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                                                                    EXHIBIT 10.1


                                 FIFTH AMENDMENT

         This FIFTH AMENDMENT (the "Amendment") dated October 27, 1998 is
entered into by and among QUORUM HEALTH GROUP, INC., a corporation organized
under the laws of Delaware (the "Borrower"), the LENDERS referred to in the
Credit Agreement (the "Lenders") and FIRST UNION NATIONAL BANK (f/k/a First
Union National Bank of North Carolina) as Agent for the Lenders (hereinafter
defined the "Agent").

                              STATEMENT OF PURPOSE

         The Borrower, the Lenders and the Agent are parties to that certain
Credit Agreement dated as of April 22, 1997 (such agreement, as previously
amended, and as further amended from time to time, herein referred to as the
"Credit Agreement") pursuant to which the Lenders have agreed to extend certain
credit facilities to the Borrower. Capitalized terms used in this Amendment not
otherwise defined herein have the respective meanings attributed to such terms
in the Credit Agreement.

         The Borrower has requested that the Lenders amend the Credit Agreement
as more fully described below. Subject to the terms and conditions set forth
below, the Lenders are willing to agree to the requested amendments.

         NOW, THEREFORE, for good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged by the parties hereto, the Borrower,
each of the Lenders and the Agent agree as follows:

         1.       Amendments to Article IX. Section 9.5 is hereby amended by
                  inserting the following proviso immediately prior to the
                  period at the end of such Section 9.5:

                  "less(d) the amount of any stock repurchases or redemptions
                  permitted pursuant to Section 10.7(e); provided that in no
                  event shall Consolidated Net Worth to be less than
                  $450,000,000."

         2.       Amendments to Article X. Section 10.7(e) is hereby amended by
                  deleting the Dollar amount "$100,000,000" in clause (i)
                  thereof and substituting the Dollar amount "$150,000,000" in
                  lieu thereof.

         3.       Amendment Fee. In consideration of the amendments set forth
                  herein, the Borrower agrees to pay to the Agent,


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                   for the benefit of the Lenders, an amendment fee of 5 basis
                   points on the commitment of each Lender delivering an
                   executed signature page to this Fifth Amendment on or prior
                   to 5:00 PM (Eastern Standard Time) on Tuesday, October 27,
                   1998.

         4.        Conditions. The effectiveness of this Amendment shall be
                   conditioned upon receipt by the Agent of (a) a copy of this
                   Amendment duly executed by the Agent, the Borrower and the
                   Required Lenders, (b) payment of the Amendment Fee and (c)
                   contemporaneous consent to this Amendment by the lenders
                   under the Quorum ELLF Credit Agreement.

         5.        Bringdown; References to Credit Agreement. The Borrower
                   hereby represents and warrants that (a) the
                   representations and warranties contained in Article VI
                   of the Credit Agreement are true and correct in all
                   material respects as of the date hereof (except and to
                   the extent that such representations and warranties
                   relate to an earlier date, in which case such
                   representations and warranties shall be true and correct
                   as of such earlier date) and (b) no Default or Event of
                   Default has occurred and is continuing as of the date
                   hereof. All references in the Loan Documents to "Credit
                   Agreement" shall refer to the Credit Agreement as
                   amended by this Amendment and as the Credit Agreement
                   may be further amended from time to time.

         6.        Miscellaneous. Except as amended hereto, the Credit
                   Agreement shall remain in full force and effect in
                   accordance with its terms. This Amendment may be
                   executed in one or more counterparts each of which shall
                   be deemed to be an original and all of which, when taken
                   together, shall constitute one and the same instrument
                   and no single counterpart of this Amendment need be
                   executed by all the parties hereto. The covenants and
                   agreements contained in this Amendment shall apply to
                   and inure to the benefit of and be binding upon the
                   parties hereto and their respective successors and
                   assigns. This Amendment shall be governed by the laws of
                   the State of North Carolina.




                            [Signature Pages Follow]


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         IN WITNESS WHEREOF, the Borrower, the Lenders and the Agent have
executed this Amendment to Credit Agreement as of the date first above written.

                                    QUORUM HEALTH GROUP, INC.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------

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                                    FIRST UNION NATIONAL BANK



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    TORONTO DOMINION (TEXAS), INC.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    SCOTIABANC INC.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    AMSOUTH BANK



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    CITICORP USA, INC.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    SUNTRUST BANK, NASHVILLE, N.A.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


<PAGE>   5



                                    NATIONSBANK, N.A.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    MELLON BANK, N.A.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    BANK OF AMERICA NATIONAL TRUST
                                    AND SAVINGS ASSOCIATION



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    FLEET NATIONAL BANK, N.A.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    ABN AMRO BANK N.V.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


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                                    COOPERATIEVE CENTRALE RAIFFEISEN
                                    BOERENLEENBANK B.A.

                                    "RABOBANK NEDERLAND,"
                                    NEW YORK BRANCH



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    NATIONAL CITY BANK OF KENTUCKY



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    UNION BANK OF CALIFORNIA, N.A.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    PARIBAS



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


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                                    LTCB TRUST COMPANY



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    THE SUMITOMO BANK, LIMITED



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    CREDIT LYONNAIS



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    BANK ONE, NA



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    THE SANWA BANK LIMITED,



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    FBTC LEASING CORP.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


<PAGE>   8



                                    THE SUMITOMO TRUST AND
                                    BANKING CO., LTD.,
                                    NEW YORK BRANCH



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    KBC BANK N.V.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    FIRST TENNESSEE BANK,
                                    NATIONAL ASSOCIATION



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    FIRST AMERICAN NATIONAL BANK



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    BANK OF TOKYO - MITSUBISHI
                                    TRUST COMPANY



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


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                                    BANK HAPOALIM B.M.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------


                                    SOUTHTRUST BANK, N.A.



                                    By:
                                        ----------------------------------------
                                        Name:
                                              ----------------------------------
                                        Title:
                                               ---------------------------------