What changed in this filing

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Item 1. Legal Proceedings

2023-08-03 compared with 2023-05-02 · 81 added, 30 removed, 73 unchanged (60% of the section changed)

2 unchanged sentences

Department of Justice and other government entities regarding various Medicare and Medicaid issues.

In addition to the matters discussed below, we are currently responding to subpoenas and administrative demands concerning (a) certain emergency care services provided at one of our Texas hospitals;

(b) billing for certain behavioral health services performed at one of our Arkansas hospitals;

and (c) billing for certain therapeutic drugs at a physician practice affiliated with one of our Pennsylvania hospitals.

In addition to the matters discussed below, we are currently responding to subpoenas and administrative demands concerning (a) certain emergency care services provided at one of our Texas hospitals and (b) billing for certain therapeutic drugs at a physician practice affiliated with one of our Pennsylvania hospitals.

In addition, we are subject to other claims and lawsuits arising in the ordinary course of our business including lawsuits and claims related to billing and collection practices at our hospitals.

2 unchanged sentences

Settlements of suits involving Medicare and Medicaid issues routinely require both monetary payments as well as corporate integrity agreements.

Additionally, qui tam or “whistleblower” actions initiated under the FCA may be pending but placed under seal by the court to comply with the FCA’s requirements for filing such suits.

Additionally, qui tam or “whistleblower”

actions initiated under the FCA may be pending but placed under seal by the court to comply with the FCA’s requirements for filing such suits.

In September 2014, the Criminal Division of the U.S.

7 unchanged sentences

Shareholder Litigation

Caleb Padilla, individually and on behalf of all others similarly situated v Community Health Systems, Inc., Wayne T.

Caleb Padilla, individually and on behalf of all others similarly situated v.

Community Health Systems, Inc., Wayne T.

Smith, Larry Cash, and Thomas J.

4 unchanged sentences

The Company filed a motion to dismiss the consolidated class complaint on March 23, 2020, and the District Court denied that motion on August 17, 2022.

We have reached a tentative settlement of this matter, which is subject to the Court’s approval.

The hearing to determine the Court’s preliminary approval of the settlement has not yet been set.

We have reached a tentative settlement of this matter, which was preliminarily approved by the District Court on May 31, 2023.

The hearing to determine the Court’s final approval of the settlement is set for October 13, 2023.

Padilla Derivative Litigation .

11 unchanged sentences

All four cases seek relief derivatively and on behalf of Community Health Systems, Inc.

against certain Company officers and directors based on alleged breaches of fiduciary duty, unjust enrichment, and other acts related to certain Company disclosures in 2017 and 2018 regarding the Company’s adoption of Accounting Standards Update 2014-09, which the Company adopted effective January 1, 2018.

Both cases are currently stayed by court order until the United States District Court for the Middle District of Tennessee rules on the defendants’ motion for summary judgment, which has yet to be filed, in the Padilla action.

Both cases are currently stayed by court order until the United States District Court for the Middle District of Tennessee rules on the defendants’

motion for summary judgment, which has yet to be filed, in the Padilla action.

Qui Tam Litigation

ex rel Larry Bomar v.

Bayfront HMA Medical Center, LLC, et al – On September 14, 2017, our former hospital in St.

Bayfront HMA Medical Center, LLC, et al –

On September 14, 2017, our former hospital in St.

Petersburg, Florida received a civil investigative demand, or CID, from the United States Department of Justice for information concerning its historic participation in the Florida Low Income Pool Program.

5 unchanged sentences

Specifically, the relator claims our former hospital in St.

Petersburg – Bayfront Medical Center St.

Petersburg – along with other, unaffiliated hospitals violated the False Claims Act by allegedly making certain contributions to a non-profit entity for the purpose of receiving supplemental Medicaid funding.

Petersburg –

Bayfront Medical Center St.

Petersburg –

along with other, unaffiliated hospitals violated the False Claims Act by allegedly making certain contributions to a non-profit entity for the purpose of receiving supplemental Medicaid funding.

The United States has declined to intervene in the case.

4 unchanged sentences

Commercial Litigation and Other Lawsuits

Thomas Mason, MD, Steven Folstad, MD and Mid-Atlantic Emergency Medical Associates, PA v Health Management Associates, LLC f/k/a Health Management Associates, Inc., Mooresville Hospital Management Associates d/b/a Lake Norman Regional Medical Center, Statesville HMA, LLC d/b/a Davis Regional Medical Center, Envision Healthcare Corporation f/k/a Emergency Medical Services Corporation, Emcare Holdings, Inc., and Emergency Medical Services, LP .

Thomas Mason, MD, Steven Folstad, MD and Mid-Atlantic Emergency Medical Associates, PA v.

Health Management Associates, LLC f/k/a Health Management Associates, Inc., Mooresville Hospital Management Associates d/b/a Lake Norman Regional Medical Center, Statesville HMA, LLC d/b/a Davis Regional Medical Center, Envision Healthcare Corporation f/k/a Emergency Medical Services Corporation, Emcare Holdings, Inc., and Emergency Medical Services, LP .

This alleged wrongful retaliation case is filed in the United States District Court for the Western District of North Carolina.

The plaintiffs allege their agreements with the defendants were terminated in retaliation for plaintiffs’ alleged refusal to admit patients unnecessarily to the defendant hospitals or otherwise perform unnecessary diagnostic testing.

The allegations of the complaint relate to time periods prior to the hospitals’ affiliation with the Company.

The plaintiffs allege their agreements with the defendants were terminated in retaliation for plaintiffs’

alleged refusal to admit patients unnecessarily to the defendant hospitals or otherwise perform unnecessary diagnostic testing.

The allegations of the complaint relate to time periods prior to the hospitals’

affiliation with the Company.

The plaintiffs filed a Third Amended Complaint on April 26, 2019.

1 unchanged sentence

We believe these claims are without merit and are vigorously defending this case.

Tower Health, f/k/a Reading Health System, et al v CHS/Community Health Systems, Inc., et al .

Tower Health, f/k/a Reading Health System, et al v.

CHS/Community Health Systems, Inc., et al .

This breach of contract action is pending in the United States District Court for the Eastern District of Pennsylvania.

The plaintiffs allege breaches of an asset purchase agreement in connection with the sale of Pottstown Memorial Medical Center.

The alleged breaches regard plaintiffs’ contention that the defendants failed to disclose certain conditions related to the physical plant of the hospital, along with various other alleged breaches of the asset purchase agreement.

The alleged breaches regard plaintiffs’

contention that the defendants failed to disclose certain conditions related to the physical plant of the hospital, along with various other alleged breaches of the asset purchase agreement.

The plaintiffs filed an amended complaint on July 22, 2019.

Trial for this matter began May 3, 2021 and closed on October 5, 2021.

On September 6, 2022, the District Court issued a Memorandum Opinion denying all of Tower Health’s claims and entering a judgment in favor of the Company.

The district Court also awarded the Company its attorneys’ fees and costs.

On October 4, 2022, Tower Health filed a Rule 59 motion to alter or amend the District Court’s judgment and a Rule 15 motion to amend its pleadings.

The Company has filed oppositions to both motions and has separately moved for its attorney’s fees.

On September 6, 2022, the District Court issued a Memorandum Opinion denying all of Tower Health’s claims and entering a judgment in favor of the Company.

The district Court also awarded the Company its attorneys’

fees and costs.

On October 4, 2022, Tower Health filed a Rule 59 motion to alter or amend the District Court’s judgment and a Rule 15 motion to amend its pleadings.

The Company has filed oppositions to both motions and has separately moved for its attorney’s fees.

All three motions are pending.

We believe Tower Health’s post judgment motions are without merit and are vigorously defending this case.

Golden, as Litigation Trustee of the QHC Litigation Trust, and Wilmington Savings Fund Society, FSB, solely in its capacity as indenture trustee v Community Health Systems, Inc., et al .

We believe Tower Health’s post judgment motions are without merit and are vigorously defending this case.

Golden, as Litigation Trustee of the QHC Litigation Trust, and Wilmington Savings Fund Society, FSB, solely in its capacity as indenture trustee v.

Community Health Systems, Inc., et al .

A complaint in this case was filed on October 25, 2021 in the United States Bankruptcy Court for the District of Delaware against various persons, including the Company, certain subsidiaries of the Company, certain former executive officers of the Company and Credit Suisse Securities (USA) LLC.

7 unchanged sentences

Cybersecurity Event

As previously disclosed on a Current Report on Form 8-K filed by us on February 13, 2023, Fortra, LLC, a third-party vendor that provides a secure file transfer software platform utilized by our subsidiaries experienced a security breach whereby Protected Health Information (“PHI”) (as defined by HIPAA) and Personal Information (“PI”) of certain patients of our healthcare facilities and certain facilities for which we performed services were exposed to Fortra’s attacker.

As previously disclosed on a Current Report on Form 8-K filed by us on February 13, 2023, Fortra, LLC, a third-party vendor that provides a secure file transfer software platform utilized by our subsidiaries, experienced a security breach whereby Protected Health Information (“PHI”) (as defined by HIPAA) and Personal Information (“PI”) of certain patients of our healthcare facilities and certain facilities for which we performed services were exposed to Fortra’s attacker.

Upon receiving notification of the security breach, we promptly launched an investigation, which has now been completed.

This security breach has had no impact on any of our information systems, and we have not experienced a material interruption of business, including the delivery of patient care.

With regard to the PHI and PI compromised by the Fortra breach, we currently estimate that approximately one million individuals may have been affected by this attack.

With regard to the PHI and PI compromised by the Fortra breach, we currently estimate that approximately 1.2 million individuals may have been affected by this attack.

We have provided notice to substantially all of the individuals affected by this attack, and have offered such individuals two years of credit monitoring and protection.

We have provided notice of the breach to the Office for Civil Rights, and we are in the process of providing required notices to various State Attorneys General.

During the three months ended March 31, 2023, we incurred, and we may continue to incur in the future, expenses and losses related to this incident, some of which may not be covered by our cyber/privacy liability insurance policies.

We have provided notice of the breach to the HHS Office for Civil Rights, and we have provided required notices to various State Attorneys General.

During the six months ended June 30, 2023, we incurred, and we may continue to incur in the future, expenses and losses related to this incident, some of which may not be covered by our cyber/privacy liability insurance policies.

While we are continuing to measure the impact of this security breach, including certain remediation expenses, existing litigation (as noted below) and/or possible future litigation that may be filed against us in connection with this event and other potential liabilities, this incident has not had, and we do not currently believe this incident will have, a material adverse effect on our business, operations, or financial results.

We are currently party to two practically identical lawsuits, Kuffrey v.

A number of practically identical purported class action lawsuits were filed against the Company in the United States District Court for the Middle District of Tennessee related to the Fortra data breach.

The first of these cases filed was Kuffrey v.

Community Health Systems, Inc.

and CHSPSC, LLC and Martin v Community Health Systems, Inc.

and CHSPSC, LLC , both filed in the United States District Court for the Middle District of Tennessee, in which the plaintiffs seek to represent a purported class of individuals who are alleged victims of the Fortra breach.

and CHSPSC, LLC.

The individuals filing these cases all sought to represent a purported class of individuals who are alleged victims of the Fortra breach.

On May 19, 2023, the District Court consolidated all of these cases into a single case.

We believe the claims are without merit and will vigorously defend the case.

Risk F actors

The following supplements the Company’s risk factors previously disclosed in the 2022 Form 10-K by adding the following risk factors.

Except as set forth below, there have been no material changes with regard to the risk factors previously disclosed in the 2022 Form 10-K.

Risks Related to Human Capital

We may be adversely impacted by the inability of third parties with whom we contract to provide hospital-based physicians as the result of industry-wide disruptions in the market for outsourced medical specialists.

We contract with various third-parties who provide hospital-based physicians, including emergency, anesthesiology, hospitalist/inpatient care, radiology, tele-radiology and surgery.

Third-party providers of hospital-based physicians, including those with whom we contract, have experienced significant disruption in the form of regulatory changes, including those stemming from enactment of the No Surprises Act, challenging labor market conditions resulting from a shortage of physicians and inflationary wage-related pressures, as well as increased competition through consolidation of physician groups.

In some instances, providers of outsourced medical specialists have become insolvent and unable to fulfill their contracts with us for providing hospital-based physicians.

The success of our hospitals depends in part on the adequacy of staffing, including through contracts with third parties.

If we are unable to adequately contract with providers, or the providers with whom we contract become unable to fulfill their contracts, our admissions may decrease, and our operating performance, capacity and growth prospects may be adversely affected.

Further, our efforts to mitigate the potential impact to our business from third-party providers who are unable to fulfill their contracts to provide hospital-based physicians, including through acquisitions of outsourced medical specialist businesses, employment of physicians and re-negotiation or assumption of existing contracts, may be unsuccessful.

These developments with respect to providers of outsourced medical specialists, and our inability to effectively respond to and mitigate the potential impact of such developments, may disrupt our ability to provide healthcare services, which may adversely impact our business and financial results.

Risks Related to Cybersecurity and Technology

If the redesign and consolidation of key business functions, including through the implementation of a core enterprise resource planning system, or ERP, does not proceed as expected or is not completed successfully, our business and financial results may be adversely impacted.

We have begun a transformative process of redesigning numerous workflows that is intended to modernize and consolidate our technology platforms and associated processes across our organization.

As part of this process, we are creating shared business

operations to carry out certain financial and operational functions and are designing and implementing a new ERP system.

We are currently in the design phases of the project and expect implementation of individual modules of the ERP and other aspects of this process to occur over a multi-year period.

The redesign of various business processes and implementation of this ERP and other aspects of this transformative process requires an investment of significant personnel and financial resources, including substantial expenditures for third-party consultants and system hardware and software.

This implementation process could disrupt our operations or otherwise adversely affect us, including as the result of delays, disruptions to business continuity, higher than anticipated expenditures, potential design defects, data migration issues, diversion of management’s attention from other key priorities, increased cybersecurity risks and adverse impacts on the effectiveness of our internal controls over financial reporting.

If we are unable to complete this redesign and consolidation of key business functions, including the implementation of the ERP, effectively, on a timely basis, or at all, our financial position, results of operations and cash flows may be adversely affected.

Moreover, there is no assurance that this new ERP and other aspects of this process, once implemented, will meet our current or future business needs or will operate as intended.

Unregistered Sale of Equi ty Securities and Use of Proceeds

The following table contains information about our purchases of common stock during the three months ended June 30, 2023.

Purchased (a)

April 1, 2023 -

April 30, 2023

May 1, 2023 -

June 1, 2023 -

June 30, 2023

(a) 15,286 shares were withheld to satisfy the payment of tax obligations related to the vesting of restricted stock awards.

(b) We had no publicly announced repurchase programs for shares of our common stock during the three months ended June 30, 2023.

The ABL Facility and the indentures governing each series of our outstanding notes restrict our subsidiaries from, among other matters, paying dividends and making distributions to us, which thereby limits our ability to pay dividends and/or repurchase stock.

As of June 30, 2023, under the most restrictive test in these agreements (and subject to certain exceptions), we have approximately $300 million of capacity to pay permitted dividends and/or repurchase shares of stock or make other restricted payments.

Defaults Upo n Senior Securities

Mine Saf ety Disclosures

Not applicable.

Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.

What changed 10-Q

Item 1. Legal Proceedings