0001209191-16-130265.txt : 20160630 0001209191-16-130265.hdr.sgml : 20160630 20160630170442 ACCESSION NUMBER: 0001209191-16-130265 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160630 FILED AS OF DATE: 20160630 DATE AS OF CHANGE: 20160630 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COMMUNITY HEALTH SYSTEMS INC CENTRAL INDEX KEY: 0001108109 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 133893191 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4000 MERIDIAN BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: 615-465-7000 MAIL ADDRESS: STREET 1: 4000 MERIDIAN BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 FORMER COMPANY: FORMER CONFORMED NAME: COMMUNITY HEALTH SYSTEMS INC/ DATE OF NAME CHANGE: 20000229 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ely James S. III CENTRAL INDEX KEY: 0001463791 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15925 FILM NUMBER: 161743809 MAIL ADDRESS: STREET 1: 4000 MERIDIAN BLVD CITY: FRANKLIN STATE: TN ZIP: 37067 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-06-30 0 0001108109 COMMUNITY HEALTH SYSTEMS INC CYH 0001463791 Ely James S. III 4000 MERIDIAN BLVD FRANKLIN TN 37067 1 0 0 0 Common Stock 43798 D Common Stock 4990 I By E5 Investors LLC Stock Units (SU) 0.00 2016-06-30 4 A 0 2489.627 12.05 A Common Stock 2489.627 8001.564 D Restricted Stock Units 0.00 2015-03-01 2024-02-29 Common Stock 1474 1474 D Restricted Stock Units 0.00 2016-03-01 2025-02-28 Common Stock 2859 2859 D Restricted Stock Units 0.00 2017-03-01 2026-02-28 Common Stock 13484 13484 D The Stock Units were accrued under the Company's Directors' Fees Deferral Plan in lieu of a portion of the Reporting Person's Director Fees and are settled 100% in the Company's common stock upon cessation as a director or upon a date specified by the director. NOTE: The number of restricted stock units and stock units accrued under the Company's Directors' Fees Deferral Plan for each award listed on Table II granted prior to April 29, 2016, was adjusted pursuant to the Employee Matters Agreement between the Issuer and Quorum Health Corporation ("QHC"), dated as of April 29, 2016, to preserve the aggregate intrinsic value of the original award as a result of the spin-off from the Issuer of QHC, effective April 29, 2016. Christopher G. Cobb, Attorney in Fact for James S. Ely 2016-06-30