SEC Form 4 · accession 0001633878-15-000001
Genesis Healthcare, Inc. · GEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert Hartman
Director · 10% Owner
Period of report
Jun 3, 2015
Accepted (ET)
Jun 5, 2015 · 5:31 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 3, 2015 | A | 19,802 | $0.00 | A | 19,802 | D | |
| Class A Common StockF3 | holding | — | — | — | 1,190,955 | I | (3) | |
| Class A Common StockF4 | holding | — | — | — | 779,766 | I | (4) |
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 19,802 unvested 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 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.
- F4Represents 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.