0001633878-19-000001.txt : 20190605
0001633878-19-000001.hdr.sgml : 20190605
20190605161631
ACCESSION NUMBER: 0001633878-19-000001
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190605
FILED AS OF DATE: 20190605
DATE AS OF CHANGE: 20190605
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hartman Robert
CENTRAL INDEX KEY: 0001633878
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33459
FILM NUMBER: 19879900
MAIL ADDRESS:
STREET 1: 6633 N. LINCOLN AVENUE
CITY: LINCOLNWOOD
STATE: IL
ZIP: 60712
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
2019-06-05
0
0001351051
Genesis Healthcare, Inc.
GEN
0001633878
Hartman Robert
C/O GENESIS HEALTHCARE, INC.
101 EAST STATE STREET
KENNETT SQUARE
PA
19348
1
0
0
0
Class A Common Stock
2019-06-05
4
A
0
124079
0
A
304531
D
Class A Common Stock
1190955
I
See footnote
Class A Common Stock
779766
I
See footnote
Grant of restricted stock units under the Issuer's 2015 Omnibus Equity Incentive Plan.
Includes 124,079 unvested restricted stock units and 52,000 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 Midway Gen Capital, LLC, of which Mr. Hartman may be deemed to be the beneficial owner. Mr. Hartman disclaims beneficial ownership of such Class A Shares, except to the extent of Mr. Hartman's pecuniary interest therein.
Represents Class A Shares held by GHC Class B LLC, of which Mr. Hartman may be deemed to be the beneficial owner. Mr. Hartman disclaims beneficial ownership of such Class A Shares, except to the extent of Mr. Hartman's pecuniary interest therein.
By: Michael Berg, Attorney-in-Fact for: Robert Hartman
2019-06-05