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                                                                    EXHIBIT 10.4

                       LIMITED LIABILITY COMPANY AGREEMENT

                                       OF

                      SUMMERLIN HOSPITAL MEDICAL CENTER LLC


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                                TABLE OF CONTENTS
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<S>      <C>      <C>                                                                                              <C>
ARTICLE 1
         CERTAIN DEFINITIONS.....................................................................................    1
         1.1      Certain Definitions............................................................................    1
                                                                                                                      
ARTICLE 2                                                                                                             
         INTERESTS IN AND CAPITAL OF THE COMPANY.................................................................    7
         2.1      Units; Percentage Shares.......................................................................    7
         2.2      Initial Capital Contributions..................................................................    7
         2.3      Assessments....................................................................................    8
         2.4      Return of Capital..............................................................................    8
         2.5      Limited Liability of Members, Assignees and Directors..........................................    8
         2.6      Options and Other Rights to Purchase Units.....................................................    8
         2.7      Restoration of Deficit Capital Account.........................................................    9
         2.8      Restrictions on Sale or Exchange...............................................................    9
                                                                                                                      
ARTICLE 3                                                                                                             
         ALLOCATIONS AND DISTRIBUTIONS...........................................................................    9
         3.1      Allocation of Profits..........................................................................    9
         3.2      Allocation of Losses...........................................................................    9
         3.3      Special Allocations............................................................................   10
         3.4      Curative Allocations...........................................................................   12
         3.5      Other Allocations Rules........................................................................   12
         3.6      Tax Allocations: Code Section 704(c)...........................................................   13
         3.7      Allocations with Respect to Transferred Interests..............................................   13
         3.8      Allocation Definitions.........................................................................   14
         3.9      Distributions..................................................................................   15
                                                                                                                      
ARTICLE 4                                                                                                             
         MANAGEMENT OF THE COMPANY'S AFFAIRS;                                                                         
         BOARD OF DIRECTORS......................................................................................   15
         4.1      General Powers of the Board of Directors.......................................................   15
         4.2      Composition of Board of Directors..............................................................   16
         4.3      Regular Meetings...............................................................................   16
         4.4      Special Meetings...............................................................................   16
         4.5      Notice of Special Meetings.....................................................................   16
         4.6      Quorum of Directors............................................................................   17
         4.7      Manner of Acting; Super-Majority Vote..........................................................   17
         4.8      Informal Action by Board of Directors..........................................................   18
         4.9      Participation by Electronic Means or Proxy.....................................................   18
         4.10     Resignation....................................................................................   18
         4.11     Removal........................................................................................   18
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<S>      <C>      <C>                                                                                              <C>
         4.12     No Committees..................................................................................   18
         4.13     Presumption of Assent..........................................................................   18
         4.14     Duty of Loyalty; Conflicts of Interest.........................................................   19
         4.15     Liability and Indemnity of the Directors and Officers..........................................   19
         4.16     Related Party Transactions.....................................................................   19
         4.17     Related Party Agreements.......................................................................   20
                                                                                                                      
ARTICLE 5                                                                                                             
         OFFICERS................................................................................................   20
         5.1      Appointment and Term of Office.................................................................   20
         5.2      Removal........................................................................................   20
                                                                                                                      
ARTICLE 6                                                                                                             
         MEMBERS.................................................................................................   21
         6.1      Admission of New Members.......................................................................   21
         6.2      Meetings.......................................................................................   21
         6.3      Quorum.........................................................................................   21
         6.4      Manner of Acting...............................................................................   21
         6.5      Proxies........................................................................................   21
         6.6      Voting by Certain Members......................................................................   22
         6.7      Action by Members Without a Meeting............................................................   22
         6.8      Voting by Ballot...............................................................................   22
         6.9      Waiver of Notice...............................................................................   22
         6.10     Resignation or Withdrawal......................................................................   22
                                                                                                                      
ARTICLE 7                                                                                                             
         TRANSFERS OF MEMBERSHIP INTERESTS BY MEMBERS............................................................   22
         7.1      Transfers......................................................................................   22
         7.2      Effect of Permitted Transfer...................................................................   23
         7.3      Prohibited Transfers...........................................................................   23
         7.4      Involuntary Withdrawal.........................................................................   23
         7.5      Exceptions to Restrictions.....................................................................   24
         7.6      Loss of Voting Rights..........................................................................   24
         7.7      Tax Treatment of Acquisitions of Interests by Company..........................................   24
                                                                                                                      
ARTICLE 8                                                                                                             
         PURCHASE RIGHTS AND OPTIONS.............................................................................   24
         8.1      Purchase Right.................................................................................   24
         8.2      Purchase Option................................................................................   26
         8.3      Tag Along/Co-Sale Rights on Transfers by a Member..............................................   27
         8.4      Put Right......................................................................................   27
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<S>      <C>      <C>                                                                                              <C>
ARTICLE 9
         DISSOLUTION AND LIQUIDATION OF THE COMPANY..............................................................   30  
         9.1      Liquidating Events.............................................................................   30  
         9.2      Method of Liquidation..........................................................................   30  
         9.3      Reasonable Time for Liquidation................................................................   31  
         9.4      Distribution to Liquidating Trust..............................................................   31  
         9.5      Date of Termination............................................................................   31  
         9.6      Certificate of Cancellation....................................................................   31  
                                                                                                                        
ARTICLE 10                                                                                                              
         COMPANY FUNDS AND ACCOUNTING............................................................................   32  
         10.1     Books of Account; Records and Information......................................................   32  
         10.2     Period and Method of Accounting................................................................   32  
         10.3     Reports........................................................................................   32  
         10.4     Tax Elections..................................................................................   32  
         10.5     Tax Matters Manager............................................................................   33  
                                                                                                                        
ARTICLE 11                                                                                                              
         NONCOMPETE..............................................................................................   33  
         11.1     Business Activities of Members.................................................................   33  
         11.2     Covenant Not to Compete........................................................................   33  
                                                                                                                        
ARTICLE 12                                                                                                              
         GENERAL.................................................................................................   35  
         12.1     Filings........................................................................................   35  
         12.2     Status of Company for Tax Purposes.............................................................   35  
         12.3     Waiver of Action for Partition.................................................................   35  
         12.4     Nonrecourse Loans..............................................................................   35  
         12.5     Notice.........................................................................................   35  
         12.6     Binding Effect.................................................................................   35  
         12.7     Construction...................................................................................   35  
         12.8     Survival of Provisions.........................................................................   36  
         12.9     Integrated Agreement...........................................................................   36  
         12.10    Governing Law..................................................................................   36  
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                       LIMITED LIABILITY COMPANY AGREEMENT

                                       OF

                      SUMMERLIN HOSPITAL MEDICAL CENTER LLC



         This Limited Liability Company Agreement ("AGREEMENT") of SUMMERLIN
HOSPITAL MEDICAL CENTER LLC (the "COMPANY") is made and entered into effective
as of 12:01 A.M. Pacific Time February 1, 1998 (the "EFFECTIVE DATE"), by and
among SUMMERLIN HOSPITAL MEDICAL CENTER, L.P., a Delaware limited partnership
("SHMC"), and NC-DSH, INC., a Nevada corporation ("NC-DSH") (each of the
foregoing, and each additional Person admitted as a member of the Company, shall
be referred to individually as a "MEMBER" and collectively as "MEMBERS").

A.       The Company was formed as a Delaware limited liability company under
         the Delaware Limited Liability Company Act (6 Delaware Code Section
         18-101, et seq., as it may be amended or succeeded from time to time
         (the "ACT")) by filing a Certificate of Formation with the Office of
         the Delaware Secretary of State on January 16, 1998.

B.       NC-DSH acquired its Interest from SHMC. Notwithstanding anything in
         this Agreement to the contrary, NC-DSH is admitted as a Member as of
         the Effective Date and such transfer is approved by the Members and
         Company and shall not be subject to the restrictions on Transfers or
         otherwise contained in this Agreement.

C.       The Members desire to enter into this Agreement to set forth the
         provisions governing the management and conduct of the business of the
         Company and the rights and obligations of the Members.

         The Members, in consideration of the foregoing premises and their
mutual covenants and agreements set forth herein, agree as follows:


                                    ARTICLE 1
                               CERTAIN DEFINITIONS

         1.1 Certain Definitions. As used in this Agreement, the following
capitalized terms shall have the meanings set forth below (certain other
definitions may be found in Section 3.8 or elsewhere in this Agreement):

                    1.1.1 Affiliate shall mean, when used with reference to a
         specified Person: (i) any Person that, directly or indirectly, through
         one or more intermediaries or by contractual agreement, controls or is
         controlled by or is under common control with the specified Person;
         (ii) any Person that is an officer of, partner in, or director


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         of, or trustee of, or serves in a similar capacity with respect to the
         specified Person or of which the specified Person is an officer,
         partner, director, or trustee, or with respect to which the specified
         Person serves in a similar capacity; (iii) any Person that, directly or
         indirectly, is the beneficial owner of ten percent (10%) or more of any
         class of the outstanding voting securities of, or otherwise has a
         substantial beneficial interest in, the specified Person, or of which
         the specified Person is, directly or indirectly, the owner of 10% or
         more of any class of voting securities of, or in which the specified
         Person has a substantial beneficial interest; and (iv) any spouse,
         brothers, sisters, ancestors and descendants of the specified Person.
         As used in this definition of "Affiliate," the term "control" means the
         possession, directly or indirectly, of the power to direct or cause the
         direction of the management and policies of a Person, whether through
         the ownership of voting securities, by contract, or otherwise, and the
         term "voting securities" includes, without limitation, partnership
         interests and limited liability company interests.

                    1.1.2 Bankruptcy or Bankrupt shall mean, with respect to any
         Person, the adjudication of bankruptcy, declaration of insolvency, or
         the assignment for the benefit of creditors of or by such Person, the
         subjection of part or all of the property of such Person to the control
         and direction of a receiver, which receivership is not dismissed within
         ninety (90) days of such receiver's appointment, or the filing by such
         Person or the involuntary filing against such Person of a petition for
         relief under any federal or other bankruptcy or insolvency law or for
         an arrangement with creditors which is not dismissed within ninety (90)
         days.

                    1.1.3 Business shall mean any lawful activity engaged in by
         the Company related to, and in furtherance of, the ownership, operation
         and management of the Hospital and related health care services
         businesses. The Company's principal executive office shall be located
         at 657 Town Center Drive, Las Vegas, Nevada 89134.

                    1.1.4 Capital Account shall mean, with respect to any
         Member, the Capital Account maintained for such Member in accordance
         with the following provisions:

                                1.1.4.1 To each Member's Capital Account there
                    shall be credited such Member's Capital Contributions, the
                    Member's distributive share of Profits and any items in the
                    nature of income or gain that are specifically allocated to
                    such Member pursuant to Section 3.3 or 3.4 hereof, and the
                    amount of any Company liabilities assumed by such Member or
                    which are secured by any Company Property distributed to
                    such Person.

                                1.1.4.2 To each Member's Capital Account there
                    shall be debited the amount of cash and the Gross Asset
                    Value of any Company Property


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                    distributed to such Member pursuant to any provision of this
                    Agreement, the Member's distributive share of Losses and any
                    items in the nature of expenses or losses that are specially
                    allocated to such Member pursuant to Section 3.3 or 3.4
                    hereof, and the amount of any liabilities of such Member
                    assumed by the Company or which are secured by any property
                    contributed by such Member to the Company.

                                1.1.4.3 In the event any Interest is transferred
                    in accordance with the terms of this Agreement, the
                    transferee shall succeed to the Capital Account of the
                    transferor to the extent it relates to the transferred
                    Interest; provided, however, that no transfer of an Interest
                    shall, in and of itself, relieve the transferor of any
                    obligation to the Company, including, but not limited to,
                    any such transferor's obligation to contribute to the
                    capital of the Company.

                                1.1.4.4 In determining the amount of any
                    liability for purposes of Subsections 1.1.4.1 and 1.1.4.2
                    hereof, there shall be taken into account Code Section
                    752(c) and any other applicable provisions of the Code and
                    Regulations.

The foregoing provisions and the other provisions of the Agreement relating to
the maintenance of Capital Accounts are intended to comply with Regulations
Section 1.704-1(b), and shall be interpreted and applied in a manner consistent
with these Regulations. In the event the Board of Directors determines that it
is prudent to modify the manner in which the Capital Accounts, or any debits or
credits thereto (including, without limitation, debits or credits relating to
liabilities that are secured by contributed or distributed property, or that are
assumed by the Company or the Members), are computed in order to comply with
such Regulations, the Board of Directors may make such modification if approved
in writing by SHMC and NC-DSH.

                    1.1.5 Capital Contribution shall mean, with respect to any
         Member, the amount of money and the initial Gross Asset Value of any
         property (other than money) contributed at any time to the Company with
         respect to such Member's Interest in the Company.

                    1.1.6 Code shall mean the Internal Revenue Code of 1986, as
         amended from time to time.

                    1.1.7 Company Property shall mean any and all interests and
         rights of any type or nature in all real and personal property,
         tangible and intangible, owned or acquired by the Company, including,
         without limitation, the Hospital and all assets used in connection with
         the Hospital that are owned, leased or operated by the Company.



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                    1.1.8 Depreciation shall mean for each fiscal year or other
         shorter period, an amount equal to the depreciation, amortization or
         other cost recovery deduction allowable with respect to an asset for
         such year or other period, except that if the Gross Asset Value of an
         asset differs from its adjusted basis for federal income tax purposes
         at the beginning of such year or other period, Depreciation shall be an
         amount which bears the same ratio to such beginning Gross Asset Value
         as the federal income tax depreciation, amortization or other cost
         recovery deduction for such year or other period bears to such
         beginning adjusted tax basis; provided, however, that if the federal
         income tax depreciation, amortization, or other cost recovery deduction
         for such year is zero, Depreciation shall be determined with reference
         to such beginning Gross Asset Value using any reasonable method
         selected by the Board of Directors and approved in writing by SHMC and
         NC-DSH.

                    1.1.9 Distributable Cash shall be defined for the applicable
         period of time as (i) the sum of (a) all cash receipts from all sources
         from the operations of the Company during such period, excluding the
         proceeds of indebtedness of the Company or from the issuance of
         additional Interests for cash, and (b) any reduction in Reserves
         established by the Board of Directors in prior periods as set forth
         below, less (ii) the sum of (aa) all cash disbursements of the Company
         during such period of time, including without limitation, disbursements
         by the Company on behalf of or amounts withheld with respect to,
         Members of the Company in the capacity of Members but only if such
         withheld amounts are pursuant to Subsection 3.9.3 hereof, if any, debt
         service (including the payment of principal, premium and interest),
         capital expenditures and redemptions of Interests in the Company
         pursuant to Section 736 of the Code, and (bb) any Reserves. "RESERVES"
         shall mean the sum of: (a) thirty (30) days operating cash computed by
         multiplying thirty (30) times the average daily actual cash
         disbursements for the previous three (3) months excluding cash
         disbursements for capital expenditures and (b) one and one-quarter
         percent (1.25%) of budgeted net revenues for the fiscal year.
         Notwithstanding anything in this Agreement to the contrary, the Company
         shall not make any distributions that would render it insolvent in
         violation of Act. Nothing contained herein nor distributions hereunder
         are intended nor shall be construed or applied to violate the fraud and
         abuse prohibitions under the Medicare and Medicaid programs.

                    1.1.10 Gross Asset Value shall mean, with respect to any
         asset, the asset's adjusted basis for federal income tax purposes,
         except as follows:

                                1.1.10.1 The initial Gross Asset Value of any
                    asset (other than cash) contributed by a Member to the
                    Company shall be the gross fair market value of such asset
                    as determined by the Members and the Company, provided that
                    the initial Gross Asset Value of the assets contributed by
                    SHMC pursuant to Section 2.2 hereof shall be Eighty Eight
                    Million Three Hundred Seventy-Three Thousand Thirty-Eight
                    and No/100


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                    Dollars ($88,373,038.00) plus the working capital
                    contributed to the Company by SHMC pursuant to the
                    Contribution Agreement;

                                1.1.10.2 The Gross Asset Values of all Company
                    assets shall be adjusted to equal their respective gross
                    fair market values, as reasonably determined by the Board of
                    Directors, as of the following times: (a) the acquisition of
                    an additional Interest by any new or existing Member in
                    exchange for more than a de minimis Capital Contribution;
                    (b) the distribution by the Company to a Member of more than
                    a de minimis amount of Company Property as consideration for
                    an Interest; and (c) the liquidation of the Company within
                    the meaning of Regulations Section 1.704-1(b)(2)(ii)(g);
                    provided, however, that the adjustments pursuant to clauses
                    (a) and (b) above shall be made only if the Board of
                    Directors reasonably determines that such adjustments are
                    necessary or appropriate to reflect the relative economic
                    rights of the Members in the Company;

                                1.1.10.3 The Gross Asset Value of any Company
                    asset distributed to any Member shall be the gross fair
                    market value of such asset on the date of distribution as
                    determined by the distributee and the Board of Directors;
                    and

                                1.1.10.4 The Gross Asset Values of Company
                    assets shall be increased (or decreased) to reflect any
                    adjustments to the adjusted basis of such assets pursuant to
                    Code Section 734(b) or Code Section 743(b), but only to the
                    extent that such adjustments are taken into account in
                    determining Capital Accounts pursuant to Regulations Section
                    1.704-1(b)(2)(iv)(m) and Section 3.5 hereof; provided,
                    however, that Gross Asset Values shall not be adjusted
                    pursuant to this Subsection 1.1.10.4 to the extent the Board
                    of Directors determines that an adjustment pursuant to
                    Subsection 1.1.10.2 is necessary or appropriate in
                    connection with a transaction that would otherwise result in
                    an adjustment pursuant to this Subsection 1.1.10.4.

If the Gross Asset Value of an asset has been determined or adjusted pursuant to
Subsections 1.1.10.1, 1.1.10.2, or 1.1.10.4 such Gross Asset Value shall
thereafter be adjusted by the Depreciation taken into account with respect to
such asset for purposes of computing Profits and Losses.

                    1.1.11 Hospital shall mean all the assets and properties the
         Company acquired from SHMC and its Affiliates pursuant to the
         Contribution Agreement, together with additions thereto and reduced by
         dispositions since such acquisition.

                    1.1.12 Interest shall mean a Member's entire ownership
         interest in the Company at any particular time, including its
         Percentage Share and the rights and obligations of such Member provided
         herein or in the Act.


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                    1.1.13 Liquidating Event shall mean any of the events listed
         in Section 9.1 requiring the dissolution, winding up and liquidation of
         the Company and its assets.

                    1.1.14 Person shall mean any individual, corporation,
         partnership, limited liability company, professional association,
         company, trust, estate or other entity.

                    1.1.15 Profits and Losses shall mean, for each fiscal year
         or other shorter period, an amount equal to the Company's taxable
         income or loss for such year or period, determined in accordance with
         Code Section 703(a) (for this purpose, all items of income, gain, loss
         or deduction required to be stated separately pursuant to Code Section
         703(a)(1) shall be included in taxable income or loss), with the
         following adjustments:

                                1.1.15.1 Any income of the Company that is
                    exempt from federal income tax and not otherwise taken into
                    account in computing Profits and Losses pursuant to this
                    Subsection 1.1.15 shall be added to such taxable income or
                    loss;

                                1.1.15.2 Any expenditures of the Company
                    described in Code Section 705(a)(2)(B) or treated as Code
                    Section 705(a)(2)(B) expenditures pursuant to Regulations
                    Section 1.704-1(b)(2)(iv)(i), and not otherwise taken into
                    account in computing Profits or Losses pursuant to this
                    Subsection 1.1.16 shall be subtracted from such taxable
                    income or loss;

                                1.1.15.3 In the event the Gross Asset Value of
                    any Company asset is adjusted pursuant to Subsection
                    1.1.15.3 or 1.1.15.4 hereof, the amount of such adjustment
                    shall be taken into account as gain or loss from the
                    disposition of such asset for purposes of computing Profits
                    or Losses;

                                1.1.15.4 Gain or loss resulting from any
                    disposition of Company Property with respect to which gain
                    or loss is recognized for federal income tax purposes shall
                    be computed by reference to the Gross Asset Value of the
                    property disposed of, notwithstanding that the adjusted tax
                    basis of such property differs from its Gross Asset Value;
                    and

                                1.1.15.5 In lieu of the depreciation,
                    amortization, and other cost recovery deductions taken into
                    account in computing such taxable income or loss, there
                    shall be taken into account Depreciation for such fiscal
                    year or other shorter period, computed in accordance with
                    Subsection 1.1.15 hereof.



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                                1.1.15.6 To the extent an adjustment to the
                    adjusted tax basis of any Company asset pursuant to Code
                    Section 734(b) or Code Section 743(b) is required pursuant
                    to Regulations Section 1.704-1(b)(2)(iv)(m)(4) to be taken
                    into account in determining Capital Accounts as a result of
                    a distribution other than in liquidation of a Member's
                    Interest, the amount of such adjustment shall be treated as
                    an item of gain (if the adjustment increases the basis of
                    the asset) or loss (if the adjustment decreases the basis of
                    the asset) from the disposition of the asset and shall be
                    taken into account for purposes of computing Profits or
                    Losses; and

                                1.1.15.7 Notwithstanding any other provisions of
                    this Subsection 1.1.15, any items which are specially
                    allocated pursuant to Section 3.3 or Section 3.4 hereof
                    shall not be taken into account in computing Profits or
                    Losses.

                    1.1.16 Contribution Agreement shall mean that Contribution
         Agreement by and between SHMC and NC-DSH dated on or about January 30,
         1998 pursuant to which the Company shall acquire the Hospital.

                    1.1.17 Regulations shall mean those regulations promulgated
         by the United States Treasury Department under the Code, as such
         regulations may be amended at any time and from time to time (including
         corresponding provisions of succeeding regulations).


                                    ARTICLE 2
                     INTERESTS IN AND CAPITAL OF THE COMPANY

         2.1 Units; Percentage Shares. Each Member's Interest in the Company
shall be denominated in "UNITS", or fractions thereof. Each Unit represents a
Capital Contribution of cash or assets with an initial Gross Asset Value of One
Hundred Thousand Dollars ($100,000.00). A Member's "PERCENTAGE SHARE" in the
Company shall be obtained by converting to a percentage the fraction having as
its numerator the number of Units held by such Member and having as its
denominator the aggregate number of Units held by all Members at the time. The
initial Units and Percentage Share of each Member shall be set forth opposite
such Member's name on Exhibit 2.1 attached hereto. Thereafter, such Percentage
Share shall be adjusted from time to time in accordance with this Agreement. All
such adjustments shall be reflected on Exhibit 2.1 hereto, which shall be
revised as a result thereof through the execution of a revised Exhibit 2.1 by
the Company's Chief Executive Officer and each of SHMC and NC-DSH. In case of
any conflict between two Exhibits 2.1, the exhibit having the latest date shall
be conclusive and binding for all purposes, absent manifest error.

         2.2 Initial Capital Contributions. The Initial Capital Contribution of
SHMC shall be the Hospital contributed pursuant to the Contribution Agreement.
Upon payment to


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SHMC of Twenty-Three Million Seventy-Eight Thousand Six Hundred Nineteen and
No/100 Dollars ($23,078,619.00) pursuant to the Contribution Agreement, NC-DSH
shall succeed to 26.115% of the Capital Account of SHMC as of the Effective
Date. A Member shall be liable only to make the initial Capital Contribution
described herein. Except as provided in the Act or Section 2.3, after such
Member's initial Capital Contribution shall be fully paid, such Member shall not
be required to make any further Capital Contributions or to lend any funds to
the Company.

         2.3 Assessments. The Board of Directors is empowered to request
additional Capital Contributions from the Members in such amounts and at such
times as determined in its reasonable judgment but only for purposes of capital
improvements to the Hospital and capital projects for expansion of the Business.
Such assessments shall be made pro rata based on each Member's Percentage Share
so as to maintain the Members' respective Percentage Shares. Each Member shall
have the right to determine if they wish to comply with an assessment. The
capital accounts of all Members who pay the assessment shall be adjusted
pursuant to Section 1.1.4 and, if not all Members comply with the assessment,
Members who pay the assessment shall receive a proportional increase in their
number of Units and Percentage Share based on the then current fair market value
of a Unit. In the event NC-DSH declines to comply with a capital assessment and
objects to the value at which additional Interests are issued or the adjustments
made to the Members' Capital Accounts, Units or Percentage Shares, NC-DSH and
SHMC shall comply with the dispute resolution provisions of Section 4.16,
provided however, that NC-DSH shall pay the cost of any arbitration engaged in
under Section 4.16 brought pursuant to this Section 2.3 and provided further
that, in the event the arbitrator determines that an appraisal is required and
selects the appraiser and controls the appraisal process, NC-DSH shall pay the
cost and expenses of such appraisal. If either NC-DSH or SHMC retain an
appraiser, the cost of such appaisal shall be borne by NC-DSH or SHMC
respectively.

         2.4 Return of Capital. Except as provided in Articles 3 and 9, no
Member or assignee shall have the right to demand or receive a return of all or
any part of such Member's initial or additional contributions to the capital of
the Company, or to receive any specific property of the Company. No Member (or
assignee) shall be entitled to any interest on such Member's Capital Account.

         2.5 Limited Liability of Members, Assignees and Directors. Except as
provided in this Section 2.5, no Member, assignee or Director shall be
personally liable for the acts, debts, liabilities, or other obligations of the
Company, whether arising in contract, tort or otherwise, or for the acts or
omissions of any other Member, assignee or Director, employee or agent of the
Company. Except as otherwise provided herein, each Member, Director and assignee
shall be liable only to make the Capital Contributions that it has agreed to
make and for such Person's own acts and conduct.

         2.6 Options and Other Rights to Purchase Units. The Board of Directors
shall not have the right to grant, sell or issue additional Units, options or
other rights, including


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convertible securities (collectively "UNIT EQUIVALENTS"), for the purchase of
Units to any Person without the written consent of each of SHMC and NC-DSH.

         2.7 Restoration of Deficit Capital Account. In the event a Member,
following a Liquidating Event, has a deficit in its Capital Account as a result
of a distribution previously made pursuant to this Agreement, then such Member
shall be obligated to pay to the Company an amount equal to such deficit. Any
Member required to so contribute shall contribute the amount of such deficit
within 30 days of a request for such payment from the Board of Directors. No
Member shall have any liability for restoration of any other Member's negative
Capital Account balance.

         2.8 Restrictions on Sale or Exchange. The Interests have not been
registered under the Securities Act of 1933, as amended, but were issued
pursuant to an exemption from such registration. Notwithstanding any provisions
to the contrary in this Agreement, except for transactions governed by Section
7.5, no reoffers, reoffers for sale, resale or transfer of the Interests may be
made except pursuant to an exemption from such registration under the Securities
Act of 1933 and applicable state law evidenced by an opinion of counsel in form
and by counsel reasonably satisfactory to the Board of Directors, SHMC and
NC-DSH.


                                    ARTICLE 3
                          ALLOCATIONS AND DISTRIBUTIONS

         3.1 Allocation of Profits. After giving effect to the special
allocations set forth in Sections 3.3 and 3.4 hereof, Profits for any fiscal
year or other shorter period shall be allocated among Members in accordance with
their respective Percentage Shares.

         3.2 Allocation of Losses. After giving effect to the special
allocations set forth in Sections 3.3 and 3.4 hereof, Losses for any fiscal year
or other shorter period shall be allocated among Members in accordance with
their respective Percentage Shares.

                    3.2.1 The Losses allocated pursuant to Section 3.2 hereof
         shall not exceed the maximum amount of Losses that can be so allocated
         without causing any Member to have an Adjusted Capital Account Deficit
         at the end of any fiscal year. In the event some but not all of the
         Members would have Adjusted Capital Account Deficits as a consequence
         of an allocation of Losses pursuant to Section 3.2, the limitation set
         forth in this Subsection 3.2.1 shall be applied on a Member by Member
         basis so as to allocate the maximum permissible Loss to each Member
         under Section 1.704-1(b)(2)(ii)(d) of the Regulations. All Losses in
         excess of the limitation set forth in this Subsection 3.2.1 shall be
         allocated among the Members in accordance with their respective
         Percentage Shares.



                                        9

<PAGE>   14



         3.3 Special Allocations. The following special allocations shall be
made in the following order (the definition of capitalized terms used in this
Article 3, not previously defined herein, are set forth in Section 3.8):

                    3.3.1 Minimum Gain Chargeback. Except as otherwise provided
         in Section 1.704-2(f) of the Regulations, notwithstanding any other
         provision of this Article 3, if there is a net decrease in Company
         Minimum Gain during any Company fiscal year or other shorter period,
         each Member shall be specially allocated items of Company income and
         gain for such year or other shorter period (and, if necessary,
         subsequent years) in an amount equal to such Member's share of the net
         decrease in Company Minimum Gain, determined in accordance with
         Regulations Section 1.704-2(g). Allocations pursuant to the previous
         sentence shall be made in proportion to the respective amounts required
         to be allocated to each Member pursuant thereto. The items to be so
         allocated shall be determined in accordance with Sections 1.704-2(f)(6)
         and 1.704-2(j)(2) of the Regulations. This Subsection 3.3.1 is intended
         to comply with the minimum gain chargeback requirement in Section
         1.704-2(f) of the Regulations and shall be interpreted consistently
         therewith.

                    3.3.2 Member Minimum Gain Chargeback. Except as otherwise
         provided in Section 1.704-2(i)(4) of the Regulations, notwithstanding
         any other provision of this Article 3 except Subsection 3.3.1, if there
         is a net decrease in Member Nonrecourse Debt Minimum Gain attributable
         to a Member Nonrecourse Debt during any Company fiscal year or other
         shorter period, each Member who has a share of the Member Nonrecourse
         Debt Minimum Gain attributable to such Member Nonrecourse Debt,
         determined in accordance with Section 1.704-2(i)(5) of the Regulations,
         shall be specially allocated items of Company income and gain for such
         year or other shorter period (and, if necessary, subsequent years) in
         an amount equal to such Member's share of the net decrease in Member
         Nonrecourse Debt Minimum Gain attributable to such Member Nonrecourse
         Debt, determined in accordance with Regulations Section 1.704-2(i)(4).
         Allocations pursuant to the previous sentence shall be made in
         proportion to the respective amounts required to be allocated to each
         Member pursuant thereto. The items to be so allocated shall be
         determined in accordance with Sections 1.704-2(i)(4) and 1.704-2(j)(2)
         of the Regulations. This Subsection 3.3.2 is intended to comply with
         the minimum gain chargeback requirement in Section 1.704-2(i)(4) of the
         Regulations and shall be interpreted consistently therewith.

                    3.3.3 Qualified Income Offset. In the event any Member
         unexpectedly receives any adjustments, allocations, or distributions
         described in Regulations Section 1.704-1(b)(2)(ii)(d)(4),
         1.704-1(b)(2)(ii)(d)(5), or 1.704-1(b)(2)(ii)(d)(6), items of income
         and gain shall be specially allocated to each such Member in an amount
         and manner sufficient to eliminate, to the extent required by the
         Regulations, the Adjusted Capital Account Deficit of such Member as
         quickly as possible, provided that an allocation pursuant to this
         Subsection 3.3.3 shall be made if and only to the


                                       10

<PAGE>   15



         extent that such Member would have an Adjusted Capital Account Deficit
         after all other allocations provided for in this Article 3 have been
         tentatively made as if this Subsection 3.3.3 were not in the Agreement.

                    3.3.4 Gross Income Allocation. In the event any Member has a
         deficit Capital Account at the end of any Company fiscal year or other
         shorter period that is in excess of the sum of (i) the amount such
         Member is obligated to restore, and (ii) the amount such Member is
         deemed to be obligated to restore pursuant to the penultimate sentences
         of Regulations Sections 1.704-2(g)(1) and 1.704-2(i)(5), each such
         Member shall be specially allocated items of Company income and gain in
         the amount of such excess as quickly as possible, provided that an
         allocation pursuant to this Subsection 3.3.4 shall be made if and only
         to the extent that such Member would have a deficit Capital Account in
         excess of such sum after all other allocations provided for in this
         Article 3 have been tentatively made as if Subsection 3.3.3 hereof and
         this Subsection 3.3.4 were not in the Agreement.

                    3.3.5 Nonrecourse Deductions. Nonrecourse Deductions for any
         fiscal year or other shorter period shall be specially allocated among
         the Members, in accordance with their respective Percentage Shares.

                    3.3.6 Member Nonrecourse Deductions. Any Member Nonrecourse
         Deductions for any fiscal year or other shorter period shall be
         specially allocated to the Member who bears the economic risk of loss
         with respect to the Member Nonrecourse Debt to which such Member
         Nonrecourse Deductions are attributable in accordance with Regulations
         Section 1.704-2(i)(1).

                    3.3.7 Code Section 754 Adjustments. To the extent an
         adjustment to the adjusted tax basis of any Company asset pursuant to
         Code Section 734(b) or Code Section 743(b) is required, pursuant to
         Regulations Section 1.704-1(b)(2)(iv)(m)(2) or Regulations Section
         1.704-1(b)(2)(iv)(m)(4), to be taken into account in determining
         Capital Accounts as the result of a distribution to a Member in
         complete liquidation of his or her Interest, the amount of such
         adjustment to the Capital Accounts shall be treated as an item of gain
         (if the adjustment increases the basis of the asset) or loss (if the
         adjustment decreases such basis), and such gain or loss shall be
         specially allocated to the Members in accordance with their interests
         in the Company in the event that Regulations Section
         1.704-1(b)(2)(iv)(m)(2) applies, or to the Members to whom such
         distribution was made in the event that Regulations Section
         1.704-1(b)(2)(iv)(m)(4) applies. No Code Section 754 election shall be
         made without the consent of each of SHMC and NC-DSH.

                    3.3.8 Allocations Relating to Taxable Issuance of Company
         Units. Any income, gain, loss or deduction realized as a direct or
         indirect result of the issuance of Units by the Company to a Member
         (the "ISSUANCE ITEMS") shall be allocated among the Members so that, to
         the extent possible, the net amount of such Issuance Items, together
         with all other allocations under this Agreement to each


                                       11

<PAGE>   16



         Member shall be equal to the net amount that would have been allocated
         to each such Member if the Issuance Items had not been realized.

                    3.3.9 Imputed Interest. To the extent the Company has
         taxable interest income with respect to any promissory note pursuant
         to Section 483 or Sections 1271 through 1288 of the Code:

                                3.3.9.1 Such interest income shall be specially 
                    allocated to the Member to whom such promissory note
                    relates; and

                                3.3.9.2 The amount of such interest income shall
                    be excluded from the Capital Contributions credited to such
                    Member's Capital Account in connection with payments of
                    principal with respect to such promissory note.

         3.4 Curative Allocations. The allocations set forth in Subsections
3.2.1, 3.3.1, 3.3.2, 3.3.3, 3.3.4, 3.3.5, 3.3.6 and 3.3.7 hereof (the
"REGULATORY ALLOCATIONS") are intended to comply with certain requirements of
the Regulations. It is the intent of the Members that, to the extent possible,
all Regulatory Allocations shall be offset either with other Regulatory
Allocations or with special allocations of other items of Company income, gain,
loss, or deduction pursuant to this Section 3.4. Therefore, notwithstanding any
other provision of this Article 3 (other than the Regulatory Allocations), the
Board of Directors shall make such offsetting special allocations of Company
income, gain, loss, or deduction in whatever manner it determines appropriate so
that, after such offsetting allocations are made, each Member's Capital Account
balance is, to the extent possible, equal to the Capital Account balance such
Member would have had if the Regulatory Allocations were not part of this
Agreement and all Company items were allocated pursuant to Sections 3.1, 3.2,
3.3.8, 3.3.9, and 3.5. In exercising its discretion under this Section 3.4, the
Board of Directors shall take into account future Regulatory Allocations under
Subsections 3.3.1 and 3.3.2 that, although not yet made, are likely to offset
other Regulatory Allocations previously made under Subsections 3.3.5 and 3.3.6.

         3.5 Other Allocations Rules.

                    3.5.1 Basis for Determining Profits or Losses. For purposes
         of determining the Profits, Losses, or any other items allocable to any
         period, Profits, Losses, and any such other items shall be determined
         on a daily, monthly, or other basis, as determined by the Board of
         Directors on a consistent basis using any permissible method under Code
         Section 706 and the Regulations thereunder.

                    3.5.2 Distributions of Cash treated as proceeds from
         Nonrecourse Liability or Member Nonrecourse Debt. To the extent
         permitted by Sections 1.704-2(h)(3) of the Regulations, the Board of
         Directors shall endeavor to treat distributions of cash as having been
         made from the proceeds of a Nonrecourse


                                       12

<PAGE>   17



         Liability or a Member Nonrecourse Debt only to the extent that such
         distributions would cause or increase an Adjusted Capital Account
         Deficit for any Member.

                    3.5.3 Allocations of Items Not Otherwise Allocated. Except
         as otherwise provided in this Agreement, all items of Company income,
         gain, credit, loss, deduction, and any other allocations not otherwise
         provided for shall be divided among the Members in the same proportions
         as they share Profits or Losses, as the case may be, for such fiscal
         year or other shorter period.

                    3.5.4 Allocations Binding. The Members are aware of the
         income tax consequences of the allocations made by this Article 3 and
         hereby agree to be bound by the provisions of this Article 3 in
         reporting their respective shares of Company income and loss for income
         tax purposes. The Members further intend that pursuant to Regulations
         Section 1.704-1(b)(3), the Members' respective interests in the Company
         are equal to their respective Percentage Shares for purposes of
         complying with Section 704(b) of the Code.

         3.6 Tax Allocations: Code Section 704(c). In accordance with Code
Section 704(c) and the Regulations thereunder, income, gain, loss, and deduction
with respect to any property contributed to the capital of the Company shall,
solely for tax purposes, be allocated among the Members so as to take account of
any variation between the adjusted basis of such property to the Company for
federal income tax purposes and its initial Gross Asset Value. In applying Code
Section 704(c) and the regulations thereunder, SHMC and NC-DSH will jointly
determine the allocation method or methods that will, to the extent allowable,
allocate items governed under Code Section 704(c) so as to provide the
contributing member with the tax depreciation and amortization it would have had
notwithstanding formation of the Company.

         3.7 Allocations with Respect to Transferred Interests.

                    3.7.1 General Rule. If any Member's Interest is transferred,
         or is increased or decreased by reason of the admission of a new
         Member, or otherwise, during any fiscal year or other shorter period of
         the Company, Profits or Losses and any other item of income, gain,
         loss, deduction or credit of the Company for such fiscal year or other
         shorter period shall be allocated among the Members in accordance with
         their varying respective Percentage Shares which they had from time to
         time during such fiscal year or other shorter period in accordance with
         Code Section 706(d).

                    3.7.2 Accounting Convention. For convenience in accounting,
         the Company may, to the extent permitted by law, treat a transfer of an
         Interest, or an increase or decrease of a Member's Percentage Share,
         that occurs at any time during a month (commencing with the month
         including the date of this Agreement) as having been consummated on the
         first day of that month, regardless of when


                                       13

<PAGE>   18



         during that month, the transfer, increase or decrease actually occurs,
         or adopt such other convention as the Board of Directors may lawfully
         select.

                    3.7.3 Sale or Other Disposition of All Assets.
         Notwithstanding anything in Section 3.6 to the contrary, gain or loss
         of the Company realized in connection with the sale or other
         disposition of all or substantially all Company Property and/or the
         liquidation of the Company shall be allocated only to Members who own
         Interests as of the date such transaction occurs.

         3.8 Allocation Definitions.

                    3.8.1 Adjusted Capital Account Deficit shall mean with
         respect to any Member, the deficit balance, if any, in such Member's
         Capital Account as of the end of the relevant fiscal year or other
         shorter period, after giving effect to the following adjustments:

                                3.8.1.1 Credit to such Capital Account any
                    amounts which such Member is obligated to restore or is
                    deemed to be obligated to restore pursuant to the
                    penultimate sentences of Regulations Sections 1.704-2(g)(1)
                    and 1.704-2(i)(5); and

                                3.8.1.2 Debit to such Capital Account the items
                    described in Sections 1.704-1(b)(2)(ii)(d)(4), (5) and (6)
                    of the Regulations.

The foregoing definition of Adjusted Capital Account Deficit is intended to
comply with the provisions of Section 1.704-1(b)(2)(ii)(d) of the Regulations
and shall be interpreted consistently therewith.

                    3.8.2 Nonrecourse Deductions has the meaning set forth in
         Section 1.704-2(b)(1) of the Regulations.

                    3.8.3 Nonrecourse Liability has the meaning set forth in
         Section 1.704-2(b)(3) of the Regulations.

                    3.8.4 Member Nonrecourse Debt has the meaning set forth in
         Section 1.704-2(b)(4) of the Regulations for "Partner Nonrecourse Debt"
         after substituting therein the word "Member" in place of the word
         "Partner".

                    3.8.5 Member Nonrecourse Debt Minimum Gain means an amount,
         with respect to each Member Nonrecourse Debt, equal to the Company
         Minimum Gain that would result if such Member Nonrecourse Debt were
         treated as a Nonrecourse Liability, determined in accordance with
         Section 1.704-2(i)(3) of the Regulations.

                    3.8.6 Member Nonrecourse Deductions has the meaning set
         forth in Sections 1.704-2(i)(1) and 1.704-2(i)(2) of the Regulations
         for "Partner Nonrecourse


                                       14

<PAGE>   19



         Deductions" after substituting therein the word "Member" in place of
         the word "Partner".

                    3.8.7 Company Minimum Gain has the meaning set forth in
         Regulations Sections 1.704-2(b)(2) and 1.704-2(d) for "Partnership
         Minimum Gain" after substituting therein the word "Company" in place of
         the word "Partnership".

          3.9 Distributions.

                    3.9.1 Distributions of Distributable Cash. The Board of
         Directors shall make distributions on a quarterly basis of
         Distributable Cash or other property to the Members (or assignees) in
         accordance with their respective Percentage Shares.

                    3.9.2 Restrictions on Use of Distributions. Nothing
         contained herein is intended nor shall be construed or applied to
         violate the fraud and abuse prohibitions under the Medicare and
         Medicaid programs.

                    3.9.3 Amounts Withheld. All amounts withheld pursuant to the
         Code or any provision of any state or local tax law with respect to any
         payment of taxes of Members or distribution to the Members shall be
         treated as amounts distributed to the Members pursuant to this Section
         3.9 for all purposes under this Agreement.

                    3.9.4 Distributions in Kind. No Member shall have the right
         to demand or receive distributions of property other than cash.
         Distributions in kind of Company property, in liquidation or otherwise,
         shall be made only with the written consent of the Board of Directors,
         SHMC and NC-DSH and only at a value agreed to in writing by the Board
         of Directors, SHMC and NC-DSH. Prior to any such distribution in kind,
         the difference between such agreed value and the book value of such
         property shall be credited or charged, as the case may be, to the
         Members' (and assignees') Capital Accounts in proportion to their
         Percentage Shares, except as may otherwise be required under Code
         Section 704(c). Upon the distribution of such property, such agreed
         value shall be charged to the Capital Accounts of the Members (or
         assignees) receiving such distribution.


                                    ARTICLE 4
                      MANAGEMENT OF THE COMPANY'S AFFAIRS;
                               BOARD OF DIRECTORS

         4.1 General Powers of the Board of Directors. The business and affairs
of the Company shall be managed by its "BOARD OF DIRECTORS" (herein so called)
and the persons serving on the Board of Directors (the "DIRECTORS"), who shall
serve in the capacity of "Managers" as defined in the Act. The Board of
Directors shall direct, manage and control the Company's business to the best of
its ability and shall have full and complete authority, power, and discretion to
make any and all decisions and do any and all things which the


                                       15

<PAGE>   20



Board of Directors deems necessary or desirable for that purpose, subject to the
rights and responsibilities of the Members including provisions of this
Agreement requiring the approval of SHMC and/or NC-DSH prior to the taking of
certain actions . Unless expressly authorized by the Board of Directors, no
Member shall have any authority to bind or obligate the Company; provided that
the acts of SHMC and NC-DSH on behalf of the Company taken for purposes of
forming the Company prior to the adoption of this Agreement are hereby ratified
in full. Certain aspects of the Company's day to day operations shall be managed
by UHS of Delaware, Inc., a Delaware Corporation, pursuant to the Management
Agreement described in Section 4.16, subject at all times to the provisions of
this Agreement requiring the approval of SHMC and/or NC-DSH prior to the taking
of certain actions.

         4.2 Composition of Board of Directors. The Board of Directors shall be
comprised of five (5) Directors, consisting of three (3) Directors appointed by
SHMC and two (2) Directors appointed by NC-DSH. No other Member shall have any
appointees. Each Director shall be an employee of a Member or an employee of a
person controlling, controlled by or under common control with such Member.
After initial appointments to the Board of Directors are made, the failure to
timely appoint or select Directors shall not affect the validity of actions
taken by those who are serving and such unfilled positions shall not be counted
in determining a quorum. The Board of Directors shall annually elect one (1) of
the Directors to serve as "CHAIRMAN." The Chairman shall preside over all
meetings of the Board of Directors (and any meetings of the Members) and shall
have such other duties and responsibilities as the Board of Directors may from
time to time designate. No Director shall receive any compensation from the
Company for service on the Board of Directors.

         4.3 Regular Meetings. The Board of Directors may provide, by
resolution, the time and place for the holding of regular meetings without other
notice than such resolution. Notwithstanding the foregoing, the Board of
Directors shall meet no less than once per calendar quarter. Pursuant to Section
4.9, such meetings need not be held in person.

         4.4 Special Meetings. Special meetings of the Board of Directors may
be called by or at the request of the Chairman of the Board of Directors, who
shall fix any place as the place for holding such special meeting.

         4.5 Notice of Special Meetings. Written notice of any special meeting
of the Board of Directors setting forth the matters to be discussed at the
special meeting shall be given by the Chairman of the Board of Directors as
follows:

                    4.5.1 By mail to each Director at his or her business
         address at least five (5) business days prior to the meeting; or

                    4.5.2 By personal delivery, telegram or telecopy at least
         seventy-two (72) hours prior to the meeting to the business address of
         each Director, or in the


                                       16

<PAGE>   21



         event such notice is given on a Saturday, Sunday or holiday, to the
         residence address of each Director. If mailed, such notice shall be
         deemed to be delivered when deposited in the United States mail, so
         addressed, with postage thereon prepaid. If notice be given by
         telegram, such notice shall be deemed to be delivered when the telegram
         is delivered to the telegraph company. If notice is delivered by
         telecopy, such notice shall be deemed to be delivered when a
         confirmation of receipt of the telecopy is printed by the sending
         telecopier.

                    4.5.3 Any Director may waive notice of any meeting. The
         attendance of a Director at any meeting shall constitute a waiver of
         notice of such meeting, except where a Director attends a meeting for
         the express purpose of objecting to the transaction of any business
         because the meeting is not lawfully called or convened.

                    4.5.4 When any notice is required to be given to a Director,
         a waiver thereof in writing signed by such Director, whether before, at
         or after the time stated therein, shall constitute the giving of such
         notice.

         4.6 Quorum of Directors. A majority of the of Directors provided in
Section 4.2 hereof shall constitute a quorum for the transaction of business of
the Board of Directors so long as at least one Director appointed by each of
SHMC and NC-DSH is present, but if less than such majority is represented at a
meeting, a majority of the Board of Directors represented may adjourn the
meeting from time to time without further notice.

         4.7 Manner of Acting; Super-Majority Vote. Each Director shall have one
(1) vote with respect to any matter put to a vote of the Board of Directors. Any
Director may act in person or by proxy. The act of all Directors voting at a
meeting at which a quorum is represented shall be deemed the act of a
"SUPER-MAJORITY" of the Board of Directors. The act of the majority of the
Directors represented at a meeting at which a quorum is represented shall be
deemed the act of the Board of Directors, except that each of the following
actions shall require the vote of a Super-Majority of the Board of Directors:

                    4.7.1 Changing the Business of the Company.

                    4.7.2 Amending this Agreement or the Certificate of
         Formation.

                    4.7.3 Approving the selection of or any change in the
         location of the Company's principal office if outside the city of Las
         Vegas, Nevada.

                    4.7.4 Except as specifically provided in Section 7.5, and as
         set forth in Article 8, the Transfer by a Member of the whole or any
         portion of its Interest.

                    4.7.5 Except as specifically provided in Section 7.5, and as
         set forth in Article 8, approving the admission of any Person as a new
         Member.



                                       17

<PAGE>   22



                    4.7.6 Issuing additional Units or Unit Equivalents other
         than to SHMC and/or NC-DSH in exchange for additional Capital
         Contributions pursuant to Section 2.3.

                    4.7.7 Approving the dissolution and liquidation of the
         Company.

                    4.7.8 Incurring any debt or interest bearing obligations
         other than: (i) trade payables and other short-term liabilities and
         leases in the ordinary course of business; and (ii) debt incurred
         pursuant to the Revolving Credit and Cash Management Agreement
         described on Exhibit 4.16.

                    4.7.9 Electing not to make a quarterly distribution of
         Distributable Cash pursuant to Section 3.9.

                    4.7.10 Selling, in any twelve (12) month period, in excess
         of $5,000,000 of the Company's assets or engaging in any merger,
         partnership, joint venture or other business combination or transaction
         of a similar nature with a value in excess of $5,000,000 in any twelve
         (12) month period.

         4.8 Informal Action by Board of Directors. The Board of Directors may
act without meeting by written consents describing the action taken and signed,
via facsimile or otherwise, by all Directors. Action taken under this Section
4.8 is effective when all Directors have signed the consent, unless the consent
specifies a different effective date.

         4.9 Participation by Electronic Means or Proxy. Any Director may
participate in a meeting of the Board of Directors by communications equipment
by which all persons participating in the meeting can hear each other at the
same time, or by written proxy. Such participation shall constitute presence in
person at the meeting.

         4.10 Resignation. Any Director of the Company may resign at any time by
giving written notice to the Chairman of the Board of Directors. The resignation
of any Director shall take effect upon receipt of notice thereof or at such
later time as shall be specified in such notice; and, unless otherwise specified
therein, the acceptance of such resignation shall not be necessary to make it
effective. Vacancies created by the resignation of one or more Directors shall
be filled as provided in Section 4.2 hereof.

         4.11 Removal. Each Member shall have the unilateral right to remove any
Director appointed by such Member. Vacancies created by the removal of one or
more Directors shall be filled as provided in Section 4.2 hereof.

         4.12 No Committees. The Board of Directors shall have no committees.

         4.13 Presumption of Assent. A Director of the Company who is present at
a meeting of the Board of Directors or committee thereof, at which action on any
matter is taken, shall be presumed to have assented to the action taken unless
such Director objects


                                       18

<PAGE>   23



at the beginning of such meeting to the holding of the meeting or to the
transacting of business at the meeting, unless his or her dissent is entered in
the minutes of the meeting, or unless he shall file a written dissent to such
action with the presiding officer of the meeting before the adjournment thereof
or shall forward such dissent by registered mail to the Company immediately
after the adjournment of the meeting. Such right to dissent shall not apply to a
Director who voted in favor of such action.

         4.14 Duty of Loyalty; Conflicts of Interest. The Board of Directors of
the Company shall perform its duties and each Director shall perform his or her
duties, in good faith, in a manner he or she reasonably believes to be in the
best interests of the Company.

         4.15 Liability and Indemnity of the Directors and Officers. Directors
and Officers shall be indemnified by the Company with respect to their service
as Directors and Officers to the fullest extent permitted by Delaware law during
their term as such and, thereafter, with respect to the period during which they
served as such.

                    4.15.1 Notwithstanding any provisions of this Agreement or
         applicable Delaware law to the contrary, neither a Director nor an
         Officer shall be personally liable to the Company or to the Members for
         monetary damages for breach of fiduciary duty, except with respect to
         (1) any breach of the duty of loyalty; (2) acts or omissions not in
         good faith or which involve intentional misconduct or a knowing
         violation of law; or (3) any transactions from which the Director or
         Officer derived an improper personal benefit.

                    4.15.2 Notwithstanding any provisions of this Agreement or
         applicable Delaware law to the contrary, neither a Director nor an
         Officer shall be liable to the Company or to any Member for any action
         taken or omitted to be taken by such Director or Officer, provided that
         such Director or Officer acted in good faith and in a manner he
         reasonably believed to be in the best interests of the Company and such
         action or omission does not involve the gross negligence, willful
         misconduct or fraud of such Director or Officer.

         4.16 Related Party Transactions. The Company shall not enter into or
modify transactions with any Members, Affiliates, Affiliates of Members or other
Persons in which the Company or its Affiliates have an ownership or investment
interest or that have an Interest in the Company except for transactions
evidenced by written agreements that are at arm's-length and fair market value
and otherwise on terms and conditions that are intrinsically fair and reasonable
to the Company within its market area. If the Company enters into or makes a
material modification to a Material Interested Agreement (as defined below), the
Company shall provide written notice of the Material Interested Agreement
(including a brief summary of its key terms) and a true and complete copy of the
Material Interested Agreement to NC-DSH. A Material Interested Agreement is one
that involves expenditures of or revenue to the Company of greater than One
Hundred Thousand Dollars ($100,000.00) in any twelve (12) month period or an
agreement that, when


                                       19

<PAGE>   24



combined with all other agreements to which the first sentence of this Section
4.16 applies, involve, in the aggregate, expenditures or revenue to the Company
of greater than Three Hundred Thousand Dollars ($300,000.00) in any twelve (12)
month period. In the event that NC-DSH objects to a Material Interested
Agreement on the grounds that such Material Interested Agreement fails to
satisfy the requirements of the first sentence of this Section 4.16 and there is
a dispute involving this Section 4.16, SHMC and NC-DSH shall initiate
arbitration proceedings with respect to the dispute. Such arbitration
proceedings shall be conducted in the state of Nevada in accordance with the
rules and procedures of the American Arbitration Association, provided that SHMC
shall bear the burden of demonstrating that the Material Interested Agreement
meets the requirements of the first sentence of this Section 4.16. Any such
arbitration shall be binding upon the parties to the fullest extent permitted by
law. SHMC and NC-DSH shall each pay one-half of the costs of such arbitration.
The Company is authorized to enter into those agreements set forth on Exhibit
4.16 attached hereto. Except for fees paid pursuant to the agreements described
on Exhibit 4.16 or agreements permitted pursuant to this Section 4.16, no Member
or Affiliate thereof shall be entitled to any salary or other compensation from
the Company and the compensation for each Member shall be limited to
Distributable Cash distributed to the Members pursuant to Section 3.9.

         4.17 Related Party Agreements. In the event that the Company is party
to an agreement with a Member or an Affiliate of a Member, or a Member or an
Affiliate of a Member has an interest in such agreement (such Member being an
"INTERESTED MEMBER"), decisions with respect to the enforcement of the Company's
rights and obligations with respect to breaches, defaults and waivers under such
agreement shall be made by SHMC if NC-DSH is the Interested Member and by NC-DSH
if SHMC is the Interested Member. The Company and Interested Member shall
provide SHMC or NC-DSH, as appropriate, with written notice of each issue
requiring decision and the facts and information necessary and appropriate for
SHMC or NC-DSH, as appropriate, to exercise its rights under this Section 4.17.


                                    ARTICLE 5
                                    OFFICERS

         5.1 Appointment and Term of Office. The "OFFICERS" of the Company shall
from time to time be appointed by the Board of Directors and shall have such
duties and responsibilities as are established by the Board of Directors. Such
Officers shall include, without limitation, a Chief Executive Officer ("CEO"),
Secretary, and such other Officers as may be appointed from time to time by the
Board of Directors. Each Officer shall hold office until his or her successor
shall have been duly appointed and shall have qualified or until his or her
death or until he or she shall resign or shall have been removed. A vacancy in
any office may be filled as if the person had never been occupied.

         5.2 Removal. Any Officer may be removed at any time by the Board of
Directors, but such removal shall be without prejudice to the contract rights,
if any, of the


                                       20

<PAGE>   25



Officer so removed. Election or appointment of an Officer shall not of itself
create contract rights.

                                    ARTICLE 6
                                     MEMBERS

         6.1 Admission of New Members. A Person may be admitted as a new Member
only upon compliance with the following conditions: (i) except for Persons
acquiring an Interest pursuant to Section 7.5 or Article 8, SHMC and NC-DSH
shall each have consented in writing to the admission of such Person as a
Member, (ii) the Person shall have executed and delivered such documents as
requested by the Board of Directors as may be necessary or appropriate to
evidence the Person's consent to be bound by the terms and conditions of this
Agreement; (iv) the Person shall have contributed to the capital of the Company
as required by the Board of Directors, SHMC and NC-DSH; and (v) the Person shall
have paid or caused to be paid all costs related to such membership, including
legal fees and expenses incurred by the Company

         6.2 Meetings. Meetings of the Members shall be held at such time, date
and place and upon such notice as is reasonably determined by the Board of
Directors but no less often than once per calendar year.

         6.3 Quorum. Members holding more than fifty percent (50%) of the
Percentage Share of all Members entitled to vote shall constitute a quorum at
any meeting of Members provided that, regardless of the Percentage Share
represented, SHMC and NC-DSH must be present at such meeting for a quorum to be
constituted. In the absence of a quorum at any such meeting, a majority of the
Members so represented may adjourn the meeting from time to time for a period
not to exceed thirty (30) days without further notice. However, if the
adjournment is for more than thirty (30) days, a notice of the adjourned meeting
shall be given to each Member of record entitled to vote at the meeting. At such
adjourned meeting at which a quorum shall be present or represented, any
business may be transacted which might have been transacted at the meeting as
originally noticed.

         6.4 Manner of Acting. If a quorum is present, the affirmative vote of
the Members owning a majority of all Percentage Shares represented at the
meeting and entitled to vote on the subject matter shall be the act of the
Members; provided, however, that if the Members are acting upon any of the items
that are the subject to Section 4.7 hereof or otherwise require the approval of
SHMC and NC-DSH, the affirmative vote of each of SHMC and NC-DSH shall be the
required to constitute the act of the Members.

         6.5 Proxies. At all meetings of Members, a Member may vote in person or
by proxy executed in writing by the Member or by a duly authorized
attorney-in-fact. Such proxy shall be filed with the Company before or at the
time of the meeting.



                                       21

<PAGE>   26



         6.6 Voting by Certain Members.

                    6.6.1 Units owned in the name of a corporation may be voted
         by such officer, agent or proxy as the Bylaws of such corporation may
         prescribe, or, in the absence of such provision, as the board of
         directors of such corporation may determine.

                    6.6.2 Units owned in the name of a receiver may be voted by
         such receiver and Units held by or under the control of a receiver may
         be voted by such receiver either in person or by proxy, but no receiver
         shall be entitled to vote Units without a transfer thereof into the
         receiver's name.

                    6.6.3 A Member whose Units are pledged shall be entitled to
         vote such Units until the Units have been transferred into the name of
         the pledgee, and thereafter the pledgee shall be entitled to vote the
         Units so transferred.

         6.7  Action by Members Without a Meeting. The Members may act without
meeting by written consents describing the action taken and signed by all
Members. Action taken under this Section 6.7 is effective when all Members
entitled to vote have signed the consent, unless the consent specifies a
different effective date.

         6.8  Voting by Ballot. Voting on any question or in any election may be
by voice vote unless the Board of Directors or at least one (1) Member shall
demand that voting be by ballot.

         6.9  Waiver of Notice. When any notice is required to be given to any
Member, a waiver thereof in writing signed by the person entitled to such
notice, whether before, at, or after the time stated therein, shall be
equivalent to the giving of such notice. The attendance of a Member at any
meeting shall constitute a waiver of notice, waiver of objection to defective
notice of such meeting, and a waiver of objection to the consideration of a
particular matter at the meeting unless the Member, at the beginning of the
meeting, objects to the holding of the meeting, the transaction of business at
the meeting, or the consideration of a particular matter at the time it is
presented at the meeting.

         6.10 Resignation or Withdrawal. No Member shall have the right to
resign or withdraw from the Company, or to assign its Interest prior to the
dissolution and winding up of the Company, except as expressly contemplated by
this Agreement.


                                    ARTICLE 7
                  TRANSFERS OF MEMBERSHIP INTERESTS BY MEMBERS

         7.1  Transfers. Except as specifically provided in Section 7.5 or
Article 8, each Member covenants and agrees that it will not directly or
indirectly, by operation of law or otherwise, sell, assign, transfer, alienate,
mortgage, pledge or otherwise dispose of or


                                       22

<PAGE>   27



encumber (each a "TRANSFER") all or any part of such Member's Units in the
Company to any Person, including the Company. A Transfer shall be deemed to
include any merger, share exchange, stock transfer, transfer of partnership
interest or other transfer of the ownership, equity or control of any Member or
any Person owning or holding, directly or indirectly through its Affiliates, an
interest in a Member.

         7.2 Effect of Permitted Transfer. In the event a Member Transfers all
or any part of its Units in the Company pursuant to this Agreement, the Company
shall continue and the transferee of such Units shall be admitted to the Company
as a Member subject to the same obligations, with the same Units and Percentage
Share in the Company, and with the same rights in and to the capital, profits,
losses and distributions of the Company as the transferring Member had with
respect to the Units so Transferred; provided, however, that the transferee
shall be subject to all of the terms and conditions of this Agreement and shall
promptly execute and deliver such documents as requested by the Board of
Directors and as may be necessary or appropriate, in the opinion of counsel for
the Company, to evidence the transferee's consent to be bound by such terms and
conditions; and provided, further, that if such Transfer is a pledge or other
encumbrance of Units in the Company, then such transferee shall not become a
substituted Member and shall only be an assignee.

         7.3 Prohibited Transfers. Any attempted Transfer by a Member of all or
any part of its Units in the Company in violation of the terms of this Agreement
shall be null and void and of no force or effect and: (i) if a third party offer
has been made, then it shall be treated as an offer to sell the Interest of such
Member as provided in Section 8.1 and 8.3, or (ii) otherwise, it shall be
treated as an Involuntary Withdrawal as provided in Section 7.4.

         7.4 Involuntary Withdrawal. Upon the Involuntary Withdrawal of any
Member, the Company shall be dissolved unless within 90 days thereof SHMC and
NC-DSH (or Members holding a majority of all Interests in the Company if SHMC
and NC-DSH do not collectively hold a majority in Interests (as such phrase is
defined in Revenue Procedure 94-46) in the Company) elect to continue the
business of the Company. The Involuntary Withdrawal of the Member shall be
treated as an offer to sell the Interest of such Member as provided in Section
8.2. In the event the remaining Members do not purchase the Interest of the
withdrawing Member and continue the business of the Company upon the Involuntary
Withdrawal of a Member, the successor in interest may, upon the written consent
of the other Members, become a transferee with respect to the Interest of the
Member with the rights set forth in Section 7.2. The "INVOLUNTARY WITHDRAWAL" of
a Member shall be deemed to have occurred with respect to a Member in the event
such Member:

                    7.4.1 suffers a "bankruptcy event" as defined in Act
         ss.18-304;

                    7.4.2 attempts to resign or withdraw from the Company in
         breach of this Agreement;



                                       23

<PAGE>   28



                    7.4.3 is dissolved, liquidated, terminated or otherwise
         ceases to exist;

                    7.4.4 makes a Transfer or attempts to Transfer any part of
         such Member's Units in violation of Section 7.1 and such Transfer is
         not treated as an offer to sell the Interest of such Member pursuant to
         Section 8.1 or 8.3; or

                    7.4.5 is responsible for any occurrence, event or state of
         facts that would otherwise cause the dissolution and liquidation of the
         Company.

         7.5 Exceptions to Restrictions. Neither: (i) any conveyance by SHMC or
NC-DSH of its Interest to a Person that controls or is controlled by or is under
common control with SHMC or NC-DSH, respectively; nor (ii) the sale of all or
substantially all of the assets of or the Transfer of the stock, merger or
change of control of Universal Health Services, Inc., a Delaware corporation, or
of Quorum Health Group, Inc., a Delaware Corporation, shall be deemed a Transfer
or Involuntary Withdrawal pursuant to this Agreement (and shall not be subject
to Article 8).

         7.6 Loss of Voting Rights. Upon the occurrence of an Involuntary
Withdrawal, no voting rights shall be exercisable with respect to the Interest
of the Member until such Units are disposed of in accordance with Article 8.

         7.7 Tax Treatment of Acquisitions of Interests by Company. The parties
hereto expressly agree that any withdrawal of all of a Member's Capital Account
whereby the Company acquires the Interest of one or more Members pursuant to
Article 7 shall be treated as a complete liquidation of such Member's Interest
pursuant to Section 736 of the Code. The Members hereby expressly agree and
acknowledge that the amount of money (or the fair market value of property)
distributed to a Member withdrawing all of his or her Capital Account shall be
treated as a payment in liquidation under Section 736(b) of the Code to the
extent of the fair market value of the withdrawing Member's "interest in
partnership property" within the meaning of Section 736 of the Code and the
excess, if any, of the withdrawal payments shall be treated as a Section 707(c)
"guaranteed payment" under Section 736(a) of the Code. Further, if in connection
with such transaction, interest is paid to a Member, the Members hereby agree
and acknowledge that the payment of such interest shall be treated as a
"guaranteed payment" which in turn shall be treated as a Code Section 736(a)
payment. Each Member agrees that the price at which the Company may reacquire
the Interests of a Member shall be agreed upon at arm's length as described in
the second paragraph of Regulation Section 1.704-1(b)(2)(ii)(b)(3).

                                    ARTICLE 8
                           PURCHASE RIGHTS AND OPTIONS

         8.1 Purchase Right. Subject to the exceptions contained in Section 7.5
and as set forth in Section 8.1.4, prior to any Transfer by a Member ("SELLING
MEMBER"), the other Members ("PURCHASING MEMBERS") shall have a right of first
refusal to purchase


                                       24

<PAGE>   29



("PURCHASE RIGHT") the Interest of the Selling Member as provided in this
Section 8.1. The terms of the Purchase Right are as follows:

                    8.1.1 Offer By Selling Member. In the event a Selling Member
         desires to make a Transfer pursuant to a bona fide written offer
         presented to the Selling Member by any prospective third party
         transferee(s) (the "THIRD PARTY OFFER"), it shall make an offer in
         writing to the Purchasing Members (the "OFFER"), and the Offer shall
         include: (i) a statement of the Selling Member's intention to make a
         Transfer, (ii) the name(s) and address(es) of the prospective third
         party transferee(s), (iii) the number of Units involved in the proposed
         third party transaction, and (iv) the full terms and conditions of the
         transaction (which shall include, but not be limited to, a detailed
         description of the transaction, the price, time, method and other
         conditions of payment), including a true copy of the Third Party Offer.

                    8.1.2 Acceptance of Offer. The Purchasing Members may, at
         each of their option, provide a written notice to the Selling Member of
         their acceptance of the Offer within 60 days of the date the Purchasing
         Members received the Offer. If there is more than one Purchasing
         Member, the Purchasing Members shall be entitled to purchase pursuant
         to the Offer in proportion to their respective Percentage Share of
         Units at the time of the Offer. If the Offer is not accepted by all
         Purchasing Members, the Selling Member shall give notice thereof to the
         accepting Purchasing Members and then any accepting Purchasing Member
         shall have the right to purchase all of the remaining Units involved in
         the Offer within the succeeding 15 day period. If not all of the Units
         described in the Offer have been accepted in the fashion described
         above, the Offer shall be deemed not accepted by any Purchasing
         Members. If the Offer is not accepted, the Selling Member may make a
         bona fide Transfer to the third party transferee named in the statement
         attached to the Offer but only in strict accordance with the Third
         Party Offer.

                    8.1.3 Purchase Price Determination. The purchase price and
         the terms and conditions subject to the Offer shall be the same as set
         forth in the Third Party Offer. The closing of the purchase shall take
         place at the principal office of the Company and shall occur within 30
         days of acceptance of the Offer. At closing, the purchase price shall
         be paid in the manner set forth in the Third Party Offer, provided that
         if the Third Party Offer includes any consideration other than cash,
         the accepting Purchasing Member(s), at their option, may pay in cash
         the fair market value of such non-cash consideration.

                    8.1.4 Exception. Notwithstanding the foregoing provisions of
         Section 8.1, SHMC shall be entitled to Transfer up to twenty percent
         (20%) of its Interest without compliance with Section 8.1 provided that
         NC-DSH has approved the transferee in advance in writing and such
         transferee shall be subject to the terms and conditions of this
         Agreement and otherwise comply with Section 7.2.



                                       25

<PAGE>   30



                    8.1.5 Additional Assets. In the event any Third Party Offer
         received by a Selling Member is part of an acquisition which extends to
         or includes assets in addition to the Interest of the Selling Member
         ("ADDITIONAL ASSETS"), the Offer shall be deemed to extend to and
         include the Additional Assets and the Offer shall contain the
         information set forth in Section 8.1.1 with respect to the Additional
         Assets. In such case, if the Offer is not accepted in its entirety,
         including, without limitation, the purchase of Additional Assets by the
         Purchasing Members, the Selling Member may consummate the transactions
         contemplated by the Third Party Offer but only in strict accordance
         with such Third Party Offer. This Section 8.1.5 shall not be
         interpreted or construed to apply to Third Party Offers that are the
         subject of clause (ii) of Section 7.5.

         8.2 Purchase Option. Upon the Involuntary Withdrawal of a Member (the
"SELLING MEMBER") the other Members ("PURCHASING MEMBERS") shall have the right
(the "INVOLUNTARY WITHDRAWAL OPTION") to purchase the Interest of the Selling
Member for a price and upon the terms set forth in this Section 8.2.

                    8.2.1 Exercise. To exercise the Involuntary Withdrawal
         Option, the Purchasing Members may, at each of their options, provide
         written notice to the Selling Member suffering an Involuntary
         Withdrawal of their intention to exercise their Involuntary Withdrawal
         Option as provided in this Section 8.2 within 15 days of the date the
         Purchasing Members receive notice of the event of Involuntary
         Withdrawal. If there is more than one Purchasing Member, the Purchasing
         Members shall be entitled to purchase in accordance with their
         respective Percentage Share of Units at the time of the written notice
         to the Selling Member.

                    8.2.2 Purchase Price Determination. Within 20 days of the
         date of the exercise of an Involuntary Withdrawal Option, the affected
         Members shall mutually agree upon a purchase price for the Interest
         being sold. If the affected Members are unable to mutually agree upon a
         purchase price, the affected Members shall mutually select a
         disinterested appraiser nationally recognized as experienced in valuing
         healthcare businesses including hospitals to evaluate the Business and
         determine the fair market value of the Company. If the affected Members
         cannot select an appraiser, then the American Arbitration Association
         shall be petitioned to designate an appraiser. The cost of the
         appraisal and any necessary arbitration shall be paid one-half by the
         Selling Member and one-half by the Purchasing Members. The appraiser
         promptly shall provide a written notice ("FAIR MARKET VALUE NOTICE") to
         each affected Member of its determination of the fair market value,
         which determination shall be binding upon the affected Members. The
         purchase price for the Interest being acquired pursuant to this Section
         8.2 shall then be the product of (i) the fair market value of the
         Company pursuant to the Fair Market Value Notice multiplied by (ii) the
         Percentage Share of the Selling Member.

                    8.2.3 Closing. The closing of the purchase pursuant to this
         Section 8.2 shall take place at the principal office of the Company as
         such time during


                                       26

<PAGE>   31



         reasonable business hours on such day as designated by the Purchasers
         or Purchasing Members, provided that such closing shall not be later
         than 10 days after the purchase price has been determined in accordance
         with Section 8.2.2. Unless otherwise agreed by the Members, the
         purchase price shall be payable in immediately available funds.

         8.3 Tag Along/Co-Sale Rights on Transfers by a Member. Should a Member
(the "SELLING MEMBER") receive a bona fide offer from an unrelated Person to
purchase all, but not less than all, of its Interest, the Selling Member shall
not consummate a Transfer to the proposed purchaser until the proposed purchaser
shall have offered to buy all Interests of all remaining Members (the "REMAINING
MEMBERS") at the same price and on the same terms and conditions. In the event
the Selling Member is unable to cause the proposed purchaser to offer to buy all
Interests of Remaining Members as set forth in this Section 8.3 and any
Remaining Member declines to exercise its Purchase Right pursuant to Section
8.1, the Selling Member shall not consummate the Transfer to the proposed
purchaser.

         8.4 Put Right.

                    8.4.1 NC-DSH shall have the right to require SHMC to
         purchase NC-DSH's Interest (the "PUT RIGHT") at any time following the
         occurrence of any one of the following events (each a "TRIGGERING
         EVENT"): (i) the Consolidated EBITDA Margin (as defined below) of
         Valley Health System LLC and Summerlin Hospital Medical Center LLC
         (collectively the "LLCS") for any trailing twelve (12) month period
         beginning twenty-five (25) months following consummation of the
         transactions contemplated under the Contribution Agreement is less than
         seventeen percent (17%) provided that the Put Notice (as defined below)
         is given within sixty (60) days following receipt by NC-DSH of the
         LLCs' financial statements that indicate the existence of a Triggering
         Event; (ii) the total cash distributions to NC-DSH for any trailing
         twelve (12) month period beginning twenty-five (25) months following
         consummation of the transactions contemplated under the Contribution
         Agreement are less than NC-DSH's Percentage Share of twelve percent
         (12%) of Consolidated Net Revenues (as defined below) of the LLCs
         provided that the Put Notice is given within sixty (60) days following
         receipt by NC-DSH of the LLCs' financial statements that indicate the
         existence of a Triggering Event; (iii) any material violation of
         Section 2.2.7 or 6.2 or 8.2 of the Management Agreement (or comparable
         provisions of any renewal or successor or replacement thereof) entered
         into by the Company pursuant to Section 4.16 of this Agreement; (iv)
         the Percentage Share of NC-DSH is reduced to less than twenty percent
         (20%) provided that the Put Notice is given within sixty (60) days
         following such reduction; (v) the Percentage Share of NC-DSH is reduced
         to less than seventeen and one-half percent (17.5%) provided that the
         Put Notice is given within sixty (60) days following such reduction;
         (vi) the Percentage Share of NC-DSH is reduced to less than fifteen
         percent (15%) provided that the Put Notice is given within sixty (60)
         days following such reduction; (vii) the Percentage Share of NC-DSH is
         reduced to


                                       27

<PAGE>   32



         less than twelve and one-half percent (12.5%) provided that the Put
         Notice is given within sixty (60) days following such reduction; or
         (viii) the Percentage Share of NC-DSH is reduced to less than ten
         percent (10%) and the Put Notice is given any time thereafter. Upon a
         Triggering Event, the Put Right shall be exercisable by NC-DSH, at
         NC-DSH's sole option, by written notice (the "PUT NOTICE") to the
         Company. Notwithstanding the foregoing, in the event the Triggering
         Event is (ii) above and was caused by a capital project that was
         approved by NC-DSH in writing and which approval refers specifically to
         clause (ii) of this Section 8.4.1 and but for such capital project no
         Triggering Event would have occurred, then such Triggering Event shall
         be deemed not to have occurred.

                    8.4.2 Upon receipt of the Put Notice, NC-DSH and the Company
         shall negotiate in good faith for sixty (60) days to determine the
         purchase price payable pursuant to the Put Right. If agreement has not
         been reached on the purchase price within sixty (60) days, each of
         NC-DSH and the Company shall promptly appoint a disinterested appraiser
         of national reputation who is a member of the American Society of
         Appraisers and holds MAI designation with the Appraisal Institute to
         provide a written appraisal of the fair market value of the Company as
         of the date of the Put Notice. If a party does not select an appraiser
         as provided in the preceding sentence within fifteen (15) days after
         the other party has given written notice of the name of its appraiser,
         such party shall lose its right to appoint an appraiser and the
         appraiser already selected shall determine the fair market value of the
         Company. In the event that both appraisers are timely selected and the
         lower of the two appraisals is not less than ninety percent (90%) of
         the higher of the two appraisals, the product of the average of the two
         appraisals multiplied by the Percentage Share of NC-DSH shall be the
         purchase price payable by the Company for NC-DSH's Interest.

                    8.4.3 In the event that the lower of the two appraisals is
         more than seventy-five percent (75%) but less than ninety percent (90%)
         of the higher of the two appraisals, the two appraisers shall promptly
         appoint a third appraiser (of the same qualifications described in
         Section 8.4.2) to provide a written appraisal of the fair market value
         of the Company as of the date of the Put Notice. The product of the
         third appraisal (subject to the other two appraisals as lower and upper
         limits) multiplied by the Percentage Share of NC-DSH shall be the
         purchase price payable by the Company for NC-DSH's Interest.

                    8.4.4 In the event that the lower of the two appraisals is
         less than seventy-five percent (75%) of the higher of the two
         appraisals, NC-DSH and the Company shall promptly cause the American
         Arbitration Association to appoint an arbitrator who will select two
         appraisers (of the same qualifications described in Section 8.4.2) and
         each appraiser shall provide a written appraisal of the fair market
         value of the Company as of the date of the Put Notice. The product of
         the average of the two appraisals (subject to the two original
         appraisals as the lower


                                       28

<PAGE>   33



         and upper limits) multiplied by the Percentage Share of NC-DSH shall be
         the purchase price payable by the Company for NC-DSH's Interest.

                    8.4.5 The rights of NC-DSH as a Member shall cease upon the
         Put Notice. The Company shall pay one dollar ($1.00) of the purchase
         price upon receipt of the Put Notice and shall pay the remainder of the
         purchase price in immediately available funds on the date of the
         closing described below plus interest at the following rates: (i) for
         the first six (6) months following the date of the Put Notice the rate
         of interest per annum shall be the rate of interest paid on one month
         certificates of deposit published in the Money Rates section of the
         Wall Street Journal plus one percent (1%), and (ii) for the remainder
         of the period the rate of interest per annum shall be equal to the
         prime rate published by the Wall Street Journal plus two percent (2%)
         as such rate changes from time-to-time. Interest shall accrue from the
         date of the Put Notice through the date of receipt of payment by
         NC-DSH. Closing of the purchase pursuant to this Section 8.4 shall take
         place at the principal office of the Company or at such other location
         and at such time during normal business hours as the Company and NC-DSH
         shall agree. The Company shall use its reasonable best efforts to close
         the transaction contemplated by this Section 8.4 as quickly as possible
         following the date of the Put Notice. In the event the parties are
         unable to agree on a Closing Date, the closing shall occur
         three-hundred and sixty seven (367) days following the date of the Put
         Notice.

                    8.4.6 For purposes of this Section 8.4 the following
         definitions shall apply: (i) "CONSOLIDATED EBITDA MARGIN" shall mean
         that fraction, expressed as a percentage, obtained by dividing the
         combined total EBITDA of the LLCs by Consolidated Net Revenues; (ii)
         "EBITDA" shall mean Consolidated Net Revenues less Consolidated
         Operating Expenses; (iii) "CONSOLIDATED NET REVENUES" shall mean the
         combined totals of the LLCs' patient revenues and other operating
         revenues (but not non-operating revenues) less contractual allowances,
         adjustments, discounts and charity (but not bad debts); and (iv)
         "CONSOLIDATED OPERATING EXPENSES" shall mean the combined totals of the
         LLCs' expenses including management fees payable pursuant to the
         Management Agreement identified on Exhibit 4.16 but excluding interest
         expense, depreciation and amortization, income taxes and non-operating
         and extraordinary expenses. For purposes of this Section 8.4, all items
         of revenue and expense will be determined and classified in accordance
         with generally accepted accounting principles consistently applied.

                    8.4.7 Each party shall bear and promptly pay the expenses
         and fees of their appraiser selected in accordance with Section 8.4.2
         and shall bear and promptly pay one-half of the expenses and fees of
         any appraiser and/or arbitrator selected in accordance with Sections
         8.4.3 and 8.4.4. Copies of all appraisals shall be addressed to and
         provided to both the Company and NC-DSH.



                                       29

<PAGE>   34



                    8.4.8 Universal Health Services, Inc. hereby guarantees the
         payment and performance of the obligations of the Company under this
         Section 8.4.


                                    ARTICLE 9
                   DISSOLUTION AND LIQUIDATION OF THE COMPANY

         9.1 Liquidating Events. The existence of the Company shall be
perpetual provided, however, that the Company shall be dissolved and liquidated
upon the occurrence of any of the following events:

                    9.1.1 The unanimous written agreement of SHMC and NC-DSH to
         terminate the Company;

                    9.1.2 The entry of a final judgment, order or decree of a
         court of competent jurisdiction adjudicating the Company to be a
         Bankrupt and the expiration of the period, if any, allowed by
         applicable law in which to appeal therefrom;

                    9.1.3 The entry of a final judgment, order or decree of
         judicial dissolution of the Company issued by a court of competent
         jurisdiction under the authority of Act Section 18-802, and the
         expiration of the period, if any, allowed by applicable law in which to
         appeal therefrom; or

                    9.1.4 The administrative dissolution of the Company by
         action of the Secretary of State of the State of Delaware and the
         expiration of the period, if any, allowed by applicable law in which to
         appeal therefrom or to become reinstated.

Notwithstanding any other provision of this Agreement, in no event shall the
redemption or purchase of the Units of a Member by the Company be a dissolving
event and any such redemption or purchase by the Company shall constitute and
evidence the consent of the Members to the continued existence and business of
the Company as provided in Act Section 18-801(4).

         9.2 Method of Liquidation. Upon the happening of any of the events
specified in Section 9.1, the Company shall continue solely for the purpose of
winding up its affairs, liquidating its assets, and satisfying the claims of its
creditors and Members. The Board of Directors shall be responsible for
overseeing the winding up and liquidation of the Company. In the course of
winding up its affairs, any of the Company's assets may be sold upon the consent
of the Board of Directors, and any proceeds derived from any such sale, together
with all assets that are not sold, shall be applied and distributed in the
following manner and in the following order of priority:

                    9.2.1 To the payment of the debts and liabilities of the
         Company and to the expenses of liquidation in the order of priority as
         provided by law, and to the


                                       30

<PAGE>   35



         establishment of any reserves that the Board of Directors, SHMC and
         NC-DSH deem necessary for any contingent liabilities or obligations of
         the Company. Such reserves shall be paid over to a bank to be held in
         escrow for the purpose of paying any such contingent liabilities or
         obligations, and at the expiration of such period as the Board of
         Directors, SHMC and NC-DSH deem advisable, distributing the balance of
         such reserves in the manner hereinafter provided; then

                    9.2.2 To the payment of any liabilities or debts, other than
         Capital Accounts, of the Company to any of the Members; then

                    9.2.3 To the Members (and assignees) in accordance with the
         relative positive balances of their Capital Accounts, after giving
         effect to all contributions, distributions and allocations under this
         Agreement for all periods as required by Section 704(b) of the Code and
         the Regulations promulgated thereunder.

In the course of any liquidation, the difference between the fair market value
and book value of any assets that are distributed in kind shall be credited or
charged, as the case may be, to the Members' (or assignees') Capital Accounts in
the manner provided in Subsection 3.9.5.

         9.3 Reasonable Time for Liquidation. A reasonable time (not to exceed
twelve (12) months) shall be allowed for the orderly liquidation and winding up
of the Company in order to minimize any losses that may be attendant upon such
liquidation.

         9.4 Distribution to Liquidating Trust. In the discretion of the Board
of Directors, SHMC and NC-DSH, assets otherwise distributable to the Members (or
assignees) pursuant to Section 9.2 may be distributed to a liquidating trust
established for the benefit, and upon the agreement, of all Members (and
assignees) for purposes of liquidating Company assets, collecting amounts owed
to the Company, and paying any contingent or potential liabilities or
obligations of the Company.

         9.5 Date of Termination. The Company shall be completely terminated
when all property of the Company shall have been disposed of by the Company in
accordance with Section 9.2. The establishment of any reserves in accordance
with the provisions of Section 9.2 or the creation of a liquidating trust in
accordance with Section 9.4 shall not have the effect of extending the existence
of the Company, but any remaining balance in any such reserve or liquidating
trust shall be distributed in the manner provided in Section 9.2 upon expiration
of the period of such reserve or liquidating trust, as the case may be.

         9.6 Certificate of Cancellation. Upon completing the winding up and
liquidation of the Company, the Company shall cause to be filed a Certificate of
Cancellation of the Company as provided by Act Section 18-203. The Members agree
to join in executing such document if such joinder is required by the Act or
deemed necessary or appropriate by the Company. Upon the filing of the
Certificate of Cancellation, the Members shall cease to be such and the Company
and this Agreement shall be terminated.


                                       31

<PAGE>   36




                                   ARTICLE 10
                          COMPANY FUNDS AND ACCOUNTING

         10.1 Books of Account; Records and Information. The books of account of
the Company shall be maintained at the Company's principal executive office and
at all reasonable times each Member (and its auditors, attorneys and
representatives) shall have access thereto, as well as to information received
by the Company pursuant to any management or similar agreement. The Company
shall also maintain such records and information required by Act Section 18-305
and shall permit the inspection and copying of such records and information by
the Members. In addition to the foregoing, the Company shall promptly provide
each Member, on a monthly basis, financial statements (including balance sheet,
income statement and statement of cash flows) of the Company. Such financial
statements shall be internally prepared in accordance with generally accepted
accounting principles consistently applied. The Company shall cause an
unqualified audit of its books and records to be performed no less than annually
by an independent certified public accountant of recognized national standing
and shall promptly provide each Member a complete copy of the audit report. No
manager of the Company shall keep confidential from the Members any information
regarding the Company pursuant to Act Section 10-305 or otherwise except to the
extent such information is the proprietary information of such manager.

         10.2 Period and Method of Accounting. The Company's books of account
shall be maintained on such fiscal year basis as may be required by Code Section
706, and such books shall be kept in accordance with such method of accounting
as may be required by the Code.

         10.3 Reports. As soon as reasonably practicable after the end of each
fiscal year, the Company shall furnish each Member (and assignee) with a copy of
a statement of income or loss of the Company for such year, and a statement
showing the amounts allocated to such Member (or assignee) pursuant to this
Agreement during or in respect of such year, and any items of income, expense or
credit allocated to it for purposes of federal income taxation pursuant to this
Agreement, all prepared in accordance with the accounting method adopted by the
Company, all of which information will be reflected in the Company's federal
income tax return. Delivery of a copy of such tax return to each Member (and
assignee) shall be sufficient to fulfill the obligation of the Company with
respect to providing such information. The Company shall use its reasonable best
efforts to provide each Member such income tax information (including Schedule
K-1) within ninety (90) days after the end of each fiscal year (for tax
purposes) of the Company.

         10.4 Tax Elections. Except as specified in Section 3.3.7, 3.6 or
elsewhere in this Agreement, the Board of Directors shall have the
responsibility for making (and revoking) all tax elections on behalf of the
Company (and which are to be made by the Company as opposed to the Members)
under the Code. Upon the transfer of an Interest in the Company or a
distribution of property to a Member (or assignee), the Company may, but


                                       32

<PAGE>   37



is not required to, elect, pursuant to Section 754 of the Code, to adjust the
basis of Company Property as allowed by Section 734(b) and 743(b) thereof.

         10.5 Tax Matters Manager. SHMC shall be Tax Matters Manager and shall
act as the Tax Matters Partner as defined in the Code Section 6231(a)(7). As
such, shall keep all the Members informed of all administrative and judicial
proceedings, as required by Code Section 6223(g) and shall furnish all Members a
copy of each notice or communication received by SHMC (as the Tax Matters
Manager) from the Internal Revenue Service regarding any such administrative or
judicial proceeding. The Tax Matters Manager shall execute, on behalf of the
Company, any and all documents and returns necessary to comply with the
Regulations promulgated under Code Sections 6221 through 6232.


                                   ARTICLE 11
                                   NONCOMPETE

         11.1 Business Activities of Members. Except as set forth in this
Article 11, each Member and its Affiliates may engage in other business
activities, including but not limited to preferred provider organizations,
health maintenance organizations or other health care provider businesses,
without liability or accounting to the Company. It shall not be deemed a breach
of any Member's duty of loyalty to the Company for that Member to pursue, for
that Member's own benefit, any opportunity outside of the Noncompete Area
described in Section 11.2 after compliance with the provisions of this Article
11.

         11.2 Covenant Not to Compete. Each of the Members, Universal Health
Services, Inc. and Quorum Health Group, Inc., for itself and on behalf of their
respective Affiliates, hereby covenant and agree that during the Noncompete
Period within the Noncompete Area they shall not directly or indirectly, (a)
build, develop, invest in, acquire, lease, manage, be a member of, consult for,
finance or own any part of (as member, shareholder, partner or otherwise) any
Person or health care facility which provides any services similar to the
services provided by the Business or Hospital, or (b) disrupt or attempt to
disrupt any past, present or reasonably foreseeable future relationship,
contractual or otherwise between the Company, on the one hand, and any
physician, physician group, or other healthcare provider with whom the Company
contracts in connection with Business or Hospital, on the other hand. The
"NONCOMPETE PERIOD" shall commence as to each Member upon such Member's
admission as a Member and terminate at such time as such Person is no longer a
Member. The "NONCOMPETE AREA" shall mean the entire area included within the
city of Las Vegas, Nevada and within a fifty (50) mile radius of the boundaries
of the city of Las Vegas, Nevada. Notwithstanding the foregoing, none of the
following shall be deemed a breach of this Section 11.2: (i) ownership of less
than five percent (5%) of the stock of a publicly held company; (ii) the
activities described in the second sentence of Section 11.1; (iii) SHMC or its
Affiliates' continued operation of Goldring Surgery Center ("GOLDRING") and
Nevada Radiation Oncology Center ("NEVADA") together with any expansion thereof
provided such expansion


                                       33

<PAGE>   38



is consistent with and limited to the operations and services of such businesses
as of the date hereof and is located at the current sites of such businesses;
and (iv) the continued operation by a Person who is an indirect transferee of an
Interest in the Company pursuant to clause (ii) of Section 7.5 of the business
of such Person conducted within the Noncompete Area on the date the transaction
undertaken pursuant to clause (ii) of Section 7.5 is first contemplated.
Further, in the event a Member or one of its Affiliates acquires, directly or
indirectly, a healthcare business with operations in the Noncompete Area from an
unrelated third Person ("UTP") as part of an acquisition from such UTP of
multiple healthcare facilities then such Member or its Affiliate shall sell the
business operated within the Noncompete Area to the Company on commercially
reasonable terms acceptable to SHMC and NC-DSH. The parties hereto acknowledge
and agree that capital projects engaged in by the Company pursuant to Section
2.3 shall not be subject to this Article 11. SHMC and its Affiliates covenant
and agree that they shall not initiate an increase in or otherwise seek to
increase, directly or indirectly, their ownership interests (beneficial or
otherwise) (collectively, the "OWNERSHIP") in Goldring and Nevada or in any
entity or organization owning or operating Goldring or Nevada or any successor
to Goldring and Nevada or the organizations owning or operating Goldring and
Nevada. SHMC and its Affiliates further covenant and agree that in the event
they are required, despite their compliance with the immediately preceding
sentence, to increase their Ownership they shall use their reasonable best
efforts to promptly convey such increased Ownership to the Company on terms and
conditions reasonably acceptable to the Company, SHMC and NC-DSH.

         11.3 Enforcement. In the event of a breach of Section 11.2 hereof, the
breaching party recognizes that monetary damages shall be inadequate to
compensate the nonbreaching party(ies) and the nonbreaching party(ies) shall be
entitled, without the posting of a bond, to an injunction restraining such
breach, with the costs (including attorneys fees) of securing such injunction to
be borne by the breaching party and its Affiliates, jointly and severally.
Nothing herein contained shall be construed as prohibiting the nonbreaching
party(ies) from pursuing any other remedy available for such breach or
threatened breach.

         11.4 Reasonableness. All parties hereto hereby acknowledge the
necessity of protection against the competition of the Members and their
respective Affiliates and that the nature and scope of such protection has been
carefully considered by the parties. The period provided and the area covered
are expressly represented and agreed to be fair, reasonable and necessary. The
consideration provided for herein is deemed to be sufficient and adequate to
compensate the parties for agreeing to the restrictions contained in Section
11.2 hereof. If, however, any court determines that the forgoing restrictions
are not reasonable, such restrictions shall be modified, rewritten or
interpreted to include as much of their nature and scope as will render them
enforceable.




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<PAGE>   39



                                   ARTICLE 12
                                     GENERAL

         12.1 Filings. The Company shall execute and cause to be filed such
certificates and documents required by any jurisdiction in which the Company
engages in business. The Company shall take all other actions reasonably
necessary to perfect and maintain the status of the Company as a limited
liability company under the laws of Delaware and any other jurisdiction in which
the Company engages in business.

         12.2 Status of Company for Tax Purposes. The Members intend that the
Company be classified as a partnership for federal income tax purposes. The
Members shall be under a continuing obligation to perform their duties and
responsibilities under this Agreement in light of such intention, and the
Company shall do any and all things and acts necessary or appropriate to
maintain such classification including filing Form 8832 with the Internal
Revenue Service.

         12.3 Waiver of Action for Partition. Each Member (and assignee)
irrevocably waives, during the term of the Company, any right that it may have
to maintain any action for partition with respect to the Company and its
property.

         12.4 Nonrecourse Loans. If the Company borrows money on a nonrecourse
basis, then the creditor who makes such a loan to the Company will not have or
acquire at any time as a result of making the loan, any direct or indirect
interest in the profits, capital or property of the Company other than as a
secured creditor.

         12.5 Notice. Any notice or request required or desired to be given
pursuant to this Agreement shall be deemed to have been properly given if the
same shall be in writing and shall be either personally delivered, or deposited
in the United States certified or registered mail, with postage prepaid, or
deposited with any other generally recognized delivery service with charges
prepaid or billed to the sender, and addressed to the Company at its principal
executive office or addressed to such other person to whom such notice or
request is intended to be given at such address as such person may have
previously furnished in writing to the Company or to such person's last known
address.

         12.6 Binding Effect. This Agreement shall inure to the benefit of and
be binding upon the Members and their respective heirs, representatives,
transferees, successors and assigns. This Agreement may be executed in
counterparts and by facsimile, which together shall deemed one and the same
instrument.

         12.7 Construction. As herein used, the singular number shall include
the plural, the plural the singular, and the use of any gender shall be
applicable to all genders, unless the context would otherwise fairly require.
The titles of the Articles and Sections herein have been inserted for
convenience of reference only and shall not control or affect the meaning or
construction of any of the terms or provisions hereof. All references herein to
Articles and Sections shall mean the appropriate numbered Article or Section
hereof


                                       35

<PAGE>   40



except where reference is made to the Act, the Code, the Regulations or to some
other specified law, regulation or instrument. The parties to this Agreement
shall be under a duty to act in good faith when exercising or declining to
exercise any right or obligation hereunder, provided that, with respect to items
that are the subject of Super-Majority approval or SHMC or NC-DSH consent, no
reasonableness standard will be imposed and such decisions shall be in each of
SHMC and NC-DSH's complete and unfettered discretion; each such party having a
veto power with respect to the action proposed to be taken by the Company. It is
acknowledged by the parties that this Agreement has undergone several drafts
with the negotiated suggestions of each and, therefore, no presumptions will
arise favoring any party by virtue of the authorship of any of its provisions or
the changes made through revisions.

         12.8 Survival of Provisions. Whenever possible, each provision and term
of this Agreement shall be interpreted in such manner as to be valid and
enforceable; provided that in the event any provision or term of this Agreement
should be determined to be invalid or unenforceable, all other provisions and
terms of this Agreement and the application thereof to all persons and
circumstances subject thereto shall remain unaffected to the extent permitted by
law.

         12.9 Integrated Agreement. This Agreement constitutes the entire
understanding and agreement among the Members with respect to the subject matter
hereof and shall control over any inconsistent understanding, restriction,
representation, or warranty among the Members.

         12.10 Governing Law. This Agreement shall be construed and governed in
accordance with the laws of the State of Delaware except where reference is
herein made to sections or provisions of the Code or Regulations. All references
to sections or provisions of the Act, Code and Regulations shall mean such
sections or provisions as now or hereafter amended and shall include any
successor sections or provisions.



                                       36

<PAGE>   41



         The undersigned Members have executed this Agreement as of the date
first above written.

                                     "SHMC"

                                     Summerlin Hospital Medical Center, L.P.


                                     By:      UHS Holding Company, Inc.

                                     Title:   General Partner

                                              By:
                                                  ---------------------------

                                              Title:
                                                     ------------------------


                                     "NC-DSH"

                                     NC-DSH, Inc.


                                     By:
                                         ------------------------------------
                                         Roland P. Richardson, Vice President



                                       37

<PAGE>   42


         The undersigned have executed this Agreement as of the date first above
written for purposes of acknowledging their agreement to the provisions of
Article 11. Universal Health Services, Inc. has executed this Agreement as of
the date first above written for the further purpose of acknowledging its
agreement to the provisions of Section 8.4.


                                          Universal Health Services, Inc.


                                          By:
                                              ---------------------------------

                                          Title:
                                                 ------------------------------


                                          Quorum Health Group, Inc.


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


                                       38