Document:

exv4w23

Exhibit 4.23

NINTH SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of October 25, 2010,
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; and

     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.

[Signature page follows]

 

 

IN WITNESS WHEREOF, the parties have caused this Supplemental
Indenture to be duly executed as of this 25th day of October,
2010.

	 	 	 	 	 
	 	CHS/Community Health Systems, Inc.

a Delaware corporation

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive vice President, Secretary & General Counsel	 
	 
	 	Bluefield Holdings, LLC,

a Delaware limited liability company

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive Vice President and Secretary 	 
	 
	 	Bluefield Hospital Company, LLC,

a Delaware limited liability company

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive Vice President and Secretary 	 
	 
	 	Warren Ohio Hospital Company, LLC,

a Delaware limited liability company

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive Vice President and Secretary 	 
	 
	 	Warren Ohio Rehab Hospital Company, LLC,

a Delaware limited liability company

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive Vice President and Secretary 	 

 

 

	 	 	 	 	 

	 	 	 	 	 
	 	Youngstown Ohio Hospital Company, LLC,

a Delaware limited liability company

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive Vice President and Secretary 	 
	 
	 	U.S. Bank National Association,

as Trustee

 	 
	 	By:  	/s/ Wally Jones
 	 
	 	 	Wally Jones 	 
	 	 	Vice Presidentexv4w24

	 	 	 	 	 

Exhibit 4.24

     RELEASE OF CERTAIN GUARANTORS (this “Release”), dated as of December 31, 2010, 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, the Sixth Supplemental Indenture dated
March 30, 2008, the Seventh Supplemental Indenture dated June 30, 2009, the Eighth Supplemental
Indenture, dated March 30, 2010, and the Ninth Supplemental Indenture, dated October 25, 2010 (the
"Indenture”), providing for the issuance of the 87/8% Senior Notes due 2015
(the “Securities”);

     WHEREAS, (i) pursuant to Section 9.09(d) of the Amended and Restated Credit Agreement, dated
as of July 25, 2007, as amended and restated dated November 5, 2010 (the ‘Credit Agreement”), 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 AG, as Administrative Agent and as Collateral
Agent, 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; 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 Released 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
Released Subsidiary Guarantors, the Trustee and every Holder of Securities heretofore or hereafter
authenticated and the Issuer, each of the Released 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.

[Signature page follows]

 

 

IN WITNESS WHEREOF, the parties have caused this Release to be
duly executed as of this 31st day of December, 2010.

	 	 	 	 	 
	 	CHS/Community Health Systems, Inc.,

a Delaware corporation

 	 
	 	By:  	/s/ Rachel A. Seifert
 	 
	 	 	Rachel A. Seifert 	 
	 	 	Executive Vice President, Secretary &
General Counsel 	 
	 
	 	Released Subsidiary Guarantors:

Arizona DH, LLC

BH Trans Company, LLC

Forrest City Clinic Company, LLC

QHG of Barberton, Inc.

Russell County Medical Center, Inc.

Triad-Denton Hospital GP, LLC

Triad-Denton Hospital, L.P.

 	 
	 	By:  	/s/ James W. Doucette
 	 
	 	 	Name:  	James W. Doucette 	 
	 	 	Title:  	Vice President and Treasurer 	 
	 

	 	 	 	 
	U.S. Bank National Association,

as Trustee

 	 
	By:  	/s/ Wally Jones
 	 
	 	Wally Jones 	 
	 	Vice President

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