-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GIaNL5Qoftu9tTWxD+Y+ECmWGDxYhD00aWkOmkCd03uZ0pD8YBwByuseJfxTc5rA WKkIQere5WFgxksdizwmcQ== 0001181431-08-027336.txt : 20080429 0001181431-08-027336.hdr.sgml : 20080429 20080429182733 ACCESSION NUMBER: 0001181431-08-027336 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080429 FILED AS OF DATE: 20080429 DATE AS OF CHANGE: 20080429 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HCA INC/TN CENTRAL INDEX KEY: 0000860730 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 752497104 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE PARK PLZ CITY: NASHVILLE STATE: TN ZIP: 37203 BUSINESS PHONE: 6153449551 MAIL ADDRESS: STREET 1: ONE PARK PLAZA CITY: NASHVILLE STATE: TN ZIP: 37203 FORMER COMPANY: FORMER CONFORMED NAME: HCA THE HEALTHCARE CO DATE OF NAME CHANGE: 20010419 FORMER COMPANY: FORMER CONFORMED NAME: COLUMBIA HCA HEALTHCARE CORP DATE OF NAME CHANGE: 20000502 FORMER COMPANY: FORMER CONFORMED NAME: COLUMBIA HCA HEALTHCARE CORP/ DATE OF NAME CHANGE: 19940314 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bain Capital Hercules Investors, LLC CENTRAL INDEX KEY: 0001432604 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 08787329 BUSINESS ADDRESS: STREET 1: C/O BAIN CAPITAL PARTNERS, LLC STREET 2: 111 HUNTINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02116 BUSINESS PHONE: 6175162878 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL PARTNERS, LLC STREET 2: 111 HUNTINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BCIP TCV, LLC CENTRAL INDEX KEY: 0001326753 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 08787330 BUSINESS ADDRESS: STREET 1: C/O BAIN CAPITAL, LLC STREET 2: 111 HUNTINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02199 BUSINESS PHONE: 617-516-2000 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL, LLC STREET 2: 111 HUNTINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02199 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bain Capital Integral Investors, LLC CENTRAL INDEX KEY: 0001326754 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 08787331 BUSINESS ADDRESS: STREET 1: C/O BAIN CAPITAL, LLC STREET 2: 111 HUNTINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02199 BUSINESS PHONE: 617-516-2000 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL, LLC STREET 2: 111 HUNTINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02199 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BAIN CAPITAL INVESTORS LLC CENTRAL INDEX KEY: 0001040508 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 08787332 BUSINESS ADDRESS: STREET 1: C/O BAIN CAPITAL LLC STREET 2: 111 HUNINGTON AVE CITY: BOSTON STATE: MA ZIP: 02199 BUSINESS PHONE: 6175162000 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL LLC STREET 2: 111 HUNINGTON AVE CITY: BOSTON STATE: MA ZIP: 02199 3 1 rrd203549.xml FORM 3 X0202 3 2008-04-29 0 0000860730 HCA INC/TN HCA 0001040508 BAIN CAPITAL INVESTORS LLC 111 HUNTINGTON AVENUE BOSTON MA 02199 0 0 1 0 0001326754 Bain Capital Integral Investors, LLC 111 HUNTINGTON AVENUE BOSTON MA 02199 0 0 1 0 0001326753 BCIP TCV, LLC 111 HUNTINGTON AVENUE BOSTON MA 02199 0 0 1 0 0001432604 Bain Capital Hercules Investors, LLC 111 HUNTINGTON AVENUE BOSTON MA 02199 0 0 1 0 Common stock, par value $0.01 per share 23373333 I See Footnotes Hercules Holding II, LLC holds 91,845,692 shares, or 97.5%, of the common stock of HCA Inc. Hercules Holding II, LCC is held by a private investor group, including affiliates of Bain Capital Investors, LLC, Kohlberg Kravis Roberts & Co. L.P. and Merrill Lynch Global Private Equity, and affiliates of HCA Inc. founder Dr. Thomas F. Frist, Jr. Each of the Reporting Persons may be deemed to be a member of a group exercising voting and investment control over the shares of common stock held by HCA Inc. However, each Reporting Person disclaims membership in any such group and disclaims beneficial ownership of these securities, except to the extent of its or his pecuniary interest therein. Bain Capital Integral Investors 2006, LLC ("Integral 2006"), whose administrative member is Bain Capital Investors, LLC ("BCI"), indirectly owns 21,720,908 shares of Common stock of HCA Inc. by virtue of its membership in Hercules Holding II, LLC. Because BCI is the administrative member of Integral 2006, BCI may be deemed to share voting and dispositive power with respect to the shares of common stock held by Integral 2006. BCI disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein. BCIP TCV, LLC ("BCIP TCV"), whose administrative member is BCI, indirectly owns 156,670 shares of common stock of HCA Inc. by virtue of its membership in Hercules Holding II, LLC. Because BCI is the administrative member of BCIP TCV, BCI may be deemed to share voting and dispositive power with respect to the shares of common stock held by BCIP TCV. BCI disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein. Bain Capital Hercules Investors, LLC ("Hercules Investors"), whose administrative member is BCI, indirectly owns 1,495,755 shares of common stock of HCA Inc. by virtue of its membership in Hercules Holding II, LLC. Because BCI is the administrative member of Hercules Investors, BCI may be deemed to share voting and dispositive power with respect to the shares of common stock held by Hercules Investors. BCI disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein. The filing of this statement shall not be deemed an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, any of the Reporting Persons is the beneficial owner of all such equity securities covered by this statement. /s/ Stephen G. Pagliuca, Managing Director of Bain Capital Investors, LLC 2008-04-29 -----END PRIVACY-ENHANCED MESSAGE-----