Statement of Changes in Beneficial Ownership (4)
May 08 2019 - 4:23PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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SMITH WAYNE T
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2. Issuer Name
and
Ticker or Trading Symbol
COMMUNITY HEALTH SYSTEMS INC
[
CYH
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Chairman & CEO
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(Last)
(First)
(Middle)
4000 MERIDIAN BOULEVARD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
5/8/2019
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(Street)
FRANKLIN, TN 37067
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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5/8/2019
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P
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6551
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A
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$3.468
(1)
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2636482
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D
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Common Stock
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206842
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I
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by 2009 WTS Irrevocable Trust Dated 2/27/09
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Common Stock
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481721
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I
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WAC LLC
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Options (Right to Buy)
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$30.32
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2/24/2011
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2/23/2020
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Common Stock
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50000
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50000
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D
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Stock Options (Right to Buy)
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$34.38
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2/23/2012
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2/22/2021
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Common Stock
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50000
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50000
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D
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Stock Options (Right to Buy)
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$17.49
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2/16/2013
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2/15/2022
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Common Stock
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40000
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40000
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D
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Stock Options (Right to Buy)
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$4.99
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3/1/2020
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2/28/2029
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Common Stock
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78750
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78750
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D
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Performance Based Restricted
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$0.00
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(2)
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(2)
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Common Stock
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75000
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75000
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D
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Performance Based Restricted
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$0.00
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(3)
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(3)
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Common Stock
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105000
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105000
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D
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Performance Based Restricted
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$0.00
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(4)
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(4)
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Common Stock
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157500
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157500
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D
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Explanation of Responses:
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(1)
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The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions on 5/8/2019 at prices ranging from $3.36 to $3.575, inclusive. The reporting person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote. Together with shares purchased by the reporting person on 5/3/2019, 5/6/2019 and 5/7/2019, which purchases were reported in the Form 4 filed for the reporting person on 5/7/2019, the reporting person has purchased a total of 1,000,000 shares of the Issuer's common stock since 5/3/2019 at a weighted average purchase price for all such purchases of $3.368.
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(2)
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The vesting of these performance-based restricted shares is subject to the attainment of certain performance objectives between 1/1/2017 and 12/31/2019 (the "2017-2019 Performance Period"). The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. Between 0% and 200% of the portion of the target number of performance-based restricted shares allocated to each applicable performance objective will ultimately vest on the third anniversary of the date of grant, subject to the attainment of the applicable performance objective, with the vesting percentage to be determined based upon the level of achievement with respect to the applicable performance objective during the 2017-2019 Performance Period.
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(3)
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The vesting of these performance-based restricted shares is subject to the attainment of certain performance objectives between 1/1/2018 and 12/31/2020 (the "2018-2020 Performance Period"). The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. Between 0% and 200% of the portion of the target number of performance-based restricted shares allocated to each applicable performance objective will ultimately vest on the third anniversary of the date of grant, subject to the attainment of the applicable performance objective, with the vesting percentage to be determined based upon the level of achievement with respect to the applicable performance objective during the 2018-2020 Performance Period.
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(4)
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The vesting of these performance-based restricted shares is subject to the attainment of certain performance objectives between 1/1/2019 and 12/31/2021 (the "2019-2021 Performance Period"). The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. Between 0% and 200% of the portion of the target number of performance-based restricted shares allocated to each applicable performance objective will ultimately vest on the third anniversary of the date of grant, subject to the attainment of the applicable performance objective, with the vesting percentage to be determined based upon the level of achievement with respect to the applicable performance objective during the 2019-2021 Performance Period.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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SMITH WAYNE T
4000 MERIDIAN BOULEVARD
FRANKLIN, TN 37067
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X
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Chairman & CEO
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Signatures
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Christopher G. Cobb, Attorney in Fact for Wayne T. Smith
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5/8/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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