Sec Form 3/A Filing - Robert & Debra F. Hartman Family Trust @ Genesis Healthcare, Inc. - 2015-02-02

Insider filing report for Changes in Beneficial Ownership
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FORM 3/A
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Robert & Debra F. Hartman Family Trust
2. Issuer Name and Ticker or Trading Symbol
Genesis Healthcare, Inc. [ GEN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
6633 NORTH LINCOLNWOOD AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
02/02/2015
(Street)
LINCOLNWOOD, IL60712
4. If Amendment, Date Original Filed (MM/DD/YY)
02/12/2015
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
Shares of Class A Common Stock (par value $0.001 per share) 243,904 D
Shares of Class A Common Stock (par value $0.001 per share) 1,190,955 ( 1 ) I See explanation footnote ( 1 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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
Class A Common Units of FC-GEN Operations Investment, LLC ( 2 ) ( 2 ) ( 2 ) Class A Common Stock 556,430 D
Class A Common Units of FC-GEN Operations Investment, LLC ( 2 ) ( 2 ) ( 2 ) Class A Common Stock 2,716,984 I See explanation footnote ( 1 )
Shares of Class C Common Stock (par value $0.001 per share) ( 3 ) ( 3 ) ( 3 ) Class A Common Stock 97 ( 3 ) D
Shares of Class C Common Stock (par value $0.001 per share) ( 3 ) ( 3 ) ( 3 ) Class A Common Stock 473 ( 3 ) I See explanation footnote ( 1 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Robert & Debra F. Hartman Family Trust
6633 NORTH LINCOLNWOOD AVENUE
LINCOLNWOOD, IL60712
X
Midway Gen Capital, LLC
6633 NORTH LINCOLN AVENUE
LINCOLNWOOD, IL60712
X
Signatures
/s/ Michael Sherman, as Attorney-in-Fact for Robert and Debra F. Hartman Family Trust 02/27/2015
Signature of Reporting Person Date
/s/ Michael Sherman, as Attorney-in-Fact for Midway Gen Capital, LLC 02/27/2015
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents shares of Class A Common Stock of the Issuer ("Class A Shares"), shares of Class C Common Stock of the Issuer ("Class C Shares") on an as-converted basis, or Class A Common Units of FC-GEN Operations Investment, LLC ("OP Units") on an as-exchanged basis, as applicable, held by Midway Gen Capital, LLC, of which the Robert and Debra F. Hartman Family Trust may be deemed to be the beneficial owner. The Robert and Debra F. Hartman Family Trust disclaims beneficial ownership of such Class A Shares, Class C Shares, or OP Units, as applicable, except to the extent of the Robert and Debra F. Hartman Family Trust's pecuniary interest therein.
( 2 )Each OP Unit is exchangeable, pursuant to the terms and subject to the limitations of the limited liability company operating agreement of FC-GEN Operations Investment, LLC and subject to certain adjustments, for one Class A Share.
( 3 )Represents Class C Shares on an as-converted basis. Concurrently with the exchange of an OP Unit as described in footnote 2, subject to certain adjustments, one Class C Share held by the holder of such OP Unit will automatically convert into 0.000174115 Class A Shares.

Remarks:
This amendment is being filed to reflect a correction to the allocation of shares issued pursuant to the transaction that gave rise to the reporting persons' reporting obligations.

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).
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