0001209191-21-016090.txt : 20210302 0001209191-21-016090.hdr.sgml : 20210302 20210302164218 ACCESSION NUMBER: 0001209191-21-016090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210301 FILED AS OF DATE: 20210302 DATE AS OF CHANGE: 20210302 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITH WAYNE T CENTRAL INDEX KEY: 0001018660 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15925 FILM NUMBER: 21704439 MAIL ADDRESS: STREET 1: 500 WEST MAIN STREET CITY: LOUISVILLE STATE: KY ZIP: 40202 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-03-01 0 0001108109 COMMUNITY HEALTH SYSTEMS INC CYH 0001018660 SMITH WAYNE T 4000 MERIDIAN BOULEVARD FRANKLIN TN 37067 1 1 0 0 Executive Chairman Common Stock 2021-03-01 4 M 0 210000 0.00 A 2725041 D Common Stock 2021-03-01 4 A 0 90000 0.00 A 2815041 D Common Stock 1606842 I by 2009 WTS Irrevocable Trust Dated 2/27/09 Common Stock 481721 I WAC LLC Performance Based Restricted 0.00 2021-03-01 4 M 0 105000 0.00 D Common Stock 105000 0 D Performance Based Restricted 0.00 2021-03-01 4 A 0 180000 0.00 A Common Stock 180000 180000 D Stock Options (Right to Buy) 8.81 2021-03-01 4 A 0 90000 0.00 A 2022-03-01 2031-02-28 Common Stock 90000 90000 D Performance Based Restricted 0.00 Common Stock 157500 157500 D Performance Based Restricted 0.00 Common Stock 225000 225000 D Stock Options (Right to Buy) 17.49 2013-02-16 2022-02-15 Common Stock 40000 40000 D Stock Options (Right to Buy) 4.99 2020-03-01 2029-02-28 Common Stock 78750 78750 D Stock Options (Right to Buy) 4.93 2021-03-01 2030-02-28 Common Stock 112500 112500 D The vesting of these performance-based restricted shares was based on the attainment of certain performance objectives between 1/1/2018 and 12/31/2020 (the "2018-2020 Performance Period"). Based on the actual level of achievement of such performance objectives for the 2018-2020 Performance Period, the award vested on March 1, 2021 at 200% of the target number of the performance-based restricted shares originally reported by the reporting person on 3/2/2018. The time-vesting restrictions on this award of restricted stock will lapse in 1/3 increments on the first, second and third anniversary of the date of grant. The vesting of these performance-based restricted shares is allocated to the attainment of the following pre-determined performance objectives between 1/1/2021 and 12/31/2023 (the "2021-2023 Performance Period"), as follows: 40% to a Cumulative Consolidated Adjusted EBITDA Growth target; 40% to a Cumulative Same-Store Net Revenue Growth target; and 20% to a Total Shareholder Return ("TSR") Percentile Rank target. The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. Between 0% and 200% of the portion of the target number of performance-based restricted shares allocated to each performance objective will ultimately vest on the third anniversary of the date of grant, subject to the attainment of the applicable performance objective, with the vesting percentage to be determined based upon the level of achievement with respect to the applicable performance objective during the 2021-2023 Performance Period. Vesting occurs in 1/3 increments on the first, second and third anniversary of the date of grant. The vesting of these performance-based restricted shares is subject to the attainment of certain performance objectives between 1/1/2019 and 12/31/2021 (the "2019-2021 Performance Period"). The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. Between 0% and 200% of the portion of the target number of performance-based restricted shares allocated to each applicable performance objective will ultimately vest on the third anniversary of the date of grant, subject to the attainment of the applicable performance objective, with the vesting percentage to be determined based upon the level of achievement with respect to the applicable performance objective during the 2019-2021 Performance Period. The vesting of these performance-based restricted shares is subject to the attainment of certain performance objectives between 1/1/2020 and 12/31/2022 (the "2020-2022 Performance Period"). The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. Between 0% and 200% of the portion of the target number of performance-based restricted shares allocated to each applicable performance objective will ultimately vest on the third anniversary of the date of grant, subject to the attainment of the applicable performance objective, with the vesting percentage to be determined based upon the level of achievement with respect to the applicable performance objective during the 2020-2022 Performance Period. Christopher G. Cobb, Attorney in Fact for Wayne T. Smith 2021-03-02