exv10w1






Exhibit 10.1




FOURTH AMENDMENT TO THE

CHS/COMMUNITY HEALTH SYSTEMS, INC. 401(K) PLAN




January 1, 2010




          WHEREAS, CHS/Community Health Systems, Inc. (the “Company”) has previously established and
currently maintains the CHS/Community Health Systems, Inc. 401(k) Plan (the “Plan”); and




          WHEREAS, the Company desires to amend the Plan to comply with guidance issued under the
Pension Protection Act of 2006 and the Heroes Earnings Assistance and Relief Tax Act of 2008 and to
make certain optional changes; and




          WHEREAS, the Company has the right to amend the Plan; and




          WHEREAS, the Board of Directors has approved of the changes set forth in this Amendment.




          NOW, THEREFORE, BE IT RESOLVED, that the Plan be and the same is hereby amended, as follows:




     1. Effective as of January 1, 2010, the following shall be added to the end of Section 1.48:




Notwithstanding the foregoing, for Employees who are case workers paid on a case-by-case
basis, such Employees shall be credited with ninety-five (95) Hours of Service for each bi-weekly
pay period in which such Employees are paid for a case.



     2. Effective as of January 1, 2007, the following shall be added to the last paragraph of
Section 4.15 in lieu of the language added in Section 10 of the First Amendment to the Plan:




In the case of a death occurring on or after January 1, 2007, if a Participant dies while
performing qualified military service (as defined in Code Section 414(u)), the
Participant’s Beneficiary is entitled to any additional benefits (other than benefit
accruals relating to the period of qualified military service) provided under the Plan as
if the Participant had resumed employment and then terminated employment on account of
death. Moreover, the Plan will credit the Participant’s qualified military service as
service for vesting purposes, as though the Participant had resumed employment under USERRA
immediately prior to the Participant’s death.



     3. Effective as of January 1, 2007, the following shall be added to the end of Section 1.24 in
lieu of the language added in Section 2 of the First Amendment:



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For years beginning after December 31, 2008: (i) an individual receiving a differential
wage payment, as defined by Code Section 3401(h)(2), is treated as an employee of the
employer making the payment; (ii) the differential wage payment is treated as compensation
for purposes of Code Section 415(c)(3) and Treasury Reg. Section 1.415(c)-2 (e.g., for
purposes of Code Section 415, top-heavy provisions of Code Section 416, and determination
of highly compensated employees under Code Section 414(q), and (iii) the Plan is not
treated as failing to meet the requirements of any provision described in Code Section
414(u)(1)(C) (or corresponding plan provisions, including, but not limited to, Plan
provisions related to the ADP or ACP test) by reason of any contribution or benefit which
is based on the differential wage payment. The Plan Administrator operationally may
determine, for purposes of the provisions described in Code Section 414(u)(1)(C), whether
to take into account any deferrals, and if applicable, any matching contributions,
attributable to differential wages. Differential wage payments (as described herein) will
also be considered compensation for all Plan purposes. Subsection (iii) above applies only
if all employees of the Employer performing service in the uniformed services described in
Code Section 3401(h)(2)(A) are entitled to receive differential wage payments (as defined
in Code Section 3401(h)(2)) on reasonably equivalent terms and, if eligible to participate
in a retirement plan maintained by the Employer, to make contributions based on the
payments on reasonably equivalent terms (taking into account Code
Sections 410(b)(3), (4),
and (5)).



     4. Effective as of January 1, 2009, the following shall be added to the end of Section 4.2(d)
in lieu of the language added in Section 6 of the First Amendment:




Notwithstanding Section 1.24(i), if a Participant performs service in the uniformed
services (as defined in Code Section 414(u)(12)(B)) on active duty for a period of more
than 30 days, the Participant will be deemed to have a severance from employment solely for
purposes of eligibility for distribution of amounts not subject to Code Section 412.
However, the Plan will not distribute such a Participant’s account on account of this
deemed severance unless the Participant specifically elects to receive a benefit
distribution hereunder. If a Participant elects to receive a distribution on account of
this deemed severance, then the individual may not make an elective deferral or employee
contribution during the 6-month period beginning on the date of the distribution. If a
Participant would be entitled to a distribution on account of a deemed severance, and a
distribution on account of another Plan provision (such as a qualified reservist
distribution),



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then the other Plan provision will control and the 6-month
suspension will not apply.



     5. Effective as of January 1, 2010, the following sentence will replace the last sentence of
Section 1.42:




For purposes of this Plan, any Forfeitures will be used or allocated in or for the Plan
Year in which the Forfeitures are incurred (the “Forfeiture Year”); if a portion of the
Forfeitures are not allocated in the Forfeiture Year, such Forfeitures will be allocated in
the following Plan Year to pay Plan expenses and/or to reduce employer matching
contributions for the Forfeiture Year.



     6. Effective as of January 1, 2010, Item 2 of Exhibit A to the Plan shall be revised to read
as follows:




Employees of Pottstown Hospital Company, LLC and Pottstown Imaging Company, LLC whose
employment is governed by a collective bargaining agreement (including an agreement that
has terminated but remains subject to negotiation);



     7. Effective as of January 1, 2007, the following provision shall be added as Section
4.14(f)(3):




Divestment. If any portion of an “applicable individual’s” account is invested in
publicly-traded employer securities, then, except as otherwise provided herein, the
“applicable individual” may elect to direct the Plan to divest any such securities, and to
reinvest an equivalent amount in other investment options which satisfy the requirements
specified herein. An “applicable individual” means: (i) a Participant; (ii) an alternate
payee who has an account under the Plan; or (iii) a Beneficiary of a deceased Participant.
Other investment options will include not less than three (3) investment options, other
than employer securities, to which the individual who has the right to divest may direct
the proceeds from the divestment of employer securities. Each of the three (3) investment
options must be diversified and have materially different risk and
return characteristics.
For this purpose, investment options that constitute a broad range of investment
alternatives within the meaning of Department of Labor Regulation §2550.404c—1(b)(3) are
treated as being diversified and having materially different risk and return
characteristics. The Plan will provide reasonable divestment and reinvestment opportunities
at least quarterly. Furthermore, except as permitted by Treas. Reg. §1.40l(a)(35)-1(e),
the Plan will not impose restrictions or conditions on the investment of employer
securities that the Plan does not impose on the investment of other Plan assets.



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     8. Except as otherwise provided in this Amendment, the Plan shall remain in full force and
effect.



          IN WITNESS WHEREOF, this Amendment has been executed on the 20th day
of December, 2010, effective as set forth herein.




	 	 	 	 	 
	 	CHS/COMMUNITY HEALTH SYSTEMS, INC.

 	 
	 	By:  	/s/ RACHEL A. SEIFERT
 	 
	 	 	RACHEL A. SEIFERT 	 
	 	 	EXECUTIVE VICE PRESIDENT 	 



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