Document:

EX-10.1

 Exhibit 10.1 

Execution Version 
 TENET
HEALTHCARE CORPORATION 
 7.50% Senior Secured Second Lien Notes due 2022 

unconditionally guaranteed as to the 

payment of principal, premium, 

if any, and interest by the 

Guarantors named on Schedule I hereto 
  

 

Exchange and Registration Rights Agreement 

December 1, 2016 
 Barclays Capital Inc. 

745 Seventh Avenue 
 New York, NY 10019 

As Representative of the Initial Purchasers 
 Ladies and
Gentlemen: 
 Tenet Healthcare Corporation, a Nevada corporation (the “Company”), issued on the Closing Date (as defined herein), $750.0
million in aggregate principal amount of its 7.50% Senior Secured Second Lien Notes due 2022 (the “Notes”). The Notes are unconditionally guaranteed by the Guarantors (as defined herein), upon the terms and conditions set forth in
that certain Offering Memorandum, dated November 16, 2016, and that certain Purchase Agreement (the “Purchase Agreement”), dated as of November 16, 2016, among the Company, the subsidiaries of the Company set forth on the
signature pages thereto (the “Guarantors”) and Barclays Capital Inc., as representative (the “Representative”) of the several Initial Purchasers (as defined herein). As an inducement to purchase the Notes, and
in satisfaction of a condition to the obligations of the Company under the Purchase Agreement, the Company and the Guarantors agree with the Representative, for the benefit of the holders (as defined herein) from time to time of the Registrable
Securities (as defined herein), as follows: 
 1. Certain Definitions. For purposes of this Exchange and Registration Rights
Agreement (this “Agreement”), the following terms shall have the following respective meanings: 
 “Base
Indenture” shall mean the indenture, dated as of November 6, 2001 between the Company and The Bank of New York Mellon Trust Company N.A., as successor trustee to The Bank of New York, as Trustee. 

“Base Interest” shall mean the interest that would otherwise accrue on the Securities under the terms thereof and the
Indenture, without giving effect to the provisions of this Agreement. 

 The term “broker-dealer” shall mean any broker or dealer registered with the
Commission under the Exchange Act. 
 “Business Day” shall have the meaning set forth in Rule 13e-4(a)(3) promulgated by
the Commission under the Exchange Act, as the same may be amended or succeeded from time to time. 
 “Closing Date” shall
mean December 1, 2016, which is the date of original issuance of the Securities. 
 “Commission” shall mean the United
States Securities and Exchange Commission, or any other federal agency at the time administering the Exchange Act or the Securities Act, whichever is the relevant statute for the particular purpose. 

“Company” shall have the meaning assigned thereto in the preamble. 

“Consummation Date” shall have the meaning assigned thereto in Section 2(a) hereof. 

“Effective Time” shall mean the time and date as of which the Commission declares the Exchange Registration Statement
effective or as of which the Exchange Registration Statement otherwise becomes effective. 
 “Exchange Act” shall mean the
Securities Exchange Act of 1934, as amended, or any successor thereto, as the same may be amended or succeeded from time to time. 

“Exchange Offer” shall have the meaning assigned thereto in Section 2(a) hereof. “Exchange Registration” shall
have the meaning assigned thereto in Section 3(c) hereof. 
 “Exchange Registration Statement” shall have the meaning
assigned thereto in Section 2(a) hereof. 
 “Exchange Securities” shall have the meaning assigned thereto in Section 2(a)
hereof.
 “FINRA” shall mean the Financial Industry Regulatory Authority, Inc. 

“Free Trade Date” shall mean the 380th day following the Closing Date. 

“Freely Tradable” shall mean, with respect to the Securities at any time of determination. that (a) all outstanding
Securities are eligible to be sold by a person who has not been an “affiliate” (as defined in Rule 405 under the Securities Act) of the Company or any Guarantor during the preceding 90 days without any volume or manner of sale restrictions
under the Securities Act, (b) the Company has provided a certificate to the Trustee instructing the Trustee that the restrictive legend on the Securities no longer applies and (c) the Securities have been assigned an unrestricted CUSIP number. 

“Guarantors” shall have the meaning assigned thereto in the preamble. 

  
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 The term “holder” shall mean each of the persons who acquire Registrable
Securities from time to time (including any successors or assigns), in each case for so long as such person owns any Registrable Securities. 

“Indenture” shall mean the Base Indenture, as supplemented by the Supplemental Indenture. 

“Initial Purchasers” shall mean Barclays Capital Inc., Citigroup Global Markets Inc. and Merrill Lynch, Pierce, Fenner &
Smith Incorporated. 
 “Notes” shall have the meaning assigned thereto in the preamble. 

The term “person” shall mean any individual, corporation, partnership, limited liability company, joint venture, trust,
unincorporated organization or government or any agency or political subdivision thereof. 
 “Purchase Agreement” shall
have the meaning assigned thereto in the preamble. 
 “Registrable Securities” shall mean the Securities; provided,
however, that a Security shall cease to be a Registrable Security upon the earliest to occur of the following: (a) in the circumstances contemplated by Section 2(a) hereof, the Security has been exchanged for an Exchange Security in an
Exchange Offer as contemplated in Section 2(a) hereof (provided that any Exchange Security that, pursuant to the second to last and third to last sentences of Section 2(a), is included in a prospectus for use in connection with resales by
broker-dealers shall be deemed to be a Registrable Security with respect to Sections 5, 6 and 9 until resale of such Registrable Security has been effected within the Resale Period); (b) the Securities become Freely Tradable or (c) such Security
shall cease to be outstanding. 
 “Registration Default” shall have the meaning assigned thereto in Section 2(b) hereof.

 “Registration Default Period” shall have the meaning assigned thereto in Section 2(b) hereof. 

“Registration Expenses” shall have the meaning assigned thereto in Section 4 hereof.

“Representative” shall have the meaning assigned thereto in the preamble. 

“Resale Period” shall have the meaning assigned thereto in Section 2(a) hereof. 

“Restricted Holder” shall mean (i) a holder that is an affiliate of the Company within the meaning of Rule 405, (ii) a holder
who acquires Exchange Securities outside the ordinary course of such holder’s business, (iii) a holder who has arrangements or understandings with any person to participate in the Exchange Offer for the purpose of distributing Exchange
Securities and (iv) a holder that is a broker-dealer, but only with respect to Exchange Securities received by such broker-dealer pursuant to an Exchange Offer in exchange for Registrable Securities acquired by the broker-dealer directly from the
Company. 

  
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 “Rule 144,” “Rule 405,” “Rule 415” and
“Rule 433” shall mean, in each case, such rule promulgated by the Commission under the Securities Act (or any successor provision), as the same may be amended or succeeded from time to time. 

“Securities” shall mean the Notes, and securities issued in exchange therefor or in lieu thereof pursuant to the
Indenture. Each Security is entitled to the benefit of the guarantees provided for in the Indenture (the “Guarantees”) and, unless the context otherwise requires, any reference herein to a “Security,” an
“Exchange Security” or a “Registrable Security” shall include the related Guarantees. 
 “Securities
Act” shall mean the Securities Act of 1933, as amended, or any successor thereto, as the same may be amended or succeeded from time to time. 

“Special Interest” shall have the meaning assigned thereto in Section 2(b) hereof. 

“Supplemental Indenture” shall mean the twenty-eighth supplemental indenture, dated as of December 1, 2016, between the
Company, the Guarantors and the Trustee, as the same shall be supplemented or amended from time to time. 
 “Trust Indenture
Act” shall mean the Trust Indenture Act of 1939, as amended, or any successor thereto, and the rules, regulations and forms promulgated thereunder, all as the same may be amended or succeeded from time to time. 

“Trustee” shall mean The Bank of New York Mellon Trust Company, N.A., as trustee under the Indenture, together with any
successors in such capacity. 
 Unless the context otherwise requires, any reference herein to a “Section” or “clause”
refers to a Section or clause, as the case may be, of this Agreement, and the words “herein,” “hereof” and “hereunder” and other words of similar import refer to this Agreement as a whole and not to any particular
Section or other subdivision. 
 2. Registration Under the Securities Act. 

(a) Subject to the last sentence of this Section 2(a), if the Securities have not become Freely Tradable on or before the Free Trade Date, the
Company and the Guarantors agree to use all commercially reasonable efforts to (i) file under the Securities Act a registration statement relating to an offer to exchange (such registration statement, the
“Exchange Registration Statement,” and such offer, the “Exchange Offer”) any and all of the Securities for a like aggregate principal amount of debt securities issued by the Company and guaranteed
by the Guarantors, which debt securities and guarantees are substantially identical to the Securities and the related Guarantees, respectively (and are entitled to the benefits of a trust indenture that is substantially identical to the Indenture or
is the Indenture and that has been qualified under the Trust Indenture Act), except that they have been registered pursuant to an effective registration statement under the Securities Act and do not contain provisions for the additional interest
contemplated in Section 2(b) below (such new debt securities are hereinafter called “Exchange Securities”), (ii) cause the Exchange Registration Statement to become effective under the Securities Act, (iii) commence the Exchange
Offer promptly after such Exchange Registration Statement has become effective, (iv) hold the Exchange Offer open for at least 20 Business Days 

  
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(or longer if required by applicable law) after the date that notice of the Exchange Offer is mailed to holders of the Securities, (v) exchange Exchange Securities for all Registrable Securities
that have been properly tendered and not withdrawn on or prior to the expiration of the Exchange Offer and (vi) consummate the Exchange Offer on the earliest practicable date after the Exchange Registration Statement has become effective, but in no
event later than 30 Business Days thereafter (such 30th Business Day being the “Consummation Date”). The Exchange Offer will be registered under the Securities Act on the appropriate form and will comply with all applicable
tender offer rules and regulations under the Exchange Act. The Exchange Offer will be deemed to have been “completed” only (A) if the debt securities and related guarantees received by holders other than Restricted Holders in the Exchange
Offer for Registrable Securities are, upon receipt, transferable by each such holder without restriction under the Securities Act and the Exchange Act and without material restrictions under the blue sky or securities laws of a substantial majority
of the states of the United States of America, and (B) upon the earlier to occur of (1) the Company having exchanged the Exchange Securities for all outstanding Registrable Securities pursuant to the Exchange Offer and (2) the Company having
exchanged, pursuant to the Exchange Offer, Exchange Securities for all Registrable Securities that have been properly tendered and not withdrawn before the expiration of the Exchange Offer, which shall be on a date that is at least 20 Business Days
following the commencement of the Exchange Offer. The Company and the Guarantors agree (I) to include in the Exchange Registration Statement a prospectus for use in any resales by any holder of Exchange Securities that is a broker-dealer and (II) to
keep such Exchange Registration Statement effective for a period (the “Resale Period”) beginning when Exchange Securities are first issued in the Exchange Offer and ending upon the earlier of the expiration of the 180th day after
the Exchange Offer has been completed or such time as such broker-dealers no longer own any Registrable Securities. With respect to such Exchange Registration Statement, such holders shall have the benefit of the rights of indemnification and
contribution set forth in Sections 6(a), (b), (c) and (d) hereof. The obligations of the Company and the Guarantors set forth in this Section 2(a) shall cease on the date on which the Securities become Freely Tradable. 

(b) If (i) the Exchange Offer has not been consummated prior to the Consummation Date, (ii) the Securities have not become Freely Tradable on
or before the Free Trade Date, or (iii) any Exchange Registration Statement required by this Agreement is filed and declared effective, but shall thereafter cease to be effective or fail to be usable for its intended purpose without being succeeded
by a post-effective amendment or prospectus supplement to such Exchange Registration Statement that cures such failure and that is itself declared effectively promptly (each such event referred to in clauses (i) through (iii), a
“Registration Default,” and the period during which a Registration Default has occurred and is continuing, the “Registration Default Period”), then, as liquidated damages for such Registration Default, subject to
the provisions of Section 8(b), special interest (“Special Interest”), in addition to the Base Interest, shall accrue at a per annum rate of 0.25% for the first 90 days of the Registration Default Period, at a per annum rate of
0.50% for the second 90 days of the Registration Default Period, at a per annum rate of 0.75% for the third 90 days of the Registration Default Period and at a per annum rate of 1.0% thereafter for the remaining portion of the Registration Default
Period, provided that in no event shall the Company be required to pay Special Interest for more than one Registration Default at any given time. The Registration Default Period shall terminate on the date on which (i) the Securities become
Freely Tradable or (ii) the Exchange Registration Statement has been declared effective and the Exchange Offer has been consummated. Special Interest shall not 

  
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accrue as a result of the Company’s failure to provide a certificate to the Trustee instructing the Trustee that the restrictive legend on the Securities no longer applies unless the Company
has received a request to do so by a holder of Securities or the Trustee on or after the 365th day after the Closing Date; provided that if the Company receives such a request on or after the fifth Business Day immediately preceding the Free Trade
Date and the restrictive legend on the Securities has not been removed by the close of business on the fifth Business Day thereafter, Special Interest shall accrue as provided in this Section 2(b) until the date on which (i) the Securities become
Freely Tradable or (ii) the Exchange Registration Statement has been declared effective and the Exchange Offer has been consummated. 
 (c)
The Company shall take, and shall cause the Guarantors to take, all actions necessary or advisable to be taken to ensure that the transactions contemplated herein are effected as so contemplated, including all actions necessary or desirable to
register the Guarantees under the Exchange Registration Statement contemplated in Section 2(a) hereof. 
 (d) Any reference herein to a
registration statement or prospectus as of any time shall be deemed to include any document incorporated, or deemed to be incorporated, therein by reference as of such time and any reference herein to any post-effective amendment to a registration
statement or to any prospectus supplement as of any time shall be deemed to include any document incorporated, or deemed to be incorporated, therein by reference as of such time. 

3. Registration Procedures. 

If the Company and the Guarantors file a registration statement pursuant to Section 2(a), the following provisions shall apply: 

(a) At or before the Effective Time of the Exchange Registration, the Company and the Guarantors shall qualify the Indenture under the Trust
Indenture Act. 
 (b) In the event that such qualification would require the appointment of a new trustee under the Indenture, the Company
and the Guarantors shall appoint a new trustee thereunder pursuant to the applicable provisions of the Indenture. 
 (c) In connection with
the Company’s and the Guarantors’ obligations with respect to the registration of Exchange Securities as contemplated by Section 2(a) (the “Exchange Registration”), if applicable, the Company and the Guarantors shall, as
soon as practicable (or as otherwise specified): 
 (i) prepare and file with the Commission an Exchange Registration
Statement on any form that may be utilized by the Company and the Guarantors and that shall permit the Exchange Offer and resales of Exchange Securities by broker-dealers during the Resale Period to be effected as contemplated by Section 2(a), and
use all commercially reasonable efforts to cause such Exchange Registration Statement to become effective; 
 (ii) prepare
and file with the Commission such amendments and supplements to such Exchange Registration Statement and the prospectus included therein as may be necessary to effect and maintain the effectiveness of such Exchange Registration

  
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Statement for the periods and purposes contemplated in Section 2(a) hereof and as may be required by the applicable rules and regulations of the Commission and the instructions applicable to the
form of such Exchange Registration Statement, and promptly provide each broker-dealer holding Exchange Securities with such number of copies of the prospectus included therein (as then amended or supplemented), in conformity in all material respects
with the requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder, as such broker-dealer reasonably may request prior to the expiration of the Resale Period, for use in connection with
resales of Exchange Securities; 
 (iii) notify each broker-dealer that has requested or received copies of the prospectus
included in such Exchange Registration Statement, and confirm such advice in writing, (A) when such Exchange Registration Statement or the prospectus included therein or any prospectus amendment or supplement or post-effective amendment has been
filed, and, with respect to such Exchange Registration Statement or any post-effective amendment, when the same has become effective, (B) of any comments by the Commission and by the blue sky or securities commissioner or regulator of any state with
respect thereto or any request by the Commission for amendments or supplements to such Exchange Registration Statement or prospectus or for additional information, (C) of the issuance by the Commission of any stop order suspending the effectiveness
of such Exchange Registration Statement or the initiation or threatening of any proceedings for that purpose, (D) if at any time the representations and warranties of the Company and the Guarantors contemplated by Section 5 cease to be true and
correct in all material respects, (E) of the receipt by the Company of any notification with respect to the suspension of the qualification of the Exchange Securities for sale in any jurisdiction or the initiation or threatening of any proceeding
for such purpose, or (F) at any time during the Resale Period when a prospectus is required to be delivered under the Securities Act, that such Exchange Registration Statement, prospectus, prospectus amendment or supplement or post-effective
amendment does not conform in all material respects to the applicable requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder or contains an untrue statement of a material fact or
omits to state any material fact required to be stated therein or necessary to make the statements therein not misleading in light of the circumstances then existing; 

(iv) in the event that the Company and the Guarantors would be required, pursuant to Section 3(c)(iii)(F) above, to notify any
broker-dealers holding Exchange Securities, prepare and furnish to each such holder a reasonable number of copies of a prospectus supplemented or amended so that, as thereafter delivered to purchasers of such Exchange Securities during the Resale
Period, such prospectus shall conform in all material respects to the applicable requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder and shall not contain an untrue statement of a
material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein not misleading in light of the circumstances then existing; 

  
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 (v) use all commercially reasonable efforts to obtain the withdrawal of any order
suspending the effectiveness of such Exchange Registration Statement or any post-effective amendment thereto at the earliest practicable date; 

(vi) use all commercially reasonable efforts to (A) register or qualify the Exchange Securities under the securities laws or
blue sky laws of such jurisdictions as are contemplated by Section 2(a) no later than the commencement of the Exchange Offer, (B) keep such registrations or qualifications in effect and comply with such laws so as to permit the continuance of
offers, sales and dealings therein in such jurisdictions until the expiration of the Resale Period and (C) take any and all other actions as may be reasonably necessary or advisable to enable each broker-dealer holding Exchange Securities to
consummate the disposition thereof in such jurisdictions; provided, however, that neither the Company nor any of the Guarantors shall be required for any such purpose to (1) qualify as a foreign corporation in any jurisdiction wherein it would not
otherwise be required to qualify but for the requirements of this Section 3(c)(vi), (2) consent to general service of process in any such jurisdiction or (3) in the case of the Company, make any changes to its certificate of incorporation or bylaws
or any agreement between it and its stockholders, and in the case of the Guarantors, make any changes to (x) the certificate (or articles) of incorporation, certificate (or articles) of organization, certificate (or articles) of formation or
certificate of limited partnership, as the case may be, and any amendments thereto, of any Guarantor, (y) the bylaws, limited liability company agreement, operating agreement or partnership agreement, as the case may be, and any amendments thereto,
of any Guarantor or (z) any agreement between any Guarantor and its stockholders, shareholders, members or partners; 
 (vii)
use all commercially reasonable efforts to obtain the consent or approval of each governmental agency or authority, whether federal, state or local, that may be required to effect the Exchange Registration, the Exchange Offer and the offering and
sale of Exchange Securities by broker-dealers during the Resale Period; 
 (viii) provide a CUSIP number for all Exchange
Securities, not later than the applicable Effective Time; and 
 (ix) comply with all applicable rules and regulations of the
Commission, and make generally available to its security holders as soon as practicable but no later than 18 months after the Effective Time of such Exchange Registration Statement, an earnings statement of the Company and its subsidiaries complying
with Section 11(a) of the Securities Act (including, at the option of the Company, Rule 158 thereunder). 
 (d) Until the expiration of one
year after the Closing Date, the Company and the Guarantors will not, and will not permit any of their “affiliates” (as defined in Rule 144) to, resell any of the Securities that have been acquired by any of them except pursuant to an
effective registration statement under the Securities Act. 

  
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 4. Registration Expenses. 

The Company and the Guarantors agree to bear and to pay or cause to be paid promptly all expenses incident to the Company’s and the
Guarantors’ performance of or compliance with this Agreement, including, without limitation, (a) all Commission and any FINRA registration, filing and review fees and expenses including fees and disbursements of counsel for the placement or
sales agent or underwriters in connection with such registration, filing and review; (b) all expenses relating to the preparation, printing, production, distribution and reproduction of each registration statement required to be filed hereunder,
each prospectus included therein or prepared for distribution pursuant hereto, each amendment or supplement to the foregoing, the expenses of preparing the Securities for delivery and the expenses of printing or producing any blue sky or legal
investment memoranda and all other documents in connection with the offering, sale or delivery of Securities to be disposed of (including certificates representing the Securities); (c) messenger, telephone and delivery expenses relating to the
offering, sale or delivery of Securities and the preparation of documents referred in clause (b) above; (d) fees and expenses of the Trustee under the Indenture, any agent of the Trustee and any counsel for the Trustee and of any collateral agent or
custodian; (e) internal expenses (including all salaries and expenses of the Company’s or Guarantors’ officers and employees performing legal or accounting duties); (f) fees, disbursements and expenses of counsel and independent
registered public accountants of the Company (including the expenses of any opinions or “comfort” letters required by or incident to such performance and compliance); (g) any fees charged by securities rating services for rating the
Securities; and (h) fees, expenses and disbursements of any other persons, including special experts, retained by the Company or its Guarantors in connection with this Agreement (collectively, the “Registration Expenses”). To the
extent that any reasonable fees are incurred, assumed or paid by any holder of Registrable Securities or its counsel, the Company or its Guarantors shall reimburse such person for the full amount of such reasonable fees so incurred, assumed or paid
promptly after receipt of a request therefor. Notwithstanding the foregoing, the holders of the Registrable Securities being registered shall pay all agency fees and commissions attributable to the sale of such Registrable Securities. 

5. Representations and Warranties. 

Each of the Company and the Guarantors, jointly and severally, represents and warrants to, and agrees with, the Initial Purchasers and each of
the holders from time to time of Registrable Securities that: 
 (a) Each registration statement covering Registrable Securities and each
prospectus (including any preliminary or summary prospectus) contained therein or furnished pursuant to Section 3(c) hereof and any further amendments or supplements to any such registration statement or prospectus, when it becomes effective or is
filed with the Commission, as the case may be, will conform in all material respects to the requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder and will not contain an untrue
statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein not misleading; and at all times subsequent to the Effective Time when a prospectus would be required to be
delivered under the Securities Act, other than from (i) such time as a notice has been given to holders of Registrable Securities pursuant to Section 3(c)(iii)(F) hereof until (ii) such time as the Company furnishes an amended

  
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or supplemented prospectus pursuant to Section 3(c)(iv) hereof, each such registration statement, and each prospectus (including any summary prospectus) contained therein or furnished pursuant to
Section 3(c) hereof, as then amended or supplemented, will conform in all material respects to the requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder and will not contain an
untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the circumstances then existing; provided, however, that this
representation and warranty shall not apply to any statements or omissions made in reliance upon and in conformity with information furnished in writing to the Company by a holder of Registrable Securities expressly for use therein. 

(b) Any documents incorporated by reference in any prospectus referred to in Section 5(a) hereof, when they become or became effective or are
or were filed with the Commission, as the case may be, will conform or conformed in all material respects to the requirements of the Securities Act or the Exchange Act, as applicable, and none of such documents will contain or contained an untrue
statement of a material fact or will omit or omitted to state a material fact required to be stated therein or necessary to make the statements therein not misleading; provided, however, that this representation and warranty shall not
apply to any statements or omissions made in reliance upon and in conformity with information furnished in writing to the Company by a holder of Registrable Securities expressly for use therein. 

(c) The compliance by the Company and the Guarantors with all of the provisions of this Agreement and the consummation of the transactions
herein contemplated will not: (i) conflict with or result in a material breach of any of the terms or provisions of, or constitute a default under, any indenture, mortgage, deed of trust, loan agreement or other agreement or instrument to which the
Company or any subsidiary of the Company is a party or by which the Company or any subsidiary of the Company is bound or to which any of the property or assets of the Company or any subsidiary of the Company is subject; (ii) result in any violation
of the provisions of the articles of incorporation, as amended, or the bylaws of the Company; the certificate (or articles) of incorporation, certificate (or articles) of organization, certificate (or articles) of formation or certificate of limited
partnership, as the case may be, and any amendments thereto, of any Guarantor; the bylaws, limited liability company agreement, operating agreement or partnership agreement, as the case may be, and any amendments thereto, of any Guarantor; or (iii)
result in any material violation of any law or statute or any order, rule or regulation of any court or governmental agency or body having jurisdiction over the Company or any subsidiary of the Company or any of their properties. No consent,
approval, authorization, order, registration or qualification of or with any such court or governmental agency or body is required for the consummation by the Company and the Guarantors of the transactions contemplated by this Agreement, except the
registration under the Securities Act of the Securities, the qualification of the Indenture under the Trust Indenture Act and such consents, approvals, authorizations, registrations or qualifications as may be required under state securities or blue
sky laws in connection with the offering and distribution of the Securities. 
 (d) This Agreement has been duly authorized, executed and
delivered by the Company and each Guarantor. 

  
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 6. Indemnification. 

(a) Indemnification by the Company and the Guarantors. The Company and the Guarantors, jointly and severally, will indemnify and hold
harmless each of the holders of Registrable Securities included in an Exchange Registration Statement, and each person who participates as a placement or sales agent or as an underwriter in any offering or sale of such Registrable Securities against
any losses, claims, damages or liabilities, joint or several, to which such holder, agent or underwriter may become subject under the Securities Act or otherwise, insofar as such losses, claims, damages or liabilities (or actions in respect thereof)
arise out of or are based upon an untrue statement or alleged untrue statement of a material fact contained in any Exchange Registration Statement under which such Registrable Securities were registered under the Securities Act, or any preliminary,
final or summary prospectus (including, without limitation, any “issuer free writing prospectus” as defined in Rule 433) contained therein or furnished by the Company to any such holder, agent or underwriter, or any amendment or supplement
thereto, or arise out of or are based upon the omission or alleged omission to state therein a material fact required to be stated therein or necessary to make the statements therein not misleading, and will reimburse such holder, such agent and
such underwriter for any legal or other expenses reasonably incurred by them in connection with investigating or defending any such action or claim as such expenses are incurred; provided, however, that neither the Company nor any
Guarantor shall be liable to any such person in any such case to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement or alleged untrue statement or omission or alleged omission made in any
registration statement contemplated hereunder, or preliminary, final or summary prospectus (including, without limitation, any “issuer free writing prospectus” as defined in Rule 433), or amendment or supplement thereto, in reliance upon
and in conformity with written information furnished to the Company by such person expressly for use therein. 
 (b) Notices of Claims,
Etc. Promptly after receipt by an indemnified party under subsection (a) above of written notice of the commencement of any action, such indemnified party shall, if a claim in respect thereof is to be made against an indemnifying party
pursuant to the indemnification provisions of or contemplated by this Section 6, notify such indemnifying party in writing of the commencement of such action; but the omission so to notify the indemnifying party shall not relieve it from any
liability which it may have to any indemnified party otherwise than under the indemnification provisions of or contemplated by Section 6(a) hereof. In case any such action shall be brought against any indemnified party and it shall notify an
indemnifying party of the commencement thereof, such indemnifying party shall be entitled to participate therein and, to the extent that it shall wish, jointly with any other indemnifying party similarly notified, to assume the defense thereof, with
counsel reasonably satisfactory to such indemnified party (who shall not, except with the consent of the indemnified party, be counsel to the indemnifying party), and, after notice from the indemnifying party to such indemnified party of its
election so to assume the defense thereof, such indemnifying party shall not be liable to such indemnified party for any legal expenses of other counsel or any other expenses, in each case subsequently incurred by such indemnified party, in
connection with the defense thereof other than reasonable costs of investigation. No indemnifying party shall, without the prior written consent of the indemnified party, effect the settlement or compromise of, or consent to the entry of any
judgment with respect to, any pending or threatened action or claim in respect of which indemnification or contribution may be sought hereunder (whether or not the indemnified 

  
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party is an actual or potential party to such action or claim) unless such settlement, compromise or judgment (i) includes an unconditional release of the indemnified party from all liability
arising out of such action or claim and (ii) does not include a statement as to or an admission of fault, culpability or a failure to act by or on behalf of any indemnified party. 

(c) Contribution. If for any reason the indemnification provisions contemplated by Section 6(a) are unavailable to or insufficient to
hold harmless an indemnified party in respect of any losses, claims, damages or liabilities (or actions in respect thereof) referred to therein, then each indemnifying party shall contribute to the amount paid or payable by such indemnified party as
a result of such losses, claims, damages or liabilities (or actions in respect thereof) in such proportion as is appropriate to reflect the relative fault of the indemnifying party and the indemnified party in connection with the statements or
omissions which resulted in such losses, claims, damages or liabilities (or actions in respect thereof), as well as any other relevant equitable considerations. The relative fault of such indemnifying party and indemnified party shall be determined
by reference to, among other things, whether the untrue or alleged untrue statement of a material fact or omission or alleged omission to state a material fact relates to information supplied by such indemnifying party or by such indemnified party,
and the parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. The parties hereto agree that it would not be just and equitable if contributions pursuant to this Section 6(c)
were determined by pro rata allocation (even if the holders or any agents or underwriters or all of them were treated as one entity for such purpose) or by any other method of allocation that does not take account of the equitable considerations
referred to in this Section 6(c). The amount paid or payable by an indemnified party as a result of the losses, claims, damages, or liabilities (or actions in respect thereof) referred to above shall be deemed to include any legal or other fees or
expenses reasonably incurred by such indemnified party in connection with investigating or defending any such action or claim. Notwithstanding the provisions of this Section 6(c), no holder shall be required to contribute any amount in excess of the
amount by which the dollar amount of the proceeds received by such holder from the sale of any Registrable Securities (after deducting any fees, discounts and commissions applicable thereto) exceeds the amount of any damages that such holder has
otherwise been required to pay by reason of such untrue or alleged untrue statement or omission or alleged omission, and no underwriter shall be required to contribute any amount in excess of the amount by which the total price at which the
Registrable Securities underwritten by it and distributed to the public were offered to the public exceeds the amount of any damages that such underwriter has otherwise been required to pay by reason of such untrue or alleged untrue statement or
omission or alleged omission. No person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Securities Act) shall be entitled to contribution from any person who was not guilty of such fraudulent misrepresentation. The
holders’ obligations in this Section 6(c) to contribute shall be several in proportion to the principal amount of Registrable Securities registered by them and not joint. 

(d) The obligations of the Company and the Guarantors under this Section 6 shall be in addition to any liability which the Company or the
Guarantors may otherwise have and shall extend, upon the same terms and conditions, to each officer, director and partner of each holder, agent and underwriter and each person, if any, who controls any holder, agent or underwriter within the meaning
of the Securities Act; and the obligations of the holders and any agents or underwriters contemplated by this Section 6 shall be in addition to any liability which the 

  
 12 

 
respective holder, agent or underwriter may otherwise have and shall extend, upon the same terms and conditions, to each officer and director of the Company or any Guarantor (including any person
who, with his consent, is named in any registration statement as about to become a director of the Company or any Guarantor) and to each person, if any, who controls the Company within the meaning of the Securities Act. 

7. Rule 144. 
 The
Company covenants to the holders of Registrable Securities that to the extent it shall be required to do so under the Exchange Act, the Company shall timely file the reports required to be filed by it under the Exchange Act or the Securities Act
(including the reports under Section 13 and 15(d) of the Exchange Act referred to in subparagraph (c)(1) of Rule 144 adopted by the Commission under the Securities Act) and the rules and regulations adopted by the Commission thereunder, and shall
take such further action as any holder of Registrable Securities may reasonably request, all to the extent required from time to time to enable such holder to sell Registrable Securities without registration under the Securities Act within the
limitations of the safe harbor provided by Rule 144 under the Securities Act, as such Rule may be amended from time to time, or any similar or successor rule or regulation hereafter adopted by the Commission. Upon the request of any holder of
Registrable Securities in connection with that holder’s sale pursuant to Rule 144, the Company shall deliver to such holder a written statement as to whether it has complied with such requirements. 

8. Miscellaneous. 
 (a)
No Inconsistent Agreements. The Company and each Guarantor represents, warrants, covenants and agrees that it has not granted, and shall not grant, registration rights with respect to Registrable Securities or any other securities which
would be inconsistent with the terms contained in this Agreement. 
 (b) Specific Performance. The parties hereto acknowledge
that there would be no adequate remedy at law if the Company or any Guarantor fails to perform any of its obligations hereunder and that the Initial Purchasers and the holders from time to time of the Registrable Securities may be irreparably harmed
by any such failure, and accordingly agree that the Initial Purchasers and such holders, in addition to any other remedy to which they may be entitled at law or in equity, shall be entitled to seek specific performance of the obligations of the
Company and the Guarantors under this Agreement in accordance with the terms and conditions of this Agreement, in any court of the United States or any state thereof having jurisdiction. 

(c) Notices. All notices, requests, claims, demands, waivers and other communications hereunder shall be in writing and shall be
deemed to have been duly given when delivered by hand, if delivered personally or by courier, or three days after being deposited in the mail (registered or certified mail, postage prepaid, return receipt requested) as follows: If to the
Company, to it at 1445 Ross Avenue, Suite 1400, Dallas, Texas 75202, Attention: Paul Castanon, Deputy General Counsel, and if to a holder, to the address of such holder set forth in the security register or other records of the Company, or to
such other address as the Company or any such holder may have furnished to the other in writing in accordance herewith, except that notices of change of address shall be effective only upon receipt. 

  
 13 

 (d) Parties in Interest. All the terms and provisions of this Agreement shall be
binding upon, shall inure to the benefit of and shall be enforceable by the parties hereto and the holders from time to time of the Registrable Securities and the respective successors and assigns of the parties hereto and such holders. In the
event that any transferee of any holder of Registrable Securities shall acquire Registrable Securities, in any manner, whether by gift, bequest, purchase, operation of law or otherwise, such transferee shall, without any further writing or action of
any kind, be deemed a beneficiary hereof for all purposes and such Registrable Securities shall be held subject to all of the terms of this Agreement, and by taking and holding such Registrable Securities such transferee shall be entitled to receive
the benefits of, and be conclusively deemed to have agreed to be bound by all of the applicable terms and provisions of this Agreement. If the Company shall so request, any such successor, assign or transferee shall agree in writing to acquire
and hold the Registrable Securities subject to all of the applicable terms hereof. 
 (e) Survival. The respective indemnities,
agreements, representations, warranties and each other provision set forth in this Agreement or made pursuant hereto shall remain in full force and effect regardless of any investigation (or statement as to the results thereof) made by or on behalf
of any holder of Registrable Securities, any director, officer or partner of such holder, any agent or underwriter or any director, officer or partner thereof, or any controlling person of any of the foregoing, and shall survive delivery of and
payment for the Registrable Securities pursuant to the Purchase Agreement and the transfer and registration of Registrable Securities by such holder and the consummation of an Exchange Offer. 

(f) Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the
State of New York. 
 (g) Headings. The descriptive headings of the several sections and paragraphs of this Agreement are
inserted for convenience only, do not constitute a part of this Agreement and shall not affect in any way the meaning or interpretation of this Agreement. 

(h) Entire Agreement; Amendments. This Agreement and the other writings referred to herein (including the Indenture, the Purchase
Agreement and the form of Securities) or delivered pursuant hereto which form a part hereof contain the entire understanding of the parties with respect to its subject matter. This Agreement supersedes all prior agreements and understandings
between the parties with respect to its subject matter. This Agreement may be amended and the observance of any term of this Agreement may be waived (either generally or in a particular instance and either retroactively or prospectively) only
by a written instrument duly executed by the Company, the Guarantors and the holders of at least a majority in aggregate principal amount of the Registrable Securities at the time outstanding. Each holder of any Registrable Securities at the
time or thereafter outstanding shall be bound by any amendment or waiver effected pursuant to this Section 8(h), whether or not any notice, writing or marking indicating such amendment or waiver appears on such Registrable Securities or is delivered
to such holder. 
 (i) Inspection. For so long as this Agreement shall be in effect, this Agreement and a complete list of the
names and addresses of all the holders of Registrable Securities shall be made available for inspection and copying on any Business Day by any holder of Registrable 

  
 14 

 
Securities for proper purposes only (which shall include any purpose related to the rights of the holders of Registrable Securities under the Securities, the Indenture and this Agreement) at the
offices of the Company at the address thereof set forth in Section 8(c) above and at the office of the Trustee under the Indenture. 
 (j)
Counterparts. This Agreement may be executed by the parties in counterparts, each of which shall be deemed to be an original, but all such respective counterparts shall together constitute one and the same instrument. Delivery of an
executed counterpart of a signature page to this Agreement by telecopier, facsimile or other electronic transmission (i.e., a “pdf’ or “tif’) shall be effective as delivery of a manually executed counterpart thereof. 

(k) Severability. If any provision of this Agreement, or the application thereof in any circumstance, is held to be invalid,
illegal or unenforceable in any respect for any reason, the validity, legality and enforceability of such provision in every other respect and of the remaining provisions contained in this Agreement shall not be affected or impaired thereby. 

(signature pages follow) 

  
 15 

 If the foregoing is in accordance with your understanding, please sign and return to us two
counterparts hereof, and upon the acceptance hereof by you, on behalf of each of the holders, this letter and such acceptance hereof shall constitute a binding agreement among each of the holders, the Guarantors and the Company. 

 

					
	 Very truly yours,
  

TENET HEALTHCARE CORPORATION

		
	By:	 	 /s/ James E. Snyder III

		 	Name:	 	James E. Snyder III
		 	Title:	 	Vice President and Assistant Treasurer

 [Signature Page to Exchange and Registration Rights Agreement] 

 AMERICAN MEDICAL (CENTRAL), INC. 

AMI INFORMATION SYSTEMS GROUP, INC. 

AMISUB (HEIGHTS), INC. 

AMISUB (HILTON HEAD), INC. 

AMISUB (SFH), INC. 

AMISUB (TWELVE OAKS), INC. 

AMISUB OF NORTH CAROLINA, INC. 

AMISUB OF SOUTH CAROLINA, INC. 

AMISUB OF TEXAS, INC. 

ANAHEIM MRI HOLDING, INC. 

BROOKWOOD HEALTH SERVICES, INC. 

CGH HOSPITAL, LTD., by: CORAL GABLES HOSPITAL, INC., as general partner 

COASTAL CAROLINA MEDICAL CENTER, INC. 

COMMUNITY HOSPITAL OF LOS GATOS, INC. 

CORAL GABLES HOSPITAL, INC. 

CYPRESS FAIRBANKS MEDICAL CENTER INC. 

DELRAY MEDICAL CENTER, INC. 

DES PERES HOSPITAL, INC. 

EAST COOPER COMMUNITY HOSPITAL, INC. 

FMC MEDICAL, INC. 

FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER 

FRYE REGIONAL MEDICAL CENTER, INC. 

GOOD SAMARITAN MEDICAL CENTER, INC. 

HEALTHCARE NETWORK CFMC, INC. 

HEALTHCARE NETWORK HOLDINGS, INC. 

HEALTHCORP NETWORK, INC. 

HEALTHCARE NETWORK LOUISIANA, INC. 

HEALTHCARE NETWORK MISSOURI, INC. 

HEALTHCARE NETWORK TEXAS, INC. 

HEALTH SERVICES NETWORK HOSPITALS, INC. 

HEALTH SERVICES NETWORK TEXAS, INC. 

HIALEAH HOSPITAL, INC. 

HILTON HEAD HEALTH SYSTEM, L.P., by: TENET PHYSICIAN SERVICES – HILTON HEAD, INC., as general partner 

HOSPITAL DEVELOPMENT OF WEST PHOENIX, INC. 

LIFEMARK HOSPITALS, INC. 

LIFEMARK HOSPITALS OF FLORIDA, INC. 

NEW MEDICAL HORIZONS II, LTD., by: CYPRESS FAIRBANKS MEDICAL CENTER INC., as general partner 

NORTH SHORE MEDICAL CENTER, INC. 

ORNDA HOSPITAL CORPORATION 

PALM BEACH GARDENS COMMUNITY HOSPITAL, INC. 

SAINT FRANCIS HOSPITAL – BARTLETT, INC. 

SLH VISTA, INC. 

SPALDING REGIONAL MEDICAL CENTER, INC. 

SRRMC MANAGEMENT, INC. 

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

 ST. MARY’S MEDICAL CENTER INC. 

SYLVAN GROVE HOSPITAL, INC. 

TENET CALIFORNIA, INC. 

TENET FLORIDA, INC. 

TENET FRISCO, LTD., by: HEALTHCARE NETWORK TEXAS, INC., as general partner 

TENET HEALTHSYSTEM HAHNEMANN, L.L.C., by: TENET HEALTHSYSTEM PHILADELPHIA, INC., as managing member 

TENET HEALTHSYSTEM MEDICAL, INC. 

TENET HEALTHSYSTEM PHILADELPHIA, INC. 

TENET HEALTHSYSTEM ST. CHRISTOPHER’S HOSPITAL FOR CHILDREN, L.L.C., by: TENET HEALTHSYSTEM PHILADELPHIA, INC., as
managing member 
 TENET HOSPITALS LIMITED, by: HEALTHCARE NETWORK TEXAS, INC., as general partner 

TENET PHYSICIAN SERVICES — HILTON HEAD, INC. 

TH HEALTHCARE, LTD., by: LIFEMARK HOSPITALS, INC., as general partner 

VHS ACQUISITION CORPORATION 

VHS ACQUISITION SUBSIDIARY NUMBER 1, INC. 

VHS ACQUISITION SUBSIDIARY NUMBER 3, INC. 

VHS ACQUISITION SUBSIDIARY NUMBER 7, INC. 

VHS ACQUISITION SUBSIDIARY NUMBER 9, INC. 

VHS BROWNSVILLE HOSPITAL COMPANY, LLC 

WEST BOCA MEDICAL CENTER, INC. 

VHS CHILDREN’S HOSPITAL OF MICHIGAN, INC. 

VHS DETROIT RECEIVING HOSPITAL, INC. 

VHS HARLINGEN HOSPITAL COMPANY, LLC 

VHS HARPER-HUTZEL HOSPITAL, INC. 

VHS HURON VALLEY-SINAI HOSPITAL, INC. 

VHS OF ARROWHEAD, INC. 

VHS OF ILLINOIS, INC. 

VHS REHABILITATION INSTITUTE OF MICHIGAN, INC. 

VHS SAN ANTONIO PARTNERS, LLC, by: VHS ACQUISITION SUBSIDIARY NUMBER 5, INC., its managing member, and VHS HOLDING COMPANY,
INC. 
 VHS SINAI-GRACE HOSPITAL, INC. 

VHS VALLEY MANAGEMENT COMPANY, INC. 

VHS WEST SUBURBAN MEDICAL CENTER, INC. 

VHS WESTLAKE HOSPITAL, INC. 

VHS OF PHOENIX, INC. 

VANGUARD HEALTH FINANCIAL COMPANY, LLC 

VANGUARD HEALTH HOLDING COMPANY I, LLC 

VANGUARD HEALTH HOLDING COMPANY II, LLC 

VANGUARD HEALTH MANAGEMENT, INC. 

VANGUARD HEALTH SYSTEMS, INC. 

VHS OF MICHIGAN, INC. 

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

 
					
	By:	 	 /s/ James E. Snyder III

		 	Name:	 	James E. Snyder III
		 	Title:	 	Treasurer

 BBH BMC, LLC 

BROOKWOOD BAPTIST HEALTH 1, LLC 

DESERT REGIONAL MEDICAL CENTER, INC. 

DOCTORS HOSPITAL OF MANTECA, INC. 

DOCTORS MEDICAL CENTER OF MODESTO, INC. 

JFK MEMORIAL HOSPITAL, INC. 

LAKEWOOD REGIONAL MEDICAL CENTER, INC. 

LOS ALAMITOS MEDICAL CENTER, INC. 

PLACENTIA-LINDA HOSPITAL, INC. 

SAN RAMON REGIONAL MEDICAL CENTER, LLC 

SIERRA VISTA HOSPITAL, INC. 

TWIN CITIES COMMUNITY HOSPITAL, INC. 

VHS VALLEY HEALTH SYSTEM, LLC 
  

					
	By:	 	 /s/ James E. Snyder III

		 	Name:	 	James E. Snyder III
		 	Title:	 	 Assistant Treasurer

 ATLANTA MEDICAL CENTER, INC. 

NORTH FULTON MEDICAL CENTER, INC. 
  

					
	By:	 	 /s/ William G. Morrison

		 	Name:	 	William G. Morrison
		 	Title:	 	Treasurer

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

 The foregoing Agreement is hereby confirmed and accepted as of the date first above written. 

 

	
	 BARCLAYS CAPITAL INC.

Acting on behalf of itself and as Representative of the several Initial Purchasers

 BARCLAYS CAPITAL INC. 
  

					
	By:	 	 /s/ John Skrobe

		 	Name:	 	John Skrobe
		 	Title:	 	Managing Director

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

 Schedule I 

Guarantors 
 American Medical (Central),
Inc. 
 AMI Information Systems Group, Inc. 
 Amisub (Heights),
Inc. 
 Amisub (Hilton Head), Inc. 
 Amisub (SFH), Inc. 

Amisub (Twelve Oaks), Inc. 
 Amisub of North Carolina, Inc. 

Amisub of South Carolina, Inc. 
 Amisub of Texas, Inc. 

Anaheim MRI Holding, Inc. 
 BBH BMC, LLC 

Atlanta Medical Center, Inc. 
 Brookwood Baptist Health 1, LLC

 Brookwood Health Services, Inc. 
 CGH Hospital, Ltd. 

Coastal Carolina Medical Center, Inc. 
 Community Hospital of Los
Gatos, Inc. 
 Coral Gables Hospital, Inc. 
 Cypress Fairbanks
Medical Center, Inc. 
 Delray Medical Center, Inc. 
 Des Peres
Hospital, Inc. 
 Desert Regional Medical Center, Inc. 
 Doctors
Hospital of Manteca, Inc. 
 Doctors Medical Center of Modesto, Inc. 

East Cooper Community Hospital, Inc. 
 FMC Medical, Inc. 

Fountain Valley Regional Hospital and Medical Center 
 Frye
Regional Medical Center, Inc. 
 Good Samaritan Medical Center, Inc. 

Healthcare Network CFMC, Inc. 
 Healthcare Network Holdings, Inc.

 Healthcare Network Louisiana, Inc. 
 Healthcare Network
Missouri, Inc. 
 Healthcare Network Texas, Inc. 
 HealthCorp
Network, Inc. 
 Health Services Network Hospitals, Inc. 

Health Services Network Texas, Inc. 
 Hialeah Hospital, Inc. 

Hilton Head Health System, L.P. 
 Hospital Development of West
Phoenix, Inc. 
 JFK Memorial Hospital, Inc. 

  
 I-1 

 Lakewood Regional Medical Center, Inc. 

Lifemark Hospitals of Florida, Inc. 
 Lifemark Hospitals, Inc.

 Los Alamitos Medical Center, Inc. 
 New Medical Horizons II,
Ltd. 
 North Fulton Medical Center, Inc. 
 North Shore Medical
Center, Inc. 
 OrNda Hospital Corporation 
 Palm Beach Gardens
Community Hospital, Inc. 
 Placentia-Linda Hospital, Inc. 

Saint Francis Hospital – Bartlett, Inc. 
 San Ramon Regional
Medical Center, LLC 
 Sierra Vista Hospital, Inc. 
 SLH Vista,
Inc. 
 Spalding Regional Medical Center, Inc. 
 SRRMC
Management, Inc. 
 St. Mary’s Medical Center Inc. 
 Sylvan
Grove Hospital, Inc. 
 Tenet California, Inc. 
 Tenet Florida,
Inc. 
 Tenet Frisco, Ltd. 
 Tenet HealthSystem Hahnemann, LLC

 Tenet HealthSystem Medical, Inc. 
 Tenet HealthSystem
Philadelphia, Inc. 
 Tenet HealthSystem St. Christopher’s Hospital for Children, L.L.C. 

Tenet Hospitals Limited 
 Tenet Physician Services — Hilton
Head, Inc. 
 TH Healthcare, Ltd. 
 Twin Cities Community
Hospital, Inc. 
 Vanguard Health Financial Company, LLC 

Vanguard Health Holding Company I, LLC 
 Vanguard Health Holding
Company II, LLC 
 Vanguard Health Management, Inc. 
 Vanguard
Health Systems, Inc. 
 VHS Acquisition Corporation 
 VHS
Acquisition Subsidiary Number 1, Inc. 
 VHS Acquisition Subsidiary Number 3, Inc. 

VHS Acquisition Subsidiary Number 7, Inc. 
 VHS Acquisition
Subsidiary Number 9, Inc. 
 VHS Children’s Hospital of Michigan, Inc. 

VHS Brownsville Hospital Company, LLC 
 VHS Harlingen Hospital
Company, LLC 
 VHS Detroit Receiving Hospital, Inc. 
 VHS
Harper-Hutzel Hospital, Inc. 
 VHS Huron Valley-Sinai Hospital, Inc. 

VHS of Arrowhead, Inc. 

  
 I-2 

 VHS of Illinois, Inc. 

VHS of Michigan, Inc. 
 VHS of Phoenix, Inc. 

VHS Rehabilitation Institute of Michigan, Inc. 
 VHS San Antonio
Partners, LLC 
 VHS Sinai-Grace Hospital, Inc. 
 VHS West
Suburban Medical Center, Inc. 
 VHS Westlake Hospital, Inc. 

VHS Valley Management Company, Inc. 
 VHS Valley Health System,
LLC 
 West Boca Medical Center, Inc. 

  
 I-3hlwd_ex101.htm

EXHIBIT 10.1
 
STOCK PURCHASE AGREEMENT
 
THIS STOCK PURCHASE AGREEMENT (this “Agreement”) by and among Almost Never Films Inc., a Nevada corporation (the “Company”) and the undersigned purchaser (“Purchaser”) is made as of the date first written on Purchaser’s signature page attached hereto.
The parties hereby agree as follows:
 
Purchase and Sale of Shares of Common Stock.
 
Sale and Issuance of Shares.
Subject to the terms and conditions of this Agreement, at the Closing (as hereinafter defined), Purchaser agrees to purchase from the Company, and the Company agrees to sell and issue to Purchaser, that number of shares of common stock, US$0.001 par value per share (the “Common Stock”), set forth on Purchaser’s signature page attached hereto, at a purchase price of US$0.02 per share. The shares of Common Stock issued to Purchaser pursuant to this Agreement shall be referred to in this Agreement as the “Shares.”
 
Closing; Delivery.
Thepurchase and sale of the Shares shall take place remotely via the exchange of documents and signatures, at such time and place as the Company and Purchaser mutually agree upon, orally or in writing (which time and place are designated as the “Closing”).
 
Use of Proceeds.
The Company will use the proceeds from the sale of the Shares for working capital and other general corporate purposes.
 
Defined Terms.
In addition to the terms defined above, the following terms used in this Agreement shall be construed to have the meanings set forth or referenced below.
 
“Affiliate” means, with respect to any specified Person, any other Person who, directly or indirectly, controls, is controlled by, or is under common control with such Person, including, without limitation, any general partner, managing member, officer or director of such Person or any venture capital fund now or hereafter existing that is controlled by one or more general partners or managing members of, or shares the same management company with, such Person.
 
“Board” means the Company’s Board of Directors. 
 
“Material Adverse Effect” means a material adverse effect on the business, financial condition, property or results of operations of the Company, together with all of its subsidiaries.
 
“Person” means any individual, corporation, partnership, trust, limited liability company, association or other entity.
 
“Securities Act” means the Securities Act of 1933, as amended, and the rules and regulations promulgated thereunder.
 
	 
	1

	

	 

 
Representations and Warranties of the Company.
The Company hereby represents and warrants to Purchaser as of the Closing that the following representations are true and complete as of the date of the Closing, except as otherwise indicated.
 
Organization, Good Standing, Corporate Power and Qualification.
The Company is a corporation duly organized, validly existing and in good standing under the laws of the State of Nevada. The Company has all requisite corporate power and authority to own and operate its properties and assets, to execute and deliver this Agreement, to issue and sell the Shares, and to carry out the provisions of this Agreement and to carry on its business as presently conducted. The Company is duly qualified to do business and is in good standing as a foreign corporation in all jurisdictions in which the nature of its activities and of its properties (both owned and leased) makes such qualification necessary, except for those jurisdictions in which failure to do so would not have a Material Adverse Effect.
 
Capitalization.
The authorized capital of the Company consists, immediately prior to March 9, 2016, of 200,000,000 shares of Common Stock, 177,341,237 shares of which are issued and outstanding immediately prior to March 9, 2016, and 5,000,000 shares of preferred stock, $0.001 par value per share, none of which are issued and outstanding. All of the outstanding shares of Common Stock have been duly authorized, are fully paid and nonassessable and were issued in compliance with all applicable federal and state securities laws. There are no outstanding options, warrants, rights (including conversion or preemptive rights and rights of first refusal or similar rights) or agreements, orally or in writing, to purchase or acquire from the Company any shares of Common Stock.
 
Authorization.
The corporate action required to be taken by the Board and the Company’s stockholders in order to authorize the Company to enter into this Agreements and to issue the Shares at the Closing has been taken or will be taken prior to the Closing. All action on the part of the officers of the Company necessary for the execution and delivery of this Agreement, the performance of all obligations of the Company under this Agreement to be performed as of the Closing, and the issuance and delivery of the Shares has been taken or will be taken prior to the Closing. This Agreement, when executed and delivered by the Company, shall constitute valid and legally binding obligations of the Company, enforceable against the Company in accordance with its respective terms except (i) as limited by applicable bankruptcy, insolvency, reorganization, moratorium, fraudulent conveyance, or other laws of general application relating to or affecting the enforcement of creditors’ rights generally, or (ii) as limited by laws relating to the availability of specific performance, injunctive relief, or other equitable remedies.
 
Valid Issuance of Shares.
The Shares, when issued, sold and delivered in accordance with the terms and for the consideration set forth in this Agreement, will be validly issued, fully paid and nonassessable and free of restrictions on transfer other than restrictions on transfer under applicable state and federal securities laws and liens or encumbrances created by or imposed by Purchaser. Assuming the accuracy of the representations of Purchaser in Section 3 of this Agreement, the Shares will be issued in compliance with all applicable federal and state securities laws.
 
	 
	2

	

	 

 
Governmental Consents and Filings.
Assuming the accuracy of the representations made by Purchaser in Section 3 of this Agreement, no consent, approval, order or authorization of, or registration, qualification, designation, declaration or filing with, any federal, state or local governmental authority is required on the part of the Company in connection with the consummation of the transactions contemplated by this Agreement.
 
Litigation.
There is no claim, action, suit, proceeding, arbitration, complaint, or charge pending or to the Company’s knowledge, currently threatened in writing (i) against the Company or any officer or director of the Company arising out of their employment or board relationship with the Company or (ii) to the Company’s knowledge, that would reasonably be expected to have, either individually or in the aggregate, a Material Adverse Effect. Neither the Company nor, to the Company’s knowledge, any of its officers or directors is a party or is named as subject to the provisions of any order, writ, injunction, judgment or decree of any court or government agency or instrumentality (in the case of officers or directors, such as would affect the Company).
 
Representations and Warranties of Purchaser.
Purchaser hereby represents and warrants to the Company as of the Closing that the following representations are true and complete as of the date of the Closing, except as otherwise indicated.
 
Authorization.
Purchaser has full power and authority to enter into this Agreement. This Agreement, when executed and delivered by Purchaser, will constitute valid and legally binding obligations of Purchaser, enforceable in accordance with its terms, except as limited by applicable bankruptcy, insolvency, reorganization, moratorium, fraudulent conveyance, and any other laws of general application affecting enforcement of creditors’ rights generally, and as limited by laws relating to the availability of specific performance, injunctive relief, or other equitable remedies.
 
Purchase Entirely for Own Account.
This Agreement is made with Purchaser in reliance upon Purchaser’s representation to the Company, which by Purchaser’s execution of this Agreement, Purchaser hereby confirms, that the Shares to be acquired by Purchaser will be acquired for investment for Purchaser’s own account, not as a nominee or agent, and not with a view to the resale or distribution of any part thereof, and that Purchaser has no present intention of selling, granting any participation in, or otherwise distributing the same. By executing this Agreement, Purchaser further represents that Purchaser does not presently have any contract, undertaking, agreement or arrangement with any Person to sell, transfer or grant participations to such Person or to any third Person, with respect to any of the Shares. Purchaser has not been formed for the specific purpose of acquiring the Shares.
 
Disclosure.
Purchaser (i) is sufficiently experienced in financial and business matters to be capable of evaluating the merits and risks involved in purchasing the Shares and to make an informed decision relating thereto, (ii) has the ability to bear the economic risk of Purchaser’s prospective investment in the Shares, (iii) has been furnished with, and has carefully reviewed, all materials that it considers relevant to an investment in the Shares and (iv) has had a full opportunity to ask questions of and receive answers from the Company or any Persons acting on behalf of the Company concerning the terms and conditions of an investment in the Shares.
 
	 
	3

	

	 

 
Restricted Securities.
Purchaser understands that the Shares have not been, and will not be, registered under the Securities Act, by reason of a specific exemption from the registration provisions of the Securities Act which depends upon, among other things, the bona fide nature of the investment intent and the accuracy of Purchaser’s representations as expressed herein. Purchaser understands that the Shares are “restricted securities” under applicable U.S. federal and state securities laws and that, pursuant to these laws, Purchaser must hold theShares indefinitely unless they are registered with the Securities and Exchange Commission and qualified by state authorities, or an exemption from such registration and qualification requirements is available. Purchaser acknowledges that the Company has no obligation to register or qualify the Shares for resale. Purchaser further acknowledges that if an exemption from registration or qualification is available, it may be conditioned on various requirements including, but not limited to, the time and manner of sale, the holding period for the Shares, and on requirements relating to the Company which are outside of Purchaser’s control, and which the Company is under no obligationand may not be able to satisfy. 
 
No Public Market.
Purchaser understands that no public market now exists for the Shares, and that the Company has made no assurances that a public market will ever exist for the Shares.
 
Legends.
Purchaser understands that the Shares and any securities issued in respect of or in exchange for the Shares, may bear one or all of the following legends:
 
“THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AND HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE OR DISTRIBUTION THEREOF. NO SUCH TRANSFER MAY BE EFFECTED WITHOUT AN EFFECTIVE REGISTRATION STATEMENT RELATED THERETO OR AN OPINION OF COUNSEL IN A FORM SATISFACTORY TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED UNDER THE SECURITIES ACT OF 1933.”
 
Any legend required by the securities laws of any state to the extent such laws are applicable to the Shares represented by the certificate so legended.
 
Investor Status.
Purchaser hereby represents that it meets the requirements of at least one of the suitability standards for an “Accredited Investor” as that term is defined in Rule 501(a)(3) of Regulation D as promulgated by the U.S. Securities and Exchange Commission under the Securities Act, and as set forth on the Investor Certification attached hereto as Annex A.
 
No General Solicitation.
Purchaser (i) was not identified or contacted through any marketing, and (ii) did not contact the Company as a result of any general solicitation.
 
Reliance.
Purchaser is not relying upon, and has not relied upon, any statement, representation or warranty made by any Person, except for the statements, representations and warranties contained in this Agreement.
 
	 
	4

	

	 

 
Miscellaneous.
 
Survival.
The representations, warranties and covenants of the Company contained in or made pursuant to this Agreement shall survive until the earliest to occur of the two (2) year anniversary of the execution and delivery of this Agreement.
 
Successors and Assigns.
The terms and conditions of this Agreement shall inure to the benefit of and be binding upon the respective successors and assigns of the parties. Nothing in this Agreement, express or implied, is intended to confer upon any party other than the parties hereto or their respective successors and assigns any rights, remedies, obligations, or liabilities under or by reason of this Agreement, except as expressly provided in this Agreement.
 
Governing Law.
This Agreement and any and all matters arising directly or indirectly herefrom shall be governed by and construed and enforced in accordance with the internal laws of the State of Nevada applicable to agreements made and to be performed entirely in such state, without giving effect to the conflict or choice of law principles thereof. For all matters arising directly or indirectly from this Agreement, each of the parties hereto hereby (i) irrevocably consents and submits to the sole exclusive jurisdiction of the United States District Court for the Southern District of New York and any state court located in New York County (and of the appropriate appellate courts from any of the foregoing) in connection with any legal action, lawsuit, arbitration, mediation, or other legal or quasi legal proceeding (“Proceeding”) directly or indirectly arising out of or relating to any Agreement Matter; provided, that a party to this Agreement shall be entitled to enforce an order or judgment of any such court in any United States or foreign court having jurisdiction over the other party, (ii) irrevocably waives, to the fullest extent permitted by law, any objection that it may now or hereafter have to the laying of the venue of any such Proceeding in any such court or that any such Proceeding which is brought in any such court has been brought in an inconvenient forum, (iii) waives, to the fullest extent permitted by law, any immunity from jurisdiction of any such court or from any legal process therein, (iv) irrevocably waives, to the fullest extent permitted by law, any right to a trial by jury in connection with a Proceeding, (v) agrees not to commence any Proceeding other than in such courts, and (vi) agrees that service of any summons, complaint, notice or other process relating to such Proceeding may be effected in the manner provided for the giving of notice as set forth in herein.
 
Counterparts.
This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. Counterparts may be delivered via electronic mail (including pdf or any electronic signature complying with the U.S. federal ESIGN Act of 2000, e.g., www.docusign.com) or other transmission method and any counterpart so delivered shall be deemed to have been duly and validly delivered and be valid and effective for all purposes.
 
Titles and Subtitles.
The titles and subtitles used in this Agreement are used for convenience only and are not to be considered in construing or interpreting this Agreement.
 
	 
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Notices.
All notices and other communications given or made pursuant to this Agreement shall be in writing and shall be deemed effectively given upon the earlier of actual receipt or: (a) personal delivery to the party to be notified, (b) when sent by electronic mail during normal business hours of the recipient, and if not sent during normal business hours, then on the next business day, or (c) one (1) business day after deposit with an internationally recognized overnight courier, freight prepaid, specifying next business day delivery, with written verification of receipt. All communications shall be sent to the respective parties at their address or e-mail address as set forth on the signature page hereto, or to such address or e-mail address as subsequently modified by written notice given in accordance with this Section 4.6.
 
No Finder’s Fees.
Each party represents that it neither is nor will be obligated for any finder’s fee or commission in connection with this transaction. Purchaser agrees to indemnify and to hold harmless the Company from any liability for any commission or compensation in the nature of a finder’s or broker’s fee arising out of this transaction (and the costs and expenses of defending against such liability or asserted liability) for which Purchaser or any of its officers, employees, or representatives is responsible. The Company agrees to indemnify and hold harmless Purchaser from any liability for any commission or compensation in the nature of a finder’s or broker’s fee arising out of this transaction (and the costs and expenses of defending against such liability or asserted liability) for which the Company or any of its officers, employees or representatives is responsible.
 
Amendments and Waivers.
Any term of this Agreement may be amended, terminated or waived only with the written consent of the Company and Purchaser. Any amendment or waiver effected in accordance with this Section 4.8 shall be binding upon the Purchaser and each transferee of the Shares, each future holder of all such securities, and the Company.
 
Severability.
If any provision or provisions of this Agreement shall be held by a court of competent jurisdiction to be invalid, void, illegal or otherwise unenforceable for any reason whatsoever: (a) the validity, legality and enforceability of the remaining provisions of this Agreement (including, without limitation, each portion of any section of this Agreement containing any such provision held to be invalid, illegal or unenforceable, that is not itself invalid, illegal or unenforceable) shall not in any way be affected or impaired thereby and shall remain enforceable to the fullest extent permitted by law; and (b) to the fullest extent possible, the provisions of this Agreement (including, without limitation, each portion of any section of this Agreement containing any such provision held to be invalid, illegal or unenforceable, that is not itself invalid, illegal or unenforceable) shall be construed so as to give effect to the intent manifested thereby.
 
Delays or Omissions.
No delay or omission to exercise any right, power or remedy accruing to any party under this Agreement, upon any breach or default of any other party under this Agreement, shall impair any such right, power or remedy of such non-breaching or non-defaulting party nor shall it be construed to be a waiver of any such breach or default, or an acquiescence therein, or of or in any similar breach or default thereafter occurring; nor shall any waiver of any single breach or default be deemed a waiver of any other breach or default theretofore or thereafter occurring. Any waiver, permit, consent or approval of any kind or character on the part of any party of any breach or default under this Agreement, or any waiver on the part of any party of any provisions or conditions of this Agreement, must be in writing and shall be effective only to the extent specifically set forth in such writing. All remedies, either under this Agreement or by law or otherwise afforded to any party, shall be cumulative and not alternative.
 
Entire Agreement.
This Agreement constitutes the full and entire understanding and agreement between the parties with respect to the subject matter hereof, and any other written or oral agreement relating to the subject matter hereof existing between the parties are expressly canceled. 
 
[Signature Pages Follow]
 
	 
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IN WITNESS WHEREOF, the parties have executed this Stock Purchase Agreement as of the date first written on Purchaser’s signature page attached hereto.
 
	 	COMPANY:
ALMOST NEVER FILMS INC.
	
	 	 	 	 
		By:		
	 
	Name: Danny Chan	 
	 	Title: CEO, CFO and Director	 
	 	 	 	 
	 
	Address: 
13636 Ventura Blvd. #475
Sherman Oaks, California 91423 
	 

 
[SIGNATURE PAGE TO STOCK PURCHASE AGREEMENT]
 
	 
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IN WITNESS WHEREOF, the parties have executed this Stock Purchase Agreement as of the date first written below.
 
	DATE OF CLOSING:
			
	SHARES PURCHASED:
			
	AGGREGATE PURCHASE PRICE:
			
	PURCHASER (INDIVIDUAL):
		PURCHASER (ENTITY):
	
	 
	 
	 
	 
	
				
	Name of Individual (Type or Print)		Name of Entity (Type or Print)
	
	 
	 
		 
	 
	
			By:
	 
	
	(Signature)		(Signature)	
	 
	 
		 
	 
	
	E-Mail:
	 
		Name:
	 
	
	 
	 
		(Type or Print)	
	Address: 
	 
		 
	 
	
	 
	 
		Title:
	 
	
	 
	 
		(Type of Print)	
	 
	 
		 
	 
	
	 
	 
		E-Mail:
	 
	
	 
	 
	 
	 
	 
	 

	 
	 
	 
	Address:
	 
	 

	 
	 
	 
	 
	 
	 

	 
	 
	 
	 
	 
	 

 
[SIGNATURE PAGE TO STOCK PURCHASE AGREEMENT]
 
	 
	8

	

	 

 
Subscription Procedures
 
	 
	1.	Complete and sign the signature page of the Agreement.
	 
	2.	Initial the Investor Certification attached as Annex A.
	 
	3.	E-mail all forms and then send all signed original documents to:

13636 Ventura Blvd. #475 
Sherman Oaks, California 91423
Attention: Danny Chan
E-mail: dc@almostneverfilms.com
	 
	4.	Send a wire transfer for the exact U.S. dollar amount of the purchase price of the Shares according to the following instructions:

[INTENTIONALLY OMITTED]

 
[SIGNATURE PAGE TO STOCK PURCHASE AGREEMENT]
    	 
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INVESTOR CERTIFICATION
For Individual Accredited Investors Only
(all Individual Accredited Investors must INITIAL where appropriate):
 
Initial _______ I have a net worth of at least $1 million either individually or through aggregating my individual holdings and those in which I have a joint, community property or other similar shared ownership interest with my spouse. (For purposes of calculating your net worth under this paragraph, (a) your primary residence shall not be included as an asset; (b) indebtedness secured by your primary residence, up to the estimated fair market value of your primary residence at the time of your purchase of the securities, shall not be included as a liability (except that if the amount of such indebtedness outstanding at the time of your purchase of the securities exceeds the amount outstanding 60 days before such time, other than as a result of the acquisition of your primary residence, the amount of such excess shall be included as a liability); and (c) indebtedness that is secured by your primary residence in excess of the estimated fair market value of your primary residence at the time of your purchase of the securities shall be included as a liability.)
 
Initial _______ I have had an annual gross income for the past two years of at least $200,000 (or $300,000 jointly with my spouse) and expect my income (or joint income, as appropriate) to reach the same level in the current year.
 
For Non-Individual Accredited Investors
(all Entity / Non-Individual Accredited Investors must INITIAL where appropriate):
 
Initial _______ The investor certifies that it is a partnership, corporation, limited liability company or business trust that is 100% owned by persons who meet at least one of the criteria for Individual Investors set forth above. 
 
Initial _______ The investor certifies that it is a partnership, corporation, limited liability company or business trust that has total assets of at least $5 million and was not formed for the purpose of investing the Company.
 
Initial _______ The investor certifies that it is an employee benefit plan whose investment decision is made by a plan fiduciary (as defined in ERISA §3(21)) that is a bank, savings and loan association, insurance company or registered investment advisor.
 
Initial _______ The investor certifies that it is an employee benefit plan whose total assets exceed $5,000,000 as of the date of this Agreement.
 
	 
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Initial _______ The undersigned certifies that it is a self-directed employee benefit plan whose investment decisions are made solely by persons who meet at least one of the criteria for Individual Investors.
 
Initial _______ The investor certifies that it is a U.S. bank, U.S. savings and loan association or other similar U.S. institution acting in its individual or fiduciary capacity.
 
Initial _______ The undersigned certifies that it is a broker-dealer registered pursuant to §15 of the Securities Exchange Act of 1934.
 
Initial _______ The investor certifies that it is an organization described in §501(c)(3) of the Internal Revenue Code with total assets exceeding $5,000,000 and not formed for the specific purpose of investing in the Company.
 
Initial _______ The investor certifies that it is a trust with total assets of at least $5,000,000, not formed for the specific purpose of investing in the Company, and whose purchase is directed by a person with such knowledge and experience in financial and business matters that such person is capable of evaluating the merits and risks of the prospective investment.
 
Initial _______ The investor certifies that it is a plan established and maintained by a state or its political subdivisions, or any agency or instrumentality thereof, for the benefit of its employees, and which has total assets in excess of $5,000,000.
 
Initial _______ The investor certifies that it is an insurance company as defined in §2(13) of the Securities Act of 1933, or a registered investment company.
 
    	11

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