0001693042-21-000001.txt : 20210528 0001693042-21-000001.hdr.sgml : 20210528 20210528152839 ACCESSION NUMBER: 0001693042-21-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210515 FILED AS OF DATE: 20210528 DATE AS OF CHANGE: 20210528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bach Paul David CENTRAL INDEX KEY: 0001693042 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33459 FILM NUMBER: 21979758 MAIL ADDRESS: STREET 1: 101 EAST STATE STREET CITY: KENNETT SQUARE STATE: PA ZIP: 19348 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 2021-05-15 0 0001351051 Genesis Healthcare, Inc. GEN 0001693042 Bach Paul David C/O GENESIS HEALTHCARE, INC. 101 EAST STATE STREET KENNETT SQUARE PA 19348 0 1 0 0 COO Class A Common Stock 2021-05-15 4 F 0 66598 0.24 D 952089 D The shares were withheld from issuance to the reporting person to satisfy the reporting person's income tax obligations with respect to the vesting of a restricted stock unit award. Includes 662,006 unvested restricted stock units that have not yet been paid in shares of the Issuer's Class A Common Stock. By: Michael Berg, Attorney-in-Fact for: Paul David Bach 2021-05-28