0001209191-17-016532.txt : 20170302 0001209191-17-016532.hdr.sgml : 20170302 20170302161243 ACCESSION NUMBER: 0001209191-17-016532 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170301 FILED AS OF DATE: 20170302 DATE AS OF CHANGE: 20170302 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: 17658891 MAIL ADDRESS: STREET 1: 4000 MERIDIAN BLVD CITY: FRANKLIN STATE: TN ZIP: 37067 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-03-01 0 0001108109 COMMUNITY HEALTH SYSTEMS INC CYH 0001463791 Ely James S. III 4000 MERIDIAN BLVD FRANKLIN TN 37067 1 0 0 0 Common Stock 2017-03-01 4 M 0 1474 0.00 A 45272 D Common Stock 2017-03-01 4 M 0 1430 0.00 A 46702 D Common Stock 2017-03-01 4 M 0 4495 0.00 A 51197 D Common Stock 4990 I By E5 Investors LLC Restricted Stock Units 0.00 2017-03-01 4 M 0 1474 0.00 D 2015-03-01 2024-02-29 Common Stock 1474 0 D Restricted Stock Units 0.00 2017-03-01 4 M 0 1430 0.00 D 2016-03-01 2025-02-28 Common Stock 1430 1429 D Restricted Stock Units 0.00 2017-03-01 4 M 0 4495 0.00 D 2017-03-01 2026-02-28 Common Stock 4495 8989 D Restricted Stock Units 0.00 2017-03-01 4 A 0 18498 9.19 A 2018-03-01 2027-02-28 Common Stock 18498 18498 D Stock Units (SU) 0.00 Common Stock 15967.943 15967.943 D The security converts to common stock on a one-to-one basis. The Restricted Stock Units vest in 1/3 increments on the first, second and third anniversary date of the date of grant. Upon vesting, the Reporting Person will be issued that number of shares of the Common Stock of the Company. 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 2017-03-02