FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
GENTIVA HEALTH SERVICES INC [ GTIV ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/11/2013 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common stock | 12/11/2013 | J(1) | V | 49,755 | D | $0 | 0 | I | By Harden Healthcare Texas, LLC | |
Common stock | 12/11/2013 | J(1) | V | 47,726 | A | $0 | 2,279,698(2) | D | ||
Common stock | 96,943 | I | By Kristen Hicks Hanson 2006 Trust, R. Steven Hicks, Trustee | |||||||
Common stock | 96,943 | I | By Robert Steven Hicks 2006 Trust, R. Steven Hicks, Trustee | |||||||
Common stock | 96,943 | I | By Brandon V. Hicks 2006 Trust, R. Steven Hicks, Trustee | |||||||
Common stock | 96,943 | I | By Shelly Mabry Ellard 2006 Trust, R. Steven Hicks, Trustee | |||||||
Common stock | 96,943 | I | By Jason Mabry 2006 Trust, R. Steven Hicks, Trustee | |||||||
Common stock | 10,000 | I | By spouse |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. Pro rata distribution from Harden Healthcare Texas, LLC, of which the reporting person is a member. In his Form 4 filed October 22, 2013, the reporting person reported ownership of 49,755 shares held indirectly through Harden Healthcare Texas, LLC, of which shares the reporting person disclaimed beneficial ownership except to the extent of his pecuniary interest therein. This distribution constitutes a mere change in the form of ownership that does not change the reporting person's pecuniary interest in the shares. |
2. Includes 1,750,684 shares received as a pro rata share of a liquidating distribution from Hicks Healthcare, LP, representing the reporting person's pecuniary interest therein. In his Form 4 filed October 22, 2013, the reporting person reported ownership of 1,906,150 shares held indirectly through Hicks Healthcare, LP, of which the reporting person was managing member of its general partner, of which shares the reporting person disclaimed beneficial ownership except to the extent of his pecuniary interest therein. This distribution constitutes a mere change in the form of ownership that does not change the reporting person's pecuniary interest in the shares. |
Remarks: |
David Brown, by power of attorney | 12/16/2013 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |