. Accordingly, he disclaims beneficial ownership of the above-referenced security except to the extent of his pecuniary interest therein. |
8. Because the derivative security is deferred restricted common stock, there is no conversion or exercise price. |
9. The deferred restricted common stock shall become vested as to 50% of the restricted shares as of the grant date under the 2003 Outside Directors' Stock Incentive Plan. On each of May 16, 2004 and May 16, 2005, the restricted stock grant shall become vested as to an additional 25% of the restricted stock if the reporting person has continuously served as a director of the Company. Any of the restricted stock which is not vested at the time that the reporting person ceases to be a director of the Company shall be forfeited to the Company. |
Remarks: |
Stefano M. Miele, as Attorney-in-Fact for Marshall E. Stearns | 02/13/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |