Document:

Ex-10.1 First Incremental Facility Amendment

 

Exhibit 10.1

     EXECUTION COPY

 

 

Up To $400,000,000

FIRST INCREMENTAL FACILITY AMENDMENT

dated as of December 13, 2006

to the

AMENDED AND RESTATED CREDIT AGREEMENT

dated as of August 19, 2004

among

CHS/COMMUNITY HEALTH SYSTEMS, INC.,

COMMUNITY HEALTH SYSTEMS, INC.

The Several Banks And Other Financial Institutions

From Time To Time Parties Thereto,

BANK OF AMERICA, N.A.,

as Documentation Agent,

WACHOVIA BANK, NATIONAL ASSOCIATION,

as Syndication Agent,

and

JPMORGAN CHASE BANK, N.A.

as Administrative Agent for the Lenders Thereunder

 

 

 

 

          FIRST INCREMENTAL FACILITY AMENDMENT dated as of December 13, 2006 (this “First
Incremental Facility Amendment”), to the Amended and Restated Credit Agreement, dated as of
August 19, 2004, as amended (the “Credit Agreement”), among CHS/Community Health Systems,
Inc. (the “Borrower”), Community Health Systems, Inc. (“Parent”), the several banks
and other financial institutions from time to time parties thereto (the “Lenders”), Bank of
America, N.A., as documentation agent, Wachovia Bank, National Association, as syndication agent,
and JPMorgan Chase Bank, N.A., as administrative agent for the Lenders thereunder (in such
capacity, the “Administrative Agent”).

WITNESSETH:

          WHEREAS, the Borrower, Parent, the Administrative Agent and the Lenders are parties to the
Credit Agreement;

          WHEREAS, subsection 2.4 of the Credit Agreement provides that the Borrower and the
Administrative Agent may amend the Credit Agreement to provide for one or more additional tranches
of term loans with the consent of the Lenders (which may be new Lenders) providing such additional
term loans, subject to the limitations and restrictions therein;

          WHEREAS, the Borrower desires to add an additional tranche of term loans to the Credit
Agreement in an aggregate amount of up to $400,000,000, and the Administrative Agent is willing to
enter into this First Incremental Facility Amendment to provide for such additional tranche of term
loans; and

          WHEREAS, the Lenders (including the new Lenders) parties to this First Incremental Facility
Amendment are willing to commit to make, and to make, term loans under the additional tranche
desired by the Borrower in the respective principal amounts set forth with their signatures to this
First Incremental Facility Amendment;

          NOW, THEREFORE, for valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, and in consideration of the premises contained herein, the parties hereto agree as
follows:

          1. Definitions. Unless otherwise defined herein, terms defined in the Credit
Agreement shall have their defined meanings when used herein.

          2. Amendment to Subsection 1.1. Subsection 1.1 of the Credit Agreement is hereby
amended by inserting the following definition in appropriate alphabetical order:

          “Incremental Term Loan Maturity Date”: February 29, 2012.

          3. Additional Term Loan Commitments. Subject to the terms and conditions of the
Credit Agreement and this First Incremental Facility Amendment, each

 

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Lender (including each new Lender) party hereto severally agrees to make a term loan (a
“First Incremental Facility Term Loan”) to the Borrower in a single drawing on the First
Incremental Facility Amendment Effective Date (as defined below) in the amount set forth with its
signature to this First Incremental Facility Amendment (the “First Incremental Facility Term
Commitment” of such Lender). The First Incremental Facility Term Loans shall have the terms
set forth below and, except as set forth below, shall otherwise be treated as “Term Loans” under
the Credit Agreement (including for purposes of sharing on a ratable basis in prepayments of Term
Loans):

     (a) Applicable Margin. The Applicable Margin for each First Incremental
Facility Term Loan for each day shall be the rate per annum for the relevant Type of such
First Incremental Facility Term Loan set forth below:

	 	 	 
	ABR Loan	 	Eurodollar Loan
	 
	 	 
	0.75%

	 	1.75%

     (b) Repayment. The First Incremental Facility Term Loan of each Lender shall
mature in 22 consecutive installments, each of which shall be in an amount equal to the
percentage that such Lender’s First Incremental Term Commitment bears of the First
Incremental Term Commitments of all the Lenders (such percentage, the “First
Incremental Term Commitment Percentage” of such Lender) multiplied by the amount set
forth below opposite the date of such installment:

	 	 	 	 	 
	Installment	 	Principal Amount
	December 31, 2006
	 	$	1,000,000	 
	March 31, 2007
	 	$	1,000,000	 
	June 30, 2007
	 	$	1,000,000	 
	September 30, 2007
	 	$	1,000,000	 
	December 31, 2007
	 	$	1,000,000	 
	March 31, 2008
	 	$	1,000,000	 
	June 30, 2008
	 	$	1,000,000	 
	September 30, 2008
	 	$	1,000,000	 
	December 31, 2008
	 	$	1,000,000	 
	March 31, 2009
	 	$	1,000,000	 
	June 30, 2009
	 	$	1,000,000	 
	September 30, 2009
	 	$	1,000,000	 
	December 31, 2009
	 	$	1,000,000	 
	March 31, 2010
	 	$	1,000,000	 
	June 30, 2010
	 	$	1,000,000	 
	September 30, 2010
	 	$	1,000,000	 
	December 31, 2010
	 	$	1,000,000	 
	March 31, 2011
	 	$	1,000,000	 
	June 30, 2011
	 	$	1,000,000	 
	September 30, 2011
	 	$	1,000,000	 
	December 31, 2011
	 	$	1,000,000	 
	Incremental Term Loan Maturity Date
	 	$	379,000,000	 

 

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     (c) Amendment to Subsection 8.1. Subsection 8.1 of the Credit Agreement with
respect to the First Incremental Term Loan is hereby deleted in its entirety and
substituting in lieu thereof the following:

          (a) Consolidated Total Indebtedness to Annualized Consolidated EBITDA. Permit
for any period of four consecutive fiscal quarters ending during any fiscal year listed
below, commencing with the fiscal quarter ending December 31, 2006, the ratio of
Consolidated Total Indebtedness as of the end of such period to Annualized Consolidated
EBITDA for such period to be more than the ratio set forth opposite the fiscal year below:

	 	 	 	 	 
	Fiscal Year Ending	 	Ratio
	 
	 	 	 	 
	December 31, 2006
	 	 	4.25 to 1	 
	December 31, 2007
	 	 	4.25 to 1	 
	December 31, 2008
	 	 	4.00 to 1	 
	December 31, 2009
	 	 	4.00 to 1	 
	December 31, 2010
	 	 	3.75 to 1	 
	December 31, 2011
	 	 	3.75 to 1	 
	Thereafter
	 	 	3.75 to 1	 

          (b) Interest Coverage Ratio. Permit for any period of four consecutive fiscal
quarters ending during any fiscal year listed below, commencing with the fiscal quarter
ending December 31, 2006, the ratio of (i) Annualized Consolidated EBITDA for such period
to (ii) Consolidated Interest Expense for such period to be less than the ratio set forth
opposite the fiscal year below:

	 	 	 	 	 
	Fiscal Year Ending	 	Ratio
	 
	 	 	 	 
	December 31, 2006
	 	 	3.25 to 1	 
	December 31, 2007
	 	 	3.25 to 1	 
	December 31, 2008
	 	 	3.25 to 1	 
	December 31, 2009
	 	 	3.25 to 1	 
	December 31, 2010
	 	 	3.25 to 1	 
	December 31, 2011
	 	 	3.25 to 1	 
	Thereafter
	 	 	3.25 to 1	 

 

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          (c) Fixed Charge Coverage Ratio. Permit for any period of four consecutive
fiscal quarters ending during any fiscal year listed below, commencing with the fiscal
quarter ending December 31, 2006, the ratio of (i) Annualized Consolidated EBITDA for such
period minus Principal Debt Payments minus Capital Expenditures (other than Replacement
Capital Expenditures) made during such period to (ii) Consolidated Interest Expense (such
ratio for any such period, the “Fixed Charge Coverage Ratio”) to be less than the
ratio set forth opposite the fiscal year below:

	 	 	 	 	 
	Fiscal Year Ending	 	Ratio
	 
	 	 	 	 
	December 31, 2006
	 	 	1.50 to 1	 
	December 31, 2007
	 	 	1.50 to 1	 
	December 31, 2008
	 	 	1.50 to 1	 
	December 31, 2009
	 	 	1.50 to 1	 
	December 31, 2010
	 	 	1.50 to 1	 
	December 31, 2011
	 	 	1.50 to 1	 
	Thereafter
	 	 	1.50 to 1	 

     (d) Amendment to Subsection 8.8. Subsection 8.8 of the Credit Agreement with
respect to the First Incremental Term Loan is hereby deleted in its entirety and
substituting in lieu thereof the following:

          “8.8 Capital Expenditures. Make or commit to make Capital Expenditures (other
than Replacement Capital Expenditures) in any fiscal year exceeding (i) $325,000,000 for
fiscal year 2006 of the Borrower, (ii) $350,000,000 for fiscal year 2007 of the Borrower,
(iii) $375,000,000 for fiscal year 2008 of the Borrower, (iv) $425,000,000 for fiscal year
2009 of the Borrower, (v) $475,000,000 for fiscal year 2010 of the Borrower, (vi)
$525,000,000 for fiscal year 2011 of the Borrower, and (vii) $575,000,000 for fiscal year
2012 of the Borrower, plus, in each case an amount equal to (A) 5% of the excess, if any,
of (i) net revenues generated during the immediately preceding fiscal year from Permitted
Acquisitions since January 1, 2002 (with such net revenues to be annualized for any
Permitted Acquisition made during such immediately preceding fiscal year based upon the
period during such fiscal year commencing on the date of such Permitted Acquisition) over
(ii) $120,000,000 times the number of completed fiscal years since January 1, 2002 and (B)
up to 50% of Capital Expenditures permitted to be made in a fiscal year pursuant to the
terms of this subsection (including this sentence) not expended in the fiscal year for
which they are permitted (which amount may be carried over for expenditure in following
fiscal years). For the avoidance of doubt, the Company and its Subsidiaries may incur
Replacement Capital Expenditures without being subject to the limitations contained in this
subsection 8.8.”

 

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     (e) Use of Proceeds. The proceeds of the First Incremental Facility Term
Loans shall be used for general corporate purposes of the Borrower and its Subsidiaries,
including repayment of Revolving Credit Loans.

For the avoidance of doubt, the definitions of the terms “Commitment Percentage” and “Commitments”
in subsection 1.1 of the Credit Agreement shall be deemed modified to refer as appropriate to the
First Incremental Facility Term Percentage of each Lender and the First Incremental Facility
Commitments, respectively.

          4. Conditions. This First Incremental Facility Amendment shall become effective, and
the agreement of each Lender to make a First Incremental Facility Term Loan in the amount of its
First Incremental Facility Term Commitment is conditioned, upon the satisfaction of the following
conditions precedent (the effective date of this Amendment, the “First Incremental Facility
Amendment Effective Date”):

     (a) Amendment. The Administrative Agent shall have received counterparts of
this First Incremental Facility Amendment executed by the Borrower and the Administrative
Agent and consented to by each Lender set forth on the signature page hereof as of the date
hereof.

     (b) Reaffirmation of Guarantees and Pledges. The Administrative Agent shall
have received a reaffirmation of the Parent Guarantee, the Parent Pledge Agreement, the
Subsidiary Guarantees and the Subsidiary Pledge Agreement with reference to the Credit
Agreement as amended by this First Incremental Facility Amendment (the
“Reaffirmation”), executed and delivered by an authorized officer of Parent, the
Borrower and each other Credit Party signatory to the Parent Guarantee, the Parent Pledge
Agreement, the Subsidiary Guarantees and/or the Subsidiary Pledge Agreement, substantially
in the form attached to the Credit Agreement as Exhibit J, mutatis
mutandis, which Reaffirmation shall include a confirmation that such guarantees
shall rank senior to any obligations of such Credit Parties in respect of or related to the
High Yield Subordinated Notes.

     (c) Representations and Warranties. Each of the representations and
warranties made by the Borrower in or pursuant to this First Incremental Facility Amendment
shall be true and correct in all material respects on and as of the First Incremental
Facility Amendment Effective Date.

     (d) Administrative Agent. The Administrative Agent shall have received (i)
opinions and closing certificates similar to those delivered under the Credit Agreement on
the Closing Date (with such changes thereto as the Administrative Agent may agree) and (ii)
reasonable evidence of the creation and perfection (including by the filing of UCC
financing statements) of all of the security interests granted under the Pledge Agreements
or required to be granted thereunder pursuant to the Credit Agreement.

          5. Representations And Warranties. In order to induce the Administrative Agent and
the Lenders to enter into this First Incremental Facility

 

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Amendment, the Borrower hereby represents and warrants to the Administrative Agent and the
Lenders the following:

     (a) Representations in the Credit Agreement. The representations and
warranties contained in the Credit Documents are true and correct in all material respects
on and as of the First Incremental Facility Amendment Effective Date (after giving effect
hereto) as if made on and as of the First Incremental Facility Amendment Effective Date
(except where 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 as of such earlier date); provided that all references to the “Credit
Agreement” in any Credit Document shall be and are deemed to refer to this First
Incremental Facility Amendment and the Credit Agreement as amended hereby;

     (b) Subsidiaries. The Subsidiaries of the Borrower listed on Schedule 5.11(c)
constitute all of the Domestic Subsidiaries of the Borrower, and the Subsidiaries listed on
Schedule 5.11(d) constitute all of the Foreign Subsidiaries of the Borrower as of the First
Incremental Facility Amendment Effective Date. Each Domestic Subsidiary that, as of the
First Incremental Facility Amendment Effective Date, is a Non-Significant Subsidiary, a
Syndication Subsidiary or a Permitted Joint Venture Subsidiary is indicated as such (or in
the case of a Permitted Joint Venture Subsidiary, is indicated as either a “Restricted
Joint Venture Subsidiary” or a “Non-Restricted Joint Venture Subsidiary”) on Schedule
5.11(c).

          6. Miscellaneous. (a) Counterparts and Consent to Third Amendment. This
First Incremental Facility Amendment may be executed by one or more of the parties to this First
Incremental Facility Amendment on any number of separate counterparts (including by telecopy), and
all of said counterparts taken together shall be deemed to constitute one and the same instrument.
A set of the copies of this First Incremental Facility Amendment signed by the parties hereto shall
be delivered to the Borrower and the Administrative Agent. Each new Lender that is a party hereto
acknowledges and agrees that from and after the First Incremental Facility Amendment Effective Date
such new Lender shall be a party to and be bound by the provisions of, and shall make the
representations provided for by each Lender in, the Credit Agreement and have the rights and
obligations of a Lender thereunder. Each new Lender shall provide an administrative questionnaire
and tax forms as required by the Credit Agreement or reasonably requested by the Administrative
Agent. Each Lender party hereto hereby consents to the execution and delivery of the Third
Amendment, dated as of December 13, 2006, to the Credit Agreement to the same extent as if it were
a direct signatory thereto.

          (b) Fees and Expenses. The Borrower agrees to pay or reimburse the Administrative
Agent for all of its reasonable out-of-pocket costs and expenses in connection with the
negotiation, preparation, execution and delivery of this First Incremental Facility Amendment,
including without limitation the reasonable fees and expenses of Simpson Thacher & Bartlett LLP.

 

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          (c) Continuing Effect, No Other Amendments or Waivers. Except as expressly set forth
in this First Incremental Facility Amendment, all of the terms and provisions of the Credit
Agreement are and shall remain in full force and effect and the Borrower shall continue to be bound
by all of such terms and provisions. The amendments provided for herein are limited to the
specific subsections of the Credit Agreement specified herein and shall not constitute an amendment
or waiver of, or an indication of the Administrative Agent’s or the Lenders’ willingness to amend
or waive, any other provisions of the Credit Agreement or the same subsections for any other date
or purpose.

          (d) GOVERNING LAW. THIS FIRST INCREMENTAL FACILITY AMENDMENT AND THE RIGHTS AND
OBLIGATIONS OF THE PARTIES UNDER THIS FIRST INCREMENTAL FACILITY AMENDMENT SHALL BE GOVERNED BY,
AND CONSTRUED AND INTERPRETED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK.

 

 

          IN WITNESS WHEREOF, the parties have caused this First Incremental Facility Amendment to be
executed and delivered by their respective duly authorized officers as of the day and year first
above written.

	 	 	 	 	 
	 	CHS/COMMUNITY HEALTH SYSTEMS, INC.

 	 
	 	By:  	/s/
 	 
	 	 	Title: Executive Vice President & CFO 	 
	 	 	 	 
	 
	 	COMMUNITY HEALTH SYSTEMS, INC.

 	 
	 	By:  	/s/
 	 
	 	 	Title: Executive Vice President & CFO 	 
	 	 	 	 
	 	[Lender Signature Pages Omitted]

	 
	 
	 	JPMORGAN CHASE BANK, N.A.

individually and as Administrative Agent
 	 
	 	 	 
	 
	 	BANK OF AMERICA, N.A.,

individually and as Documentation Agent

 	 
	 	 	 ,
	 	as a LenderEx-10.2 Third Amendment

 

Exhibit 10.2

EXECUTION COPY

THIRD AMENDMENT

          THIRD AMENDMENT, dated as of December 13, 2006 (this “Third Amendment”), representing
an amendment to the Amended and Restated Credit Agreement, dated as of August 19, 2004 (as amended
by the First Amendment and Waiver dated as of December 16, 2004 and the Second Amendment dated as
of July 8, 2005, the “Credit Agreement”), among CHS/COMMUNITY HEALTH SYSTEMS, INC., a
Delaware corporation (the “Borrower” or “CHS”), COMMUNITY HEALTH SYSTEMS, INC., a
Delaware corporation (“Parent”), the several lenders from time to time parties thereto (the
“Lenders”), WACHOVIA BANK, NATIONAL ASSOCIATION, as syndication agent (in such capacity,
the “Syndication Agent”), BANK OF AMERICA, N.A., as documentation agent (in such capacity,
the “Documentation Agent”) and JPMORGAN CHASE BANK, N.A. (f/k/a JPMorgan Chase Bank), as
administrative agent for the Lenders (in such capacity, the “Administrative Agent”).

WITNESSETH:

          WHEREAS, the Borrower, Parent, the Syndication Agent, the Documentation Agent, the
Administrative Agent and the Lenders are parties to the Credit Agreement;

          WHEREAS, the Borrower and Parent have requested that the Administrative Agent and the Required
Lenders agree to amend certain provisions of the Credit Agreement;

          WHEREAS, the Administrative Agent and the Lenders parties hereto are willing to agree to the
requested amendments, but only upon the terms and conditions set forth herein; and

          WHEREAS, it is expected that substantially contemporaneous with this Third Amendment becoming
effective the Credit Agreement will be amended, as contemplated in subsection 2.4 of the Credit
Agreement, to provide for an additional tranche of term loans, in the aggregate principal amount of
$400,000,000, with such amendment to be executed and delivered by the Borrower, the Administrative
Agent and the Lenders (including new Lenders) committing to make such term loans;

          NOW, THEREFORE, for valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, and in consideration of the premises contained herein, the parties hereto agree as
follows:

          1. Defined Terms. Unless otherwise defined herein, capitalized terms which are
defined in the Credit Agreement are used herein as defined therein.

          2. Amendment to Definition of “Asset Sale Prepayment Trigger” in Subsection 1.1. The
definition of “Asset Sale Prepayment Trigger” in subsection 1.1 of the Credit Agreement is hereby
amended by inserting after the amount “$75,000,000” in the fifth line thereof the parenthetical
phrase “(or, in the case of an Asset Sale after the effective date of

 

 

2

the Third Amendment to this Agreement, the aggregate cash Net Proceeds received in connection
with all such Asset Sales on and after the effective date of the Third Amendment to this Agreement
exceed $75,000,000)”.

          3. Amendment to the Definition of “Contingent Obligation” in Subsection 1.1. The
definition of “Contingent Obligation” in subsection 1.1 of the Credit Agreement is hereby amended
by inserting after the word “dividends” in the second line thereof the parenthetical phrase “(other
than stock dividends of the Parent)”.

          4. Amendment to the Definition of “Replacement Capital Expenditures” in Subsection
1.1. The definition of “Replacement Capital Expenditures” in subsection 1.1 of the Credit
Agreement is hereby amended by inserting after the word “of” in the second line thereto the
parenthetical numeral “(i)” and by inserting after the word “thereafter” in the fifth line thereto
the phrase “or (ii) the Hospital in Barstow, California (owned, leased or operated by the Borrower
or any of its Subsidiaries or in which the Borrower or any of its Subsidiaries owns an equity
interest as of the effective date of the Third Amendment) and the Hospital in Lindenhurst,
Illinois”.

          5. Amendment to Subsection 2.4. Subsection 2.4 of the Credit Agreement is hereby
amended by replacing the phrase “Closing Date” with the phrase “First Incremental Amendment
Effective Date”.

          6. Amendment to Subsection 4.6(d)(i). Subsection 4.6(d)(i) of the Credit Agreement is
hereby deleted in its entirety and inserting in lieu thereof the following:

          “(i) Amounts to be applied in connection with prepayments made pursuant to paragraph (a) or
(b) above other than from proceeds from issuance of Convertible Subordinated Debt or High Yield
Subordinated Debt shall be applied, first, to the ratable prepayment of the Term Loans (in
the manner set forth in clause (ii) of this paragraph (d)) and second, to the prepayment of
Revolving Credit Loans then outstanding (without any accompanying reduction of the Revolving Credit
Commitments). Amounts to be applied in connection with prepayments made pursuant to paragraph (a)
above in connection with proceeds from issuance of Convertible Subordinated Debt or High Yield
Subordinated Debt shall be applied to the ratable prepayment of the Term Loans (in the manner set
forth in clause (ii) of this paragraph (d)) or to the prepayment of Revolving Credit Loans then
outstanding (without any accompanying reduction of the Revolving Credit Commitments) in an order to
be determined as specified by the Borrower in a notice to the Administrative Agent. Amounts to be
applied in connection with prepayments made pursuant to paragraph (c) above shall be applied,
first, to the ratable prepayment of the Term Loan installments scheduled to be paid during
the next twelve months after the date of such prepayment, in the order that such installments are
scheduled to be paid; second, to the prepayment of Revolving Credit Loans then outstanding
(without any accompanying reduction of the Revolving Credit Commitments); and third, to the
prepayment of the remaining installments of the Term Loans on a pro rata basis.”

          7. Amendment to Subsection 8.2(h). Subsection 8.2(h) is hereby amended by inserting
at the end of clause (iii)(B) thereof, immediately before the word “and”, the parenthetical phrase
"(excluding any such payment in the form of a cash net settlement payment

 

3

in connection with the exercise of the conversion right under any Convertible Subordinated
Debt, provided that the aggregate principal amount of such payments shall at no time exceed
$350,000,000).”

          8. Amendment to Subsection 8.7. Subsection 8.7 is hereby amended by (i) deleting the
“and” at the end of paragraph (n) thereof, (ii) deleting the period and inserting in lieu thereof
”; and” at the end of paragraph (o) thereof; and inserting after paragraph (n) thereof the
following:

          “(p) the Borrower and its Subsidiaries may make Investments in securities convertible into,
exchangeable for or exercisable into the shares of capital stock or other equity interests of the
Parent.”

          9. Amendment to Subsection 8.9. Subsection 8.9 of the Credit Agreement is hereby
amended by:

          (a) inserting after the phrase “any class of stock” in the fourth line thereof the
parenthetical phrase “(other than in exchange for or out of the net cash proceeds to Parent from
the substantially concurrent issue or sale of other shares of capital stock or other equity
interests of Parent, or warrants, options or rights to purchase or acquire any shares of capital
stock or other equity interest of Parent)”.

          (b) deleting paragraph (c) thereof in its entirety and inserting in lieu thereof:

          “(c) so long as no Default or Event of Default has occurred or would occur after giving effect
to such declaration or payment, the Borrower may, from time to time, declare and pay cash dividends
or make other distributions to Parent on the common stock of the Borrower (including, without
limitation, payments made for the purchase, redemption, retirement or other acquisition of any
shares of any class of stock (including, without limitation, the outstanding capital stock of
Parent); provided that the proceeds of such dividends shall be used within 30 days of the
receipt of such dividends by Parent to repurchase, or pay dividends on, Parent stock and,
provided further, that the amount of such cash dividends and other distributions or
payments paid or made from and after the effective date of the Third Amendment does not exceed in
the aggregate $300,000,000 plus (to the extent not previously used) the net cash proceeds received
by the Parent in respect of any Employee Issuances after the Closing Date; and”.

          10. Amendment to Subsection 8.11. Subsection 8.11 of the Credit Agreement is hereby
amended by inserting “(i)” after the word “transactions” in the third line thereof and inserting
after the word “inventory” in the last line thereof “or (ii) relating to or on the shares of
capital stock or other equity interests of the Parent”.

          11. Amendment to Subsection 8.15. Subsection 8.15 of the Credit Agreement is hereby
amended by replacing the term “24 months” with the term “30 months” and by replacing the amount
“$50,000,000” with the amount “$75,000,000”.

          12. Amendment to Section 11. Section 11 of the Credit Agreement is hereby amended by
inserting the following new Subsection 11.14 in its entirety after Subsection 11.13:

 

4

          “11.14 Confidentiality. Each of the Administrative Agent and each Lender agrees to
keep confidential all non-public information provided to it by any Credit Party, the Administrative
Agent or any Lender pursuant to or in connection with this Agreement that is designated by the
provider thereof as confidential; provided that nothing herein shall prevent the Administrative
Agent or any Lender from disclosing any such information (a) to the Administrative Agent, any other
Lender or any affiliate thereof, (b) subject to an agreement to comply with the provisions of this
Section, to any actual or prospective Assignee, (c) to its employees, directors, agents, attorneys,
accountants and other professional advisors or those of any of its affiliates, (d) upon the request
or demand of any Governmental Authority, (e) in response to any order of any court or other
Governmental Authority or as may otherwise be required pursuant to any Requirement of Law, (f) if
requested or required to do so in connection with any litigation or similar proceeding, (g) that
has been publicly disclosed, (h) to the National Association of Insurance Commissioners or any
similar organization or any nationally recognized rating agency that requires access to information
about a Lender’s investment portfolio in connection with ratings issued with respect to such
Lender, or (i) in connection with the exercise of any remedy hereunder or under any other Credit
Document.

          “Each Lender acknowledges that information furnished to it pursuant to this Agreement or the
other Credit Documents may include material non-public information concerning the Borrower and its
Affiliates and their related parties or their respective securities, and confirms that it has
developed compliance procedures regarding the use of material non-public information and that it
will handle such material non-public information in accordance with those procedures and applicable
law, including Federal and state securities laws.

          “All information, including requests for waivers and amendments, furnished by the Borrower or
the Administrative Agent pursuant to, or in the course of administering, this Agreement or the
other Credit Documents will be syndicate-level information, which may contain material non-public
information about the Borrower and its Affiliates and their related parties or their respective
securities. Accordingly, each Lender represents to the Borrower and the Administrative Agent that
it has identified in its administrative questionnaire a credit contact who may receive information
that may contain material non-public information in accordance with its compliance procedures and
applicable law, including Federal and state securities laws.”

          13. Conditions to Effectiveness of this Third Amendment. This Third Amendment
shall become effective upon receipt by the Administrative Agent of (i) counterparts of this Third
Amendment duly executed by each of the Borrower, Parent and the Administrative Agent and consented
to by the Required Lenders (such date, the “Third Amendment Effective Date”) and (ii) a fee
for each Lender that has executed and delivered to the Administrative Agent an executed signature
page of this Third Amendment by 5:00 p.m., New York time, on December 6, 2006 of 0.05% of the sum
of the outstanding principal amount of the Term Loan and the amount of the Revolving Credit
Commitment of such Lender.

          14. Representations and Warranties. On and as of the date hereof and after giving
effect to this Third Amendment, the Borrower hereby confirms, reaffirms and restates the
representations and warranties set forth in Section 5 of the Credit Agreement mutatis
mutandis, except to the extent that such representations and warranties expressly relate to
a specific earlier

 

5

date in which case the Borrower hereby confirms, reaffirms and restates such representations
and warranties as of such earlier date, provided that the references to the Credit
Agreement in such representations and warranties shall be deemed to refer to the Credit Agreement
as amended pursuant to this Amendment.

          15. Continuing Effect; No Other Amendments. Except as expressly set forth in this
Third Amendment, all of the terms and provisions of the Credit Agreement are and shall remain in
full force and effect and the Borrower shall continue to be bound by all of such terms and
provisions. The amendments provided for herein are limited to the specific subsections of the
Credit Agreement specified herein and shall not constitute an amendment of, or an indication of the
Administrative Agent’s or the Lenders’ willingness to amend or waive, any other provisions of the
Credit Agreement or the same subsections for any other date or purpose.

          16. Expenses. The Borrower agrees to pay and reimburse the Administrative Agent for
all its reasonable costs and expenses incurred in connection with the preparation and delivery of
this Third Amendment, including, without limitation, the reasonable fees and disbursements of
counsel to the Administrative Agent.

          17. Counterparts. This Third Amendment may be executed by one or more of the parties
to this Third Amendment on any number of separate counterparts (including by telecopy), and all of
said counterparts taken together shall be deemed to constitute one and the same instrument. A set
of the copies of this Third Amendment signed by the parties hereto shall be delivered to the
Borrower and the Administrative Agent. The execution and delivery of this Third Amendment by any
Lender shall be binding upon each of its successors and assigns (including transferees of its
Commitments and Loans in whole or in part prior to effectiveness hereof) and binding in respect of
all of its Commitments and Loans, including any acquired subsequent to its execution and delivery
hereof and prior to the effectiveness hereof.

          18. GOVERNING LAW. THIS THIRD AMENDMENT AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES
UNDER THIS THIRD AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED AND INTERPRETED IN ACCORDANCE WITH,
THE LAW OF THE STATE OF NEW YORK.

[Signature Pages Follow]

 

 

     IN WITNESS WHEREOF, the parties hereto have caused this Third Amendment to be executed and
delivered by their respective duly authorized officers as of the date first above written.

	 	 	 	 	 
	 	CHS/COMMUNITY HEALTH SYSTEMS, INC.

 	 
	 	By:  	/s/
 	 
	 	 	Name:  	W. Larry Cash 	 
	 	 	Title:  	Executive Vice President & CFO 	 
	 
	 	COMMUNITY HEALTH SYSTEMS, INC.

 	 
	 	By:  	/s/
 	 
	 	 	Name:  	W. Larry Cash 	 
	 	 	Title:  	Executive Vice President & CFO 	 
	 
	 	[Lender Signature Pages Omitted]

JPMORGAN CHASE BANK, N.A., as 

Administrative Agent and as a Lender

[                                                                                                   ],

as a Lender

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