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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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
[_] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Kovach Susan Allene
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(Last) (First) (Middle)
900 Victors Way, Suite 350
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(Street)
Ann Arbor MI 48108
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Omega Healthcare Investors, Inc. (OHI)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
April, 2000
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [_] 10% Owner
[X] Officer (give title below) [_] Other (specify below)
Vice President, General Counsel and Secretary
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7. Individual or Joint/Group Filing (Check applicable line)
[x] Form filed by one Reporting Person [_] Form filed by more than one
Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock 01/31/2000 A* V 3,355 A $7.750 D
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Common Stock 02/10/2000 A** V 18,708 A $5.9375 D
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Common Stock 02/15/2000 A*** V 100.089 A $6.7090 23,506.085 D
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*Common stock acquired represents 3,355 shares of restricted stock granted under the Company's Stock Option and Restricted Stock
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Plan which shares vest one-half on July 31, 2000 and one-half on January 31,2001.
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**Common stock acquired represents 18,708 shares of restricted stock granted under the Company's Stock Option and Restricted Stock
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Plan. Vesting is based on two criteria: the Company's achievement of a specific trading price per share and the officer's period
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of service after the date of the grant. If the trading price reaches $8.00, $9.00 or $10.00, 50%, 75% or 100%, respectively, of the
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stock would vest, subject to the officer satisfying the service requirements. After performing six months of service for the Company
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after the date of grant, the officer will be vested in 50% of the shares available for vesting as a result of a trading price target
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being met. After one year of service, the officer will be vested in 100% of the shares available for vesting as a result of a
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trading price target being met. In order for a trading price target to be met, the stock must either stay at or above the target
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level for 10 consecutive business days, or the average stock price for any 30 consecutive business day period must equal or exceed
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the target level.
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***Shares acquired through the Company's Dividend Reinvestment Plan.
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* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses)
(Over)
(Form 4-07/98)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially
Owned (e.g., puts, calls, warrants, options, convertible securities)
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10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Explanation of Responses:
/s/ Susan Allene Kovach May 10, 2000
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**Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
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