Document:

EX-4.1

    Exhibit 4.1

 

    SIXTH SUPPLEMENTAL INDENTURE (this “Supplemental
    Indenture”), dated as of March 30, 2009, among
    CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation (the
    “Issuer”), each of the parties identified as a
    New Subsidiary Guarantor on the signature pages hereto (each, a
    “New Subsidiary Guarantor” and collectively,
    the “New Subsidiary Guarantors”) and
    U.S. BANK NATIONAL ASSOCIATION, as Trustee under the
    Indenture (the “Trustee”).

 

    W I T N E S S E T H:
    

 

    WHEREAS the Issuer has heretofore executed and delivered to the
    Trustee an Indenture (the “Indenture”), dated
    as of July 25, 2007, providing for the issuance of the
    87/8% Senior
    Notes due 2015 (the “Securities”).

 

    WHEREAS, each of the undersigned New Subsidiary Guarantors has
    deemed it advisable and in its best interest to execute and
    deliver this Supplemental Indenture, and to become a New
    Subsidiary Guarantor under the Indenture.

 

    WHEREAS, following the merger of National Healthcare of
    Cleveland, Inc., an existing Subsidiary Guarantor, with and into
    Cleveland Tennessee Hospital Company, LLC on February 1,
    2009, Cleveland Tennessee Hospital Company, LLC is entering into
    this Supplemental Indenture pursuant to Section 5.01(b) of
    the Indenture.

 

    WHEREAS, National Healthcare of Cleveland, Inc. (i) has
    been merged into Cleveland Tennessee Hospital Company, LLC;
    (ii) has therefore ceased to exist, and (iii) will
    therefore no longer be a Subsidiary Guarantor under the
    Indenture.

 

    WHEREAS, pursuant to Section 9.01(4) of the Indenture, the
    Trustee, the Issuer and the New Subsidiary Guarantors are
    authorized to execute and deliver this Supplemental Indenture.

 

    NOW THEREFORE, in consideration of the foregoing and for good
    and valuable consideration, the receipt of which is hereby
    acknowledged, the Issuer, the New Subsidiary Guarantors and the
    Trustee mutually covenant and agree for the equal and ratable
    benefit of the Holders of the Securities as follows:

 

    Section 1.  Capitalized
    Terms.  Capitalized terms used herein but not
    defined shall have the meanings assigned to them in the
    Indenture.

 

    Section 2.  Guaranties.  Each
    New Subsidiary Guarantor hereby agrees to guarantee the
    Issuer’s obligations under the Securities on the terms and
    subject to the conditions set forth in Article 10 of the
    Indenture and to be bound by all other applicable provisions of
    the Indenture as a Subsidiary Guarantor.

 

    Section 3.  Ratification
    of Indenture; Supplemental Indentures Part of
    Indenture.  Except as expressly amended
    hereby, the Indenture is in all respects ratified and confirmed
    and all the terms, conditions and provisions thereof shall
    remain in full force and effect. This Supplemental Indenture
    shall form a part of the Indenture for all purposes, shall inure
    to the benefit of the Trustee and every Holder of Securities
    heretofore or hereafter authenticated and the Issuer, the
    Trustee and every Holder of Securities heretofore or hereafter
    authenticated and delivered shall be bound hereby.

 

    Section 4.  Governing
    Law.  THIS SUPPLEMENTAL INDENTURE SHALL BE
    GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE
    STATE OF NEW YORK.

 

    Section 5.  Trustee
    Makes No Representation.  The Trustee makes no
    representation as to the validity or sufficiency of this
    Supplemental Indenture.

 

    Section 6.  Counterparts.  The
    parties may sign any number of copies of this Supplemental
    Indenture. Each signed copy shall be an original, but all of
    them together represent the same agreement.

 

    Section 7.  Effect
    of Headings.  The Section headings herein are
    for convenience only and shall not effect the construction of
    this Supplemental Indenture.

 

    IN WITNESS WHEREOF, the parties have caused this

    Supplemental Indenture to be duly executed as of this 30th day of

    March, 2009.

 

	 	 	 
	
 
	
 
	
    CHS/Community Health Systems, Inc.a Delaware corporation

	
 
	
 
	
 

	
 
	
 
	

    By: /s/  Rachel
    A.
    Seifert

Rachel
    A. Seifert

    Senior Vice President, Secretary & General
    Counsel

	
 
	
 
	
 

	
 
	
 
	
    Cleveland Tennessee Hospital Company, LLC,

    a Delaware limited liability company

    

    DHFW Holdings, LLC, 

    a Delaware limited liability company 

    

    Northwest Hospital, LLC,

    a Delaware limited liability company

    

    NOV Holdings, LLC,

    a Delaware limited liability company

    

    Oro Valley Hospital, LLC,

    a Delaware limited liability company

    

    Wesley Health System, LLC, 

    a Delaware limited liability company

	
 
	
 
	
 

	
 
	
 
	

    By: /s/  Rachel
    A.
    Seifert

Rachel
    A. SeifertSenior Vice President and Secretary

	
 
	
 
	
 

	
 
	
 
	
    U.S. Bank National Association,as Trustee

	
 
	
 
	
 

	
 
	
 
	

    By: /s/  Wally
    Jones

Wally
    JonesVice President

    

    2EX-4.2

    Exhibit 4.2

 

    RELEASE OF CERTAIN GUARANTORS (this “Release”),
    dated as of March 30, 2009, by and among CHS/COMMUNITY
    HEALTH SYSTEMS, INC., a Delaware corporation (the
    “Issuer”), those Subsidiary Guarantors parties
    hereto, and U.S. BANK NATIONAL ASSOCIATION, as Trustee
    under the Indenture (the “Trustee”).

 

    W I T N E S S E T H:
    

 

    WHEREAS, the Issuer has heretofore executed and delivered to the
    Trustee an Indenture, dated as of July 25, 2007, as
    supplemented by the First Supplemental Indenture, dated as of
    July 25, 2007, the Second Supplemental Indenture, dated as
    of December 31, 2007, the Third Supplemental Indenture,
    dated as of October 10, 2008, the Fourth Supplemental
    Indenture, dated December 1, 2008, the Fifth Supplemental
    Indenture, dated February 5, 2009, and the Sixth
    Supplemental Indenture of even date herewith (the
    “Indenture”), providing for the issuance of the
    87/8% Senior
    Notes due 2015 (the “Securities”);

 

    WHEREAS, pursuant to that certain Private Placement Memorandum,
    dated October 24, 2007 (as amended, supplemented or
    otherwise modified from time to time, the “Sunbury
    PPM”), Sunbury Hospital Company, LLC, a Delaware
    limited liability company (“SHC”), has offered
    and sold membership interests in SHC to certain physician
    investors effective as of January 1, 2008 (such
    transaction, the “Sunbury Syndication”).

 

    WHEREAS, pursuant to that certain Private Placement Memorandum,
    dated November 13, 2007 (as amended, supplemented or
    otherwise modified from time to time, the “Abilene
    PPM”), ARMC, L.P., a Delaware limited partnership
    (“ARMC”), has offered and sold partnership
    interests in ARMC to certain physician investors effective as of
    June 1, 2008 (such transaction, the “Abilene
    Syndication”).

 

    WHEREAS, pursuant to that certain Private Placement Memorandum,
    dated July 22, 2008 (as amended, supplemented or otherwise
    modified from time to time, the “Ft. Wayne
    PPM”), Lutheran Health Network Investors, LLC, a
    Delaware limited liability company (“LHNI”),
    has offered and sold membership interests in LHNI to certain
    physician investors effective as of October 1, 2008 (such
    transaction, the “Ft. Wayne Syndication”).

 

    WHEREAS, IOM Health System, LP, an Indiana limited partnership,
    St. Joseph Health System, LLC, a Delaware limited liability
    company, and Triad Indiana Holdings, LLC, a Delaware limited
    liability company, are wholly-owned, directly or indirectly, by
    LHNI.

 

    WHEREAS, (i) upon the consummation of the Syndications,
    each of the Subsidiary Guarantors listed on the signature pages
    hereto (the “Syndicated Subsidiary Guarantors”)
    has been released as a Subsidiary Guarantor under the Credit
    Agreement, dated as of July 25, 2007, by and among the
    Issuer, Community Health Systems, Inc., the lenders that from
    time to time become parties to the Credit Agreement and Credit
    Suisse, as Collateral Agent, and (ii) the Issuer has
    delivered an Officer’s Certificate to the Trustee
    certifying that the Syndicated Subsidiary Guarantors no longer
    have any Indebtedness outstanding that would require such
    Syndicated Subsidiary Guarantors to enter into a Guaranty
    Agreement pursuant to Section 4.12 of the Indenture.

 

    WHEREAS pursuant to Section 10.06(4) of the Indenture, a
    Guarantor will be released from its obligations under the
    Indenture under the circumstances described in the immediately
    preceding recital.

 

    WHEREAS pursuant to the last sentence of Section 10.06 of
    the Indenture, the Issuer requests and the Trustee is authorized
    to execute and deliver this Release evidencing such release
    pursuant to Section 10.06(4) of the Indenture.

 

    NOW THEREFORE, in consideration of the foregoing and for good
    and valuable consideration, the receipt of which is hereby
    acknowledged, the Issuer, those Subsidiary Guarantors parties
    hereto and the Trustee mutually covenant and agree as follows:

 

    Section 1.  Capitalized
    Terms.  Capitalized terms used herein but not
    defined shall have the meanings assigned to them in the
    Indenture.

 

    Section 2.  Subsidiary
    Guarantors.  Effective from and after the
    consummation of the Syndication, each of the Syndicated
    Subsidiary Guarantors is hereby irrevocably released and
    discharged from its obligations under Article 10 of the
    Indenture, any Guaranty Agreement to which it may be party or
    any obligations with respect to the Securities.

 

    Section 3.  Ratification
    of Indenture; Release Part of
    Indenture.  Except as expressly modified
    hereby, the Indenture is in all respects ratified and confirmed
    and all the terms, conditions and provisions thereof shall
    remain in full force and effect. This Release shall form a part
    of the Indenture for all purposes, shall inure to the benefit of
    the Issuer, each of the Syndicated Subsidiary Guarantors, the
    Trustee and every Holder of Securities heretofore or hereafter
    authenticated and the Issuer, each of the Syndicated Subsidiary
    Guarantors, the Trustee and every Holder of Securities
    heretofore or hereafter authenticated and delivered shall be
    bound hereby.

 

    Section 4.  Governing
    Law.  THIS RELEASE SHALL BE GOVERNED BY,
    AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW
    YORK.

 

    Section 5.  Trustee
    Makes No Representation.  The Trustee makes no
    representation as to the accuracy or correctness of the recitals
    of this Release.

 

    Section 6.  Counterparts.  The
    parties may sign any number of copies of this Release. Each
    signed copy shall be an original, but all of them together
    represent the same agreement.

 

    Section 7.  Effect
    of Headings.  The Section headings herein are
    for convenience only and shall not effect the construction of
    this Release.

    

    2

 

 

    IN WITNESS WHEREOF, the parties have caused this Release to be
    duly executed as of this 30th day of March 2009.

 

	 	 	 
	
 
	
 
	
    CHS/Community Health Systems, Inc.,a Delaware corporation

	
 
	
 
	
 

	
 
	
 
	

    By: /s/  Rachel
    A.
    Seifert

Rachel
    A. SeifertSenior Vice President, Secretary & General
    Counsel

	
 
	
 
	
 

	
 
	
 
	
    Syndicated Subsidiary Guarantors:

    ARMC, L.P.

    IOM Health System, LP

    St. Joseph Health System, LLC

    Sunbury Hospital Company, LLC

    Triad Indiana Holdings, LLC

	
 
	
 
	
 

	
 
	
 
	

    By: /s/  James
    W.
    Doucette

James
    W. Doucette

    Vice President, Finance and Treasurer 

 

    U.S. Bank National Association,

    as Trustee

 

		
	    By: 	
    /s/  Wally
    Jones

    Wally Jones

    Vice President

    

    3

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