0001104659-20-107836.txt : 20200923 0001104659-20-107836.hdr.sgml : 20200923 20200923163212 ACCESSION NUMBER: 0001104659-20-107836 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20200923 DATE AS OF CHANGE: 20200923 GROUP MEMBERS: ASCENSION HEALTH ALLIANCE GROUP MEMBERS: NEAL MOSZKOWSKI GROUP MEMBERS: RAMEZ SOUSOU GROUP MEMBERS: TCP-ASC GP, LLC GROUP MEMBERS: TI IV ACHI HOLDINGS GP, LLC GROUP MEMBERS: TI IV ACHI HOLDINGS, LP GROUP MEMBERS: TOWERBROOK INVESTORS LTD. SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-85967 FILM NUMBER: 201192354 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 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: TCP-ASC ACHI Series LLLP CENTRAL INDEX KEY: 0001663108 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: 65 E 55TH ST 27TH FLOOR STREET 2: TOWERBROOK CAPITAL PARTNERS L.P. CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2126992200 MAIL ADDRESS: STREET 1: 65 E 55TH ST 27TH FLOOR STREET 2: TOWERBROOK CAPITAL PARTNERS L.P. CITY: NEW YORK STATE: NY ZIP: 10022 SC 13D/A 1 tm2031595d1_sc13da.htm SC 13D/A

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13D

Under the Securities Exchange Act of 1934

(Amendment No. 9)*

R1 RCM INC.

(Name of Issuer)

Common Stock, par value $0.01 per share

(Title of Class of Securities)

00438V103

(CUSIP Number)

Glenn Miller

c/o TowerBrook Capital Partners L.P.

Park Avenue Tower

65 East 55th Street, 19th Floor

New York, NY 10022

(212) 699-2200

Copy to:

Steven A. Cohen

Wachtell, Lipton, Rosen & Katz

51 West 52nd Street

New York, NY 10019

(212) 403-1000

Joseph R. Impicciche

c/o Ascension Health Alliance

101 S. Hanley Road, Suite 450

St. Louis, MO 63105

(314) 733-8000

Copy to:

Stephen A. Infante

Covington & Burling LLP

620 Eighth Avenue

New York, NY 10018

(212) 841-1000

(Name, Address and Telephone Number of Persons
Authorized to Receive Notices and Communications)

September 18, 2020

(Date of Event which Requires Filing of this Statement)

If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. ¨

Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See § 240.13d-7 for other parties to whom copies are to be sent.

^* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (the “Exchange Act”) or otherwise subject to the liabilities of that section of the Exchange Act but shall be subject to all other provisions of the Exchange Act (however, see the Notes).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS TCP-ASC ACHI Series LLLP
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) PN

(1) Consists of 113,136,400 shares of Common Stock issuable upon conversion of 282,841 shares of the Issuer’s 8.00% Series A Convertible Preferred Stock and 60,000,000 shares of Common Stock issuable upon exercise of the Warrant. 200,000 shares of the Issuer’s 8.00% Series A Convertible Preferred Stock and the Warrant were issued by the Issuer to the Reporting Persons upon Closing of the Purchase (which occurred on February 16, 2016). The remaining 82,841 shares of the Issuer’s 8.00% Series A Convertible Preferred Stock were issued by the Issuer to the Reporting Persons as a payment-in-kind dividends pursuant to the Series A CoD. See Items 2 and 6.

(2) For purposes of calculating beneficial ownership of the Reporting Person, the total number of shares of Common Stock outstanding is based on (1) 115,578,971 shares of Common Stock outstanding as of July 28, 2020 as reported by the Issuer in its quarterly report on Form 10-Q for the quarterly period ended June 30, 2020 filed with the SEC on August 5, 2020 and (2) 173,136,400 shares of Common Stock (see Note 1).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS TCP-ASC GP, LLC
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) OO

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS TI IV ACHI Holdings GP, LLC
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1) (3)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) OO

(3) TI IV ACHI Holdings GP, LLC disclaims beneficial ownership of 77,911,380 shares of Common Stock held directly by Series AS (as defined in Item 6 herein).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS TI IV ACHI Holdings, LP
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1) (3)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) PN

(3) TI IV ACHI Holdings, LP disclaims beneficial ownership of 77,911,380 shares of Common Stock held directly by Series AS (as defined in Item 6 herein).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS TowerBrook Investors Ltd.
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION Cayman Islands

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1) (3)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) OO

(3) TowerBrook Investors Ltd. disclaims beneficial ownership of 77,911,380 shares of Common Stock held directly by Series AS (as defined in Item 6 herein).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS Neal Moszkowski
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION U.S.A.

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1) (3)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) IN

(3) Neal Moszkowski disclaims beneficial ownership of 77,911,380 shares of Common Stock held directly by Series AS (as defined in Item 6 herein).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS Ramez Sousou
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION U.K.

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1) (3)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) IN

(3) Ramez Sousou disclaims beneficial ownership of 77,911,380 shares of Common Stock held directly by Series AS (as defined in Item 6 herein).

CUSIP No. 00438V103

1.		NAMES OF REPORTING PERSONS ASCENSION HEALTH ALLIANCE
2.		CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (see instructions) (a) x (b) ¨
3.		SEC USE ONLY
4.		SOURCE OF FUNDS (see instructions) OO
5.		CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨
6.		CITIZENSHIP OR PLACE OF ORGANIZATION Missouri

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	7.	SOLE VOTING POWER 0
	8.	SHARED VOTING POWER 173,136,400 (1)
	9.	SOLE DISPOSITIVE POWER 0
	10.	SHARED DISPOSITIVE POWER 173,136,400 (1)

11.		AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON Common Stock: 173,136,400 (1) (3)
12.		CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (see instructions) ¨
13.		PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) Common Stock: 60% (1) (2)
14.		TYPE OF REPORTING PERSON (see instructions) CO

(3) Ascension Health Alliance disclaims beneficial ownership of 95,225,020 shares of Common Stock held directly by Series TB (as defined in Item 6 herein).

This Amendment No. 9 to Schedule 13D (this “Amendment No. 9”) amends and supplements the statement on Schedule 13D jointly filed by TCP-ASC ACHI Series LLLP (the “Partnership”), TCP-ASC GP, LLC, TI IV ACHI Holdings GP, LLC, TI IV ACHI Holdings, LP, TowerBrook Investors Ltd., Neal Moszkowski, Ramez Sousou and Ascension Health Alliance d/b/a Ascension (together, the “Reporting Persons”) with the Securities and Exchange Commission (the “Commission”) on February 16, 2016, as amended on July 11, 2016, September 9, 2016, April 3, 2017, January 2, 2018, February 23, 2018, May 8, 2018, July 2, 2018 and July 2, 2019 (as it may be amended from time to time, this “Statement”), relating to the common stock, $0.01 par value per share (the “Common Stock”), of R1 RCM Inc. (the “Issuer”), formerly known as Accretive Health, Inc. Initially capitalized terms used in this Amendment No. 9 that are not otherwise defined herein shall have the same meanings attributed to them in the Statement. Except as expressly provided herein, all Items of the Statement remain unchanged.

ITEM 2. Identity and Background.

The seventh, eighth and ninth paragraphs of Item 2 of this Schedule 13D are hereby amended and restated in its entirety as follows:

TowerBrook is a Cayman Islands corporation and its principal business is to serve as the general partner or member of various affiliates of investment funds managed or advised by TowerBrook Capital Partners L.P. Its principal business address is 65 East 55th Street, 19th Floor, New York, New York 10022. The directors of TowerBrook are Neal Moszkowski and Ramez Sousou.

Neal Moszkowski is a citizen of the United States and director and, with Ramez Sousou, one of the joint controlling shareholders, of TowerBrook. His principal occupation relates to his position with the TowerBrook Entities and affiliated funds and investment vehicles. His principal business address is 65 East 55th Street, 19th Floor, New York, New York 10022.

Ramez Sousou is a citizen of the United Kingdom and director and, with Neal Moszkowski, one of the joint controlling shareholders, of TowerBrook. His principal occupation relates to his position with the TowerBrook Entities and affiliated funds and investment vehicles. His principal business address is 1 St. James’s Market, Carlton Street, London SW1Y 4AH, United Kingdom.

ITEM 3. Source or Amount of Funds or Other Consideration.

The second and third paragraphs of Item 3 of this Schedule 13D are hereby amended and restated in its entirety as follows:

Each Reporting Person may be deemed to have acquired beneficial ownership of 140,000,000 shares of Common Stock reported on this Statement on February 16, 2016 pursuant to the Purchase Agreement. The funding for the Purchase was obtained from the Aggregator from the contributed capital of the investment funds managed or advised by TowerBrook Capital Partners L.P. The funding for the Purchase was obtained from Ascension from available cash.

Each Reporting Person may be deemed to have acquired beneficial ownership of the remaining 33,136,400 shares of Common Stock reported on this Statement pursuant to (i) a payment-in-kind dividend of 4,040 shares of Series A Preferred Stock on the 200,000 shares of Series A Preferred Stock it acquired under the Purchase Agreement (the “July 2016 PIK Dividend”), (ii) a payment-in-kind dividend of 4,120 shares of Series A Preferred Stock on the 204,040 shares of Series A Preferred Stock that it held as of September 30, 2016 as well as a payment-in-kind dividend of 2,000 shares of Series A Preferred Stock for the period beginning on February 16, 2016 and ending on March 31, 2016, that was previously accrued and unpaid (the “October 2016 PIK Dividends”), (iii) a payment-in-kind dividend of 4,203 shares of Series A Preferred Stock on the 210,160 shares of Series A Preferred Stock that it held as of December 31, 2016 (the “January 2017 PIK Dividend”), (iv) a payment-in-kind dividend of 4,287 shares of Series A Preferred Stock on the 214,363 shares of Series A Preferred Stock that it held as of March 31, 2017 (the “April 2017 PIK Dividend”) (v) a payment-in-kind dividend of 4,373 shares of Series A Preferred Stock on the 218,650 shares of Series A Preferred Stock that it held as of June 30, 2017 (the “July 2017 PIK Dividend”), (vi) a payment-in-kind dividend of 4,460 shares of Series A Preferred Stock on the 223,023 shares of Series A Preferred Stock that it held as of September 30, 2017 (the “October 2017 PIK Dividend”) (vii) a payment-in-kind dividend of 4,549 shares of Series A Preferred Stock on the 227,483 shares of Series A Preferred Stock that it held as of December 31, 2017 (the “January 2018 PIK Dividend”) (viii) a payment-in-kind dividend of 4,640 shares of Series A Preferred Stock on the 232,032 shares of Series A Preferred Stock that it held as of March 31, 2018 (the “April 2018 PIK Dividend”) (ix) a payment-in-kind dividend of 4,733 shares of Series A Preferred Stock on the 236,672 shares of Series A Preferred Stock that it held as of June 30, 2018 (the “July 2018 PIK Dividend”), (x) a payment-in-kind dividend of 4,828 shares of Series A Preferred Stock on the 241,405 shares of Series A Preferred Stock that it held as of September 30, 2018 (the “October 2018 PIK Dividend”), (xi) a payment-in-kind dividend of 4,924 shares of Series A Preferred Stock on the 246,233 shares of Series A Preferred Stock that it held as of December 31, 2018 (the “January 2019 PIK Dividend”), (xii) a payment-in-kind dividend of 5,023 shares of Series A Preferred Stock on the 251,157 shares of Series A Preferred Stock that it held as of March 31, 2019 (the “April 2019 PIK Dividend”), (xiii) a payment-in-kind dividend of 5,123 shares of Series A Preferred Stock on the 256,180 shares of Series A Preferred Stock that it held as of June 30, 2019 (the “July 2019 PIK Dividend”), (ix) a payment-in-kind dividend of 5,226 shares of Series A Preferred Stock on the 261,303 shares of Series A Preferred Stock that it held as of September 30, 2019 (the “October 2019 PIK Dividend”), (x) a payment-in-kind dividend of 5,330 shares of Series A Preferred Stock on the 266,529 shares of Series A Preferred Stock that it held as of December 31, 2019 (the “January 2020 PIK Dividend”), (xi) a payment-in-kind dividend of 5,437 shares of Series A Preferred Stock on the 271,859 shares of Series A Preferred Stock that it held as of June 30, 2020 (the “April 2020 PIK Dividend”) and (xii) a payment-in-kind dividend of 5,545 shares of Series A Preferred Stock on the 277,296 shares of Series A Preferred Stock that it held as of June 30, 2020 (the “July 2020 PIK Dividend”). The July 2016 PIK Dividend, October 2016 PIK Dividends, January 2017 PIK Dividend, April 2017 PIK Dividend, July 2017 PIK dividend, October 2017 PIK Dividend, January 2018 PIK Dividend, April 2018 PIK Dividend, July 2018 PIK Dividend, October 2018 PIK Dividend, January 2019 PIK Dividend, April 2019 PIK Dividend, July 2019 PIK Dividend, October 2019 PIK Dividend, January 2020 PIK Dividend, April 2020 PIK Dividend and July 2020 PIK Dividend were paid by the Issuer on July 8, 2016, October 1, 2016, January 3, 2017, April 3, 2017, July 3, 2017, October 2, 2017, January 2, 2018, April 2, 2018, July 2, 2018, October 1, 2018, January 2, 2019, April 1, 2019, July 1, 2019, October 1, 2019, January 2, 2020, April 1, 2020 and July 1, 2020, respectively, in each case pursuant to the Series A CoD.

ITEM 4. Purpose of Transaction.

The Issuer has requested that the Partnership undertake a discussion with board members unaffiliated with the Partnership about potential transactions to convert or otherwise reduce in whole or in part the Series A Convertible Preferred Stock. Such discussions may be discontinued or restarted at any time. There can be no assurance as to whether any transaction will be agreed, the terms or the timing of any such transaction.

ITEM 5. Interest in Securities of the Issuer.

Sections (a) and (b) of Item 5 are hereby amended and restated in their entirety as follows:

(a)

In the aggregate, the Reporting Persons may be deemed to beneficially own, as of the date hereof, an aggregate of 173,136,400 shares of Common Stock, including 60,000,000 shares of Common Stock that may be issued upon the exercise of the Warrant.

(b)

Each Reporting Person, as a member of a “group” with the other Reporting Persons for the purposes of Section 13(d)(3) of the Exchange Act, may be deemed to have shared voting, disposition and investment power with respect to the 173,136,400 shares of Common Stock issuable upon the conversion of 282,841 shares of Series A Preferred Stock and the exercise of the Warrant. Each of TI IV ACHI Holdings GP, LLC, TCP-ASC ACHI Holdings, LP, TowerBrook Investors Ltd., Neal Moszkowski and Ramez Sousou disclaims beneficial ownership of 77,911,380 shares of Common Stock held directly by Series AS (as defined in Item 6 herein). Ascension disclaims beneficial ownership of 95,225,020 shares of Common Stock held directly by Series TB (as defined in Item 6 herein).

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

	Date:	September 23, 2020


	TCP-ASC ACHI SERIES LLLP

	By:	TCP-ASC GP, LLC, its General Partner


	By:	/s/ Glenn F. Miller
	Name:	Glenn F. Miller
	Title:	Vice President


	TCP-ASC GP, LLC


	By:	/s/ Glenn F. Miller
	Name:	Glenn F. Miller
	Title:	Vice President


	TI IV ACHI Holdings GP, LLC


	By:	/s/ Glenn F. Miller
	Name:	Glenn F. Miller
	Title:	Vice President


	TI IV ACHI HOLDINGS, LP

	By:	TI IV ACHI Holdings GP, LLC, its General Partner

	By:	/s/ Glenn F. Miller
	Name:	Glenn F. Miller
	Title:	Vice President

[Signature Page to 13D Amendment]

	TOWERBROOK INVESTORS LTD.


	By:	/s/ Neal Moszkowski
	Name:	Neal Moszkowski
	Title:	Director


	NEAL MOSZKOWSKI


	/s/ Neal Moszkowski
	Neal Moszkowski


	RAMEZ SOUSOU


	/s/ Ramez Sousou
	Ramez Sousou


	ASCENSION HEALTH ALLIANCE


	By:	/s/ Anthony J. Speranzo
	Name:	Anthony J. Speranzo
	Title:	President and Chief Executive Officer,
	Ascension Capital, LLC (authorized signatory)

[Signature Page to 13D Amendment]