0001209191-16-098986.txt : 20160216 0001209191-16-098986.hdr.sgml : 20160215 20160216200818 ACCESSION NUMBER: 0001209191-16-098986 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160216 DATE AS OF CHANGE: 20160216 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 JR CENTRAL INDEX KEY: 0000900596 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 161431239 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2015-12-31 0 0 0 0000860730 HCA Holdings, Inc. HCA 0000900596 FRIST THOMAS F JR 3100 WEST END AVENUE NASHVILLE TN 37203 0 0 1 0 Common Stock, par value $0.01 per share 2015-02-25 5 G 0 625674.3884 0.00 D 0 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist, Jr. 2013 GRAT Common Stock, par value $0.01 per share 2015-02-25 5 G 0 213824.8834 0.00 D 0 I Held indirectly through Hercules Holding II, LLC by Patricia Champion Frist 2013 GRAT Common Stock, par value $0.01 per share 2015-05-26 5 G 0 317076 0.00 D 0 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist Jr. 2010 GRAT Common Stock, par value $0.01 per share 72561.6299 I Held indirectly through Hercules Holding II, LLC Common Stock, par value $0.01 per share 204968.4898 I Held indirectly through Hercules Holding II, LLC by Patricia C. Frist Common Stock, par value $0.01 per share 72589.0649 I Held indirectly through Hercules Holding II, LLC by Thomas F. Frist GST Tax Exempt Trust Common Stock, par value $0.01 per share 340217 I Held indirectly through Hercules Holding II, LLC by Patricia Champion Frist 2013 GRAT No. 3 Common Stock, par value $0.01 per share 168876 I Held indirectly through Hercules Holding II, LLC by Patricia Champion Frist 2015 GRAT Common Stock, par value $0.01 per share 387659.7546 I Held indirectly through Hercules Holding II, LLC by Frist Children's Trust Common Stock, par value $0.01 per share 6657331.3176 I Held indirectly through Hercules Holding II, LLC by Frist Children's Trust II 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 84,137,913 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 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's wife is the trustee of (i) Frist Children's Trust, (ii) Frist Children's Trust II, (iii) Thomas F. Frist, Jr. 2013 Grantor Retained Annuity Trust and (iv) Thomas F. Frist, Jr. 2010 Grantor Retained Annuity Trust and the Reporting Person may therefore 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 is the trustee of (i) Thomas F. Frist GST Tax Exempt Trust, (ii) Patricia Champion Frist 2013 Grantor Retained Annuity Trust No. 3, (iii) Patricia Champion Frist 2015 Grantor Retained Annuity Trust and (iv) Patricia Champion Frist 2013 Grantor Retained Annuity Trust 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 directly owns 72,561.6299 units of Hercules and therefore may be deemed to own indirectly the same number of shares of common stock of HCA Holdings, Inc. by virtue of his membership in Hercules. The Reporting Person may also be deemed to have indirect beneficial ownership in respect of 204,968.4898 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 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 2016-02-16