0001316576-18-000001.txt : 20180606
0001316576-18-000001.hdr.sgml : 20180606
20180606154313
ACCESSION NUMBER: 0001316576-18-000001
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180606
FILED AS OF DATE: 20180606
DATE AS OF CHANGE: 20180606
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Whitman Arnold M
CENTRAL INDEX KEY: 0001316576
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33459
FILM NUMBER: 18883775
MAIL ADDRESS:
STREET 1: 3280 MANSELL ROAD
STREET 2: SUITE 280
CITY: ALPHARETTA
STATE: GA
ZIP: 30022
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Genesis Healthcare, Inc.
CENTRAL INDEX KEY: 0001351051
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 101 EAST STATE STREET
CITY: KENNETT SQUARE
STATE: PA
ZIP: 19348
BUSINESS PHONE: 610-444-6350
MAIL ADDRESS:
STREET 1: 101 EAST STATE STREET
CITY: KENNETT SQUARE
STATE: PA
ZIP: 19348
FORMER COMPANY:
FORMER CONFORMED NAME: Skilled Healthcare Group, Inc.
DATE OF NAME CHANGE: 20070209
FORMER COMPANY:
FORMER CONFORMED NAME: SHG Holding Solutions Inc
DATE OF NAME CHANGE: 20060126
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2018-06-06
0
0001351051
Genesis Healthcare, Inc.
GEN
0001316576
Whitman Arnold M
C/O GENESIS HEALTHCARE, INC.
101 EAST STATE STREET
KENNETT SQUARE
PA
19348
1
0
1
0
Class A Common Stock
2018-06-06
4
A
0
68650
0
A
191952
D
Class A Common Stock
6937750
I
(3)
Class A Common Stock
1003512
I
(4)
Class A Common Stock
501815
I
(5)
Grant of restricted stock units under the Issuer's 2015 Omnibus Equity Incentive Plan.
Includes 68,650 unvested restricted stock units and 92,000 vested restricted stock units that have not yet been paid in shares of the Issuer's Class A Common Stock.
Represents shares of Class A Common Stock of the Issuer ("Class A Shares") held by HCCF Management Group XI, LLC, of which Mr. Whitman may be deemed to be the beneficial owner.
Represents Class A Shares held by HCCF Management Group, Inc., of which Mr. Whitman may be deemed to be the beneficial owner.
Represents Class A Shares held by FC Profit Sharing, LLC, of which Mr. Whitman may be deemed to be the beneficial owner as a principal of Formation Capital, LLC, the sole member of FC Profit Sharing, LLC. Mr. Whitman disclaims beneficial ownership of such Class A Shares, except to the extent of Mr. Whitman's pecuniary interest therein.
Michael Berg, Attorney-in-Fact for: Arnold M. Whitman
2018-06-06