EX-4.2



 



Exhibit 4.2




$3,021,331,000




CHS/COMMUNITY HEALTH SYSTEMS, INC.




87/8% Senior Notes due 2015




JOINDER TO THE REGISTRATION RIGHTS AGREEMENT




July 25, 2007




CREDIT SUISSE SECURITIES (USA) LLC,

WACHOVIA CAPITAL MARKETS, LLC

As Representatives of the Several Initial Purchasers

   c/o Credit Suisse Securities (USA) LLC,

   Eleven Madison Avenue,

   New York, New York 10010-3629




Ladies and Gentlemen:




          Reference is made to the Purchase Agreement (the “Purchase Agreement”) dated June 27, 2007,
among CHS/Community Health Systems, Inc., a Delaware corporation (the “Company”), Holdings and the
Guarantors, the Initial Purchasers, concerning the purchase of the Initial Securities from the
Company by the Initial Purchasers. This is the Joinder Agreement to the Registration Rights
Agreement dated July 25, 2007 (the “Registration Rights Agreement” or this “Agreement”).
Capitalized terms used herein but not defined herein shall have the meanings ascribed to such terms
in the Registration Rights Agreement.




          Each of the parties hereto agrees that this Agreement is being executed and delivered in
connection with the issue and sale of the Initial Securities pursuant to the Purchase Agreement and
to induce the Purchasers to purchase the Initial Securities thereunder. This Agreement is being
executed on the Closing Date concurrently with the consummation of the Acquisition.




          1. Joinder. Each of Triad and the Triad Guarantors listed on Schedule II to the
Registration Rights Agreement (together, the “Joining Parties”) hereby agrees to become bound by
the terms, conditions and other provisions of the Registration Rights Agreement with all attendant
rights, duties and obligations stated therein, with the same force and effect as if originally
named therein as a party and as if such party executed the Registration Rights Agreement on the
date thereof.




          2. Representations and Warranties of the Joining Parties. Each of the Joining
Parties represents and warrants to, and agrees with, the Purchasers on and as of the date hereof
that this Agreement has been duly authorized, executed and delivered by such Joining Party.




          3. GOVERNING LAW. THIS AGREEMENT SHALL BE GOVERNED BY AND
CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK.




 









 








          4. Counterparts. This Agreement may be executed in one or more counterparts, each of
which shall each be deemed to be an original, but all such counterparts shall together constitute
one and the same instrument.




          5. Amendments. No amendment or waiver of any provision of this Agreement, nor any
consent or approval to any departure therefrom, shall in any event be effective unless the same
shall be in writing and signed by the parties hereto.




          6. Headings. The headings herein are inserted for convenience of reference only and
are not intended to be part of, or to affect the meaning or interpretation of, this Agreement.




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



	 	 	 	 	 	 	 	 	 	 	 
	 	 	Very truly yours,	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 





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	 	QHG of Enterprise, Inc. 

QHG of Jacksonville, Inc.

QHG of Springdale, Inc.

Triad-El Dorado, Inc.

Abilene Hospital, LLC

Abilene Merger, LLC

Arizona DH, LLC

ARMC, LP

Birmingham Holdings, LLC

Bluffton Health System, LLC

Brownwood Hospital, L.P.

Brownwood Medical Center, LLC

Carlsbad Medical Center, LLC

Claremore Regional Hospital, LLC

Clarksville Holdings, LLC

College Station Hospital, L.P.

College Station Medical Center, LLC

College Station Merger, LLC

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

Desert Hospital Holdings, LLC

Detar Hospital, LLC

Dukes Health System, LLC

Gadsden Regional Medical Center, LLC

Greenbrier VMC, LLC

GRMC Holdings, LLC

Hobbs Medco, LLC

Las Cruces Medical Center, LLC

Lea Regional Hospital, LLC

Longview Merger, LLC

LRH, LLC

Lutheran Health Network of Indiana, LLC

Massillon Health System, LLC

Medical Center of Brownwood, LLC

MMC of Nevada, LLC

Navarro Hospital, L.P.

 	 
	 	By:  	/s/ James W. Doucette
 	 
	 	 	Name:  	James W. Doucette 	 
	 	 	Title:  	Vice President, Finance and Treasurer 	 
	 



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Joinder to Registration Rights Agreement





 









 





	 	 	 	 	 
	 	Navarro Regional, LLC 

NRH, LLC

Oregon Healthcorp, LLC

Palmer-Wasilla Health System, LLC

Quorum Health Resources, LLC

Regional Hospital of Longview, LLC

Russellville Holdings, LLC

SACMC, LLC

San Angelo Community Medical Center, LLC

San Angelo Hospital, L.P.

San Angelo Medical, LLC

Southern Texas Medical Center, LLC

St. Joseph Health System, LLC

Tennyson Holdings, Inc.

Triad Healthcare Corporation

Triad Holdings III, LLC

Triad Holdings IV, LLC

Triad Holdings V, LLC

Triad Healthcare Corporation

Triad of Alabama, LLC

Triad of Oregon, LLC

Triad-ARMC, LLC

Triad-Denton Hospital GP, LLC

Triad-Denton Hospital, L.P.

Triad-Navarro Regional Hospital Subsidiary, LLC

VHC Medical, LLC

Vicksburg Healthcare, LLC

Victoria Hospital, LLC

Victoria of Texas, L.P.

WHMC, LLC

Willamette Valley Medical Center, LLC

Women & Children’s Hospital, LLC

Woodland Heights Medical Center, LLC

Woodward Health System, LLC

QHG Georgia Holdings, Inc.

QHG Georgia, L.P.

Frankfort Health Partner, Inc.

IOM Health System, L.P.

QHG of Bluffton, Inc.

QHG of Clinton County, Inc.

QHG of Fort Wayne, Inc.

QHG of Warsaw, Inc.

QHG of Forrest County, Inc.

QHG of Hattiesburg, Inc.

 	 
	 	By:  	/s/ James W. Doucette
 	 
	 	 	Name:  	James W. Doucette 	 
	 	 	Title:  	Vice President, Finance and Treasurer 	 
	 



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Joinder to Registration Rights Agreement





 









 





	 	 	 	 	 
	 	QHG of Massillon, Inc. 

SouthCrest, L.L.C.

River Region Medical Corporation

NC-DSH, Inc.

QHG of Barberton, Inc.Triad-South Tulsa Hospital

Company, Inc.

QHG of South Carolina, Inc.

QHG of Spartanburg, Inc.

 	 
	 	By:  	/s/ James W. Doucette
 	 
	 	 	Name:  	James W. Doucette 	 
	 	 	Title:  	Vice President, Finance and Treasurer 	 
	 



Joinder to Registration Rights Agreement