0001209191-16-143597.txt : 20161003 0001209191-16-143597.hdr.sgml : 20161003 20161003161814 ACCESSION NUMBER: 0001209191-16-143597 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161001 FILED AS OF DATE: 20161003 DATE AS OF CHANGE: 20161003 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: Hingtgen Tim CENTRAL INDEX KEY: 0001598637 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15925 FILM NUMBER: 161915927 MAIL ADDRESS: STREET 1: 4000 MERIDIAN BOULEVARD CITY: FRANKLIN STATE: TN ZIP: 37067 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-10-01 0 0001108109 COMMUNITY HEALTH SYSTEMS INC CYH 0001598637 Hingtgen Tim 4000 MERIDIAN BOULEVARD FRANKLIN TN 37067 0 1 0 0 President and COO Common Stock 2016-10-01 4 A 0 50000 0.00 A 126074 D Stock Options (Right to Buy) 33.18 2009-05-20 2018-05-19 Common Stock 1500 1500 D Stock Options (Right to Buy) 30.32 2011-02-24 2020-02-23 Common Stock 1000 1000 D Stock Options (Right to Buy) 34.38 2012-02-23 2021-02-22 Common Stock 1000 1000 D Stock Options (Right to Buy) 17.49 2013-02-16 2022-02-15 Common Stock 334 334 D Performance Based Restricted 0.00 2017-03-01 2026-02-28 Common Stock 40000 40000 D These restricted shares were granted to the Reporting Person in conjunction with his promotion to President and Chief Operating Officer of the Issuer. The restrictions will lapse in 1/3 increments on the first, second and third anniversary of the date of grant. Each performance based restricted share represents a contingent right to receive one share of CYH common stock. There are two elements to the lapsing of the performance-based restriction; first, Issuer must achieve specified targeted amount of adjusted EBITDA or net revenue from continuing operations, and if the performance objective is met, the time-vesting restrictions will lapse in 1/3 increments on the first, second and third anniversary of the date of grant. If the performance objectives are not met, the shares will be forfeited. NOTE: The per share exercise price of each option 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 Tim Hingtgen 2016-10-03