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EXHIBIT 10.2.1

                       INTEGRATED HEALTHCARE HOLDINGS INC.

                                AMENDMENT NO.1 TO
                              COMMON STOCK WARRANT

                                  JULY 18, 2008

         This Amendment No.1 to Common Stock Warrant (this "AMENDMENT NO.1") is
made and entered into as of the date set forth above (the "EFFECTIVE DATE") by
and between Integrated Healthcare Holdings, Inc., a Nevada corporation (the
"COMPANY"), and Healthcare Financial Management & Acquisitions, Inc., a Nevada
corporation (the "HOLDER").

                                    RECITALS

         A. On October 9, 2007, the Company issued to Holder a warrant to
subscribe for and purchase a minimum of 16,880,484 shares of Common Stock of the
Company subject to the provisions and upon the terms and conditions set forth
therein (the "WARRANT").

         B. The Warrant was issued pursuant to that certain Credit Agreement
($80,000,000 Facility) dated as of October 9, 2007 by and between the Company
and certain of its subsidiaries (collectively, the "BORROWERS"), the "Credit
Parties" (as defined therein), and Medical Provider Financial Corporation II,
Inc., a Nevada corporation, as the lender.

         C. Concurrently herewith, another loan made pursuant to a separate
Credit Agreement ($10,700,000 Facility) dated as of October 9, 2007 by and
between the Borrowers, the Credit Parties, and Medical Provider Financial
Corporation III, Inc., a Nevada corporation, as the lender is being paid off
early by the Borrowers and, as additional consideration for the early pay off,
Borrowers have requested that the Warrant be amended as set forth herein.

         NOW, THEREFORE, in consideration of the foregoing recitals and the
mutual promises hereinafter set forth and for other good and valuable
consideration the receipt and sufficiency of which is hereby acknowledged, the
parties hereto agree to amend the Warrant as set forth herein and agree as
follows:

                                    AGREEMENT

         1. RECITALS. The foregoing Recitals are incorporated by reference as
though fully set forth herein.

         2. DEFINITIONS. Unless otherwise defined herein, capitalized terms
shall have the meanings assigned to such terms in the Warrant.

         3. Section 9(b)(ii) of the Warrant is hereby amended to read in its
entirety as follows:

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                  "The Company shall permit, or shall cause the managing
         underwriter of a proposed offering to permit, the Holders from whom
         such written requests have been received to include such number of
         Shares (the "PIGGY-BACK SHARES") in the proposed offering on terms and
         conditions no less favorable to the Holders as the terms and conditions
         applicable to securities of the Company included therein or as
         applicable to securities of any person other than the Company and the
         Holders of Piggy-back Shares if the securities of any such person are
         included therein; provided, however, that the Company shall not be
         required to honor any such request that is received more than sixty
         (60) days after the proper giving of the Company's notice or after the
         Expiration Date. Notwithstanding any other provision of this Section
         9(b), if the underwriter advises the Holder in writing that marketing
         factors require a limitation of the number of shares to be
         underwritten, the number of shares of Shares held by the Holder to be
         included in such underwriting shall not be reduced unless all other
         securities, other than securities to be offered for the accounts of
         Kali P. Chaudhuri, William E. Thomas and their transferees (the "OTHER
         SHARES") and securities to be offered for the account of the Holder and
         the Company, are first entirely excluded from the underwriting, and
         unless the number of Other Shares, on the one hand, and Piggy-back
         Shares on the other hand, are cut back on a pro rata basis based on the
         number of Piggy-back Shares and Other Shares requested to be included
         in such offering. The Company shall bear and pay all expenses incurred
         in connection with any registration, filing or qualification of the
         Shares with respect to the registrations pursuant to this Section for
         each Holder, including (without limitation) all registration, filing,
         and qualification fees, printers and accounting fees relating or
         apportionable thereto and the fees and disbursements of one counsel for
         the selling Holders selected by them."

4. Except as set forth herein, the Warrant shall remain unmodified and in full
force and effect.

5. This Amendment No.1 may be executed in counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same
instrument.





                            [SIGNATURE PAGE FOLLOWS.]


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                                                                  EXECUTION COPY

         IN WITNESS WHEREOF, the parties hereto have executed this Amendment
No.1 to Common Stock Warrant as of the date and year first above written.


                                           INTEGRATED HEALTHCARE HOLDINGS, INC.,
                                           A NEVADA CORPORATION


                                           By: /s/ Bruce Mogel
                                               --------------------------------
                                           Name: Bruce Mogel

                                           Title: Chief Executive Officer



                                           HEALTHCARE FINANCIAL MANAGEMENT &
                                           ACQUISITIONS, INC., A NEVADA
                                           CORPORATION


                                           By: /s/ Joseph J. Lampariello
                                               -------------------------------
                                           Name: Joseph J. Lampariello

                                           Title:   President and COO



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