Loan Modification Agreement



 Exhibit 10.1 
 EXECUTION VERSION 
 LOAN MODIFICATION AGREEMENT dated as of
August 22, 2012 (this “Agreement”), among CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation (the “Borrower”), COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation
(“Parent”), the Subsidiary Guarantors listed on the signature pages hereto, the Accepting Lenders (as defined below) and CREDIT SUISSE AG (“CS”), as administrative agent (in such capacity, the
“Administrative Agent”). 
 PRELIMINARY STATEMENT 

Reference is made to the Credit Agreement dated as of July 25, 2007, as amended and restated as of November 5, 2010, and
February 2, 2012 and as amended as of August 3, 2012 (as the same may be further amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the
Borrower, Parent, the Subsidiaries of the Borrower party thereto, the Lenders party thereto and CS, as Administrative Agent and as Collateral Agent. 
 Pursuant to Section 2.25(a) of the Credit Agreement, the Borrower made, by written notice to the Administrative Agent and each Non-Extended Funded Term Loan Lender, a Loan Modification Offer to all
of the Non-Extended Funded Term Loan Lenders to make certain Permitted Amendments as described herein and therein. 
 The
Lenders party hereto (the “Accepting Lenders”) are willing to agree to such Permitted Amendments as of the Loan Modification Effective Date (as defined below), on the terms and subject to the conditions set forth herein and
in the Credit Agreement. 
 Accordingly, in consideration of the foregoing and for other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, the parties hereto hereby agree as follows: 
 SECTION 1. Defined
Terms. (a) Capitalized terms used but not otherwise defined herein (including the Preliminary Statement hereto) shall have the meanings assigned thereto in the Credit Agreement. The provisions of Section 1.02 of the Credit Agreement
are hereby incorporated by reference herein, mutatis mutandis. This Agreement shall be a “Loan Document” and a “Loan Modification Agreement” for all purposes of the Credit Agreement and the other Loan Documents.

 (b) The Non-Extended Term Loans outstanding immediately prior to the Loan Modification Effective Date are referred to herein
as “Existing Non-Extended Term Loans”. 
 SECTION 2. Loan Modifications. (a) Subject to the
terms and conditions set forth herein and in the Credit Agreement, as of the Loan Modification Effective Date, each Accepting Lender agrees that (i) 100% of its Existing Non-Extended Term Loans or (ii) such lesser principal amount of its
Existing Non-Extended Term Loans as may be 







 
specified by such Accepting Lender on its executed counterpart of this Agreement will be converted into Extended Term Loans (as defined in the Credit Agreement) of like outstanding principal
amount, provided that, in the event that the aggregate principal amount of the Existing Non-Extended Term Loans which Accepting Lenders agree to convert into Extended Term Loans in accordance with the foregoing clause (i) or
(ii) (such Existing Non-Extended Term Loans being referred to herein as the “Designated Existing Non-Extended Term Loans”) is greater than $300,000,000, the Borrower may (but shall not be obligated to) elect, by written
notice to the Administrative Agent, to cause less than all (but not less than $300,000,000 aggregate principal amount) of the Designated Existing Non-Extended Term Loans to become Extended Term Loans, such allocation to be made on a pro rata basis
among the Accepting Lenders, such that the same proportion of each Accepting Lender’s Designated Existing Non-Extended Term Loans is so converted into Extended Term Loans (such election, a “Pro Rata Allocation
Election”). 
 (b) The Existing Non-Extended Term Loans of any Lender that are not converted into Extended Term
Loans shall, following the Loan Modification Effective Date, continue to be in effect and outstanding under the Credit Agreement, on the terms and conditions set forth therein, as “Non-Extended Funded Term Loans”. 

(c) The parties hereto hereby agree that (i) the Administrative Agent, in consultation with the Borrower and the Accepting Lenders,
is authorized to take such actions as are necessary to ensure that the Existing Non-Extended Term Loans converted into Extended Term Loans pursuant to this Agreement are included within the Borrowings of Extended Term Loans outstanding on the Loan
Modification Effective Date on a ratable basis (calculated by reference to the aggregate principal amount of the Borrowings of Extended Term Loans outstanding on the Loan Modification Effective Date) and (ii) no breakage or similar costs will
accrue solely as a result of the transactions contemplated by this Section 2. 
 (d) The terms and conditions of the
Non-Extended Term Loans extended pursuant to this Agreement shall be identical to those of the Extended Term Loans as set forth in the Credit Agreement; provided that, beginning with the Extended Term Loan Repayment Date falling on the last
Business Day of September 2012, for purposes of calculating the amount of the repayment due with respect to Extended Term Loans on each Extended Term Loan Repayment Date pursuant to Section 2.11(a)(iii) of the Credit Agreement, the aggregate
principal amount of all Extended Term Loans outstanding on the First Restatement Effective Date shall include both the aggregate principal amount of the Non-Extended Term Loans that were converted to Extended Term Loans on the Second Restatement
Effective Date and the aggregate principal amount of the Non-Extended Term Loans converted to Extended Term Loans on the Loan Modification Effective Date pursuant to this Agreement, in each case as if such Non-Extended Term Loans had been converted
to Extended Term Loans on the First Restatement Effective Date. 

  
 2 








 SECTION 3. Representations and Warranties. Each of Parent, the Borrower and each
Subsidiary Guarantor hereby represents and warrants to each other party hereto that: 
 (a) The representations and warranties
set forth in Article III of the Credit Agreement and in each other Loan Document are true and correct in all material respects on and as of the Loan Modification Effective Date as though made on and as of such date, except to the extent that
such representations and warranties expressly relate to an earlier date, in which case such representations and warranties were true and correct in all material respects as of such earlier date. 

(b) No Default or Event of Default has occurred and is continuing. 

(c) None of the Security Documents in effect on the Loan Modification Effective Date will be rendered invalid, non-binding or
unenforceable against any Loan Party as a result of this Agreement. The Guarantees created under such Security Documents will continue to guarantee the Obligations (as the Obligations are modified hereunder) to the same extent as they guaranteed the
Obligations immediately prior to the Loan Modification Effective Date. The Liens created under such Security Documents will continue to secure the Obligations (as the Obligations are modified hereunder), and will continue to be perfected, in each
case, to the same extent as they secured the Obligations or were perfected immediately prior to the Loan Modification Effective Date. 
 SECTION 4. Effectiveness. This Agreement shall become effective on and as of the date on which each of the following conditions precedent is satisfied (such date, the “Loan Modification
Effective Date”): 
 (a) The Administrative Agent shall have received counterparts hereof duly executed and
delivered by Parent, the Borrower, each Subsidiary Guarantor and each Accepting Lender. 
 (b) The Administrative Agent shall
have received a favorable written opinion of Kirkland & Ellis LLP, counsel for Parent and the Borrower, substantially to the effect set forth on Exhibit A-1. 
 (c) The Administrative Agent shall have received (i) a certificate as to the good standing of the Parent and the Borrower as of a recent date, from the Secretary of State of its state of
organization; (ii) a certificate of the Secretary or Assistant Secretary of the Parent and the Borrower dated the Loan Modification Effective Date and certifying (A) that attached thereto is a true and complete copy of (1) the by-laws
(or equivalent thereof) and (2) the certificate or articles of incorporation, certified as of a recent date by the Secretary of State of the applicable state of organization, in each case of such Loan Party as in effect on the Loan Modification
Effective Date and at all times since a date prior to the date of the resolutions described in clause (B) below, (or, if such by-laws (or equivalent thereof) or certificate or articles of incorporation have not been amended or modified since
any delivery thereof to the Administrative Agent on or subsequent to the Closing Date certifying that no such amendment or modification has occurred), (B) that 

  
 3 








 
attached thereto is a true and complete copy of resolutions duly adopted by the Board of Directors (or equivalent thereof) of such Loan Party authorizing the execution, delivery and performance
of the Loan Documents to which such person is a party, and that such resolutions have not been modified, rescinded or amended and are in full force and effect and (C) as to the incumbency and specimen signature of each officer executing this
Agreement or any other document delivered in connection herewith on behalf of such Loan Party; (iii) a certificate of another officer as to the incumbency and specimen signature of the Secretary or Assistant Secretary executing the certificate
pursuant to clause (ii) above; and (iv) such other documents as the Administrative Agent may reasonably request. 

(d) The Administrative Agent shall have received a certificate, dated the Loan Modification Effective Date and signed by a Financial
Officer of the Borrower, confirming compliance with the conditions precedent set forth in paragraphs (b) and (c) of Section 4.01 of the Credit Agreement. 
 (e) The Administrative Agent shall have received all Fees and other amounts due and payable on or prior to the Loan Modification Effective Date, including, to the extent invoiced, reimbursement or payment
of all out-of-pocket expenses required to be reimbursed or paid by the Borrower hereunder or under any other Loan Document. 

(f) The Security Documents shall be in full force and effect on the Loan Modification Effective Date, and the Collateral Agent on behalf
of the Secured Parties shall have a security interest in the Collateral of the type and priority described in each Security Document. 
 (g) The Administrative Agent shall have received payment from the Borrower, for the account of each Accepting Lender, a fee in an amount equal to 2.10% of the aggregate principal amount of such Accepting
Lender’s Existing Non-Extended Term Loans that are converted into Extended Term Loans on the Loan Modification Effective Date. Such fees shall be payable in immediately available funds and, once paid, shall not be refundable in whole or in
part. 
 The Administrative Agent shall notify the parties hereto of the Loan Modification Effective Date and such notice shall
be conclusive and binding. 
 SECTION 5. Reaffirmation; Further Assurances. (a) Each of Parent, the Borrower and
each of the Subsidiary Guarantors identified on the signature pages hereto (collectively, Parent, the Borrower and such Subsidiary Guarantors, the “Reaffirming Loan Parties”) hereby acknowledges that it expects to receive
substantial direct and indirect benefits as a result of this Agreement and the transactions contemplated hereby. Each Reaffirming Loan Party hereby consents to this Agreement and the transactions contemplated hereby, and hereby confirms its
respective guarantees, pledges and grants of security interests, as applicable, under each of the Loan Documents to which it is party, and agrees that, notwithstanding the effectiveness of this Agreement and the transactions contemplated hereby,
such guarantees, pledges and grants of security interests shall continue to be in full force and effect and shall accrue to the benefit of the 

  
 4 








 
Secured Parties. Each of the Reaffirming Loan Parties further agrees to take any action that may be required or that is reasonably requested by the Administrative Agent to effect the purposes of
this Agreement, the transactions contemplated hereby or the Loan Documents and hereby reaffirms its obligations under each provision of each Loan Document to which it is party. 

(b) Within 90 days after the Loan Modification Effective Date (or such later date as the Administrative Agent in its sole discretion may
permit) the Borrower shall deliver, with respect to each Mortgage encumbering a Mortgaged Property, either (x) an amendment thereof (each, a “Mortgage Amendment”), setting forth such changes as are reasonably necessary
to reflect that the lien securing the Obligations under the Credit Agreement encumbers such Mortgaged Property and to further grant, preserve, protect, confirm and perfect the first-priority lien and security interest thereby created and perfected,
and opinions by local counsel reasonably acceptable to the Administrative Agent regarding the enforceability of each such Mortgage Amendment, or (y) opinions or other written confirmations from local counsel reasonably acceptable to the
Administrative Agent stating, to the reasonably satisfaction of the Administrative Agent, that no such Mortgage Amendment is required with respect to a Mortgaged Property, in each case in substantially the same form as those Mortgage Amendments and
local counsel opinions delivered to the Administrative Agent on the First Restatement Effective Date, except for those changes necessary to reflect the transactions contemplated hereby, and each of the foregoing being in all respects reasonably
acceptable to the Administrative Agent. 
 SECTION 6. Expenses. The Borrower agrees to reimburse the Administrative Agent
for its reasonable out-of-pocket expenses in connection with the Loan Documents (including the preparation of this Agreement), including the reasonable fees, charges and disbursements of counsel for the Administrative Agent. 

SECTION 7. Notices. All notices hereunder shall be given in accordance with Section 9.01 of the Credit Agreement. 

SECTION 8. Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original,
but all of which together shall constitute one and the same instrument. Delivery by electronic transmission of an executed counterpart of a signature page to this Agreement shall be effective as delivery of an original executed counterpart of this
Agreement. 
 SECTION 9. Governing Law. (a) THIS AGREEMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH,
THE LAWS OF THE STATE OF NEW YORK. 
 (b) EACH PARTY HERETO HEREBY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW,
ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN ANY LEGAL PROCEEDING DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY (WHETHER BASED ON 

  
 5 








 
CONTRACT, TORT OR ANY OTHER THEORY). EACH PARTY HERETO (I) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PARTY HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER
PARTY WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER AND (II) ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND
CERTIFICATIONS IN THIS SECTION. 
 SECTION 10. Headings. Section headings used herein are for convenience of reference
only, are not part of this Agreement and shall not affect the construction of, or be taken into consideration in interpreting, this Agreement. 
 [Remainder of page intentionally left blank] 

  
 6 








 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed by
their respective authorized officers as of the date first above written. 
  

					
	CHS/COMMUNITY HEALTH SYSTEMS, INC.,
			
		 	By:	 	 /s/ W. Larry Cash

		 		 	Name: W. Larry Cash
		 		 	Title: Executive Vice President and Chief Financial Officer
	
	COMMUNITY HEALTH SYSTEMS, INC.,
			
		 	By:	 	 /s/ W. Larry Cash

		 		 	Name: W. Larry Cash
		 		 	Title: Executive Vice President and Chief Financial Officer


 [SIGNATURE PAGE TO LOAN
MODIFICATION AGREEMENT TO 
 CREDIT AGREEMENT
OF CHS/COMMUNITY HEALTH SYSTEMS, INC.] 







 
					
	CREDIT SUISSE AG, CAYMAN ISLANDS BRANCH, individually and as Administrative Agent,
		 	 by
	 	
		 		 	 /s/ Ari Bruger

		 		 	 Name: Ari Bruger

		 		 	 Title: Vice President

			
		 	 by
	 	
		 		 	 /s/ Rahul Parmar

		 		 	 Name: Rahul Parmar

		 		 	 Title: Associate




  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	Abilene Hospital LLC
	Abilene Merger LLC
	Affinity Health Systems, LLC
	Affinity Hospital, LLC
	Anna Hospital Corporation
	Berwick Hospital Company, LLC
	Big Bend Hospital Corporation
	Big Spring Hospital Corporation
	Birmingham Holdings II, LLC
	Birmingham Holdings, LLC
	Blue Island Hospital Company, LLC
	Blue Island Illinois Holdings, LLC
	Bluefield Holdings, LLC
	Bluefield Hospital Company, LLC
	Bluffton Health System, LLC
	Brownsville Hospital Corporation
	Brownwood Medical Center, LLC
	Bullhead City Hospital Corporation
	Bullhead City Hospital Investment Corporation
	Carlsbad Medical Center, LLC
	Centre Hospital Corporation
	CHHS Holdings, LLC
	CHS Kentucky Holdings, LLC
	CHS Pennsylvania Holdings, LLC
	CHS Virginia Holdings, LLC
	CHS Washington Holdings, LLC
	Clarksville Holdings, LLC
	Cleveland Hospital Corporation
	Cleveland Tennessee Hospital Company, LLC
	Clinton Hospital Corporation
	Coatesville Hospital Corporation
	College Station Medical Center, LLC
	College Station Merger, LLC
	Community GP Corp.
	Community Health Investment Company, LLC
	Community LP Corp.
		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	CP Hospital GP, LLC
	CPLP, LLC
	Crestwood Hospital LP, LLC
	Crestwood Hospital, LLC
	CSMC, LLC
	CSRA Holdings, LLC
	Deaconess Holdings, LLC
	Deaconess Hospital Holdings, LLC
	Deming Hospital Corporation
	Desert Hospital Holdings, LLC
	Detar Hospital, LLC
	DHFW Holdings, LLC
	DHSC, LLC
	Dukes Health System, LLC
	Dyersburg Hospital Corporation
	Emporia Hospital Corporation
	Evanston Hospital Corporation
	Fallbrook Hospital Corporation
	Foley Hospital Corporation
	Forrest City Arkansas Hospital Company, LLC
	Forrest City Hospital Corporation
	Fort Payne Hospital Corporation
	Frankfort Health Partner, Inc.
	Franklin Hospital Corporation
	Gadsden Regional Medical Center, LLC
	Galesburg Hospital Corporation
	Granbury Hospital Corporation
	Granite City Hospital Corporation
	Granite City Illinois Hospital Company, LLC
	Greenville Hospital Corporation
	GRMC Holdings, LLC
	Hallmark Healthcare Company, LLC
	Hobbs Medco, LLC
	Hospital of Barstow, Inc.
	Hospital of Fulton, Inc.
	Hospital of Louisa, Inc.
	Hospital of Morristown, Inc.
		
	By:	 	/s/ James W. Doucette
		 	  

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	Jackson Hospital Corporation
	Jackson Hospital Corporation
	Jourdanton Hospital Corporation
	Kay County Hospital Corporation
	Kay County Oklahoma Hospital Company, LLC
	Kirksville Hospital Company, LLC
	Lakeway Hospital Corporation
	Lancaster Hospital Corporation
	Las Cruces Medical Center, LLC
	Lea Regional Hospital, LLC
	Lexington Hospital Corporation
	Longview Clinic Operations Company, LLC
	Longview Merger, LLC
	LRH, LLC
	Lutheran Health Network of Indiana, LLC
	Marion Hospital Corporation
	Martin Hospital Corporation
	Massillon Health Community System, LLC
	Massillon Health System, LLC
	Massillon Holdings, LLC
	McKenzie Tennessee Hospital Company, LLC
	McNairy Hospital Corporation
	MCSA, L.L.C.
	Medical Center of Brownwood, LLC
	Merger Legacy Holdings, LLC
	MMC of Nevada, LLC
	Moberly Hospital Company, LLC
	MWMC Holdings, LLC
	Naticoke Hospital Company, LLC
	National Healthcare of Leesville, Inc.
	National Healthcare of Mt. Vernon, Inc.
	National Healthcare of Newport, Inc.
	Navarro Regional, LLC
	NC-DSH, LLC
		
	By:	 	/s/ James W. Doucette
		 	  

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	Northampton Hospital Company, LLC
	Northwest Hospital, LLC
	NOV Holdings, LLC
	NRH, LLC
	Oak Hill Hospital Corporation
	Oro Valley Hospital, LLC
	Palmer-Wasilla Health System, LLC
	Payson Hospital Corporation
	Peckville Hospital Company, LLC
	Pennsylvania Hospital Company, LLC
	Phillips Hospital Corporation
	Phoenixville Hospital Company, LLC
	Pottstown Hospital Company, LLC
	QHG Georgia Holdings II, LLC
	QHG Georgia Holdings, Inc.
	QHG of Bluffton Company, LLC
	QHG of Clinton County, Inc.
	QHG of Enterprise, Inc.
	QHG of Forrest County, Inc.
	QHG of Fort Wayne Company, LLC
	QHG of Hattiesburg, Inc.
	QHG of Massillon, Inc.
	QHG of South Carolina, Inc.
	QHG of Spartanburg, Inc.
	QHG of Springdale, Inc.
	QHG of Warsaw Company, LLC
	Quorum Health Resources, LLC
	Red Bud Hospital Corporation
	Red Bud Illinois Hospital Company, LLC
	Regional Hospital of Longview, LLC
	River Region Medical Corporation
	Roswell Hospital Corporation
	Ruston Hospital Corporation
	Ruston Louisiana Hospital Company, LLC
	SACMC, LLC
	Salem Hospital Corporation
	San Angelo Community Medical Center, LLC
		
	By:	 	/s/ James W. Doucette
		 	  

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	San Angelo Medical, LLC
	San Miguel Hospital Corporation
	Scranton Holdings, LLC
	Scranton Hospital Company, LLC
	Scranton Quincy Holdings, LLC
	Scranton Quincy Hospital Company, LLC
	Shelbyville Hospital Corporation
	Siloam Springs Arkansas Hospital Company, LLC
	Siloam Springs Holdings, LLC
	Southern Texas Medical Center, LLC
	Spokane Valley Washington Hospital Company, LLC
	Spokane Washington Hospital Company, LLC
	Tennyson Holdings, LLC
	Tomball Texas Holdings, LLC
	Tomball Texas Hospital Company, LLC
	Tooele Hospital Corporation
	Triad Health Care Corporation
	Triad Holdings III, LLC
	Triad Holdings IV, LLC
	Triad Holdings V, LLC
	Triad Nevada Holdings, LLC
	Triad of Alabama, LLC
	Triad of Oregon, LLC
	Triad-ARMC, LLC
	Triad-El Dorado, Inc.
	Triad-Navarro Regional Hospital Subsidiary, LLC
	Tunhannock Hospital Company, LLC
	VHC Medical, LLC
	Vicksburg Healthcare, LLC
	Victoria Hospital, LLC
	Virginia Hospital Company, LLC
	Warren Ohio Hospital Company, LLC
	Warren Ohio Rehab Hospital Company, LLC
		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	Watsonville Hospital Corporation
	Waukegan Hospital Corporation
	Waukegan Illinois Hospital Company, LLC
	Weatherford Hospital Corporation
	Weatherford Texas Hospital Company, LLC
	Webb Hospital Corporation
	Webb Hospital Holdings, LLC
	Wesley Health System, LLC
	West Grove Hospital Company, LLC
	WHMC, LLC
	Wilkes-Barre Behavioral Hospital Company, LLC
	Wilkes-Barre Holdings, LLC
	Wilkes-Barre Hospital Company, LLC
	Williamston Hospital Corporation
	Women & Children’s Hospital, LLC
	Woodland Heights Medical Center, LLC
	Woodward Health System, LLC
	Youngstown Ohio Hospital Company, LLC
		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	 Brownwood Hospital, L.P.
 By: Brownwood Medical Center, LLC
 Its: General Partner

		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer
	
	 College Station Hospital, L.P.
 By: College Station Medical Center, LLC
 Its: General Partner

		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer
	
	 Longview Medical Center, L.P.
 By: Regional Hospital of Longview, LLC
 Its: General Partner

		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer
	
	 Navarro Hospital, L.P.
 By: Navarro Regional, LLC
 Its: General Partner

		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 
			
	 QHG Georgia, LP

By: QHG Georgia Holdings II, LLC
 Its: General
Partner

		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer
	
	 Victoria of Texas, L.P.
 By: Detar Hospital, LLC
 Its: General Partner

		
	By:	 	 /s/ James W. Doucette

		 	Name: James W. Doucette
		 	Title: Vice President and Treasurer



  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 LENDER SIGNATURE PAGE TO 

LOAN MODIFICATION AGREEMENT 
 TO CREDIT AGREEMENT OF 
 CHS/COMMUNITY HEALTH SYSTEMS, INC. 

  

[SIGNATURE PAGE TO LOAN MODIFICATION
AGREEMENT TO 
 CREDIT AGREEMENT OF
CHS/COMMUNITY HEALTH SYSTEMS, INC.] 








 EXHIBIT A-1 
 Form of Kirkland & Ellis LLP Opinion