X0306 4 2021-12-29 0001095565 HEALTHSTREAM INC HSTM 0001217273 FRIST ROBERT A JR 500 11TH AVENUE NORTH SUITE 1000 NASHVILLE TN 37203 1 1 1 CEO and Chairman Common Stock Holding 2021-12-29 4 D 0 93607 0 D 4762843 D Common Stock Holding 10000 I The Carolyn Marie Frist 2005 Vested Trust Common Stock Holding 10000 I The Cate Merriman Frist 2005 Vested Trust Common Stock Holding 10000 I The Eleanor Knox Frist 2005 Vested Trust Common Stock Holding 18335 I Louise Trust u/a/d 08-16-2007 Common Stock Holding 18334 I Merriman Trust u/a/d 08-16-2007 Common Stock Holding 18334 I Marie Trust u/a/d 08-16-2007 Common Stock Holding 18334 I Knox Trust u/a/d 08-16-2007 Common Stock Holding 595000 I Bobby and Melissa Frist Children's 2012 GST-Exempt Trust On December 29, 2021, Robert A. Frist, Jr., the chief executive officer and chairman of HealthStream, Inc. (the "Company"), contributed 86,494 of his shares of Company common stock to the Company without any consideration paid to Mr. Frist. This contribution is for the benefit of over 1,000 employees, excluding executives, vice presidents, or associate vice presidents. The Company has approved the grant of that same number of shares contributed by Mr. Frist under its 2016 Omnibus Incentive Plan to these employees. It is contemplated that these shares, which will not be subject to any vesting conditions, will be issued on December 29, 2021. In addition, on December 29, 2021, Mr. Frist contributed an additional 7,113 shares to the Company, without consideration paid to Mr. Frist, which amount is equivalent to the estimated Company costs associated with the equity grants, such as administrative expenses and employer payroll taxes, which will be associated with the grants. /s/ Robert A. Frist, Jr. 2021-12-29