Document:

EX-4.1

 Exhibit 4.1 

EXECUTION VERSION 
 TRANCHE A-5
TERM LOAN 
 JOINDER AGREEMENT NO. 1 

JOINDER AGREEMENT NO. 1, dated as of June 10, 2015 (this “Agreement”), by and among Bank of America, N.A. and the other
Tranche A-5 Term Loan Lenders named herein (each, a “Tranche A-5 Term Loan Lender”), HCA INC., a Delaware corporation (the “Borrower”) and BANK OF AMERICA, N. A., as Administrative Agent and as Collateral Agent.

 RECITALS: 

WHEREAS, reference is hereby made to the Credit Agreement, dated as of November 17, 2006, as amended and restated as of
May 4, 2011, and as further amended and restated as of February 26, 2014 (as further amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Borrower, the Lenders party
thereto, Bank of America, N. A., as Administrative Agent, Swingline Lender and Letter of Credit Issuer and the other parties named therein (capitalized terms used but not defined herein having the meaning provided in the Credit Agreement); 

WHEREAS, subject to the terms and conditions of the Credit Agreement, the Borrower may establish New Term Loan Commitments by, among
other things, entering into one or more Joinder Agreements with New Term Loan Lenders; 
 WHEREAS, the Borrower desires to
establish a Series of New Term Loans pursuant to this Agreement which shall be titled the “Tranche A-5 Term Loans;” 

WHEREAS, the Tranche A-5 Term Loans constitute Ratio First Lien Indebtedness under the Credit Agreement;  

WHEREAS, Merrill Lynch, Pierce, Fenner & Smith Incorporated, Citigroup Global Markets Inc., Goldman Sachs Bank USA, J.P.
Morgan Securities LLC and Wells Fargo Securities, LLC are acting as joint lead arrangers and joint bookrunners for the Tranche A-5 Term Loans; and 

WHEREAS, Fifth Third Bank, The Bank of Tokyo-Mitsubishi UFJ, Ltd., Barclays Bank PLC, Deutsche Bank Securities Inc., RBC Capital
Markets, LLC, and SunTrust Robinson Humphrey, Inc. are acting as co-documentation agents for the Tranche A-5 Term Loans. 
 NOW,
THEREFORE, in consideration of the premises and agreements, provisions and covenants herein contained, the parties hereto agree as follows: 

Each Tranche A-5 Term Loan Lender, severally and not jointly, hereby agrees to commit to provide a New Term Loan Commitment with respect to
the Tranche A-5 Term Loans (each, a “Tranche A-5 Term Loan Commitment”), in the amount set forth opposite such Tranche A-5 Term Loan Lender’s name on Schedule I annexed hereto, on the terms and subject to the conditions
set forth below. 

 Each Tranche A-5 Term Loan Lender (i) confirms that it has received a copy of the Credit
Agreement and the other Credit Documents and the exhibits thereto, together with copies of the financial statements referred to therein and such other documents and information as it has deemed appropriate to make its own credit analysis and
decision to enter into this Agreement; (ii) agrees that it will, independently and without reliance upon the Administrative Agent or any other Tranche A-5 Term Loan Lender or any other Lender or Agent and based on such documents and information
as it shall deem appropriate at the time, continue to make its own credit decisions in taking or not taking action under the Credit Agreement; (iii) appoints and authorizes the Administrative Agent to take such action as agent on its behalf and
to exercise such powers under the Credit Agreement and the other Credit Documents as are delegated to the Administrative Agent by the terms thereof, together with such powers as are reasonably incidental thereto; and (iv) agrees that it will
perform in accordance with their terms all of the obligations which by the terms of the Credit Agreement are required to be performed by it as a Tranche A-5 Term Loan Lender. 

Each Tranche A-5 Term Loan Lender hereby agrees to make its respective Commitment on the following terms and conditions: 

 

	1.	Applicable Margins. The Applicable ABR Margin and Applicable LIBOR Margin for the Tranche A-5 Term Loans shall be as set forth below: 

 

									
	 Status
	  	Applicable ABR Margin for
Tranche A-5 Term Loans	 	 	Applicable LIBOR Margin
for Tranche A-5 Term
Loans	 
	 Level I Status
	  	 	1.50	% 	 	 	2.50	% 
	 Level II Status
	  	 	1.25	% 	 	 	2.25	% 
	 Level III Status
	  	 	1.00	% 	 	 	2.00	% 
	 Level IV Status
	  	 	0.75	% 	 	 	1.75	% 
	 Level V Status
	  	 	0.50	% 	 	 	1.50	% 

  

	2.	Principal Payments. The Borrower shall make principal payments on the Tranche A-5 Term Loans in installments on the dates and in the amounts set forth below (with amounts set forth below expressed as a percentage
of the aggregate principal amount of the Tranche A-5 Term Loans on the Tranche A-5 Effective Date): 

  

					
	 (A)
 New Repayment

Date
	  	(B)
Tranche A-5 Term Loan
Repayment Amount	 
	 September 30, 2015
	  	 	1.25	% 
	 December 31, 2015
	  	 	1.25	% 
	 March 31, 2016
	  	 	1.25	% 
	 June 30, 2016
	  	 	1.25	% 
	 September 30, 2016
	  	 	1.25	% 
	 December 31, 2016
	  	 	1.25	% 
	 March 31, 2017
	  	 	1.25	% 
	 June 30, 2017
	  	 	1.25	% 
	 September 30, 2017
	  	 	1.25	% 
	 December 31, 2017
	  	 	1.25	% 
	 March 31, 2018
	  	 	1.25	% 
	 June 30, 2018
	  	 	1.25	% 
	 September 30, 2018
	  	 	1.25	% 
	 December 31, 2018
	  	 	1.25	% 
	 March 31, 2019
	  	 	1.25	% 
	 June 30, 2019
	  	 	1.25	% 
	 September 30, 2019
	  	 	1.25	% 
	 December 31, 2019
	  	 	1.25	% 
	 March 31, 2020
	  	 	1.25	% 
	 Tranche A-5 Term Loan Maturity Date
	  	 	76.25	% 

  
 -2- 

 Notwithstanding the foregoing, the Borrower shall repay all outstanding Tranche A-5 Term Loans on June 10,
2020 (or, if such day is not a Business Day, the next preceding Business Day) (the “Tranche A-5 Term Loan Maturity Date”). 
  

	3.	Voluntary and Mandatory Prepayments. Scheduled installments of principal of the Tranche A-5 Term Loans set forth above shall be reduced in connection with any voluntary or mandatory prepayments of the Tranche A-5
Term Loans in accordance with Sections 5.1 and 5.2 of the Credit Agreement, respectively. For the avoidance of doubt, all such payments shall, subject to Section 2.11 of the Credit Agreement, be without premium or penalty. 

  

	4.	Other Terms of Tranche A-5 Term Loans. Except as expressly set forth herein, the terms of the Tranche A-5 Term Loans shall be identical to the terms of the Tranche A-4 Term Loans. References in the Credit
Agreement to Term Loans shall include, without limitation, the Tranche A-5 Term Loans, which shall be deemed to be a separate Class of Term Loans under the Credit Agreement. 

 

	5.	Funding of Tranche A Term Loans. Subject to the terms and conditions of this Agreement, on the Tranche A-5 Effective Date, each Tranche A-5 Term Loan Lender agrees to make to the Borrower a Tranche A-5 Term Loan
in an aggregate principal amount equal to its Tranche A-5 Term Loan Commitment. The Tranche A-5 Term Loan Commitment of each Tranche A-5 Term Loan Lender shall be automatically and permanently reduced to $0 upon the funding of the Tranche A-5 Term
Loans pursuant to this Section 5. 

  

	6.	Credit Agreement Governs. Except as set forth in this Agreement, the Tranche A-5 Term Loans shall otherwise be subject to the provisions of the Credit Agreement and the other Credit Documents.

  
 -3- 

	7.	Borrower’s Certifications. By its execution of this Agreement, the undersigned officer, to the best of his or her knowledge, and the Borrower hereby certifies that: 

 

	 	(i)	The representations and warranties contained in the Credit Agreement and the other Credit Documents are true and correct in all material respects on and as of the date hereof to the same extent as though made on and as
of the date hereof, except to the extent such representations and warranties expressly relate to an earlier date, in which case such representations and warranties were true and correct in all material respects on and as of such earlier date; and

  

	 	(ii)	No event has occurred and is continuing or would result from the consummation of the proposed Borrowing contemplated hereby that would constitute a Default or an Event of Default. 

 

	8.	Conditions to Tranche A-5 Effective Date. This Agreement shall become effective on the date (the “Tranche A-5 Effective Date”) when each of the conditions set forth below has been satisfied:

 (a) The Administrative Agent shall have received executed counterparts hereof (which may include
facsimile or other electronic transmission of a signed signature page to this Agreement) from the Borrower, each Tranche A-5 Term Loan Lender and the Administrative Agent; 

(b) The Administrative Agent shall have received from the Borrower an opinion of counsel from Simpson Thacher &
Bartlett LLP reasonably acceptable to the Administrative Agent covering such matters as are required pursuant to Section 2.14 of the Credit Agreement; 

(c) The Administrative Agent shall have received a completed “Life-of-Loan” Federal Emergency Management Agency
standard flood hazard determination with respect to each improved Mortgaged Property (together with a notice about special flood hazard area status and flood disaster assistance duly executed by the applicable Credit Party relating thereto) and,
with respect to any Mortgaged Property on which any “building” (as defined in the Flood Insurance Laws) is located in a special flood hazard area, evidence of flood insurance as and to the extent required under Section 9.3 of the
Credit Agreement; and 
 (d) The Administrative Agent shall have received an officers’ certificate of the Borrower
setting forth the calculations (in reasonable detail) demonstrating compliance with (i) the financial test described in Section 10.8 of the Credit Agreement and (ii) the ratio set forth in the definition of “Ratio First Lien
Indebtedness” in the Credit Agreement. 
  

	9.	No later than 90 days following the Tranche A-5 Effective Date, the Borrower shall deliver or cause to be delivered to the Collateral Agent either (a) or (b): 

(a) No Mortgage Amendment Necessary 

  
 -4- 

	 	(i)	Written confirmation from local counsel in the jurisdiction in which the Mortgaged Property is located substantially to the effect that: (i) the recording of the existing Mortgage (and any related fixture filing)
is the only filing or recording necessary to give constructive notice to third parties of the lien created by such Mortgage as security for the Obligations, including the Secured Obligations evidenced by this Agreement and the other documents
executed in connection herewith, for the benefit of the Secured Parties, and (ii) no other documents, instruments, filings, recordings, re-recordings, re-filings or other actions, including, without limitation, the payment of any mortgage
recording taxes or similar taxes are necessary or appropriate under applicable law in order to maintain the continued enforceability, validity or priority of the lien created by such Mortgage as security for the Obligations, including the
Obligations evidenced by this Agreement and the other documents executed in connection herewith, for the benefit of the Secured Parties, unless any such mortgage recording taxes are payable in connection with the transactions contemplated by this
Agreement, in which case such written confirmation shall so state; and 

  

	 	(ii)	a title search relating to the applicable Mortgaged Property, dated on or after the Tranche A-5 Effective Date, demonstrating that such Mortgaged Property is free and clear of all Liens, except for Liens expressly
permitted by Section 10.2 of the Credit Agreement as of the date of the search 

  

	 	(b)	Mortgage Amendment Necessary 

  

	 	(i)	an amendment to each Mortgage (each, a “Mortgage Amendment”) to which a Credit Party is then party duly executed and acknowledged by the applicable Credit Party, and in form for recording in the
recording office where the respective Mortgage was recorded, together with such certificates, affidavits, questionnaires or returns as shall be required in connection with the recording or filing thereof under applicable law, in each case in form
and substance reasonably satisfactory to the Administrative Agent; 

  

	 	(ii)	executed legal opinions, in form and substance reasonably satisfactory to the Administrative Agent, with respect to such amended Mortgages; and 

 

	 	(iii)	 with respect to each amended Mortgage (i) a title search of the relevant Mortgaged Property (except for Mortgaged Properties located in Texas)
confirming that there are no Liens of record in violation of the provisions of the applicable Mortgage and (ii) for Mortgaged Properties located in Texas, a date-down or modification endorsement to the policy or policies of title insurance
insuring the Lien of each Mortgage, issued by a nationally recognized title insurance company (x) insuring that such Mortgage, as amended by such Mortgage Amendment is a valid and enforceable first priority lien on such Mortgaged Property in
favor of the 

  
 -5- 

	 	
Collateral Agent for the benefit of the Secured Parties free and clear of all Liens except as expressly permitted by Section 10.2 of the Credit Agreement or consented to by the
Administrative Agent (y) otherwise in form and substance reasonably satisfactory to the Administrative Agent and (z) having the effect of a valid, issued and binding endorsement to the respective title insurance policy. 

 

	10.	Recordation of the New Loans. Upon execution and delivery hereof, the Administrative Agent will record the Tranche A-5 Term Loans made by the Tranche A-5 Term Loan Lender in the Register.

  

	11.	FATCA. For the avoidance of doubt and for purposes of determining withholding Taxes imposed under FATCA, the Borrower and the Administrative Agent shall treat (and the Lenders hereby authorize the Administrative
Agent to treat) the Tranche A-5 Term Loans as not qualifying as “grandfathered obligations” within the meaning of Treasury Regulation Section 1.1471-2(b)(2)(i).  

 

	12.	Amendment, Modification and Waiver. This Agreement may not be amended, modified or waived except by an instrument or instruments in writing signed and delivered on behalf of each of the parties hereto.

  

	13.	Entire Agreement. This Agreement, the Credit Agreement and the other Credit Documents constitute the entire agreement among the parties hereto and thereto with respect to the subject matter hereof and thereof and
supersede all other prior agreements and understandings, both written and verbal, among the parties or any of them with respect to the subject matter hereof.  

 

	14.	GOVERNING LAW. THIS AGREEMENT AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES HEREUNDER SHALL BE GOVERNED BY, AND SHALL BE CONSTRUED AND ENFORCED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK.

  

	15.	Severability. Any term or provision of this Agreement which is invalid or unenforceable in any jurisdiction shall, as to that jurisdiction, be ineffective to the extent of such invalidity or unenforceability
without rendering invalid or unenforceable the remaining terms and provisions of this Agreement or affecting the validity or enforceability of any of the terms or provisions of this Agreement in any other jurisdiction. If any provision of this
Agreement is so broad as to be unenforceable, the provision shall be interpreted to be only so broad as would be enforceable. 

  

	16.	Counterparts. This Agreement may be executed in counterparts (including by facsimile or other electronic transmission), each of which shall be deemed to be an original, but all of which shall constitute one and
the same agreement. 

  

	17.	 Effect of Joinder Agreement. Each and every term, condition, obligation, covenant and agreement contained in the Credit Agreement or any other
Credit Document is hereby ratified and re-affirmed in all respects and shall continue in full force and effect. Each Credit Party reaffirms its obligations under the Credit Documents to which it is party and

  
 -6- 

	 	
the validity of the Liens granted by it pursuant to the Security Documents. From and after the effective date of this Agreement, all references to the Credit Agreement in any Credit Document
shall, unless expressly provided otherwise, refer to the Credit Agreement as supplemented by this Agreement. This Agreement shall be deemed a Credit Document under the Credit Agreement. 

[Remainder of page intentionally left blank. Signature pages follow.] 

  
 -7- 

 IN WITNESS WHEREOF, each of the undersigned has caused its duly authorized officer to execute and deliver
this Agreement as of the date set forth above. 
  

			
	HCA INC.
		
	By:		 /s/ David G. Anderson

	Name:		David G. Anderson
	Title:		Senior Vice President - Finance
	
	Each of the GUARANTORS listed on Schedule II hereto
		
	By:		 /s/ Donald Stinnett

	Name:		Donald Stinnett
	Title:		Senior Vice President

 SCHEDULE II 
  

					
	 Guarantor
	  	By its
General
Partner	  	By its
Sole
Member
	 American Medicorp Development Co.
	  		  	
	 Bay Hospital, Inc.
	  		  	
	 Brigham City Community Hospital, Inc.
	  		  	
	 Brookwood Medical Center of Gulfport, Inc.
	  		  	
	 Capital Division, Inc.
	  		  	
	 Centerpoint Medical Center of Independence, LLC
	  		  	
	 Central Florida Regional Hospital, Inc.
	  		  	
	 Central Shared Services, LLC
	  		  	
	 Central Tennessee Hospital Corporation
	  		  	
	 CHCA Bayshore, L.P.
	  	*	  	
	 CHCA Conroe, L.P.
	  	*	  	
	 CHCA Mainland, L.P.
	  	*	  	
	 CHCA Pearland, L.P.
	  	*	  	
	 CHCA West Houston, L.P.
	  	*	  	
	 CHCA Woman’s Hospital, L.P.
	  	*	  	
	 Chippenham & Johnston-Willis Hospitals, Inc.
	  		  	
	 Citrus Memorial Hospital, Inc.
	  		  	
	 Citrus Memorial Property Management, Inc.
	  		  	
	 Colorado Health Systems, Inc.
	  		  	
	 Columbia ASC Management, L.P.
	  	*	  	
	 Columbia Healthcare System of Louisiana, Inc.
	  		  	
	 Columbia Jacksonville Healthcare System, Inc.
	  		  	
	 Columbia LaGrange Hospital, LLC
	  		  	
	 Columbia Medical Center of Arlington Subsidiary, L.P.
	  	*	  	
	 Columbia Medical Center of Denton Subsidiary, L.P.
	  	*	  	
	 Columbia Medical Center of Las Colinas, Inc.
	  		  	
	 Columbia Medical Center of Lewisville Subsidiary, L.P.
	  	*	  	
	 Columbia Medical Center of McKinney Subsidiary, L.P.
	  	*	  	
	 Columbia Medical Center of Plano Subsidiary, L.P.
	  	*	  	
	 Columbia North Hills Hospital Subsidiary, L.P.
	  	*	  	
	 Columbia Ogden Medical Center, Inc.
	  		  	
	 Columbia Parkersburg Healthcare System, LLC
	  		  	
	 Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P.
	  	*	  	
	 Columbia Polk General Hospital, Inc.
	  		  	
	 Columbia Rio Grande Healthcare, L.P.
	  	*	  	
	 Columbia Riverside, Inc.
	  		  	
	 Columbia Valley Healthcare System, L.P.
	  	*	  	

					
	 Guarantor
	  	By its
General
Partner	  	By its
Sole
Member
	 Columbia/Alleghany Regional Hospital, Incorporated
	  		  	
	 Columbia/HCA John Randolph, Inc.
	  		  	
	 Columbine Psychiatric Center, Inc.
	  		  	
	 Columbus Cardiology, Inc.
	  		  	
	 Conroe Hospital Corporation
	  		  	
	 Dallas/Ft. Worth Physician, LLC
	  		  	
	 Dublin Community Hospital, LLC
	  		  	
	 Eastern Idaho Health Services, Inc.
	  		  	
	 Edward White Hospital, Inc.
	  		  	
	 El Paso Surgicenter, Inc.
	  		  	
	 Encino Hospital Corporation, Inc.
	  		  	
	 EP Health, LLC
	  		  	
	 Fairview Park GP, LLC
	  		  	
	 Fairview Park, Limited Partnership
	  	*	  	
	 Frankfort Hospital, Inc.
	  		  	
	 Galen Property, LLC
	  		  	
	 Good Samaritan Hospital, L.P.
	  	*	  	
	 Goppert-Trinity Family Care, LLC
	  		  	
	 GPCH-GP, Inc.
	  		  	
	 Grand Strand Regional Medical Center, LLC
	  		  	
	 Green Oaks Hospital Subsidiary, L.P.
	  	*	  	
	 Greenview Hospital, Inc.
	  		  	
	 HCA American Finance LLC
	  		  	
	 HCA - IT&S Field Operations, Inc.
	  		  	
	 HCA - IT&S Inventory Management, Inc.
	  		  	
	 HCA Central Group, Inc.
	  		  	
	 HCA Health Services of Florida, Inc.
	  		  	
	 HCA Health Services of Louisiana, Inc.
	  		  	
	 HCA Health Services of Oklahoma, Inc.
	  		  	
	 HCA Health Services of Tennessee, Inc.
	  		  	
	 HCA Health Services of Virginia, Inc.
	  		  	
	 HCA-HealthONE LLC
	  		  	
	 HCA Management Services, L.P.
	  	*	  	
	 HCA Pearland GP, Inc.
	  		  	
	 HCA Realty, Inc.
	  		  	
	 HCA SFB 1 LLC
	  		  	
	 HD&S Corp. Successor, Inc.
	  		  	
	 Health Midwest Office Facilities Corporation
	  		  	
	 Health Midwest Ventures Group, Inc.
	  		  	
	 Hendersonville Hospital Corporation
	  		  	
	 Hospital Corporation of Tennessee
	  		  	

					
	 Guarantor
	  	By its
General
Partner	  	By its
Sole
Member
	 Hospital Corporation of Utah
	  		  	
	 Hospital Development Properties, Inc.
	  		  	
	 HPG Enterprises, LLC
	  		  	
	 HSS Holdco, LLC
	  		  	
	 HSS Systems, LLC
	  		  	
	 HSS Virginia, L.P.
	  	*	  	
	 HTI MOB, LLC
	  		  	*
	 HTI Memorial Hospital Corporation
	  		  	
	 Integrated Regional Lab, LLC
	  		  	
	 Integrated Regional Laboratories, LLP
	  	*	  	
	 JFK Medical Center Limited Partnership
	  	*	  	
	 KPH-Consolidation, Inc.
	  		  	
	 Lakeland Medical Center, LLC
	  		  	
	 Lakeview Medical Center, LLC
	  		  	
	 Largo Medical Center, Inc.
	  		  	
	 Las Vegas Surgicare, Inc.
	  		  	
	 Lawnwood Medical Center, Inc.
	  		  	
	 Lewis-Gale Hospital, Incorporated
	  		  	
	 Lewis-Gale Medical Center, LLC
	  		  	
	 Lewis-Gale Physicians, LLC
	  		  	
	 Lone Peak Hospital, Inc.
	  		  	
	 Los Robles Regional Medical Center
	  		  	
	 Management Services Holdings, Inc.
	  		  	
	 Marietta Surgical Center, Inc.
	  		  	
	 Marion Community Hospital, Inc.
	  		  	
	 MCA Investment Company
	  		  	
	 Medical Centers of Oklahoma, LLC
	  		  	
	 Medical Office Buildings of Kansas, LLC
	  		  	
	 Memorial Healthcare Group, Inc.
	  		  	
	 Midwest Division - ACH, LLC
	  		  	
	 Midwest Division - LRHC, LLC
	  		  	
	 Midwest Division - LSH, LLC
	  		  	
	 Midwest Division - MCI, LLC
	  		  	
	 Midwest Division - MMC, LLC
	  		  	
	 Midwest Division - OPRMC, LLC
	  		  	
	 Midwest Division - PFC, LLC
	  		  	
	 Midwest Division - RBH, LLC
	  		  	
	 Midwest Division - RMC, LLC
	  		  	
	 Midwest Holdings, Inc.
	  		  	
	 Montgomery Regional Hospital, Inc.
	  		  	
	 Mountain Division- CVH, LLC
	  		  	

					
	 Guarantor
	  	By its
General
Partner	  	By its
Sole
Member
	 Mountain View Hospital, Inc.
	  		  	
	 Nashville Shared Services General Partnership
	  	*	  	
	 National Patient Account Services, Inc.
	  		  	
	 New Iberia Healthcare Corporation
	  		  	
	 New Port Richey Hospital, Inc.
	  		  	
	 New Rose Holding Company, Inc.
	  		  	
	 North Florida Immediate Care Center, Inc.
	  		  	
	 North Florida Regional Medical Center, Inc.
	  		  	
	 North Texas – MCA, LLC
	  		  	
	 Northern Utah Healthcare Corporation
	  		  	
	 Northern Virginia Community Hospital, LLC
	  		  	
	 Northlake Medical Center, LLC
	  		  	
	 Notami Hospitals of Louisiana, Inc.
	  		  	
	 Notami Hospitals, LLC
	  		  	
	 Okaloosa Hospital, Inc.
	  		  	
	 Okeechobee Hospital, Inc.
	  		  	
	 Outpatient Cardiovascular Center of Central Florida, LLC
	  		  	
	 Palms West Hospital Limited Partnership
	  	*	  	
	 Palmyra Park Hospital, LLC
	  		  	
	 Parallon Business Solutions, LLC
	  		  	
	 Parallon Enterprises, LLC
	  		  	
	 Parallon Health Information Solutions, LLC
	  		  	
	 Parallon Holdings, LLC
	  		  	
	 Parallon Payroll Solutions, LLC
	  		  	
	 Parallon Physician Services, LLC
	  		  	
	 Parallon Technology Solutions, LLC
	  		  	
	 Parallon Workforce Management Solutions, LLC
	  		  	
	 Pasadena Bayshore Hospital, Inc.
	  		  	
	 Pearland Partner, LLC
	  		  	
	 Plantation General Hospital, L.P.
	  	*	  	
	 Poinciana Medical Center, Inc.
	  		  	
	 Primary Health, Inc.
	  		  	
	 Primary Health Management, Ltd.
	  	*	  	
	 Pulaski Community Hospital, Inc.
	  		  	
	 Redmond Park Hospital, LLC
	  		  	
	 Redmond Physician Practice Company
	  		  	
	 Regional Health System of Acadiana, LLC, The
	  		  	
	 Reston Hospital Center, LLC
	  		  	
	 Retreat Hospital, LLC
	  		  	
	 Rio Grande Regional Hospital, Inc.
	  		  	
	 Riverside Healthcare System, L.P.
	  	*	  	

					
	 Guarantor
	  	By its
General
Partner	  	By its
Sole
Member
	 Riverside Hospital, Inc.
	  		  	
	 Samaritan, LLC
	  		  	
	 San Jose Healthcare System, LP
	  	*	  	
	 San Jose Hospital, L.P.
	  	*	  	
	 San Jose Medical Center, LLC
	  		  	
	 San Jose, LLC
	  		  	
	 Sarah Cannon Research Institute, LLC
	  		  	*
	 Sarasota Doctors Hospital, Inc.
	  		  	
	 SCRI Holdings, LLC
	  		  	
	 SJMC, LLC
	  		  	
	 Southern Hills Medical Center, LLC
	  		  	
	 Southpoint, LLC
	  		  	
	 Spalding Rehabilitation L.L.C.
	  		  	
	 Spotsylvania Medical Center, Inc.
	  		  	
	 Spring Branch Medical Center, Inc.
	  		  	
	 Spring Hill Hospital, Inc.
	  		  	
	 Sun City Hospital, Inc.
	  		  	
	 Sunrise Mountainview Hospital, Inc.
	  		  	
	 Surgicare of Brandon, Inc.
	  		  	
	 Surgicare of Florida, Inc.
	  		  	
	 Surgicare of Houston Women’s, Inc.
	  		  	
	 Surgicare of Manatee, Inc.
	  		  	
	 Surgicare of Newport Richey, Inc.
	  		  	
	 Surgicare of Palms West, LLC
	  		  	
	 Surgicare of Riverside, LLC
	  		  	
	 Tallahassee Medical Center, Inc.
	  		  	
	 TCMC Madison-Portland, Inc.
	  		  	
	 Terre Haute Hospital GP, Inc.
	  		  	
	 Terre Haute Hospital Holdings, Inc.
	  		  	
	 Terre Haute MOB, L.P.
	  	*	  	
	 Terre Haute Regional Hospital, L.P.
	  	*	  	
	 Timpanogos Regional Medical Services, Inc.
	  		  	
	 Trident Medical Center, LLC
	  		  	
	 U.S. Collections, Inc.
	  		  	
	 Utah Medco, LLC
	  		  	
	 VH Holdco, Inc.
	  		  	
	 VH Holdings, Inc.
	  		  	
	 Virginia Psychiatric Company, Inc.
	  		  	
	 Vision Consulting Group, LLC
	  		  	
	 Vision Holdings, LLC
	  		  	
	 W & C Hospital, Inc.
	  		  	

					
	 Guarantor
	  	By its
General
Partner	  	By its
Sole
Member
	 Walterboro Community Hospital, Inc.
	  		  	
	 WCP Properties, LLC
	  		  	
	 Wesley Medical Center, LLC
	  		  	
	 West Florida – MHT, LLC
	  		  	
	 West Florida – PPH, LLC
	  		  	
	 West Florida – TCH, LLC
	  		  	
	 West Florida Regional Medical Center, Inc.
	  		  	
	 West Valley Medical Center, Inc.
	  		  	
	 Western Plains Capital, Inc.
	  		  	
	 WHMC, Inc.
	  		  	
	 Woman’s Hospital of Texas, Incorporated
	  		  	

 
			
	Consented to by:
	
	 BANK OF AMERICA, N.A.,
 as
Administrative Agent

		
	By:		 /s/ Brian J. Walsh

	Name:		Brian J. Walsh
	Title:		Vice PresidentMAG-2015 Ex10.1 0614

NINTH AMENDMENT TO CREDIT AGREEMENT
THIS NINTH AMENDMENT TO CREDIT AGREEMENT (this "Amendment"), dated effective as of June 14, 2015, is by and between ASSOCIATED BANK, NATIONAL ASSOCIATION, a national banking association (the "Bank"), and MAGNETEK, INC., a Delaware corporation (the "Company"), and amends and supplements that certain Credit Agreement dated as of November 6, 2007, as amended to date (as so amended, the "Credit Agreement"), by and between the Company and the Bank.
RECITAL
The Company and the Bank desire to amend and supplement the Credit Agreement as provided below.
AGREEMENTS
In consideration of the Recital and the promises and agreements set forth in the Credit Agreement, as amended hereby, the parties agree as follows:
1.    Definitions and References.  Capitalized terms not otherwise defined herein have the meanings assigned in the Credit Agreement.  All references to the Credit Agreement contained in the Collateral Documents and the other Loan Documents, as amended or amended and restated, shall, upon the execution of this Amendment, mean the Credit Agreement as amended by this Amendment.

2.    Amendments to Credit Agreement.  The Credit Agreement is hereby amended as follows:
(a) The defined term "Maturity Date" appearing in section 1.1 of the Credit Agreement is hereby amended by deleting the date "June 14, 2015" appearing therein and inserting the date "June 12, 2016" in its place.

(b)Section 2.5(a) of the Credit Agreement is hereby amended by deleting the rate "two and three-quarters of one percent (2.75%)" appearing therein and inserting the rate "two and one-quarter of one percent (2.25%)" in its place.

(c)Section 5.1(g) of the Credit Agreement is hereby amended and restated in its entirety to read as follow:

(g)    Intentionally Omitted.
(d)Section 5.2 of the Credit Agreement is hereby amended and restated in its entirety to read as follows:

5.2    Books and Records; Inspections; Field Exam.  (a) Keep proper books of record and account in which full, true and correct entries 

are made of all dealings and transactions in relation to its business and activities; (b) permit representatives of the Bank (including employees of the Bank or any consultants, accountants, lawyers and appraisers retained by the Bank), at the Bank's option upon reasonable prior notice to the Company and at the Company's expense, to visit and inspect its properties, to examine and make extracts from its books and records, including to examine and make extracts from environmental assessment reports and Phase I or Phase II studies, and to discuss the Company's affairs, finances and condition with its officers and independent accountants; and (c) (i) if a Default or Event of Default exists, (ii) if the outstanding principal balance of the Note is not equal to $0.00 at all times for ninety (90) days (of which, thirty (30) such days must be consecutive) during any twelve (12) month period, or (iii) if the outstanding principal balance of the Note is greater than $500,000 for fifteen (15) days or more (whether consecutive or non-consecutive) during any twelve (12) month period, permit representatives of the Bank (including employees of the Bank or any consultants, accountants, lawyers and appraisers retained by the Bank), at the Bank's option upon reasonable prior notice to the Company and at the Company's expense, to conduct field examinations.
(e)    Section 6.10 of the Credit Agreement is amended and restated in its entirety to read as follows:

6.10.    Maximum Pension Payments.  Make cash contributions to the defined benefit retirement plan maintained by the Company, except for payments during the following periods not exceeding the amounts (measured on a cash basis) for such periods:
	
		
	Period
	Maximum Contribution

	Twelve-month period ending June 12, 2016
	$8,000,000

Nothing herein shall prohibit the Company from making stock (non-cash) contributions to the defined benefit retirement plan maintained by the Company, provided that such stock contributions do not result in a Change in Control.
(f)    Section 6.11 of the Credit Agreement is amended in its entirety to read as follows:

6.11    Capital Expenditures.  Make or commit to make, directly or indirectly, any Capital Expenditure if, after giving effect thereto, the aggregate amount of all Capital Expenditures by the Company and its Consolidated Subsidiaries would exceed 2,000,000 for any fiscal year.
3.    Closing Conditions.  This Amendment shall become effective upon the execution and delivery by the parties of this Amendment and receipt by the Bank of such other forms, certificates, agreements, documents and instruments as the Bank may reasonably request.

4.    No Waiver.   The Company agrees that nothing contained herein shall be construed by the Company as a waiver by the Bank of the Company's compliance with each representation, warranty and/or covenant contained in the Credit Agreement, the Collateral Documents and the other Loan Documents and that no waiver of any provision of the Credit Agreement, the Collateral Documents or the other Loan Documents by the Bank has occurred.  The Company further agrees that nothing contained herein shall impair the right of the Bank to require strict performance by the Company of the Credit Agreement.

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5.    Representations and Warranties.  The Company represents and warrants to the Bank that:

(a)The execution and delivery of this Amendment is within its corporate power, has been duly authorized by proper corporate action on the part of the Company, is not in violation of any existing law, rule or regulation of any governmental agency or authority, any order or decision of any court, the Certificate of Incorporation or By-Laws of the Company or the terms of any agreement, restriction or undertaking to which the Company is a party or by which it is bound, and does not require the approval or consent of the stockholders of the Company, any governmental body, agency or authority or any other person or entity, except for those approvals and consents which have already been obtained and are in full force and effect; 

(b)This Amendment has been duly executed and delivered by the Company and constitutes a legal, valid and binding obligation of the Company, enforceable in accordance with its terms, subject to applicable bankruptcy, insolvency, reorganization, moratorium or other laws affecting creditors' rights generally and subject to general principles of equity, regardless of whether considered in a proceeding in equity or at law; and

(c)The representations and warranties of the Company contained in the Credit Agreement, the Collateral Documents and the Loan Documents are true and correct in all material respects as of the date of this Amendment (except to the extent such representations and warranties relate to an earlier date in which case they are true and correct in all material respects as of such earlier date).

6.    Miscellaneous.  

(d)Charges, Expenses and Fees.  The Company agrees to pay on demand all reasonable out-of-pocket costs and expenses paid or incurred by the Bank in connection with the negotiation, preparation, execution and delivery of this Amendment and all forms, certificates, agreements, documents and instruments hereto or otherwise contemplated hereby, including the reasonable fees and expenses of the Bank's counsel.

(e)Amendments and Waivers.  This Amendment may not be changed or amended orally, and no waiver hereunder may be oral, and any change or amendment hereto or any waiver hereunder must be in a writing which is identified as an amendment or waiver of this Amendment and signed by the party or parties against whom such change, amendment or waiver is sought to be enforced.

(f)Headings.  The headings in this Amendment are intended solely for convenience of reference and shall be given no effect in the construction or interpretation of this Amendment.

(g)Affirmation.  Each party hereto affirms and acknowledges that the Credit Agreement as amended by this Amendment remains in full force and effect in accordance with its terms.

(h)Counterparts.  This Amendment may be executed in one or more counterparts, each of which shall constitute an original, but all of which when taken together shall constitute one and the same instrument.  Delivery of an executed counterpart by facsimile or by e-mail of a portable document file (PDF) shall be as effective as delivery of an original counterpart hereof.

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IN WITNESS WHEREOF, the parties have executed this Ninth Amendment to Credit Agreement as of the date first written above.

	
			
	 
	COMPANY:

	
			
	 
	MAGNETEK, INC.

	 
	 

	 
	 

	 
	By:
	/s/ Marty J. Schwenner

	 
	 
	Marty J. Schwenner, Vice President and 

	 
	 
	Chief Financial Officer

	
			
	 
	BANK:

	
			
	 
	ASSOCIATED BANK,

	 
	NATIONAL ASSOCIATION

	 
	 

	 
	By:
	/s/ Michael Weber

	 
	 
	Michael Weber, Vice President

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