0001209191-15-014550.txt : 20150218 0001209191-15-014550.hdr.sgml : 20150216 20150217164606 ACCESSION NUMBER: 0001209191-15-014550 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141231 FILED AS OF DATE: 20150217 DATE AS OF CHANGE: 20150217 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HCA Holdings, Inc. CENTRAL INDEX KEY: 0000860730 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 273865930 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 INC/TN DATE OF NAME CHANGE: 20010627 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FRIST THOMAS F III CENTRAL INDEX KEY: 0001223892 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 15623663 MAIL ADDRESS: STREET 1: 3100 WEST END AVENUE SUITE 1225 CITY: NASHVILLE STATE: TN ZIP: 37203 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2014-12-31 0 0 0 0000860730 HCA Holdings, Inc. HCA 0001223892 FRIST THOMAS F III 3100 WEST END AVENUE NASHVILLE TN 37203 1 0 1 0 Common Stock, par value $0.01 per share 2014-02-25 5 G 0 965312.9574 0.00 A 1298338.4974 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist III 2014 Annuity Trust I Common Stock, par value $0.01 per share 2014-05-19 5 G 0 2155327.3333 0.00 A 2155327.3333 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist III 2014 Annuity Trust II Common Stock, par value $0.01 per share 2014-11-17 5 G 0 172883.5988 0.00 A 172883.5988 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist III 2014 Annuity Trust III Common Stock, par value $0.01 per share 9496.54 I Held indirectly through Hercules Holding II, LLC by Julie D. Frist Common Stock, par value $0.01 per share 251424.0497 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist III 2010 GRAT Common Stock, par value $0.01 per share 250170 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist III 2013 Annuity Trust I Common Stock, par value $0.01 per share 28489.62 I Held indirectly through Hercules Holding II, LLC by Trusts for Children Common Stock, par value $0.01 per share 36629163.8593 I Held indirectly through Hercules Holding II, LLC by Frisco, Inc. Hercules Holding II, LLC ("Hercules") holds 91,750,834 shares of the common stock of HCA Holdings, Inc. Hercules has issued one unit per share of HCA Holdings, Inc. that it owns directly. Hercules is held by a private investor group, including affiliates of Bain Capital Investors, LLC, Kohlberg Kravis Roberts & Co. L.P. and affiliates of HCA Inc. founder Dr. Thomas F. Frist, Jr. The Reporting Person may be deemed to be a member of a group exercising voting and investment control over the shares of common stock of HCA Holdings, Inc. held by Hercules. However, the Reporting Person disclaims membership in any such group and disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein. The Reporting Person received gifts of 965,312.9574, 2,155,327.3333 and 172,883.5988 units of Hercules on February 25, 2014, May 19, 2014 and November 17, 2014, respectively, which were subsequently transferred to Thomas F. Frist III 2014 Annuity Trust I, Thomas F. Frist III 2014 Annuity Trust II and Thomas F. Frist III 2014 Annuity Trust III, respectively, each of which he serves as trustee. Following receipt of these gifts, the Reporting Person may be deemed the beneficial owner of the units of Hercules held by these trusts, and therefore may be deemed to own indirectly the same number of shares of common stock of HCA Holdings, Inc. The Reporting Person may be deemed to have in indirect beneficial ownership in respect of 9,496.54 units of Hercules through an indirect pecuniary interest in such units held by his wife and therefore may be deemed to own indirectly the same number of shares of common stock of HCA Holdings, Inc. The Reporting Person is the trustee of (i) Thomas F. Frist III 2010 Grantor Retained Annuity Trust and (ii) Thomas F. Frist III 2013 Annuity Trust I and may be deemed to be the beneficial owner of the units of Hercules held by these trusts, and therefore may be deemed to own indirectly the same number of shares of common stock of HCA Holdings, Inc. The Reporting Person may be deemed to be the beneficial owner of the aggregate 28,489.62 units of Hercules held by certain trusts for the benefit of his children, each of which his sister serves as trustee, and therefore may be deemed to own indirectly the same number of shares of common stock of HCA Holdings, Inc. The Reporting Person may be deemed to share voting and dispositive power with respect to 36,629,163.8593 shares of HCA Holdings, Inc. beneficially owned by Frisco, Inc., by virtue of his position as a director of Frisco, Inc. Frisco, Inc. has beneficial ownership of 36,629,163.8593 units of Hercules, and therefore may be deemed to own indirectly the same number of shares of common stock of HCA Holdings, Inc. /s/ Natalie Harrison Cline, Attorney-in-Fact 2015-02-17