Document:

Copyright Security Agreement

 Exhibit 4.3 

COPYRIGHT SECURITY AGREEMENT dated as of August 17, 2012 (this
“Agreement”), among COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation, CHS WASHINGTON HOLDINGS, LLC, a Delaware limited liability company, NORTHWEST HOSPITAL, LLC, a Delaware limited liability company and QUORUM HEALTH
RESOURCES, LLC, a Delaware limited liability company (each a “Grantor”, and collectively, the “Grantors”) and CREDIT SUISSE AG, as collateral agent (in such capacity, the “Collateral
Agent”). 
 Reference is made to (a) the Amended and Restated Guarantee and Collateral
Agreement dated as of July 25, 2007, as amended and restated as of November 5, 2010 (as further amended, restated, supplemented or otherwise modified from time to time, the “Security Agreement”), among CHS/Community
Health Systems, Inc., a Delaware corporation (the “Company”), Community Health Systems, Inc., a Delaware corporation (the “Parent”), the Subsidiaries of the Company party thereto and the Collateral
Agent, (b) the Underwriting Agreement dated as of August 8, 2012 (as amended, restated, supplemented or otherwise modified from time to time, the “Underwriting Agreement”) among the Company, the Guarantors party
thereto and Credit Suisse Securities (USA) LLC, as representative of the several underwriters specified therein (the “Representative”), (c) the Indenture dated as of August 17, 2012 (as amended, restated,
supplemented or otherwise modified from time to time, the “Indenture”), among the Company, the Guarantors party thereto, the Collateral Agent and Regions Bank, as trustee (the “Trustee”), and
(d) that certain designation certificate delivered to the Collateral Agent pursuant to Section 7.09(c) of the Security Agreement in order to secure the Notes and related obligations on a pari passu basis with the other obligations secured
under the Security Agreement (subject to certain exceptions in the case of pledged stock). The Trustee and underwriters referred to above have agreed to purchase $1,600,000,000 aggregate principal amount of 5.125% Senior Secured Notes due 2018 of
the Company (the “Notes”) on the terms and subject to the conditions set forth in the Underwriting Agreement. The obligations of the underwriters to purchase the Notes are conditioned upon, among other things, the execution
and delivery of this Agreement. The Grantor will derive substantial benefits from the issuance of the Notes pursuant to the Indenture and is willing to execute and deliver this Agreement in order to induce the underwriters to purchase the Notes.
Accordingly, the parties hereto agree as follows: 
 SECTION 1.  Terms.  Capitalized
terms used in this Agreement and not otherwise defined herein have the meanings specified in the Security Agreement. The rules of construction specified in Section 1.01(b) of the Security Agreement also apply to this Agreement. 

SECTION 2.  Grant of Security Interest.  As security for the payment or performance, as the
case may be, in full of the Obligations, the Grantor, pursuant to the Security Agreement, did and hereby does grant to the Collateral Agent, its successors and assigns, for the benefit of the Secured Parties, a security interest in and lien on, all
right, 

 
title or interest in or to any and all of the following assets and properties now owned or at any time hereafter acquired by the Grantor or in which the Grantor now has or at any time in the
future may acquire any right, title or interest (collectively, the “Copyright Collateral”): 
 (a) all copyright rights in any work subject to the copyright laws of the United States or any other country, whether as author, assignee, transferee or otherwise; and 

(b) all registrations and applications for registration of any such copyright in the United States or any
other country, including registrations, recordings, supplemental registrations and pending applications for registration in the United States Copyright Office (or any successor office), including those listed on Schedule I attached hereto.

 SECTION 3.  Security Agreement.  The security interests granted to the Collateral
Agent herein are granted in furtherance, and not in limitation of, the security interests granted to the Collateral Agent pursuant to the Security Agreement. Each Grantor hereby acknowledges and affirms that the rights and remedies of the Collateral
Agent with respect to the Copyright Collateral are more fully set forth in the Security Agreement, the terms and provisions of which are hereby incorporated herein by reference as if fully set forth herein. In the event of any conflict between the
terms of this Agreement and the Security Agreement, the terms of the Security Agreement shall govern. 

SECTION 4.  Execution in Counterparts.  This Agreement may be executed in any number of
counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement. 
 SECTION 5.  Choice of Law.  This Agreement shall be governed by, and construed in accordance with, the laws of the State of New York. 

[Remainder of this page intentionally left blank] 

 IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as
of the day and year first above written. 
  

			
	 COMMUNITY HEALTH SYSTEMS, INC.,

		
	       by
	 	
		 	   /s/ Rachel A. Seifert

		 	   Name:  Rachel A. Seifert

		 	   Title:    Executive Vice President

  

			
	 CHS WASHINGTON HOLDINGS, LLC,

		
	       by
	 	
		 	   /s/ Rachel A. Seifert

		 	   Name:  Rachel A. Seifert

		 	   Title:    Executive Vice President

  

			
	 NORTHWEST HOSPITAL, LLC,

		
	       by
	 	
		 	   /s/ Rachel A. Seifert

		 	   Name:  Rachel A. Seifert

		 	   Title:    Executive Vice President

  

			
	 QUORUM HEALTH RESOURCES, LLC,

		
	       by
	 	
		 	   /s/ Rachel A. Seifert

		 	   Name:  Rachel A. Seifert

		 	   Title:    Executive Vice President

  
 [Signature
Page to Copyright Security Agreement] 

 
			
	 CREDIT SUISSE AG, CAYMAN ISLANDS BRANCH, as Collateral Agent,

		
	       by
	 	
		 	   /s/ Robert Hetu

		 	   Name:  Robert Hetu

		 	   Title:   Managing Director

		
	       by
	 	
		 	   /s/ Rahul Parmer

		 	 Name:  Rahul Parmer

		 	 Title:    Associate

  
 [Signature
Page to Copyright Security Agreement] 

 Schedule I 

 
 I. Copyrights 

 

							
	Title	 	Grantor	 	Registration No.	 	Author
	Failure Mode and Effects Analysis: Neuraxial Anesthesia and Anticoagulation	 	CHS Washington Holdings, LLC	 	TXu001152745
12/8/2003	 	Empire Health Services
	Quality Profile: Trended Data from 1992 through September
1996	 	CHS Washington Holdings, LLC	 	TXu000779488
 1/7/1997
	 	Empire Health Services
(author Norwood,
Cynthia Ellen and Stark,
Sharilyn Su as a
work for
hire)
	Arthritis: Education and Exercise	 	Northwest Hospital, LLC	 	TX0002267273	 	Northwest Physical
Therapy and
Occupational Therapy
	Northwest Osteoporosis Center Osteoporosis Prevention and
Treatment Guidelines	 	Northwest Hospital, LLC	 	TX0004915182	 	n/a
	Med-Info Health Care Protocols and Manuals	 	Northwest Hospital, LLC	 	TXu000281933	 	n/a
	Vantage Scorecard	 	Community Health Systems, Inc.	 	TX0007142717
10/12/2007	 	Atiba Software, LLC
	Surgipointe V 1.0.4	 	Quorum Health Resources, LLC	 	TX0007381920
7/29/2008	 	Quorum Health
Resources, LLC,
(employer for hire)

 II. Copyright Applications 
 None. 
 III. Copyright Licenses 

None.Trademark Security Agreement

 Exhibit 4.4 

TRADEMARK SECURITY AGREEMENT dated as of August 17, 2012 (this
“Agreement”), among CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation, BLUE ISLAND HOSPITAL COMPANY, LLC, a Delaware limited liability company, CHS WASHINGTON HOLDINGS, LLC, a Delaware limited liability company,
QUORUM HEALTH RESOURCES, LLC, a Delaware limited liability company, TRIAD HEALTHCARE CORPORATION, a Delaware corporation and YOUNGSTOWN OHIO HOSPITAL COMPANY, LLC, a Delaware limited liability company (each a “Grantor”, and
collectively, the “Grantors”) and CREDIT SUISSE AG, as Collateral Agent (the “Collateral Agent”). 
 Reference is made to (a) the Amended and Restated Guarantee and Collateral Agreement dated as of July 25, 2007, as amended and restated as of November 5, 2010 (as further amended, restated,
supplemented or otherwise modified from time to time, the “Security Agreement”), among CHS/Community Health Systems, Inc., a Delaware corporation (the “Company”), Community Health Systems, Inc., a
Delaware corporation (the “Parent”), the Subsidiaries of the Company party thereto and the Collateral Agent, (b) the Underwriting Agreement dated as of August 8, 2012 (as amended, restated, supplemented or otherwise
modified from time to time, the “Underwriting Agreement”) among the Company, the Guarantors party thereto and Credit Suisse Securities (USA) LLC, as representative of the several underwriters specified therein (the
“Representative”), (c) the Indenture dated as of August 17, 2012 (as amended, restated, supplemented or otherwise modified from time to time, the “Indenture”), among the Company, the
Guarantors party thereto, the Collateral Agent and Regions Bank, as trustee (the “Trustee”), and (d) that certain designation certificate delivered to the Collateral Agent pursuant to Section 7.09(c) of the Security
Agreement in order to secure the Notes and related obligations on a pari passu basis with the other obligations secured under the Security Agreement (subject to certain exceptions in the case of pledged stock). The Trustee and underwriters referred
to above have agreed to purchase $1,600,000,000 aggregate principal amount of 5.125% Senior Secured Notes due 2018 of the Company (the “Notes”) on the terms and subject to the conditions set forth in the Underwriting
Agreement. The obligations of the underwriters to purchase the Notes are conditioned upon, among other things, the execution and delivery of this Agreement. The Grantor will derive substantial benefits from the issuance of the Notes pursuant to the
Indenture and is willing to execute and deliver this Agreement in order to induce the underwriters to purchase the Notes. Accordingly, the parties hereto agree as follows: 

SECTION 1.  Terms.  Capitalized terms used in this Agreement and not otherwise defined herein
have the meanings specified in the Security Agreement. The rules of construction specified in Section 1.01(b) of the Security Agreement also apply to this Agreement. 

 SECTION 2.  Grant of Security Interest.  As
security for the payment or performance, as the case may be, in full of the Obligations, each Grantor, pursuant to the Security Agreement, did and hereby does grant to the Collateral Agent, its successors and assigns, for the benefit of the Secured
Parties, a security interest in and lien on, all right, title or interest in or to any and all of the following assets and properties now owned or at any time hereafter acquired by such Grantor or in which such Grantor now has or at any time in the
future may acquire any right, title or interest (collectively, the “Trademark Collateral”): 
 (a) all trademarks, service marks, trade names, corporate names, company names, business names, fictitious business names, trade styles, trade dress, logos, other source or business identifiers, designs
and general intangibles of like nature, now existing or hereafter adopted or acquired, all registrations and recordings thereof, and all registration and recording applications filed in connection therewith, including registrations and applications
for registration (other than intent-to-use applications) in the United States Patent and Trademark Office (or any successor office), and all extensions or renewals thereof, including those listed on Schedule I attached hereto (the
“Trademarks”); 
 (b) all goodwill associated with or symbolized by the
Trademarks; and 
 (c) all assets, rights and interests that uniquely reflect or embody the
Trademarks. 
 Notwithstanding the foregoing, no applications for registration of Trademarks filed in the
United States Patent and Trademark Office on an intent-to-use basis will be included in the Trademark Collateral until such time as a statement of use has been filed and accepted by the United States Patent and Trademark Office with respect to
such Trademark, to the extent that the grant of a security interest in any such Trademark application would adversely affect the validity or enforceability or result in cancelation or voiding of such Trademark application. 

SECTION 3.  Security Agreement.  The security interests granted to the Collateral Agent
herein are granted in furtherance, and not in limitation of, the security interests granted to the Collateral Agent pursuant to the Security Agreement. Each Grantor hereby acknowledges and affirms that the rights and remedies of the Collateral Agent
with respect to the Trademark Collateral are more fully set forth in the Security Agreement, the terms and provisions of which are hereby incorporated herein by reference as if fully set forth herein. In the event of any conflict between the terms
of this Agreement and the Security Agreement, the terms of the Security Agreement shall govern. 
 SECTION
4.  Execution in Counterparts.  This Agreement may be executed in any number of counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute one and the
same agreement. 

 SECTION 5.  Choice of Law.  This Agreement shall
be construed in accordance with and governed by the laws of the State of New York. 
 [Remainder of the page intentionally left
blank] 

 IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as
of the day and year first above written. 
  

									
		 	 CHS/COMMUNITY HEALTH SYSTEMS, INC.,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Rachel A. Seifert

		 		 		 	  Name:	 	Rachel A. Seifert
		 		 		 	  Title:	 	Executive Vice President,
Secretary and General Counsel
		 	  
 BLUE ISLAND HOSPITAL COMPANY,
LLC,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Rachel A. Seifert

		 		 		 	  Name:	 	Rachel A. Seifert
		 		 		 	  Title:	 	Executive Vice President
		 	  
 CHS WASHINGTON HOLDINGS,
LLC,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Rachel A. Seifert

		 		 		 	  Name:	 	Rachel A. Seifert
		 		 		 	  Title:	 	Executive Vice President
		 	  
 QUORUM HEALTH RESOURCES,
LLC,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Rachel A. Seifert

		 		 		 	  Name:	 	Rachel A. Seifert
		 		 		 	  Title:	 	Executive Vice President
		 	  
 TRIAD HEALTHCARE
CORPORATION,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Rachel A. Seifert

		 		 		 	  Name:	 	Rachel A. Seifert
		 		 		 	  Title:	 	Executive Vice President

  
 [Signature
Page to Trademark Security Agreement] 

									
		 	 YOUNGSTOWN OHIO HOSPITAL COMPANY, LLC,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Rachel A. Seifert

		 		 		 	  Name:	 	Rachel A. Seifert
		 		 		 	  Title:	 	Executive Vice President
		 	  
 CREDIT SUISSE AG, CAYMAN ISLANDS
BRANCH, as Collateral Agent,

		 		 	  
 by
	 		 	
		 		 		 	   /s/ Robert Hetu

		 		 		 	  Name:	 	Robert Hetu
		 		 		 	  Title:	 	Managing Director
		 		 	  
 by

		 		 		 	   /s/ Rahul Parmer

		 		 		 	Name:	 	Rahul Parmer
		 		 		 	Title:	 	Associate

  
 [Signature
Page to Trademark Security Agreement] 

 Schedule I 

 
 I. Trademarks 

 

							
	Registered Owner	  	U.S. Mark	 	Reg. Date	 	Reg. No.
	CHS/Community Health Systems, Inc.	  	  
 

  
	 	7/23/1996	 	1988032
	CHS/Community Health Systems, Inc.	  	A TIP-TOP MATERNITY CLUB	 	4/10/2001	 	2442377
	CHS/Community Health Systems, Inc.	  	  
 

  
 Class 035
	 	6/26/2001	 	2463770
	CHS/Community Health Systems, Inc.	  	  
 

  
 Class 041
	 	10/30/2001	 	2501702
	Community Health Systems Professional Services
Corporation	  	  
 COMMUNITY CARES
 Standard Character CL 35

 
	 	6/26/2001	 	2463771
	Community Health Systems Professional Services
Corporation	  	  
 COMMUNITY CARES
 standard character CL 41

 
	 	10/23/2001	 	2499955
	Community Health Systems Professional Services Corporation
(assigned by Community Health Systems, Inc. on 1/13/2011)	  	

	 	9/28/2010	 	3852138

  

							
	Registered Owner	  	Mark	 	Reg. No.	 	Reg. Date
	Triad Healthcare Corporation	  	GATEWAY HOME CARE	 	2750685	 	8/12/03
	Triad Healthcare Corporation	  	GATEWAY MEDICAL CENTER	 	2775950	 	10/21/03
	Triad Healthcare Corporation	  	REDIMED	 	3037881	 	1/3/06
	Triad Healthcare Corporation	  	REHABILTIATION HOSPITAL OF FORT WAYNE	 	3111485	 	7/4/06

							
	Triad Healthcare Corporation	  	KCH REGIONAL REHABILITATION CENTER	 	3119373	 	7/25/06
	Triad Healthcare Corporation	  	LUTHERAN HEART PAVILION	 	3131393	 	8/15/06
	Triad Healthcare Corporation	  	MARY BLACK HEALTH SYSTEM & Design	 	3140091	 	9/5/06
	Triad Healthcare Corporation	  	LUTHERAN CHILDREN’S HOSPITAL	 	3144409	 	9/19/06
	Triad Healthcare Corporation	  	LUTHERAN HOSPITAL OF INDIANA	 	3144410	 	9/19/06
	Triad Healthcare Corporation	  	LUTHERAN HEART CENTER	 	3156408	 	10/17/06
	Triad Healthcare Corporation	  	LUTHERAN SLEEP DISORDERS CENTER	 	3166943	 	10/31/06
	Triad Healthcare Corporation	  	         (Device
Only)
 (Leaf Design)
	 	3167543	 	11/7/06
	Triad Healthcare Corporation	  	ST. JOSEPH BEHAVIORAL HEALTH	 	3179375	 	12/5/06
	Triad Healthcare Corporation	  	LUTHERAN HEALTH NETWORK	 	3185051	 	12/12/06
	Triad Healthcare Corporation	  	BIRTHPLACE AT KOSCIUSKO COMMUNITY HOSPITAL & Design	 	3185595	 	12/19/06
	Triad Healthcare Corporation	  	INNOVATIVE RECOVERIES	 	3191986	 	1/2/07
	Triad Healthcare Corporation	  	NORTHWEST HEALTH SYSTEM	 	3322657	 	10/30/07
	Triad Healthcare Corporation	  	NORTHWEST HEALTH SYSTEM (Design ONLY)	 	3285337	 	8/28/07
	Triad Healthcare Corporation	  	NOTHWEST HEALTH SYSTEM & Design	 	3322661	 	10/30/07
	Triad Healthcare Corporation	  	FAMILY TREE HEALTHCARE	 	3361686	 	1/1/08
	Triad Healthcare Corporation	  	  
 

  
	 	3444757	 	6/10/08
	Triad Healthcare Corporation	  	THOUGHTFUL CARE	 	3437433	 	5/27/08
	Triad Healthcare Corporation	  	LABCARE PLUS	 	3299222	 	9/25/07
	Triad Healthcare Corporation	  	LABCARE PLUS & Design	 	3299223	 	9/25/07

							
	Triad Healthcare Corporation	  	TRINITY MEDICAL CENTER	 	3321061	 	10/23/07
	Triad Healthcare Corporation	  	TRINITY MEDICAL CENTER & Design	 	3321062	 	10/23/07

  

							
	Registered Owner	  	U.S. Mark	 	Reg. Date	 	Reg. No.
	Quorum Health Resources, LLC	  	QHR	 	3/28/2006	 	3074195
	 Quorum Health
Resources, LLC
  
	  	QHR	 	10/10/2006	 	3153336
	Quorum Health Resources, LLC	  	  
  

SURVIVE AND THRIVE
  

 
	 	11/27/2007	 	3345425
	Quorum Health Resources, LLC	  	  
  

  
  
	 	12/1/2009	 	3719929
	Quorum Health Resources, LLC	  	  
 

  
	 	1/12/2010	 	3737811
	Quorum Health Resources, LLC	  	  
 

  
  
	 	2/8/2011	 	3916779
	 Quorum Health
Resources, LLC
  
  
	  	REFORM READY	 	9/27/2011	 	4030986
	 Quorum Health
Resources, LLC
  
  
	  	VANTAGE SCORECARD	 	8/24/2010	 	3836740
	 Quorum Health
Resources, LLC
  
  
	  	 VANTAGE LMS

 
	 	9/13/2011	 	4024411
	Quorum Health Resources, LLC	  	 

  
	 	9/27/2011	 	4032424

							
	Quorum Health Resources, LLC	  	  

  
  
	 	4/16/2012	 	4128270

  

							
	Registered Owner	  	U.S. Mark	 	Reg. Date	 	Reg. No.
	 Youngstown Ohio
Hospital Company, LLC
  
	  	

	 	10/22/1991	 	1662085
	Youngstown Ohio Hospital Company, LLC	  	TMH	 	10/13/1998	 	2194834

  

							
	Registered Owner	  	U.S. Mark	 	Reg. Date	 	Reg. No.
	Blue Island Hospital Company, LLC	  	 METROSOUTH

MEDICAL CENTER
	 	11/17/2009	 	3710989

 II. Trademark Applications 
  

							
	Registered Owner	  	U.S. Mark	 	App. Date	 	App. No.
	CHS Washington Holdings LLC	  	HEALTHCARE NORTHWEST INTEGRATED DELIVERY SYSTEM	 	Filed 2/5/2010	 	S.N. 77/929467
	CHS Washington Holdings LLC	  	ROCKWOOD HEALTH SYSTEM	 	Filed 11/2/2011	 	S.N. 85/462,774
	Quorum Health Resources, LLC	  	 

  
	 	Filed 1/11/2010	 	S.N. 77/909121

 III. Trademark Licenses 
 None.

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