0001628280-22-000275.txt : 20220104 0001628280-22-000275.hdr.sgml : 20220104 20220104210937 ACCESSION NUMBER: 0001628280-22-000275 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220104 DATE AS OF CHANGE: 20220104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SPARBY JOHN M. CENTRAL INDEX KEY: 0001840665 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34746 FILM NUMBER: 22508697 MAIL ADDRESS: STREET 1: C/O R1 RCM INC. STREET 2: 401 N. MICHIGAN AVENUE, SUITE 2700 CITY: CHICAGO STATE: IL ZIP: 60611 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: R1 RCM INC. CENTRAL INDEX KEY: 0001472595 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741] IRS NUMBER: 020698101 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 401 NORTH MICHIGAN AVENUE STREET 2: SUITE 2700 CITY: CHICAGO STATE: IL ZIP: 60611 BUSINESS PHONE: 312-324-7820 MAIL ADDRESS: STREET 1: 401 NORTH MICHIGAN AVENUE STREET 2: SUITE 2700 CITY: CHICAGO STATE: IL ZIP: 60611 FORMER COMPANY: FORMER CONFORMED NAME: Accretive Health, Inc. DATE OF NAME CHANGE: 20090918 4 1 wf-form4_164134856128763.xml FORM 4 X0306 4 2021-12-31 0 0001472595 R1 RCM INC. RCM 0001840665 SPARBY JOHN M. C/O R1 RCM INC. 434 W. ASCENSION WAY, 6TH FLOOR MURRAY UT 84123 0 1 0 0 Chief Operating Officer Common Stock 2021-12-31 4 F 0 6212 25.49 D 150265 D Common Stock 10000 I By childrens' grantor retained annuity trust Common Stock 30046 I By family grantor retained annuity trust Represents shares of common stock withheld for taxes upon completion of the remaining time-based vesting condition for awards that were reported on the reporting person's Form 4 on December 23, 2020. These shares of common stock are held in a grantor retained annuity trust for the benefit of the reporting person and his two children. The reporting person's former spouse is the trustee of the trust. These shares of common stock are held in a grantor retained annuity trust for the benefit of the reporting person and his nieces and nephews. The reporting person shares investment control over issuer securities held by the trust with his former spouse, who is the trustee of the trust. /s/ E. Terry Platis, Attorney-in-Fact 2022-01-04