Document:

Form of Amendment to Common Stock Warrant

 Exhibit 4.15 
 FORM OF AMENDMENT TO 
 COMMON STOCK WARRANT 

OF 

ROCKWELL MEDICAL, INC. 
 This Amendment (“Amendment”), dated November     , 2012, amends the Common Stock Warrants dated November 28, 2007 (the “Warrants”) and issued by Rockwell
Medical, Inc. (formerly Rockwell Medical Technologies, Inc., referred to herein as the “Company”) on such date and held by the undersigned holder (“Holder”). 

WHEREAS, each of the Company and Holder have determined that an extension of the expiration date of the Warrants pursuant to the terms of
this Amendment is in their best interests and wish to amend the Warrants in accordance with Section 7 of the Warrants; 

NOW THEREFORE, the Warrants are amended as set forth below. 
 1. The definition of Expiration Date in the first sentence of the preamble to the Warrants shall be and hereby is amended so that the Expiration Date of the Warrants shall be January 28, 2013 and not
the fifth anniversary of the date of the Warrants. 
 2. The undersigned Holder is the record and beneficial owner of the
Warrants stated next to Holder’s signature and is legally authorized to execute this Amendment with respect to such Warrants. 
 3. Holder’s signature below constitutes Holder’s consent to this Amendment to the extent required by the terms of the Warrants. 

4. The term “Warrant” as used in the Warrants shall be deemed to refer to the Warrants as amended hereby. 

5. Except as specifically modified herein, the remaining provisions of the Warrants remain in full force and effect. 

6. This Amendment may be executed in any number of counterparts, all of which shall constitute one and the same Amendment. This Amendment
may be executed by signatures delivered by facsimile or electronic mail, each of which shall be fully binding on the signing party. 

 IN WITNESS WHEREOF, the undersigned have caused this Amendment to be duly executed as of the
date first set forth above. 
  

													
	HOLDER	    	 	 	 
				
	By:	 	  
	    		 	 Warrants owned by Holder:

	Its:	 		    		 	Aggregate number of underlying shares:

  

	
	ROCKWELL MEDICAL, INC.
	
	By: /s/ Thomas E. Klema
	Thomas E. Klema
	Vice President, Chief Financial Officer and TreasurerAmendment to Common Stock Warrant

 Exhibit 4.16 
 AMENDMENT TO 
 COMMON STOCK WARRANT OF 

ROCKWELL MEDICAL, INC. 
 This Amendment (“Amendment”), dated November 22, 2012, amends the Common Stock Warrant dated November 28, 2007 (the “Warrant”) to purchase 80,000 common shares at $10.00 per
share issued by Rockwell Medical, Inc. (formerly Rockwell Medical Technologies, Inc., referred to herein as the “Company”) on such date and held by RJ Aubrey IR Services LLC (“Holder”). 

WHEREAS, each of the Company and Holder have determined that an extension of the expiration date of the Warrant pursuant to the terms of
this Amendment is in their best interests and wish to amend the Warrant in accordance with Section 7 of the Warrant; 
 NOW
THEREFORE, the Warrant is amended as set forth below. 
 1. The definition of Expiration Date in the first sentence of the
preamble to the Warrant shall be and hereby is amended so that the Expiration Date of the Warrant shall be November 28, 2013 and not the fifth anniversary of the date of the Warrant. 

2. The undersigned Holder is the record and beneficial owner of the Warrant stated next to Holder’s signature and is legally
authorized to execute this Amendment with respect to such Warrant. 
 3. Holder’s signature below constitutes Holder’s
consent to this Amendment to the extent required by the terms of the Warrant. 
 4. The term “Warrant” as used in the
Warrant shall be deemed to refer to the Warrant as amended hereby. 
 5. Except as specifically modified herein, the remaining
provisions of the Warrant remain in full force and effect. 
 6. This Amendment may be executed in any number of counterparts,
all of which shall constitute one and the same Amendment. This Amendment may be executed by signatures delivered by facsimile or electronic mail, each of which shall be fully binding on the signing party. 

 IN WITNESS WHEREOF, the undersigned have caused this Amendment to be duly executed as of the
date first set forth above. 
  

	
	HOLDER - RJ Aubrey IR Services LLC
	
	By: /s/Ronald J. Aubrey
	Its: President

  

	
	ROCKWELL MEDICAL, INC.
	
	By: /s/ Thomas E. Klema
	Thomas E. Klema
	Vice President, Chief Financial Officer and TreasurerAmendment No. 2 to the Credit Agreement

 Exhibit 10.1 

AMENDMENT NO. 2 dated as of November 27, 2012 (this “Amendment”), to the CREDIT AGREEMENT
dated as of July 25, 2007, as amended and restated as of November 5, 2010, and February 2, 2012, and as amended as of August 3, 2012 (as heretofore amended, supplemented, amended and restated or otherwise modified, the
“Credit Agreement”), among CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation (the “Borrower”), COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation (“Parent”), the
lenders party thereto (the “Lenders”) and CREDIT SUISSE AG, as administrative agent (in such capacity, the “Administrative Agent”) and as collateral agent for the Lenders. 

PRELIMINARY STATEMENT 
 A. Pursuant to the Credit Agreement, the Lenders have extended, and have agreed to extend, credit to the Borrower. 
 B. The Borrower, Parent and the Required Lenders desire that certain provisions of the Credit Agreement be amended as provided herein. 

C. Parent, the Borrower and the Subsidiary Guarantors are party to one or more of the Security Documents, pursuant to which, among other
things, Parent and the Subsidiary Guarantors Guaranteed the Obligations of the Borrower under the Credit Agreement and provided security therefor. 
 Accordingly, in consideration of the mutual agreements herein contained and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto
hereby agree as follows: 
 SECTION 1. Defined Terms. Capitalized terms used but not otherwise defined herein (including
the preliminary statement hereto) shall have the meanings assigned thereto in the Credit Agreement. The provisions of Section 1.02 of the Credit Agreement are hereby incorporated by reference herein, mutatis mutandis. 

SECTION 2. Amendments to the Credit Agreement. Subject to the satisfaction of the conditions set forth in Section 4 hereof,
the Credit Agreement is hereby amended as follows: 
 (a) Section 1.01 of the Credit Agreement is hereby amended by
inserting the following defined term in the appropriate alphabetical order therein: 
 “Amendment
No. 2 Effective Date” shall mean November 27, 2012. 

 (b) The definition of the term “Applicable Percentage” set forth in
Section 1.01 of the Credit Agreement is hereby amended and restated in its entirety to read as follows: 

““Applicable Percentage” shall mean, for any day (a) with respect to any Eurodollar Non-Extended Term
Loan, ABR Non-Extended Term Loan, Eurodollar Extended Term Loan or ABR Extended Term Loan, the applicable percentage set forth below under the caption “Eurodollar Spread—Non-Extended Term Loans”, “ABR Spread—Non-Extended
Term Loans”, “Eurodollar Spread—Extended Term Loans” or “ABR Spread—Extended Term Loans”, as the case may be, in each case based upon the Secured Leverage Ratio as of the relevant date of determination, and
(b) (i) with respect to any Eurodollar Incremental Term Loan incurred on the First Incremental Term Loan Assumption Agreement Date, ABR Incremental Term Loan incurred on the First Incremental Term Loan Assumption Agreement Date, Eurodollar
Revolving Loan or ABR Revolving Loan, the applicable percentage set forth below under the caption “Eurodollar Spread—Incremental Term Loans”, “ABR Spread—Incremental Term Loans”, “Eurodollar Spread—Revolving
Loans” or “ABR Spread—Revolving Loans”, as the case may be, and (ii) with respect to the Revolving Credit Commitment Fee, the applicable rate set forth below under the caption “Revolving Credit Commitment Fee
Rate”, in each case based upon the Leverage Ratio as of the relevant date of determination: 
  

									
	 Secured

Leverage

Ratio
	  	 Eurodollar

Spread—

Non-

Extended

Term Loans
	  	 ABR

Spread—

Non-

Extended

Term Loans
	  	 Eurodollar

Spread—

Extended

Term

Loans
	  	 ABR

Spread—

Extended

Term

Loans

	 Category 1

> 3.50 to 1.00
	  	2.50%	  	1.50%	  	3.75%	  	2.75%
	 Category 2

£ 3.50 to 1.00
	  	2.25%	  	1.25%	  	3.50%	  	2.50%

  
 2 

											
	 Leverage

Ratio
	  	 Eurodollar

Spread—

Incremental

Term Loans
	  	 ABR

Spread—

Incremental

Term Loans
	  	 Eurodollar

Spread—

Revolving

Loans
	  	 ABR

Spread—

Revolving

Loans
	  	 Revolving

Credit

Commitment

Fee Rate

	 Category 1

3 5.50 to 1.00
	  	3.00%	  	2.00%	  	3.00%	  	2.00%	  	0.50%
	 Category 2

3 5.00 to 1.00 and

< 5.50 to 1.00
	  	2.75%	  	1.75%	  	2.75%	  	1.75%	  	0.50%
	 Category 3

3 4.50 to 1.00 and

< 5.00 to 1.00
	  	2.50%	  	1.50%	  	2.50%	  	1.50%	  	0.50%
	 Category 4

3 4.00 to 1.00 and

< 4.50 to 1.00
	  	2.25%	  	1.25%	  	2.25%	  	1.25%	  	0.375%
	 Category 5

< 4.00 to 1.00
	  	2.00%	  	1.00%	  	2.00%	  	1.00%	  	0.375%

 Each change in the Applicable Percentage resulting from a change in the Secured Leverage Ratio or the Leverage Ratio, as
the case may be, shall be effective with respect to all Loans and Letters of Credit outstanding on and after the date of delivery to the Administrative Agent of the financial statements and certificates required by Section 5.04(a) or
(b) and Section 5.04(c), respectively, indicating such change until the date immediately preceding the next date of delivery of such financial statements and certificates indicating another such change. Notwithstanding the foregoing,
(a) the Secured Leverage Ratio shall be deemed to be in Category 2 for purposes of determining the Applicable Percentage until the end of the first full fiscal quarter following the Amendment No. 2 Effective Date (at which time,
subject to the immediately succeeding sentence, the Secured Leverage Ratio shall be determined on the basis of the financial statements and certificates most recently delivered pursuant to Section 5.04(a) or (b) and Section 5.04(c),
respectively, prior to such date, and the Applicable Percentage resulting from such Secured Leverage Ratio shall be effective until any such change is required pursuant to the immediately preceding sentence) and (b) the Leverage Ratio shall be
deemed to be in Category 3 for purposes of determining the Applicable Percentage until the end of the first full fiscal quarter following the First Incremental Term Loan Assumption Agreement Date (at which time, subject to the immediately
succeeding sentence, the Leverage Ratio shall be determined on the basis of the financial statements and certificates most recently delivered pursuant to Section 5.04(a) or (b) and Section 5.04(c), respectively, prior to such date,
and the Applicable Percentage resulting from such Leverage Ratio shall be effective until any such change is required pursuant to the immediately preceding sentence). In addition, (a) at any time during which the Borrower has failed to deliver
the financial statements and certificates required by Section 5.04(a) or (b) and Section 5.04(c), respectively (until the time of the delivery thereof), the Secured Leverage Ratio and the Leverage Ratio shall each be deemed to be in
Category 1 for purposes of determining the Applicable Percentage, or (b) at any time after the occurrence and during the continuance of an Event of Default, the Leverage Ratio shall be deemed to be in Category 1 for purposes of determining the
Applicable Percentage.” 

  
 3 

 (c) The definition of the term “Secured Leverage Ratio Condition” set forth in
Section 1.01 of the Credit Agreement is hereby amended by replacing “3.5” therein with “3.75”. 
 (d)
The definition of the term “Spinout Transaction” set forth in Section 1.01 of the Credit Agreement is hereby amended by replacing “3.50” in subclause (x) of clause (ii) of the proviso thereto with “3.75”.

 (e) Section 1.03(b) (Pro Forma Calculations) of the Credit Agreement is hereby amended by: 

(i) inserting the words “and synergies” immediately after the words “cost savings” in each place they
appear therein; and 
 (ii) inserting the words “; provided, further, that the aggregate
amount added to or included in Consolidated EBITDA above in respect of synergies for any period of four consecutive fiscal quarters shall not exceed an amount equal to 5% of Consolidated EBITDA.” at the end of the first sentence of such
section. 
 (f) Section 2.12 (Optional Prepayment) of the Credit Agreement is hereby amended by: 

(i) adding at the end of the second sentence of Section 2.12(c) the words ”, except as expressly provided in
Section 2.12(e)”; and 
 (ii) inserting the following in its entirety as a new Section 2.12(e):

 “(e) If, prior to the first anniversary of the Amendment No. 2 Effective Date, (i) all or any portion of the
Extended Term Loans are prepaid out of the proceeds of a substantially concurrent issuance or incurrence of secured term loans and the effective yield (as determined by the Administrative Agent in a manner consistent with generally accepted
financial practice and, in any event, excluding the effect of any arrangement, structuring, syndication, commitment or other fees in connection therewith that are not shared with all providers of such financing, and without taking into account any
fluctuations in the Adjusted LIBO Rate) of such secured term loan financing is less than the yield (as determined by the Administrative Agent on the same basis) of the Extended Term Loans or (ii) an Extended Term Loan Lender must assign its
Extended Term Loans pursuant to Section 2.21 as a result of its failure to consent to an amendment that would reduce (as determined by the Administrative Agent) any of the interest rate margins (or other pricing-related terms) then in effect
with respect to such Extended Term Loans, then in each case the aggregate principal amount so prepaid or assigned will be subject to a fee payable by the Borrower, in each case equal to 1.0% of the

  
 4 

 
principal amount thereof; provided that this Section 2.12(e) shall not apply to any prepayment of the Extended Term Loans upon the occurrence of a Change in Control.” 

(g) Section 5.04(c) (Financial Statements, Reports, etc.) of the Credit Agreement is hereby amended as follows: 

(i) by replacing the word “and” immediately prior to the designator “(iii)” in such section with
“,”; and 
 (ii) by inserting the following immediately following the words “in excess of
$10,000,000” in such section: 
 “and (iv) setting forth computations in reasonable detail satisfactory to the
Administrative Agent of the Secured Leverage Ratio”. 
 (h) Section 6.04(h) (Investments) of the Credit Agreement is
hereby amended by replacing the words “the Leverage Ratio Condition would be satisfied” in clause (iii)(B)(1) of the proviso to such section with the words “the Borrower would be in compliance with the covenant set forth in
Section 6.13 on the last day of the most recently ended fiscal quarter for which financial statements have been or were required to be delivered, after giving pro forma effect to such transaction and to any other event occurring after such
period as to which pro forma recalculation is appropriate (including any other transaction described in this Section 6.04(h) occurring after such period) as if such transaction had occurred as of the first day of such period”. 

(i) Section 6.06(a) (Restricted Payments; Restrictive Agreements) of the Credit Agreement is hereby amended as follows: 

(i) by amending and restating clause (v) of such section in its entirety to read as follows: 

“(v) in addition to Restricted Payments permitted by clauses (i) through (iv) above, so long as no Event of Default or
Default shall have occurred and be continuing or would result therefrom, the Borrower may make other Restricted Payments, and Parent may make Restricted Payments, in an aggregate amount from and after the Amendment No. 2 Effective Date not to
exceed $150,000,000 less the amount of payments made from and after the Amendment No. 2 Effective Date pursuant to Section 6.09(b)(i);”; 
 (ii) by amending clause (vii) of such section to (x) replace “3.0 to 1.0” with “3.5 to 1.0” and (y) delete the word “and” at the end of such clause;

 (iii) by amending clause (viii) of such section to replace the period at the end of such section with
“; and”; and 

  
 5 

 (iv) by inserting the following as a new clause (ix) in such section: 

“(ix) so long as no Event of Default or Default shall have occurred and be continuing or would result therefrom, the Borrower may
make other Restricted Payments, and Parent may make Restricted Payments, in an aggregate amount not to exceed $25,000,000 in any fiscal year, beginning with the fiscal year ending December 31, 2013.”. 

(j) Section 6.09 (Other Indebtedness) of the Credit Agreement is hereby amended by replacing clause (i) of the proviso to
Section 6.09(b) in its entirety with “(i) from and after the Amendment No. 2 Effective Date, Senior Notes and subordinated Indebtedness for an aggregate price not in excess of (A) $150,000,000 less (B) the amount of
Restricted Payments made from and after the Amendment No. 2 Effective Date pursuant to clause (v) of Section 6.06(a)”. 
 (k) Section 6.12 (Interest Coverage Ratio) of the Credit Agreement is hereby amended as follows: 
 (i) by deleting the period “October 1, 2011 through September 30, 2013” and the corresponding ratio “2.25 to 1.00”; and 

(ii) by replacing the ratio “2.50 to 1.00” which corresponds to the period labeled “Thereafter” with
“2.25 to 1.00”. 
 (l) Section 6.13 (Maximum Leverage Ratio) of the Credit Agreement is hereby amended as
follows: 
 (i) by replacing the period “October 1, 2011 through September 30, 2013” with the
period “October 1, 2011 through December 31, 2014”; and 
 (ii) by replacing the ratio “5.00
to 1.00” which corresponds to the period labeled “Thereafter” with “5.25 to 1.00”. 
 SECTION 3.
Representations and Warranties. To induce the other parties hereto to enter into this Amendment, each of Parent, the Borrower and each Subsidiary Guarantor hereby represents and warrants to each of the Lenders, the Administrative Agent, the
Issuing Banks and the Collateral Agent that, after giving effect to this Amendment: 
 (a) The representations and warranties
set forth in Article III of the Credit Agreement and in each other Loan Document are true and correct in all material respects on and as of the Amendment Effective Date as though made on and as of such date, except to the extent that such
representations and warranties expressly relate to an earlier date. 
 (b) No Default or Event of Default has occurred and is
continuing. 

  
 6 

 (c) None of the Security Documents in effect on the Amendment Effective Date will be
rendered invalid, non-binding or unenforceable against any Loan Party as a result of this Amendment. The Guarantees created under such Security Documents will continue to guarantee the Obligations to the same extent as they guaranteed the
Obligations immediately prior to the Amendment Effective Date. The Liens created under such Security Documents will continue to secure the Obligations, and will continue to be perfected, in each case, to the same extent as they secured the
Obligations or were perfected immediately prior to the Amendment Effective Date. 
 SECTION 4. Effectiveness. This
Amendment shall become effective on and as of the date on which each of the following conditions precedent is satisfied (such date, the “Amendment Effective Date”): 

(a) The Administrative Agent shall have received duly executed and delivered counterparts of this Amendment that, when taken together,
bear the signatures of Parent, the Borrower, each Subsidiary Guarantor and the Required Lenders. 
 (b) The Administrative Agent
shall have received payment from the Borrower, for the account of each Non-Extended Funded Term Loan Lender and Extended Term Loan Lender that shall have unconditionally and irrevocably delivered to the Administrative Agent (or its counsel) its
executed signature page to this Amendment at or prior to 12:00 p.m., noon, New York City time, on November 20, 2012, an amendment fee in an amount equal to 0.20% of the aggregate outstanding principal amount of such Lender’s Non-Extended
Funded Term Loans and Extended Term Loans, as the case may be, in each case as of the Amendment Effective Date. Such fees shall be payable in immediately available funds and, once paid, shall not be refundable in whole or in part. 

(c) The Administrative Agent shall have received all other Fees and other amounts due and payable on or prior to the Amendment Effective
Date, including, to the extent invoiced, reimbursement or payment of all out-of-pocket expenses required to be reimbursed or paid by the Borrower in connection with the transactions contemplated hereby or under any other Loan Document. 

The Administrative Agent shall notify the parties hereto of the Amendment Effective Date and such notice shall be conclusive and binding. 

SECTION 5. Effect of this Amendment. (a) Except as expressly set forth herein, this Amendment shall not by implication or
otherwise limit, impair, constitute a waiver of, or otherwise affect the rights and remedies of the Administrative Agent, the Lenders or any other Secured Party under the Credit Agreement or any other Loan Document, and shall not alter, modify,
amend or in any way affect any of the terms, conditions, obligations, covenants or agreements contained in the Credit Agreement or any other Loan Document, all of which are ratified and affirmed in all respects and shall continue in full force and
effect. Nothing herein shall be deemed to entitle any Loan Party to a consent to, or a waiver, amendment, modification or other change of, any of the terms, conditions, obligations, covenants or agreements contained in the Credit

  
 7 

 
Agreement or any other Loan Document in similar or different circumstances. This Amendment shall apply and be effective only with respect to the provisions of the Credit Agreement specifically
referred to herein. 
 (b) After the date hereof, any reference to the Credit Agreement shall mean the Credit Agreement as
modified hereby. 
 (c) This Amendment shall constitute a “Loan Document” for all purposes of the Credit Agreement and
the other Loan Documents. 
 SECTION 6. Reaffirmation. Each of Parent, the Borrower and each of the Subsidiary Guarantors
identified on the signature pages hereto (collectively, Parent, the Borrower and such Subsidiary Guarantors, the “Reaffirming Loan Parties”) hereby acknowledges that it expects to receive substantial direct and indirect
benefits as a result of this Amendment and the transactions contemplated hereby. Each Reaffirming Loan Party hereby consents to this Amendment and the transactions contemplated hereby, and hereby confirms its respective guarantees, pledges and
grants of security interests, as applicable, under each of the Loan Documents to which it is party, and agrees that, notwithstanding the effectiveness of this Amendment and the transactions contemplated hereby, such guarantees, pledges and grants of
security interests shall continue to be in full force and effect and shall accrue to the benefit of the Secured Parties. 

SECTION 7. Expenses. The Borrower agrees to reimburse the Administrative Agent for its reasonable out-of-pocket expenses in
connection with the Loan Documents (including the preparation of this Amendment), including the reasonable fees, charges and disbursements of counsel for the Administrative Agent. 

SECTION 8. Counterparts. This Amendment 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 by electronic transmission (e.g., “pdf”) of an executed counterpart of a signature page to this Amendment shall be effective as delivery of an original
executed counterpart of this Amendment, and, once delivered, may not be withdrawn or revoked unless the Amendment fails to become effective in accordance with its terms on or prior to December 31, 2012. 

SECTION 9. No Novation. This Amendment shall not extinguish the obligations for the payment of money outstanding under the Credit
Agreement or discharge or release the Lien or priority of any Loan Document or any other security therefor or any guarantee thereof. Nothing herein contained shall be construed as a substitution or novation of the Obligations outstanding under the
Credit Agreement or instruments guaranteeing or securing the same, which shall remain in full force and effect, except as modified hereby or by instruments executed concurrently herewith. Nothing expressed or implied in this Amendment or any other
document contemplated hereby shall be construed as a release or other discharge of the Borrower under the Credit Agreement or any Loan Party under any other Loan Document from any of its obligations and liabilities thereunder. The Credit Agreement
and each of the other Loan Documents shall remain in full force and effect, until and except as modified hereby or thereby in connection herewith or therewith. 

  
 8 

 SECTION 10. Governing Law. (a) THIS AMENDMENT SHALL BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK. 
 (b) EACH PARTY HERETO HEREBY WAIVES, TO THE FULLEST EXTENT
PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN ANY LEGAL PROCEEDING DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AMENDMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY (WHETHER BASED ON CONTRACT, TORT OR ANY OTHER
THEORY). EACH PARTY HERETO (I) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PARTY HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PARTY WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER AND
(II) ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AMENDMENT BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION. 

SECTION 11. Headings. Section headings used herein are for convenience of reference only, are not part of this Amendment and shall
not affect the construction of, or be taken into consideration in interpreting, this Amendment. 
 [Remainder of page
intentionally left blank] 

  
 9 

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

					
	CHS/COMMUNITY HEALTH SYSTEMS, INC.,
			
		 	By:	 	 /s/ W. Larry Cash

		 	Name:	 	W. Larry Cash
		 	Title:	 	 Executive Vice President and

Chief Financial Officer

  

					
	COMMUNITY HEALTH SYSTEMS, INC.,
			
		 	By:	 	 /s/ W. Larry Cash

		 	Name:	 	W. Larry Cash
		 	Title:	 	 Executive Vice President and

Chief Financial Officer

  

[SIGNATURE PAGE TO AMENDMENT NO. 2 TO

 CREDIT AGREEMENT OF CHS/COMMUNITY HEALTH
SYSTEMS, INC.] 

			
	CREDIT SUISSE AG, CAYMAN ISLANDS BRANCH, individually and as Administrative Agent, Collateral Agent, Swingline Lender and an Issuing Bank,
		
	 by
	    	
		    	 /s/ Robert Hetu

		    	Name: Robert Hetu
		    	Title: Managing Director
		
	 by
	    	
		    	 /s/ Rahul Parmar

		    	Name: Rahul Parmar
		    	Title: Associate

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 11 

			
	WELLS FARGO BANK, N.A., individually and as an Issuing Bank,
		
	 by
	    	
		    	 /s/ Andrea S. Chen

		    	Name: Andrea S. Chen
		    	Title: Director

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 12 

			
	 Abilene Hospital LLC
 Abilene Merger LLC
 Affinity Health Systems, LLC

Affinity Hospital, LLC
 Anna Hospital
Corporation
 Berwick Hospital Company, LLC
 Big Bend Hospital Corporation
 Big Spring Hospital Corporation

Birmingham Holdings II, LLC
 Birmingham Holdings,
LLC
 Blue Island Hospital Company, LLC

Blue Island Illinois Holdings, LLC
 Bluefield
Holdings, LLC
 Bluefield Hospital Company, LLC
 Bluffton Health System, LLC
 Brownsville Hospital Corporation

Brownwood Medical Center, LLC
 Bullhead City
Hospital Corporation
 Bullhead City Hospital Investment Corporation
 Carlsbad Medical Center, LLC
 Centre Hospital Corporation

CHHS Holdings, LLC
 CHS Kentucky Holdings,
LLC
 CHS Pennsylvania Holdings, LLC

CHS Virginia Holdings, LLC
 CHS Washington
Holdings, LLC
 Clarksville Holdings, LLC

Cleveland Hospital Corporation
 Cleveland
Tennessee Hospital Company, LLC
 Clinton Hospital Corporation
 Coatesville Hospital Corporation
 College Station Medical Center, LLC

College Station Merger, LLC
 Community GP
Corp.
 Community Health Investment Company, LLC
 Community LP Corp.

		
	by	    	
		    	 /s/ James W. Doucette

		    	Name: James W. Doucette
		    	Title: Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 13 

			
	 CP Hospital GP, LLC
 CPLP, LLC
 Crestwood Hospital LP, LLC
 Crestwood Hospital, LLC
 CSMC, LLC
 CSRA Holdings, LLC
 Deaconess Holdings, LLC
 Deaconess Hospital Holdings, LLC
 Deming Hospital Corporation

Desert Hospital Holdings, LLC
 Detar Hospital,
LLC
 DHFW Holdings, LLC
 DHSC,
LLC
 Dukes Health System, LLC

Dyersburg Hospital Corporation
 Emporia Hospital
Corporation
 Evanston Hospital Corporation
 Fallbrook Hospital Corporation
 Foley Hospital Corporation

Forrest City Arkansas Hospital Company, LLC

Forrest City Hospital Corporation
 Fort Payne
Hospital Corporation
 Frankfort Health Partner, Inc.
 Franklin Hospital Corporation
 Gadsden Regional Medical Center, LLC

Galesburg Hospital Corporation
 Granbury Hospital
Corporation
 Granite City Hospital Corporation
 Granite City Illinois Hospital Company, LLC
 Greenville Hospital Corporation

GRMC Holdings, LLC
 Hallmark Healthcare Company,
LLC
 Hobbs Medco, LLC
 Hospital of
Barstow, Inc.
 Hospital of Fulton, Inc.

Hospital of Louisa, Inc.
 Hospital of Morristown,
Inc.

		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 14 

			
	 Jackson Hospital Corporation
 Jackson Hospital Corporation
 Jourdanton Hospital Corporation

Kay County Hospital Corporation
 Kay County
Oklahoma Hospital Company, LLC
 Kirksville Hospital Company, LLC
 Lakeway Hospital Corporation
 Lancaster Hospital Corporation

Las Cruces Medical Center, LLC
 Lea Regional
Hospital, LLC
 Lexington Hospital Corporation
 Longview Clinic Operations Company, LLC
 Longview Merger, LLC

LRH, LLC
 Lutheran Health Network of Indiana,
LLC
 Marion Hospital Corporation

Martin Hospital Corporation
 Massillon Health
Community System, LLC
 Massillon Health System, LLC
 Massillon Holdings, LLC
 McKenzie Tennessee Hospital Company, LLC

McNairy Hospital Corporation
 MCSA,
L.L.C.
 Medical Center of Brownwood, LLC

Merger Legacy Holdings, LLC
 MMC of Nevada,
LLC
 Moberly Hospital Company, LLC

MWMC Holdings, LLC
 Naticoke Hospital Company,
LLC
 National Healthcare of Leesville, Inc.
 National Healthcare of Mt. Vernon, Inc.
 National Healthcare of Newport, Inc.

Navarro Regional, LLC
 NC-DSH,
LLC

		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 15 

			
	 Northampton Hospital Company, LLC
 Northwest Arkansas Hospitals, LLC
 Northwest Hospital, LLC

NOV Holdings, LLC
 NRH, LLC

Oak Hill Hospital Corporation
 Oro Valley
Hospital, LLC
 Palmer-Wasilla Health System, LLC
 Payson Hospital Corporation
 Peckville Hospital Company, LLC

Pennsylvania Hospital Company, LLC
 Phillips
Hospital Corporation
 Phoenixville Hospital Company, LLC
 Pottstown Hospital Company, LLC
 QHG Georgia Holdings II, LLC

QHG Georgia Holdings, Inc.
 QHG of Bluffton
Company, LLC
 QHG of Clinton County, Inc.
 QHG of Enterprise, Inc.
 QHG of Forrest County, Inc.

QHG of Fort Wayne Company, LLC
 QHG of
Hattiesburg, Inc.
 QHG of Massillon, Inc.
 QHG of South Carolina, Inc.
 QHG of Spartanburg, Inc.

QHG of Springdale, Inc.
 QHG of Warsaw Company,
LLC
 Quorum Health Resources, LLC
 Red
Bud Hospital Corporation
 Red Bud Illinois Hospital Company, LLC
 Regional Hospital of Longview, LLC
 River Region Medical Corporation

Roswell Hospital Corporation
 Ruston Hospital
Corporation
 Ruston Louisiana Hospital Company, LLC
 SACMC, LLC
 Salem Hospital Corporation
 San Angelo Community Medical Center, LLC

		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 16 

			
	 San Angelo Medical, LLC
 San Miguel Hospital Corporation
 Scranton Holdings, LLC

Scranton Hospital Company, LLC
 Scranton Quincy
Holdings, LLC
 Scranton Quincy Hospital Company, LLC
 Shelbyville Hospital Corporation
 Siloam Springs Arkansas Hospital Company, LLC

Siloam Springs Holdings, LLC
 Southern Texas
Medical Center, LLC
 Spokane Valley Washington Hospital Company, LLC
 Spokane Washington Hospital Company, LLC
 Tennyson Holdings, LLC

Tomball Texas Holdings, LLC
 Tomball Texas
Hospital Company, LLC
 Tooele Hospital Corporation
 Triad Health Care Corporation
 Triad Holdings III, LLC

Triad Holdings IV, LLC
 Triad Holdings V,
LLC
 Triad Nevada Holdings, LLC
 Triad
of Alabama, LLC
 Triad of Oregon, LLC

Triad-ARMC, LLC
 Triad-El Dorado, Inc.

Triad-Navarro Regional Hospital Subsidiary, LLC

Tunhannock Hospital Company, LLC
 VHC Medical,
LLC
 Vicksburg Healthcare, LLC

Victoria Hospital, LLC
 Virginia Hospital
Company, LLC
 Warren Ohio Hospital Company, LLC
 Warren Ohio Rehab Hospital Company, LLC

		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 17 

			
	 Watsonville Hospital Corporation
 Waukegan Hospital Corporation
 Waukegan Illinois Hospital Company, LLC

Weatherford Hospital Corporation
 Weatherford
Texas Hospital Company, LLC
 Webb Hospital Corporation
 Webb Hospital Holdings, LLC
 Wesley Health System, LLC

West Grove Hospital Company, LLC
 WHMC,
LLC
 Wilkes-Barre Behavioral Hospital Company, LLC
 Wilkes-Barre Holdings, LLC
 Wilkes-Barre Hospital Company, LLC

Williamston Hospital Corporation

Women & Children’s Hospital, LLC

Woodland Heights Medical Center, LLC
 Woodward
Health System, LLC
 York Pennsylvania Holdings, LLC
 York Pennsylvania Hospital Company, LLC
 Youngstown Ohio Hospital Company, LLC

		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 18 

 
			
	Brownwood Hospital, L.P.
	By: Brownwood Medical Center, LLC
	Its: General Partner
		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

			
	College Station Hospital, L.P.
	By: College Station Medical Center, LLC
	Its: General Partner
		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

			
	Longview Medical Center, L.P.
	By: Regional Hospital of Longview, LLC
	Its: General Partner
		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

			
	Navarro Hospital, L.P.
	By: Navarro Regional, LLC
	Its: General Partner
		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 19 

			
	QHG Georgia, LP
	By: QHG Georgia Holdings II, LLC
	Its: General Partner
		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

			
	Victoria of Texas, L.P.
	By: Detar Hospital, LLC
	Its: General Partner
		
	By:	 	 /s/ James W. Doucette

	Name:	 	James W. Doucette
	Title:	 	Vice President and Treasurer

  

[Signature Page to Amendment No. 2 to 
 Credit Agreement of CHS/Community Health Systems, Inc.] 
  
 20 

 LENDER SIGNATURE PAGE TO 

AMENDMENT NO. 2 
 TO
CREDIT AGREEMENT OF 
 CHS/COMMUNITY HEALTH SYSTEMS, INC. 

Name of
Lender:                                        
     
  

			
	by	 	
		 	  

		 	Name:
		 	Title:

 For any Lender requiring a second signature line: 

 

			
	by	 	
		 	  

		 	Name:
		 	Title:

  

[SIGNATURE PAGE TO AMENDMENT NO. 2 TO

 CREDIT AGREEMENT OF CHS/COMMUNITY HEALTH
SYSTEMS, INC.]

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