Exhibit 10.50

 

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*** Confidential Information Omitted and filed separately with the Securities
and Exchange Commission.

 

CONTRACT FOR HOSPITAL INPATIENT SERVICES

 

Amendment No. 18

 

Contract No.

 

No. 00-83122

 

 

 

Facility:

 

ALTA LOS ANGELES HOSPITALS, INC.

 

 

dba: LOS ANGELES COMMUNITY HOSPITAL

 

 

 

Address:

 

4081 East Olympic Boulevard

 

 

Los Angeles, CA 90023-3330

 

CONFIDENTIAL
DO NOT RELEASE
Exempt from Public Records Act
(Government Code Section 6254 [q])

 

PHSF.RD3B

 

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AMENDMENT NO. 18 TO CONTRACT NO. 00-83122  BETWEEN THE STATE OF CALIFORNIA AND
ALTA LOS ANGELES HOSPITALS, INC., DOING BUSINESS AS LOS ANGELES COMMUNITY
HOSPITAL.

 

WHEREAS, the State of California, hereinafter designated “the State”, and ALTA
LOS ANGELES HOSPITALS, INC., doing business as LOS ANGELES COMMUNITY HOSPITAL,
hereinafter designated “the Provider”, entered into a contract (Contract
No. 00-83122) for provision of inpatient hospital services effective
September 14, 2000 and subsequently amended;

 

NOW THEREFORE, in accordance with the provisions for renegotiation and
modification set forth in Article 6, Paragraph 6.11 of the Contract, the
Contract is amended as follows:

 

Paragraph One – Appendix D

 

Appendix D is hereby amended to read as attached.

 

Paragraph Two – Notice of Termination

 

In accordance with Welfare and Institutions Code section 14166.12 (p), Provider
shall not submit a notice for the purpose of terminating this Contract as
provided in Paragraph 6.15 of this Contract, Termination without Cause, until on
or after

 

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December 31, 2008, unless a later date is specified in Paragraph 6.15.

 

Paragraph Three – Effective Date of Contract Amendment

 

Unless otherwise specified herein, Contract changes agreed to in this Amendment
are effective on February 7, 2008.

 

Paragraph Four - Incorporation of Contract Rights, Duties and Obligations

 

All other terms and provisions of the Contract shall remain in full force and
effect, so that all rights, duties and obligations, and liabilities of the
parties hereto otherwise remain unchanged.

 

 

/

 

 

/

 

 

/

 

 

/

 

 

/

 

2

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SIGNATURES

 

 

The signatories to this Amendment warrant that they have full and binding
authority to make the commitments contained herein on behalf of their respective
entities.

 

Provider

State of California
Department of Health Care Services

 

 

 

 

 

Signature

 

 

Signature

 

 

 

 

 

 

 

 

David Topper

 

 

Sandra Shewry

Type Name

 

 

Director

 

 

 

 

Chief Executive Officer

 

 

 

Type Title

 

 

 

 

 

 

 

Date:

February 20, 2008

 

Date:

April 1, 2008

 

3

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APPENDIX D

 

PRIVATE HOSPITAL SUPPLEMENTAL FUND

 

This version of Appendix D governs dates of services and related Medi-Cal
supplemental reimbursements for State Fiscal Year 2007-08.

 

Pursuant to the provisions of Welfare and Institutions Code Section 14166.12
relating to negotiations and disbursements from the Private Hospital
Supplemental Fund (Fund), the parties agree as follows:

 

A.                                  Payment

 

In accordance with subdivisions (j) and (m) of Section 14166.12 of the Welfare
and Institutions Code, and subject to Section B of this Appendix D, the State
agrees to pay the Provider from the Fund:

 

(1)                                For services rendered from July 1, 2007
through November 30, 2007:

 

(a)                                  The installment amount of *** if Provider
is listed on the 2007-08 tentative Disproportionate Share Hospital (DSH) list
issued by the California Department of Health Care Services (Department).

 

4

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Payment will be made by September 27, 2007, or as soon thereafter as
practicable.

 

(b)                      The installment amount of *** if Provider is listed on
the 2007-08 final DSH list issued by the Department.  Payment shall be made by
December 1, 2007, or as soon thereafter as practicable after the issuance of the
2007-08 final DSH list.

 

(2) For services rendered from January 1, 2008 through April 30, 2008 as
follows:

 

(a)                                              The installment amount of ***
will be made by April 1, 2008, or as soon thereafter as practicable.

 

(b)                                             The installment amount of ***
will be made by May 15, 2008, or as soon thereafter as practicable.

 

B.                                    Recovery, Right of Offset, and Hold
Harmless

 

(1)                                Payment(s) received by Provider from the Fund
for the 2007-08 state fiscal  year may be subject to recovery by the Department
if the Department determines that the Provider fails at any time during the
2007-08 state fiscal year to meet the eligibility criteria for Fund
disbursements, as specified in

 

5

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Welfare and Institutions Code Section 14166.12.  If the Provider fails to return
the funds within 30 calendar days from the time of the Department’s
notification, the Department may offset the amount to be recovered against any
Medi-Cal payments which otherwise would be payable by the Department to the
Provider, pursuant to Welfare and Institutions Code Section 14115.5.

 

(a)                                  Provider must promptly return to the
Department all payments received from the Fund for the 2007-08 state fiscal year
if the Department determines that the Provider fails at any time during the
2007-08 state fiscal year to receive and/or maintain final DSH status, under
Welfare and Institutions Code Sections 14166.11, 14105.98, and 14163, for the
2007-08 DSH payment adjustment year.

 

(b)                                 Unless Subparagraph (a) applies, Provider
must promptly return to the Department amounts received from the Fund for the
2007-08 state fiscal year that equal the pro-rata portion of Provider’s 2002-03
supplement fund amount, plus any payments over the Provider’s 2002-03 supplement
fund amount received from the Fund for the 2007-08 state fiscal year if the
Department determines that the Provider failed to meet participation criteria
for the entire 2007-08 state fiscal year, other than DSH status addressed in
Subparagraph (a) above,

 

6

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specified in Welfare and Institutions Code Sections 14085.6 and 14166.12, which
includes, but is not limited to, failed for any reason to maintain its Emergency
Department as operational and licensed at the Basic Level or higher level.  For
purposes of this Subparagraph (b), the amount equal to the pro-rata portion of
Provider’s 2002-03 supplement fund payment, pursuant to Welfare and Institutions
Code Section 14166.12 (j), will be calculated on the number of days during the
2007-08 state fiscal year that the Provider failed to meet participation
criteria.

 

(2) It is understood that payment made to the Provider pursuant to this Appendix
D, and all prior versions of Appendix D, include State and federal funds.  The
State shall be held harmless from any federal disallowance or withholding
resulting from payment made to Provider pursuant to this Appendix D, or any
prior version(s) of Appendix D, and the Provider shall be liable for any reduced
federal financial participation resulting from the payment of funds pursuant to
this Appendix D, or any prior version(s) of Appendix D.  In the event of federal
disallowance or withholding of federal financial participation for any payments
made to the Provider pursuant to this Appendix D, or any prior versions(s) of
Appendix D, at the time of the federal disallowance or withholding the State, in
its sole discretion, may limit its recovery from the Provider to the amount of
funds

 

7

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disallowed and paid by the State to the Provider.  Provider agrees that the
amount of any such recovery may be recouped by the State by withholding and
offsetting, under Welfare and Institutions Code Section 14115.5, the amount due
from what would otherwise be the State’s liability to the Provider under this
Contract or otherwise, seeking recovery by payment from the Provider, or a
combination of these two methods. If, after federal disallowance or withholding
and State recovery or offset of funds paid to the Provider, the State regains
the federal funds disallowed or withheld, then the federal and related state
funds shall be repaid by the State to the Provider.

 

8

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00-83122; A-19

 

CONTRACT FOR HOSPITAL INPATIENT SERVICES

 

Amendment No. 19

 

Contract No.

 

No. 00-83122

 

 

 

Facility:

 

ALTA LOS ANGELES HOSPITALS, INC

 

 

dba: LOS ANGELES COMMUNITY HOSPITAL

 

 

 

Address:

 

4081 East Olympic Boulevard

 

 

Los Angeles, CA 90023-3330

 

CONFIDENTIAL
DO NOT RELEASE
Exempt from Public Records Act
(Government Code Section 6254 [q])

 

PHSF.RD4A

 

--------------------------------------------------------------------------------

 

AMENDMENT NO. 19 TO CONTRACT NO. 00-83122  BETWEEN THE STATE OF CALIFORNIA AND
ALTA LOS ANGELES HOSPITALS, INC., DOING BUSINESS AS LOS ANGELES COMMUNITY
HOSPITAL.

 

WHEREAS, the State of California, hereinafter designated “the State”, and ALTA
LOS ANGELES HOSPITALS, INC., doing business as LOS ANGELES COMMUNITY HOSPITAL,
hereinafter designated “the Provider”, entered into a contract (Contract
No. 00-83122) for provision of inpatient hospital services effective
September 14, 2000 and subsequently amended;

 

NOW THEREFORE, in accordance with the provisions for renegotiation and
modification set forth in Article 6, Paragraph 6.11 of the Contract, the
Contract is amended as follows:

 

Paragraph One – Appendix D

 

Appendix D is hereby amended to read as attached.

 

Paragraph Two – Notice of Termination

 

In accordance with Welfare and Institutions Code section 14166.12 (p), Provider
shall not submit a 120-day notice for the purpose of terminating this Contract
as provided in Paragraph 6.15 of this Contract, Termination without Cause, until
on or after December 31, 2009, unless a later date is specified in Paragraph
6.15.

 

2

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Paragraph Three – Effective Date of Contract Amendment

 

Unless otherwise specified herein, Contract changes agreed to in this Amendment
are effective on October 9, 2008.

 

Paragraph Four – 30 Days to Sign and Return Contract Amendment

 

If this Amendment is not signed and returned to the California Medical
Assistance Commission within 30 days of its effective date, then the California
Medical Assistance Commission may take action to disapprove this Amendment.

 

Paragraph Five - Incorporation of Contract Rights, Duties and Obligations

 

All other terms and provisions of the Contract shall remain in full force and
effect, so that all rights, duties and obligations, and liabilities of the
parties hereto otherwise remain unchanged.

 

3

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SIGNATURES

 

 

The signatories to this Amendment warrant that they have full and binding
authority to make the commitments contained herein on behalf of their respective
entities.

 

 

Provider

State of California
Department of Health Care Services

 

 

 

 

Signature

 

Signature

 

 

 

 

 

 

David Topper

 

Sandra Shewry

Type Name

 

Director

 

 

 

CEO

 

 

Type Title

 

 

 

 

 

Date:

10/17/08

 

Date:

10/28/08

 

 

4

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APPENDIX D

 

PRIVATE HOSPITAL SUPPLEMENTAL FUND

 

This version of Appendix D governs dates of services and related Medi-Cal
supplemental reimbursements for State Fiscal Year 2008-09.

 

Pursuant to the provisions of Welfare and Institutions Code Section 14166.12
relating to negotiations and disbursements from the Private Hospital
Supplemental Fund (Fund), the parties agree as follows:

 

A.                                   Payment

 

In accordance with subdivisions (j) and (m) of Section 14166.12 of the Welfare
and Institutions Code, and subject to Section B of this Appendix D, the State
agrees to pay the Provider from the Fund:

 

(1) For services rendered from July 1, 2008 through October 31, 2008:

 

(a)                                  The installment amount of *** if Provider
is listed on the 2008-09 tentative Disproportionate Share Hospital (DSH) list
issued by the California Department of Health Care Services (Department). 
Payment will be made by November 1, 2008, or as soon thereafter as practicable.

 

5

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B. Recovery, Right of Offset, and Hold Harmless

 

(1) Payment(s) received by Provider from the Fund for the 2008-09 state fiscal
year may be subject to recovery by the Department if the Department determines
that the Provider fails at any time during the 2008-09 state fiscal year to meet
the eligibility criteria for Fund disbursements, as specified in Welfare and
Institutions Code Section 14166.12.  If the Provider fails to return the funds
within 30 calendar days from the time of the Department’s notification, the
Department may offset the amount to be recovered against any Medi-Cal payments
which otherwise would be payable by the Department to the Provider, pursuant to
Welfare and Institutions Code Section 14115.5.

 

(a)                      Provider must promptly return to the Department all
payments received from the Fund for the 2008-09 state fiscal year if the
Department determines that the Provider fails at any time during the 2008-09
state fiscal year to receive and/or maintain final DSH status, under Welfare and
Institutions Code Sections 14166.11, 14105.98, and 14163, for the 2008-09 DSH
payment adjustment year.

 

(b)                     Unless Subparagraph (a) applies, Provider must promptly
return to the Department amounts received from the Fund for the 2008-09 state
fiscal year that equal the pro-rata portion of Provider’s 2002-03 supplement
fund amount, plus any payments over the Provider’s 2002-03 supplement fund
amount received from the Fund for the

 

6

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2008-09 state fiscal year if the Department determines that the Provider failed
to meet participation criteria for the entire 2007-08 state fiscal year, other
than DSH status addressed in Subparagraph (a) above, specified in Welfare and
Institutions Code Sections 14085.6 and 14166.12, which includes, but is not
limited to, failed for any reason to maintain its Emergency Department as
operational and licensed at the Basic Level or higher level.  For purposes of
this Subparagraph (b), the amount equal to the pro-rata portion of Provider’s
2002-03 supplement fund payment, pursuant to Welfare and Institutions Code
Section 14166.12 (j), will be calculated on the number of days during the
2008-09 state fiscal year that the Provider failed to meet participation
criteria.

 

(2) It is understood that payment made to the Provider pursuant to this Appendix
D, and all prior versions of Appendix D, include State and federal funds.  The
State shall be held harmless from any federal disallowance or withholding
resulting from payment made to Provider pursuant to this Appendix D, or any
prior version(s) of Appendix D, and the Provider shall be liable for any reduced
federal financial participation resulting from the payment of funds pursuant to
this Appendix D, or any prior version(s) of Appendix D.  In the event of federal
disallowance or withholding of federal financial participation for any payments
made to the Provider pursuant to this Appendix D, or any prior versions(s) of
Appendix D, at the time of the federal disallowance or withholding the State, in
its sole discretion,

 

7

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may limit its recovery from the Provider to the amount of funds disallowed and
paid by the State to the Provider.  Provider agrees that the amount of any such
recovery may be recouped by the State by withholding and offsetting, under
Welfare and Institutions Code Section 14115.5, the amount due from what would
otherwise be the State’s liability to the Provider under this Contract or
otherwise, seeking recovery by payment from the Provider, or a combination of
these two methods. If, after federal disallowance or withholding and State
recovery or offset of funds paid to the Provider, the State regains the federal
funds disallowed or withheld, then the federal and related state funds shall be
repaid by the State to the Provider.

 

8

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