0000950170-23-072382.txt : 20231221
0000950170-23-072382.hdr.sgml : 20231221
20231221202930
ACCESSION NUMBER: 0000950170-23-072382
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231219
FILED AS OF DATE: 20231221
DATE AS OF CHANGE: 20231221
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kaplan Andrew T.
CENTRAL INDEX KEY: 0001752059
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37576
FILM NUMBER: 231506932
MAIL ADDRESS:
STREET 1: C/O BAIN CAPITAL PRIVATE EQUITY, LP
STREET 2: 200 CLARENDON STREET
CITY: BOSTON
STATE: MA
ZIP: 02116
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Surgery Partners, Inc.
CENTRAL INDEX KEY: 0001638833
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062]
ORGANIZATION NAME: 08 Industrial Applications and Services
IRS NUMBER: 473620923
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 310 SEVEN SPRINGS WAY
STREET 2: SUITE 500
CITY: BRENTWOOD
STATE: TN
ZIP: 37027
BUSINESS PHONE: 615-234-5900
MAIL ADDRESS:
STREET 1: 310 SEVEN SPRINGS WAY
STREET 2: SUITE 500
CITY: BRENTWOOD
STATE: TN
ZIP: 37027
4
1
ownership.xml
4
X0508
4
2023-12-19
0001638833
Surgery Partners, Inc.
SGRY
0001752059
Kaplan Andrew T.
200 CLARENDON STREET
BOSTON
MA
02116
true
false
true
false
false
Common Stock
2023-12-19
4
S
false
7826870
33.44
D
50421379
I
See footnote
Common Stock
2023-12-19
4
J
false
474407
0
D
49946972
I
See footnote
Represents shares of Common Stock held directly by BCPE Seminole Holdings LP ("BCPE Seminole"), BCPE Seminole Holdings II Intermediate LP ("BCPE Seminole II"), BCPE Seminole Holdings III, L.P. ("BCPE Seminole III") and BCPE Seminole Holdings IV, L.P. ("BCPE Seminole IV" and, together with BCPE Seminole, BCPE Seminole II and BCPE Seminole III, the "Bain Capital Entities").
Bain Capital Investors, LLC ("BCI") is the sole member of (i) BCPE Seminole GP LLC, which is the general partner of BCPE Seminole and BCPE Seminole IV, (ii) BCPE Seminole GP II LLC, which is the general partner of BCPE Seminole II, and (iii) BCPE Seminole GP III LLC, which is the general partner of BCPE Seminole III. Mr. Kaplan is a Partner of BCI. By virtue of the relationships described in these footnotes, Mr. Kaplan may be deemed to share voting and dispositive power with respect to the shares of Common Stock held by the Bain Capital Entities. Mr. Kaplan disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
On December 19, 2023, BCPE Seminole distributed 474,407 shares of Common Stock to one or more members or partners in connection with certain charitable gifts made by such members or partners or their direct or indirect owners.
/s/ Andrew Kaplan
2023-12-21