SEC Form 4 · accession 0001316576-18-000001
Genesis Healthcare, Inc. · GEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Arnold M Whitman
Director · 10% Owner
Period of report
Jun 6, 2018
Accepted (ET)
Jun 6, 2018 · 3:43 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001351051
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF2 | Jun 6, 2018 | A | 68,650 | $0.00 | A | 191,952 | D | |
| Class A Common StockF3 | holding | — | — | — | 6,937,750 | I | (3) | |
| Class A Common StockF4 | holding | — | — | — | 1,003,512 | I | (4) | |
| Class A Common StockF5 | holding | — | — | — | 501,815 | I | (5) |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Grant of restricted stock units under the Issuer's 2015 Omnibus Equity Incentive Plan.
- F2Includes 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.
- F3Represents 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.
- F4Represents Class A Shares held by HCCF Management Group, Inc., of which Mr. Whitman may be deemed to be the beneficial owner.
- F5Represents 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.