EX-4.2



 Exhibit 4.2 

EXECUTION VERSION 

Quorum Health Corporation 

$400,000,000 11.625% Senior Notes due 2023 

REGISTRATION RIGHTS JOINDER 

April 29, 2016 
 CREDIT
SUISSE SECURITIES (USA) LLC, 
   As Representative of the several Initial Purchasers, 

        C/O CREDIT SUISSE SECURITIES (USA)
LLC 
 Eleven Madison Avenue 

New York, New York 10010 
 Ladies and Gentlemen:

 Reference is made to the Registration Rights Agreement (the “Registration Rights Agreement”) dated April 22, 2016,
among Quorum Health Corporation, a Delaware corporation (the “Issuer” or the “Company”), and the several Initial Purchasers listed on Schedule A thereto (the “Initial Purchasers”), for whom Credit
Suisse Securities (USA) LLC is acting as representative (in such capacity, the “Representative”), concerning certain registration rights provisions with respect to the $400,000,000 aggregate principal amount of 11.625% Senior Notes
due 2023 issued by the Issuer. Capitalized terms used and not otherwise defined herein have the meanings ascribed to them in the Registration Rights Agreement. This agreement (this “Registration Rights Joinder”) is the
“Registration Rights Joinder” referred to in the Registration Rights Agreement. 
 Each of the Guarantors, for good and valuable
consideration, the receipt and sufficiency of which is hereby acknowledged, hereby agrees to join, and to become bound by the terms, conditions, covenants, agreements, indemnities and other provisions of, the Registration Rights Agreement as a
“Guarantor”, in each case with all attendant rights, duties and obligations stated therein, with the same force and effect as if originally a party thereto, and as if such party executed the Registration Rights Agreement on the date
thereof. 







 If the foregoing is in accordance with your understanding, please indicate your acceptance of
this Registration Rights Joinder by signing in the space provided below. 
  

									
		 		 		 		 	Very truly yours,
					
		 		 	By:	 		 	 /s/ Michael J. Culotta

		 		 	Name:	 		 	Michael J. Culotta
		 		 	Title:	 		 	President
		 		 		 		 	Acting on behalf of each of the Guarantors set
		 		 		 		 	forth below
				
	Anna Hospital Corporation	 		 		 	Massillon Community Health System LLC
				
	Big Bend Hospital Corporation	 		 		 	Massillon Health System LLC
				
	Big Spring Hospital Corporation	 		 		 	Massillon Holdings, LLC
				
	Blue Island Hospital Company, LLC	 		 		 	McKenzie Tennessee Hospital Company, LLC
				
	Blue Island Illinois Holdings, LLC	 		 		 	MMC of Nevada, LLC
				
	Blue Ridge Georgia Holdings, LLC	 		 		 	Monroe HMA, LLC
				
	Centre Hospital Corporation	 		 		 	MWMC Holdings, LLC
				
	Clinton Hospital Corporation	 		 		 	National Healthcare of Mt. Vernon, Inc.
				
	CSRA Holdings, LLC	 		 		 	Phillips Hospital Corporation
				
	Deming Hospital Corporation	 		 		 	QHC California Holdings, LLC
				
	DHSC, LLC	 		 		 	QHG of Massillon, Inc.
				
	Evanston Hospital Corporation	 		 		 	Quorum Health Investment Company, LLC
				
	Forrest City Arkansas Hospital Company, LLC	 		 		 	Quorum Health Resources, LLC
				
	Forrest City Hospital Corporation	 		 		 	Red Bud Hospital Corporation
				
	Fort Payne Hospital Corporation	 		 		 	Red Bud Illinois Hospital Company, LLC
				
	Galesburg Hospital Corporation	 		 		 	San Miguel Hospital Corporation
				
	Granite City Hospital Corporation	 		 		 	Sunbury Hospital Company, LLC
				
	Granite City Illinois Hospital Company, LLC	 		 		 	Tooele Hospital Corporation
				
	Greenville Hospital Corporation	 		 		 	Triad of Oregon, LLC
				
	Hamlet H.M.A., LLC	 		 		 	Watsonville Hospital Corporation
				
	Hospital of Barstow, Inc.	 		 		 	Waukegan Hospital Corporation
				
	Hospital of Louisa, Inc.	 		 		 	Waukegan Illinois Hospital Company, LLC
				
	Jackson Hospital Corporation (KY)	 		 		 	Williamston Hospital Corporation
				
	Lexington Hospital Corporation	 		 		 	Winder HMA, LLC
				
	Marion Hospital Corporation	 		 		 	


  
 [Signature Page to the
Registration Rights Agreement Joinder] 








 The foregoing Registration Rights Joinder 

is hereby accepted as of the date first above written. 
  

			
	CREDIT SUISSE SECURITIES (USA) LLC,
		
	By:	 	 /s/ Priyanka Verma

	Name:	 	Priyanka Verma
	Title:	 	Director
		
		 	 Acting on behalf of itself and as Representative

of the several Initial Purchasers



  
 [Signature Page to the
Registration Rights Agreement Joinder]