SEC Form 4 · accession 0001209191-17-016563
COMMUNITY HEALTH SYSTEMS INC · CYH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rachel A Seifert
Officer — Executive VP and Secretary
Period of report
Mar 1, 2017
Accepted (ET)
Mar 2, 2017 · 4:20 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001108109
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Mar 1, 2017 | F | 14,132 | $9.19 | D | 243,065 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options (Right to Buy) | $28.70 | holding | — | — | — | Feb 27, 2009 | Feb 26, 2018 | Common Stock | 10,000 | 10,000 | D |
| Stock Options (Right to Buy) | $15.01 | holding | — | — | — | Feb 25, 2010 | Feb 24, 2019 | Common Stock | 2,500 | 2,500 | D |
| Stock Options (Right to Buy) | $30.32 | holding | — | — | — | Feb 24, 2011 | Feb 23, 2020 | Common Stock | 7,500 | 7,500 | D |
| Stock Options (Right to Buy) | $34.38 | holding | — | — | — | Feb 23, 2012 | Feb 22, 2021 | Common Stock | 7,500 | 7,500 | D |
| Stock Options (Right to Buy) | $17.49 | holding | — | — | — | Feb 16, 2013 | Feb 15, 2022 | Common Stock | 7,500 | 7,500 | D |
Remarks
NOTE: The per share exercise price of each option listed on Table II granted prior to April 29, 2016, was adjusted pursuant to the Employee Matters Agreement between the Issuer and Quorum Health Corporation ("QHC"), dated as of April 29, 2016, to preserve the aggregate intrinsic value of the original award as a result of the spin-off from the Issuer of QHC, effective April 29, 2016.