0001179022-11-000057.txt : 20110906
0001179022-11-000057.hdr.sgml : 20110905
20110906112356
ACCESSION NUMBER: 0001179022-11-000057
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110901
FILED AS OF DATE: 20110906
DATE AS OF CHANGE: 20110906
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Retchin Sheldon M
CENTRAL INDEX KEY: 0001470958
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-15669
FILM NUMBER: 111075004
MAIL ADDRESS:
STREET 1: 3350 RIVERWOOD PARKWAY SUITE 1400
CITY: ATLANTA
STATE: GA
ZIP: 30339
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: GENTIVA HEALTH SERVICES INC
CENTRAL INDEX KEY: 0001096142
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082]
IRS NUMBER: 364335801
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0101
BUSINESS ADDRESS:
STREET 1: 3350 RIVERWOOD PARKWAY
STREET 2: SUITE 1400
CITY: ATLANTA
STATE: GA
ZIP: 30339
BUSINESS PHONE: 7709516450
MAIL ADDRESS:
STREET 1: 3350 RIVERWOOD PARKWAY
STREET 2: SUITE 1400
CITY: ATLANTA
STATE: GA
ZIP: 30339
FORMER COMPANY:
FORMER CONFORMED NAME: OLSTEN HEALTH SERVICES HOLDING CORP
DATE OF NAME CHANGE: 19991001
4
1
edgar.xml
PRIMARY DOCUMENT
X0304
4
2011-09-01
0001096142
GENTIVA HEALTH SERVICES INC
GTIV
0001470958
Retchin Sheldon M
3350 RIVERWOOD PKWY, SUITE 1400
ATLANTA
GA
30339
1
0
0
0
Common stock units
0
2011-09-01
4
A
0
4141
0
A
Common stock
4141
10313
D
The common stock units of Gentiva Health Services, Inc. are convertible to shares of common stock of Gentiva at a conversion ratio of one unit for one share of common stock.
The common stock units are convertible upon the date of termination of service to the Issuer.
David Brown, by power of attorney
2011-09-06