Document:

Exhibit 10.11

 

*                 Confidential
Information identified below was omitted and filed separately with the
Securities and Exchange Commission.

 

Bank of
America, N.A.

WA1-501-17-32

800 Fifth
Avenue, Floor 17

Seattle,
WA  98104

 

March 6, 2009

 

Prospect Medical Group, Inc.

1920 East 17th Street, Suite 200

Santa Ana, CA 92705

 

Re:                               Fifth
Amendment to Letter Agreement Regarding Divestiture Plan and Consent (this “Agreement”)

 

Ladies and Gentlemen:

 

Reference is hereby made to that certain side letter
agreement dated as of May 15, 2008 (as amended, restated, supplemented or
otherwise modified from time to time, the “Divestiture Letter Agreement”)
among Prospect Medical Holdings, Inc. (“Holdings”), Prospect
Medical Group, Inc. (“Prospect” and, collectively with Holdings,
the “Borrowers” and each, individually, a “Borrower”), Bank of
America, N.A., as Administrative Agent (in such capacity, the “First Lien Administrative Agent”), and the lenders party thereto
(collectively, the “First Lien Lenders”).  Reference is also hereby made to that
certain First Lien Credit Agreement dated as of August 8, 2007 (as
amended, restated, supplemented or otherwise modified, the “First Lien
Credit Agreement”), pursuant to which the First Lien Lenders have agreed to
make the Loans and other extensions of credit, all upon the terms and
conditions set forth in the First Lien Credit Agreement.  Terms
not otherwise defined in this Agreement shall have the meaning assigned thereto
in the Divestiture Letter Agreement and the First Lien Credit Agreement, as
applicable.

 

1.             Fifth Amendment to the Divestiture Letter Agreement:

 

Under
the terms of the Divestiture Letter Agreement, the Borrowers agreed to complete
the sale of the ProMed Entities (as defined in the Divestiture Plan) no later
than March 6, 2009 (the “Sale Deadline”).  The Borrowers have requested that the First
Lien Administrative Agent and the First Lien Lenders amend the Divestiture
Letter Agreement to extend the Sale Deadline to March 12, 2009 (the “Extension
Deadline”).  During this additional
extension period, in addition to working on the sale of the ProMed Entities, it
is expected that the parties will negotiate a term sheet setting forth the
salient terms for an amendment to the First Lien Credit Agreement.  The First Lien Administrative Agent and the
First Lien Lenders are willing to grant the Borrowers’ request subject to the
terms and conditions of this Agreement.

 

 

In furtherance thereof, the
First Lien Administrative Agent, the First Lien Lenders and the Borrowers agree
that paragraph (c) of the Divestiture Letter Agreement is hereby amended
and restated in its entirety to read as follows:

 

“              (c)           The Borrowers shall complete the sale
of (i) the Antelope Valley Entities (as defined in the Divesture Plan) no
later than October 1, 2008 and in accordance with the terms set forth in
the Amendment and (ii) the ProMed Entities (as defined in the Divesture
Plan) no later than March 12,
2009 on terms and conditions reasonably
satisfactory to the First Lien Administrative Agent and the Required Lenders.”

 

2.             Consent
by the First Lien Lenders

 

Prospect Hospital Advisory Services, Inc., a
Prospect subsidiary, presently owns a minority interest in Brotman Medical
Center, Inc. (“Brotman”).  In
connection with Brotman’s exit from current bankruptcy proceedings and as part
of a plan of reorganization for Brotman, the Borrowers placed certain amounts
with the U.S. Bankruptcy Court for the Central District of California, Los
Angeles Division, in an attempt to purchase additional equity in Brotman.  Should the Borrowers prevail, the Borrowers’
resulting ownership interest could approach 70% or more.

 

Under the terms of the Credit Agreement, acquiring a
majority interest in Brotman would immediately qualify Brotman as a “Subsidiary”
of the Borrowers and would require joinder of Brotman to the Collateral
Agreement and the Subsidiary Guaranty Agreement within a short period of time
following such acquisition.

 

Accordingly, the Borrowers have requested that, in
the event that any Borrower (or any Subsidiary or Subsidiaries thereof)
acquires a majority interest in Brotman prior to the Extension Deadline, the
First Lien Administrative Agent and the First Lien Lenders exclude Brotman as a
“Subsidiary” under the First Lien Credit Agreement until the expiration of the
Extension Deadline.

 

Subject to the terms and conditions of this
Agreement, the First Lien Administrative Agent and the First Lien Lenders
hereby consent and agree that, should any Borrower (or any Subsidiary or
Subsidiaries thereof), acquire a majority ownership interest in Brotman prior
to the expiration of the Extension Deadline, Brotman shall not be deemed or
considered a “Subsidiary” under the terms of the First Lien Credit Agreement
for any purpose until the expiration of the Extension Deadline.

 

This
Agreement shall become effective as of March 6, 2009, upon (a) execution
and delivery of this Agreement by the Borrowers, the Guarantors, the First Lien
Administrative Agent and the Required Lenders under the First Lien Credit
Agreement, (b) execution and delivery by the Borrowers, the Guarantors,
the Second Lien Administrative Agent and the “Required” Lenders under the
Second Lien Credit Agreement of an agreement substantially similar to this
Agreement, and (c) payment of all professional fees and expenses of the
First Lien Administrative Agent and the First Lien Lenders in connection with
this Agreement and the transactions contemplated hereby and thereby (including
all fees and expenses of Winston & Strawn LLP, in its capacity as
counsel to the First Lien Administrative Agent), pursuant to wire transfer instructions to be
provided by the First Lien Administrative Agent.

 

 

Except
for the amendment and consent contained herein, all of the terms and provisions
of the Divestiture Letter Agreement, the First Lien Credit Agreement and the
other Loan Documents shall remain in full force and effect.  The Borrowers, by their acceptance hereof,
hereby acknowledge and agree that the failure to complete the sale of the
ProMed Entities prior to the date specified in the Divestiture Letter
Agreement, as amended hereby, shall result in an Event of Default in accordance
with Section 8.01(b) of the First Lien Credit Agreement.  In addition, the Borrowers acknowledge and
agree that, should the Borrowers (or any Subsidiary or Subsidiaries thereof) obtain majority
ownership of Brotman and unless otherwise addressed prior to such date in
accordance with the terms of the First Lien Credit Agreement, upon the
expiration of the Extension Deadline, the Borrowers shall be required to comply
with, and Brotman shall be subject to, the terms of the First Lien Credit
Agreement and the other Loan Documents in all respects.

 

Each of the Guarantors,
by their acknowledgment hereto, agree and consent to this Agreement, to all
prior Loan Documents, and to the documents and agreements referred to herein
and therein, and to all future modifications and amendments thereto, and any
termination thereof, and to any and all other present and future documents and
agreements between or among the Borrowers, the First Lien Administrative
Agent.  The Guarantors agree to be bound
by all terms of the Loan Documents applicable to “Loan Parties”.  Nothing contained herein shall in any way
expand, limit or diminish any of the obligations of the Guarantors under their
respective guaranty, each such guaranty being hereby ratified and
affirmed.  The signatures of each of the
Guarantors shall be fully effective even if any other Guarantor fails to sign
this Agreement.

 

[Signature Pages Follow]

 

 

This Agreement shall
constitute a Loan Document and may be executed in one or more counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same
instrument.  Delivery of executed
counterparts of this Agreement by
telecopy or pdf shall be effective as an original.

 

 

Very truly yours,

 

	
   

  	
  BANK OF AMERICA, N.A., in its capacity as First Lien Administrative
  Agent

  
	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Tiffany Shin

  
	
   

  	
  Name:

  	
  Tiffany Shin

  
	
   

  	
  Title:

  	
  Assistant Vice
  President

  

 

[Signature Pages Continue]

 

Fifth Amendment to First Lien Divestiture Letter Agreement and Consent

 

 

	
   

  	
  BANK OF AMERICA, N.A., as a First Lien Lender, L/C Issuer and Swing
  Line Lender

  
	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Thomas E. Brown

  
	
   

  	
  Name:

  	
  Thomas E. Brown

  
	
   

  	
  Title:

  	
  Senior Vice
  President

  

 

[Signature Pages Continue]

 

Fifth Amendment to First
Lien Divestiture Letter Agreement and Consent

 

 

[CONFIDENTIAL
INFORMATION OMITTED AND FILED SEPARATELY

WITH THE
SECURITIES AND EXCHANGE COMMISSION]

 

Fifth Amendment to First
Lien Divestiture Letter Agreement and Consent

 

 

Accepted and Agreed:

 

PROSPECT MEDICAL
HOLDINGS, INC.

 

	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  
	
  Title:

  	
  Chief Executive Officer

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  PROSPECT MEDICAL GROUP,
  INC.

  	
   

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  
	
  Title:

  	
  Senior Vice President

  	
   

  

 

[Guarantor
Signature Pages Follow]

 

Fifth Amendment to First
Lien Divestiture Letter Agreement and Consent

 

 

	
  ALTA
  HOSPITALS SYSTEM, LLC, formerly known

  as PROSPECT HOSPITALS SYSTEM, LLC

  	
   

  	
  NUESTRA
  FAMILIA MEDICAL GROUP, INC.

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  	
  By:

  	
  /s/ Samuel S. Lee

  
	
  Name:

  	
  Samuel S. Lee 

  	
   

  	
  Name:

  	
  Samuel S. Lee 

  
	
  Title:

  	
  Chief Executive Officer

  	
   

  	
  Title:

  	
  Vice President

  
	
   

  	
   

  	
   

  
	
  PROMED
  HEALTH CARE ADMINISTRATORS 

  PROMED HEALTH SERVICES COMPANY

  	
   

  	
  PROSPECT
  ADVANTAGE NETWORK, INC. 

  PINNACLE HEALTH RESOURCES 

  PROSPECT HOSPITAL ADVISORY SERVICES, INC.

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By:

  	
  /s/ Samuel S. Lee

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  	
  Name:

  	
  Samuel S. Lee

  
	
  Name:

  	
  Samuel S. Lee 

  	
   

  	
  Title:

  	
  President and Chief Executive Officer

  
	
  Title:

  	
  Vice President

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  POMONA
  VALLEY MEDICAL GROUP, INC. 

  UPLAND MEDICAL GROUP, A PROFESSIONAL MEDICAL CORPORATION

  	
   

  	
  ARTHUR
  E. LIPPER, solely in his capacity as Pledgor

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  	
   

  
	
  Name:

  	
  Samuel S. Lee 

  	
   

  	
  /s/ Arthur E. Lipper

  
	
  Title:

  	
  Vice President

  	
   

  	
   

  

 

[Signature Pages Continue]

 

Fifth Amendment to First
Lien Divestiture Letter Agreement and Consent

 

 

	
  ALTA
  LOS ANGELES HOSPITALS, INC.

  ALTA HOLLYWOOD HOSPITALS, INC.

  	
   

  	
  PROSPECT
  MEDICAL SYSTEMS, INC.

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By:

  	
  /s/ Samuel S. Lee 

  
	
  By:

  	
  /s/ Ellen J. Shin 

  	
   

  	
  Name:

  	
  Samuel S. Lee 

  
	
  Name:

  	
  Ellen J. Shin

  	
   

  	
  Title:

  	
  Chairman of the Board

  
	
  Title:

  	
  Secretary

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  SANTA
  ANA/TUSTIN PHYSICIANS GROUP, INC.

  PROSPECT HEALTH SOURCE MEDICAL
  GROUP, INC.

  PROSPECT PROFESSIONAL CARE MEDICAL GROUP, INC.

  PROSPECT NWOC MEDICAL GROUP, INC.

  APAC MEDICAL GROUPS, INC.

  STARCARE MEDICAL GROUP, INC.
 GENESIS HEALTHCARE OF SOUTHERN

  CALIFORNIA, INC., A MEDICAL GROUP
 PROSPECT PHYSICIANS ASSOCIATES, INC.

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee 

  	
   

  	
   

  
	
  Name:

  	
  Samuel S. Lee 

  	
   

  	
   

  
	
  Title:

  	
  Senior Vice President

  	
   

  	
   

  
	
   

  	
   

  	
   

  

 

Fifth Amendment to First
Lien Divestiture Letter Agreement and ConsentExhibit 10.12

 

*                 Confidential
Information identified below was omitted and filed separately with the
Securities and Exchange Commission.

 

Bank of
America, N.A.

WA1-501-17-32

800 Fifth
Avenue, Floor 17

Seattle,
WA  98104

 

March 6, 2009

 

Prospect Medical Group, Inc.

1920 East 17th Street, Suite 200

Santa Ana, CA 92705

 

Re:                               Fifth
Amendment to Letter Agreement Regarding Divestiture Plan and Consent (this “Agreement”)

 

Ladies and Gentlemen:

 

Reference is hereby made to that certain side letter
agreement dated as of May 15, 2008 (as amended, restated, supplemented or
otherwise modified from time to time, the “Divestiture Letter Agreement”)
among Prospect Medical Holdings, Inc. (“Holdings”), Prospect
Medical Group, Inc. (“Prospect” and, collectively with Holdings,
the “Borrowers” and each, individually, a “Borrower”), Bank of
America, N.A., as Administrative Agent (in such capacity, the “Second Lien Administrative Agent”), and the lenders party thereto
(collectively, the “Second Lien Lenders”).  Reference is also hereby made to that
certain Second Lien Credit Agreement dated as of August 8, 2007 (as
amended, restated, supplemented or otherwise modified, the “Second Lien
Credit Agreement”), pursuant to which the Second Lien Lenders have agreed
to make the Loans and other extensions of credit, all upon the terms and
conditions set forth in the Second Lien Credit Agreement.  Terms
not otherwise defined in this Agreement shall have the meaning assigned thereto
in the Divestiture Letter Agreement and the Second Lien Credit Agreement, as
applicable.

 

1.             Fourth Amendment to the Divestiture Letter Agreement:

 

Under
the terms of the Divestiture Letter Agreement, the Borrowers agreed to complete
the sale of the ProMed Entities (as defined in the Divestiture Plan) no later
than March 6, 2009 (the “Sale Deadline”).  The Borrowers have requested that the Second
Lien Administrative Agent and the Second Lien Lenders amend the Divestiture
Letter Agreement to extend the Sale Deadline to March 12, 2009 (the “Extension
Deadline”).  During this additional
extension period, in addition to working on the sale of the ProMed Entities, it
is expected that the parties will negotiate a term sheet setting forth the
salient terms for an amendment to the Second Lien Credit Agreement.  The Second Lien Administrative Agent and the
Second Lien Lenders are willing to grant the Borrowers’ request subject to the
terms and conditions of this Agreement.

 

 

In furtherance thereof, the
Second Lien Administrative Agent, the Second Lien Lenders and the Borrowers
agree that paragraph (c) of the Divestiture Letter Agreement is hereby
amended and restated in its entirety to read as follows:

 

“              (c)           The Borrowers shall complete the sale
of (i) the Antelope Valley Entities (as defined in the Divesture Plan) no
later than October 1, 2008 and in accordance with the terms set forth in
the Amendment and (ii) the ProMed Entities (as defined in the Divesture
Plan) no later than March 12, 2009 on terms and conditions
reasonably satisfactory to the Second Lien Administrative Agent and the
Required Lenders.”

 

2.             Consent
by the Second Lien Lenders

 

Prospect Hospital Advisory Services, Inc., a
Prospect subsidiary, presently owns a minority interest in Brotman Medical
Center, Inc. (“Brotman”).  In
connection with Brotman’s exit from current bankruptcy proceedings and as part
of a plan of reorganization for Brotman, the Borrowers placed certain amounts
with the U.S. Bankruptcy Court for the Central District of California, Los
Angeles Division, in an attempt to purchase additional equity in Brotman.  Should the Borrowers prevail, the Borrowers’
resulting ownership interest could approach 70% or more.

 

Under the terms of the Credit Agreement, acquiring a
majority interest in Brotman would immediately qualify Brotman as a “Subsidiary”
of the Borrowers and would require joinder of Brotman to the Collateral
Agreement and the Subsidiary Guaranty Agreement within a short period of time
following such acquisition.

 

Accordingly, the Borrowers have requested that, in
the event that any Borrower (or any Subsidiary or Subsidiaries thereof)
acquires a majority interest in Brotman prior to the Extension Deadline, the
Second Lien Administrative Agent and the Second Lien Lenders exclude Brotman as
a “Subsidiary” under the Second Lien Credit Agreement until the expiration of
the Extension Deadline.

 

Subject to the terms and conditions of this
Agreement, the Second Lien Administrative Agent and the Second Lien Lenders
hereby consent and agree that, should any Borrower (or any Subsidiary or
Subsidiaries thereof), acquire a majority ownership interest in Brotman prior
to the expiration of the Extension Deadline, Brotman shall not be deemed or
considered a “Subsidiary” under the terms of the Second Lien Credit Agreement
for any purpose until the expiration of the Extension Deadline.

 

This
Agreement shall become effective as of March 6, 2009, upon (a) execution
and delivery of this Agreement by the Borrowers, the Guarantors, the Second
Lien Administrative Agent and the Required Lenders under the Second Lien Credit
Agreement, (b) execution and delivery by the Borrowers, the Guarantors,
the First Lien Administrative Agent and the “Required” Lenders under the First
Lien Credit Agreement of an agreement substantially similar to this Agreement,
and (c) payment of all professional fees and expenses of the Second Lien
Administrative Agent and the Second Lien Lenders in connection with this
Agreement and the transactions contemplated hereby and thereby (including all
fees and expenses of Winston & Strawn LLP, in its capacity as counsel
to the Second Lien Administrative Agent), pursuant to wire transfer instructions to be provided by the Second
Lien Administrative Agent.

 

 

Except
for the amendment and consent contained herein, all of the terms and provisions
of the Divestiture Letter Agreement, the Second Lien Credit Agreement and the
other Loan Documents shall remain in full force and effect.  The Borrowers, by their acceptance hereof,
hereby acknowledge and agree that the failure to complete the sale of the
ProMed Entities prior to the date specified in the Divestiture Letter
Agreement, as amended hereby, shall result in an Event of Default in accordance
with Section 8.01(b) of the Second Lien Credit Agreement.  In addition, the Borrowers acknowledge and
agree that, should the Borrowers (or any Subsidiary or Subsidiaries thereof) obtain majority
ownership of Brotman and unless otherwise addressed prior to such date in
accordance with the terms of the Second Lien Credit Agreement, upon the
expiration of the Extension Deadline, the Borrowers shall be required to comply
with, and Brotman shall be subject to, the terms of the Second Lien Credit
Agreement and the other Loan Documents in all respects.

 

Each of the Guarantors,
by their acknowledgment hereto, agree and consent to this Agreement, to all
prior Loan Documents, and to the documents and agreements referred to herein
and therein, and to all future modifications and amendments thereto, and any
termination thereof, and to any and all other present and future documents and
agreements between or among the Borrowers, the Second Lien Administrative
Agent.  The Guarantors agree to be bound
by all terms of the Loan Documents applicable to “Loan Parties”.  Nothing contained herein shall in any way
expand, limit or diminish any of the obligations of the Guarantors under their
respective guaranty, each such guaranty being hereby ratified and
affirmed.  The signatures of each of the
Guarantors shall be fully effective even if any other Guarantor fails to sign
this Agreement.

 

[Signature Pages Follow]

 

 

This Agreement shall
constitute a Loan Document and may be executed in one or more counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same
instrument.  Delivery of executed counterparts
of this Agreement by telecopy or
pdf shall be effective as an original.

 

 

Very truly yours,

 

	
   

  	
  BANK OF AMERICA, N.A., in its capacity as Second Lien Administrative
  Agent

  
	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Tiffany Shin

  
	
   

  	
  Name:

  	
  Tiffany Shin

  
	
   

  	
  Title:

  	
  Assistant Vice
  President

  

 

[Signature Pages Continue]

 

Fifth Amendment to Second
Lien Divestiture Letter Agreement and Consent

 

 

[CONFIDENTIAL
INFORMATION OMITTED AND FILED SEPARATELY

WITH THE
SECURITIES AND EXCHANGE COMMISSION]

 

Fifth Amendment to Second
Lien Divestiture Letter Agreement and Consent

 

 

Accepted and Agreed:

 

	
  PROSPECT MEDICAL
  HOLDINGS, INC.

  	
   

  
	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  
	
  Title:

  	
  Chief Executive Officer

  	
   

  
	
   

  	
   

  
	
  PROSPECT MEDICAL GROUP,
  INC.

  	
   

  
	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  
	
  Title:

  	
  Senior Vice President

  	
   

  

 

[Guarantor
Signature Pages Follow]

 

Fifth Amendment to Second Lien Divestiture Letter Agreement and Consent

 

 

	
  ALTA
  HOSPITALS SYSTEM, LLC, formerly known

  as PROSPECT HOSPITALS SYSTEM, LLC

  	
   

  	
  NUESTRA
  FAMILIA MEDICAL GROUP, INC.

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  	
  By:

  	
  /s/ Samuel S. Lee

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  	
  Name:

  	
  Samuel S. Lee

  
	
  Title:

  	
  Chief Executive Officer

  	
   

  	
  Title:

  	
  Vice President

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  PROMED
  HEALTH CARE ADMINISTRATORS

  	
   

  	
  PROSPECT
  HOSPITAL ADVISORY SERVICES, INC.

  
	
  PROMED
  HEALTH SERVICES COMPANY

  	
   

  	
  PINNACLE
  HEALTH RESOURCES

  
	
   

  	
   

  	
  PROSPECT
  ADVANTAGE NETWORK, INC.

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  	
  By:

  	
  /s/ Samuel S. Lee

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  	
  Name:

  	
  Samuel S. Lee

  
	
  Title:

  	
  Vice President

  	
   

  	
  Title:

  	
  President and Chief
  Executive Officer

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  POMONA
  VALLEY MEDICAL GROUP, INC.

  	
   

  	
  ARTHUR
  E. LIPPER, solely in his capacity as Pledgor

  
	
  UPLAND
  MEDICAL GROUP, A PROFESSIONAL MEDICAL CORPORATION

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee

  	
   

  	
   

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  	
  /s/ Arthur E. Lipper

  
	
  Title:

  	
  Vice President

  	
   

  	
   

  

 

[Signature Pages Continue]

 

Fifth Amendment to Second Lien Divestiture Letter Agreement and Consent

 

 

	
  ALTA
  LOS ANGELES HOSPITALS, INC.

  ALTA HOLLYWOOD HOSPITALS, INC.

  	
   

  	
  PROSPECT
  MEDICAL SYSTEMS, INC.

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By:

  	
  /s/ Samuel S. Lee 

  
	
  By:

  	
  /s/ Ellen J. Shin

  	
   

  	
  Name:

  	
  Samuel S. Lee 

  
	
  Name:

  	
  Ellen J. Shin

  	
   

  	
  Title:

  	
  Chairman of the Board

  
	
  Title:

  	
  Secretary

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  SANTA
  ANA/TUSTIN PHYSICIANS GROUP, INC.

  PROSPECT HEALTH SOURCE MEDICAL GROUP, INC.

  PROSPECT PROFESSIONAL CARE
  MEDICAL GROUP, INC.
 PROSPECT NWOC MEDICAL GROUP, INC.

  APAC MEDICAL GROUPS, INC.

  STARCARE MEDICAL GROUP, INC.

  GENESIS HEALTHCARE OF SOUTHERN

  CALIFORNIA, INC., A MEDICAL GROUP
 PROSPECT PHYSICIANS ASSOCIATES, INC.

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Samuel S. Lee 

  	
   

  	
   

  
	
  Name:

  	
  Samuel S. Lee

  	
   

  	
   

  
	
  Title:

  	
  Senior Vice President

  	
   

  	
   

  

 

Fifth Amendment to Second
Lien Divestiture Letter Agreement and Consent

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