0000899243-22-023848.txt : 20220623 0000899243-22-023848.hdr.sgml : 20220623 20220623214056 ACCESSION NUMBER: 0000899243-22-023848 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220621 FILED AS OF DATE: 20220623 DATE AS OF CHANGE: 20220623 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SPARBY JOHN M. CENTRAL INDEX KEY: 0001840665 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41428 FILM NUMBER: 221036834 MAIL ADDRESS: STREET 1: C/O R1 RCM INC. STREET 2: 401 N. MICHIGAN AVENUE, SUITE 2700 CITY: CHICAGO STATE: IL ZIP: 60611 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: R1 RCM Inc. /DE CENTRAL INDEX KEY: 0001910851 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741] IRS NUMBER: 874340782 FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 434 W. ASCENSION WAY, 6TH FLOOR CITY: MURRAY STATE: UT ZIP: 84123 BUSINESS PHONE: (312) 324-7820 MAIL ADDRESS: STREET 1: 434 W. ASCENSION WAY, 6TH FLOOR CITY: MURRAY STATE: UT ZIP: 84123 FORMER COMPANY: FORMER CONFORMED NAME: PROJECT ROADRUNNER PARENT INC. DATE OF NAME CHANGE: 20220211 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-06-21 0 0001910851 R1 RCM Inc. /DE RCM 0001840665 SPARBY JOHN M. C/O R1 RCM INC. 434 W. ASCENSION WAY, 6TH FLOOR MURRAY UT 84123 0 1 0 0 See Remarks Common Stock 2022-06-21 4 A 0 201916 A 201916 D Common Stock 2022-06-21 4 A 0 10000 A 10000 I By children's grantor retained annuity trust Common Stock 2022-06-21 4 A 0 30046 A 30046 I By family grantor retained annuity trust Stock Option (right to buy) 2.42 2022-06-21 4 A 0 61012 A 2026-10-03 Common Stock 61012 61012 D Stock Option (right to buy) 3.85 2022-06-21 4 A 0 10000 A 2027-06-12 Common Stock 10000 10000 D On June 21, 2022, pursuant to the Transaction Agreement and Plan of Merger, dated as of January 9, 2022, by and among R1 RCM Holdco Inc. (f/k/a R1 RCM Inc.) ("Old R1"), R1 RCM Inc. (f/k/a Project Roadrunner Parent Inc.) (the "Company"), Project Roadrunner Merger Sub Inc. ("R1 Merger Sub"), CoyCo 1, L.P., CoyCo 2, L.P. and certain other parties, R1 Merger Sub was merged with and into Old R1, with Old R1 surviving as a direct, wholly owned subsidiary of the Company (the "Reorganization"). Upon consummation of the Reorganization, each share of Old R1's common stock issued and outstanding immediately prior to the Reorganization was automatically exchanged into an equivalent corresponding share of common stock of the Company and Old R1's stockholders became stockholders of the Company. In addition, each restricted stock unit ("RSU") and option to purchase shares of common stock of Old R1 issued and outstanding immediately prior to the Reorganization was automatically exchanged into an equivalent corresponding RSU or option to purchase shares of common stock of the Company, subject to the same terms and conditions (including applicable vesting terms) as were applicable to RSUs or options to purchase shares immediately prior to the consummation of the Reorganization. These shares of common stock are held in a grantor retained annuity trust for the benefit of the reporting person and his two children. The reporting person's former spouse is the trustee of the trust. These shares of common stock are held in a grantor retained annuity trust for the benefit of the reporting person and his nieces and nephews. The reporting person shares investment control over issuer securities held by the trust with his former spouse, who is the trustee of the trust. Option was granted under a stock incentive plan, in a transaction exempt under Rule 16(b)-3. The option is fully vested. Executive Vice President, Chief Solutions & Customer Officer /s/ E. Terry Platis, Attorney-in-fact 2022-06-23