0001209191-18-052614.txt : 20180928 0001209191-18-052614.hdr.sgml : 20180928 20180928174246 ACCESSION NUMBER: 0001209191-18-052614 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180927 FILED AS OF DATE: 20180928 DATE AS OF CHANGE: 20180928 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FISH ROBERT H CENTRAL INDEX KEY: 0001220405 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37550 FILM NUMBER: 181095162 MAIL ADDRESS: STREET 1: C/O SKILLED HEALTHCARE STREET 2: 27442 PORTOLA PARKWAY, SUITE 200 CITY: FOOTHILL RANCH STATE: CA ZIP: 92610 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Quorum Health Corp CENTRAL INDEX KEY: 0001650445 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 474725208 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1573 MALLORY LANE CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 615-221-1400 MAIL ADDRESS: STREET 1: 1573 MALLORY LANE CITY: BRENTWOOD STATE: TN ZIP: 37027 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-09-27 0 0001650445 Quorum Health Corp QHC 0001220405 FISH ROBERT H 1573 MALLORY LANE SUITE 100 BRENTWOOD TN 37027 1 1 0 0 President and CEO Common stock, par value $0.0001 per share 2018-09-27 4 J 0 500000 0.00 D 0 D Common stock, par value $0.0001 per share 2018-09-27 4 A 0 500000 0.00 A 500000 D On September 27, 2018, Quorum Health Corporation (the "Issuer") and the reporting person entered into an Acknowledgement of Award Cancellation cancelling the August 24, 2018 award of 500,000 shares of the Issuer's restricted common stock because it was issued in excess of the limitations under the Issuer's 2016 Stock Award Plan. Thereafter, the Issuer re-granted to the reporting person 500,000 shares of restricted common stock as an inducement award outside the Issuer's 2016 Stock Award Plan in reliance on the employment inducement exemption to shareholder approval provided under the New York Stock Exchange's Listed Company Manual Rule 303A.08. 50% of the award is time-based restricted stock and vests in one-third increments on each of the first three anniversaries of May 21, 2018. 50% of the award is performance-based restricted stock with both performance and time vesting components. /s/ R. Harold McCard, Jr., Attorney in Fact for Robert H. Fish 2018-09-28