0001633878-20-000002.txt : 20201203
0001633878-20-000002.hdr.sgml : 20201203
20201203180348
ACCESSION NUMBER: 0001633878-20-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201201
FILED AS OF DATE: 20201203
DATE AS OF CHANGE: 20201203
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: 201367965
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
2020-12-01
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
2020-12-01
4
J
0
1335565.5
0.4789
D
0
I
By HKT1 LLC
Class A Common Stock
2020-12-01
4
J
0
1335565.5
0.4789
A
1335565.5
I
By HKT1 LLC
Class A Common Stock
284729
D
Class A Common Stock
779766
I
By GHC Class B LLC
On December 1, 2020, for estate planning purposes, Mr. Hartman and the Robert Hartman Family Trust, which together owned 100% of HKT1 LLC, sold the entirety of their interests in HKT1 LLC to the Kutner Children Trust, a trust for the benefit of members of Mr. Hartman's family and of which Mr. Hartman serves as the investment manager.
The consideration for the transaction described in footnote 1 consisted of promissory notes for $639,602.32, or $0.4789 per share of Class A Common Stock (the "Shares") held by HKT1 LLC.
Prior to the transaction described in footnote 1, HKT1 LLC was owned by Mr. Hartman and the Robert Hartman Family Trust. Mr. Hartman disclaims beneficial ownership of the Shares, except to the extent of his pecuniary interest therein.
Following the transaction described in footnote 1, HKT1 LLC is now owned 100% by the Kutner Children Trust. Mr. Hartman disclaims beneficial ownership of the Shares, except to the extent of his pecuniary interest therein.
Includes 176,079 vested restricted stock units that have not yet been paid in the Shares.
Mr. Hartman disclaims beneficial ownership of the Shares, except to the extent of his pecuniary interest therein.
By: Michael Berg, Attorney-in-Fact for: Robert Hartman
2020-12-03