SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 04/21/2022 | 3. Issuer Name and Ticker or Trading Symbol AMEDISYS INC [ AMED ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 3,402(1) | D | |
Common Stock | 213(2) | I | By 401(k) Plan |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (Right to Buy) | (3) | 07/25/2028 | Common Stock | 272 | 95.76 | D | |
Stock Option (Right to Buy) | (4) | 07/25/2029 | Common Stock | 320 | 132.41 | D | |
Stock Option (Right to Buy) | (5) | 07/25/2030 | Common Stock | 563 | 214.74 | D | |
Stock Option (Right to Buy) | (6) | 07/25/2031 | Common Stock | 708 | 264 | D | |
Stock Option (Right to Buy) | (7) | 07/25/2032 | Common Stock | 2,040 | 143.25 | D | |
Restricted Stock Unit (Performance-Based Vesting) | (8) | (8) | Common Stock | 1,746 | (8) | D |
Explanation of Responses: |
1. Represents restricted stock units ("RSUs") that vest based on the passage of time. 1,824 of the RSUs vest on July 25, 2022, 386 of the RSUs vest on July 25, 2023, 247 of the RSUs vest on July 25, 2024, 72 of the RSUs vest on July 25, 2025, 218 of the RSUs vest on February 20, 2023, 218 of the RSUs vest on February 20, 2024, 218 of the RSUs vest on February 20, 2025 and 219 of the RSUs vest on February 20, 2026, assuming the Reporting Person remains continuously employed by the Issuer on each such vesting date, subject to certain pro-rated vesting provisions as provided in the award agreement for the RSUs. |
2. The information in this report is based on a plan statement dated as of March 31, 2022. |
3. The Stock Options are subject to time-based vesting conditions and will vest on July 25, 2022, provided that the Reporting Person remains continuously employed by the Issuer on such date, subject to pro-rated vesting provisions as provided in the award agreement for the Stock Options. |
4. The Stock Options are subject to time-based vesting conditions. 107 Stock Options vested on July 25, 2021, 107 Stock Options will vest on July 25, 2022 and 106 Stock Options will vest on July 25, 2023, provided that the Reporting Person remains continuously employed by the Issuer on each such date, subject to pro-rated vesting provisions as provided in the award agreement for the Stock Options. |
5. The Stock Options are subject to time-based vesting conditions. 140 Stock Options vested on July 25, 2021, and 141 Stock Options will vest on each of July 25, 2022, July 25, 2023 and July 25, 2024, provided that the Reporting Person remains continuously employed by the Issuer on each such date, subject to pro-rated vesting provisions as provided in the award agreement for the Stock Options. |
6. The Stock Options are subject to time-based vesting conditions. 177 Stock Options vest on each of July 25, 2022, July 25, 2023, July 25, 2024 and July 25, 2025, provided that the Reporting Person remains continuously employed by the Issuer on each such date, subject to pro-rated vesting provisions as provided in the award agreement for the Stock Options. |
7. The Stock Options are subject to time-based vesting conditions. 510 Stock Options vest on each of July 25, 2023, July 25, 2024, July 25, 2025 and July 25, 2026, provided that the Reporting Person remains continuously employed by the Issuer on each such date, subject to pro-rated vesting provisions as provided in the award agreement for the Stock Options. |
8. The performance-based RSUs will vest based on certification of achievement of an identified performance measure for 2022, with additional time-based vesting in equal 25% installments on each of the certification date and February 20, 2024, 2025 and 2026, assuming the Reporting Person remains continuously employed on the vesting date. The amount reported represents the amount of shares payable at target performance; the Reporting Person could earn 0%-200% of the amount reported depending on the level of performance achieved. |
Remarks: |
Exhibit 24.1 - Power of Attorney |
Jennifer Guckert Griffin, pursuant to a power of attorney | 05/02/2022 | |
** 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 5 (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. |