Document:

EX-4.4

 

Exhibit 4.4

          FIRST SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of July 25, 2007, among
CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation (the “Issuer”), each of the parties
identified as a Triad Guarantor on the schedules to the signature pages hereto (each, a “Triad
Guarantor” and collectively, the “Triad Guarantors”) and U.S. BANK NATIONAL ASSOCIATION, as Trustee
under the Indenture (the “Trustee”).

W I T N E S S E T H:

          WHEREAS the Issuer has heretofore executed and delivered to the Trustee an Indenture (the
“Indenture”), dated as of July 25, 2007, providing for the issuance of the 87/8% Senior Notes due
2015 (the “Securities”);

          WHEREAS, each of the undersigned Triad Guarantors has deemed it advisable and in its best
interest to execute and deliver this Supplemental Indenture, and to become a Triad Guarantor under
the Indenture; and

          WHEREAS, pursuant to Section 9.01(4) of the Indenture, the Trustee, the Issuer and the Triad
Guarantors are authorized to execute and deliver this Supplemental Indenture.

          NOW THEREFORE, in consideration of the foregoing and for good and valuable consideration, the
receipt of which is hereby acknowledged, the Issuer, the Triad Guarantors and the Trustee mutually
covenant and agree for the equal and ratable benefit of the Holders of the Securities as follows:

          SECTION 1. Capitalized Terms. Capitalized terms used herein but not defined shall
have the meanings assigned to them in the Indenture.

          SECTION 2. Guaranties. Each Triad Guarantor hereby agrees to guarantee the Issuer’s
obligations under the Securities on the terms and subject to the conditions set forth in Article 10
of the Indenture and to be bound by all other applicable provisions of the Indenture as a
Subsidiary Guarantor.

          SECTION 3. Ratification of Indenture; Supplemental Indentures Part of Indenture.
Except as expressly amended hereby, the Indenture is in all respects ratified and confirmed and all
the terms, conditions and provisions thereof shall remain in full force and effect. This
Supplemental Indenture shall form a part of the Indenture for all purposes, and every holder of
Securities heretofore or hereafter authenticated and delivered shall be bound hereby.

          SECTION 4. Governing Law. THIS SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

          SECTION 5. Trustee Makes No Representation. The Trustee makes no representation as
to the validity or sufficiency of this Supplemental Indenture.

 

 

          SECTION 6. Counterparts. The parties may sign any number of copies of this
Supplemental Indenture. Each signed copy shall be an original, but all of them together represent
the same agreement.

          SECTION 7. Effect of Headings. The Section headings herein are for convenience only
and shall not effect the construction of this Supplemental Indenture.

 

 

     IN WITNESS WHEREOF, the parties have caused this Supplemental Indenture to be duly
executed as of this 25th day of July, 2007.

	 	 	 	 	 
	 	 	CHS/COMMUNITY HEALTH SYSTEMS, INC.
	 
	 	 	 	 
	 

	 	By:
	 	/s/ W. Larry Cash
	 

	 	 	 	 
	 

	 	Name:
	 	W. Larry Cash
	 

	 	Title:
	 	Executive Vice President and Chief
Financial Officer

	 	 	 	 	 
	 	 	U.S. BANK NATIONAL ASSOCIATION,
as Trustee
	 
	 	 	 	 
	 

	 	By:
	 	/s/ Wally Jones
	 

	 	 	 	 
	 

	 	Name:

Title:
	 	Wally Jones

Assistant Vice President

Supplemental
Indenture - 8 7/8% Senior Notes due 2015

 

 

QHG of Enterprise, Inc.

QHG of Jacksonville, Inc.

QHG of Springdale, Inc.

Triad-El Dorado, Inc.

Abilene Hospital, LLC

Abilene Merger, LLC

Arizona DH, LLC

ARMC, LP

Birmingham Holdings, LLC

Bluffton Health System, LLC

Brownwood Hospital, L.P.

Brownwood Medical Center, LLC

Carlsbad Medical Center, LLC

Claremore Regional Hospital, LLC

Clarksville Holdings, LLC

College Station Hospital, L.P.

College Station Medical Center, LLC

College Station Merger, LLC

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

Desert Hospital Holdings, LLC

Detar Hospital, LLC

Dukes Health System, LLC

Gadsden Regional Medical Center, LLC

Greenbrier VMC, LLC

GRMC Holdings, LLC

Hobbs Medco, LLC

Las Cruces Medical Center, LLC

Lea Regional Hospital, LLC

Longview Merger, LLC

LRH, LLC

Lutheran Health Network of Indiana, LLC

Massillon Health System, LLC

Medical Center of Brownwood, LLC

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

[SIGNATURE PAGES CONTINUED]

Supplemental
Indenture - 8 7/8% Senior Notes due 2015

 

 

MMC of Nevada, LLC

Navarro Hospital, L.P.

Navarro Regional, LLC

NRH, LLC

Oregon Healthcorp, LLC

Palmer-Wasilla Health System, LLC

Quorum Health Resources, LLC

Regional Hospital of Longview, LLC

Russellville Holdings, LLC

SACMC, LLC

San Angelo Community Medical Center, LLC

San Angelo Hospital, L.P.

San Angelo Medical, LLC

Southern Texas Medical Center, LLC

St. Joseph Health System, LLC

Tennyson Holdings, Inc.

Triad Holdings III, LLC

Triad Holdings IV, LLC

Triad Holdings V, LLC

Triad Healthcare Corporation

Triad of Alabama, LLC

Triad of Oregon, LLC

Triad-ARMC, LLC

Triad-Denton Hospital GP, LLC

Triad-Denton Hospital, L.P.

Triad-Navarro Regional Hospital Subsidiary, LLC

VHC Medical, LLC

Vicksburg Healthcare, LLC

Victoria Hospital, LLC

Victoria of Texas, L.P.

WHMC, LLC

Willamette Valley Medical Center, LLC

Women & Children’s Hospital, LLC

Woodland Heights Medical Center, LLC

Woodward Health System, LLC

QHG Georgia Holdings, Inc.

QHG Georgia, L.P.

Frankfort Health Partner, Inc.

IOM Health System, L.P.

QHG of Bluffton, Inc.

QHG of Clinton County, Inc.

QHG of Fort Wayne, Inc.

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

[SIGNATURE PAGES CONTINUED]

Supplemental
Indenture - 8 7/8% Senior Notes due 2015

 

 

QHG of Warsaw, Inc.

QHG of Forrest County, Inc.

QHG of Hattiesburg, Inc.

QHG of Massillon, Inc.

SouthCrest, L.L.C.

River Region Medical Corporation

NC-DSH, Inc.

QHG of Barberton, Inc.

Triad-South Tulsa Hospital Company, Inc.

QHG of South Carolina, Inc.

QHG of Spartanburg, Inc.

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

Supplemental
Indenture - 8 7/8% Senior Notes due 2015EX-4.5

 

Exhibit 4.5

COMMUNITY HEALTH SYSTEMS, INC.

AND

U.S. BANK NATIONAL ASSOCIATION

as successor Trustee to Suntrust Bank

 

FIRST SUPPLEMENTAL INDENTURE

Dated as of July 24, 2007

to

Indenture

Dated as of December 16, 2004

61/2% SENIOR SUBORDINATED NOTES DUE 2012

A-1

 

               THIS FIRST SUPPLEMENTAL INDENTURE, dated as of July 24, 2007 (this “Supplemental
Indenture”), is by and between Community Health Systems, Inc., a Delaware corporation (the
“Issuer”) and U.S. Bank National Association, successor to Suntrust Bank, as trustee (the
“Trustee”).

               WHEREAS, the Issuer and the Trustee have entered into that certain Indenture dated as of
December 16, 2004 (the “Indenture”), providing for the issuance of 61/2%
Senior Subordinated Notes due 2012 (the “Notes”);

               WHEREAS, there are currently $300,000,000 aggregate principal amount of Notes outstanding;

               WHEREAS, Section 9.2 of the Indenture provides that the Indenture may be amended with the
consent of the Holders of at least a majority in aggregate principal amount of the Notes then
outstanding, voting as a single class (including, without limitation, consents obtained in
connection with a tender offer or exchange offer for, or purchase of, Notes) (subject to certain
exceptions);

               WHEREAS, the Issuer desires and has requested the Trustee to join with it in entering into
this Supplemental Indenture for the purpose of amending the Indenture in certain respects as
permitted by Section 9.2 of the Indenture;

               WHEREAS, the execution and delivery of this Supplemental Indenture has been authorized by the
Board of Directors of the Issuer;

               WHEREAS, (1) the Issuer has received the consent of the Holders of at least a majority in
aggregate principal amount of the outstanding Notes and has satisfied all other conditions
precedent, if any, provided under the Indenture to enable the Issuer and the Trustee to enter into
this Supplemental Indenture, all as certified by an Officers’ Certificate, delivered to the Trustee
simultaneously with the execution and delivery of this Supplemental Indenture as contemplated by
Sections 9.2 and 9.6 of the Indenture, and (2) the Issuer has delivered to the Trustee
simultaneously with the execution and delivery of this Supplemental Indenture an Opinion of Counsel
relating to this Supplemental Indenture as contemplated by Section 9.6 of the Indenture; and

               NOW, THEREFORE, in consideration of the above premises, each party hereby agrees, for the
benefit of the others and for the equal and ratable benefit of the Holders of the Notes, as
follows:

ARTICLE I

DEFINITIONS

               Section 1.1 Deletion of Definitions and Related References. Section 1.01 of the
Indenture is hereby amended to delete in their entirety all terms and their respective definitions
for which all references are eliminated in the Indenture as a result of the amendments set forth in
Article II of this Supplemental Indenture.

ARTICLE II

AMENDMENTS TO INDENTURE

               Section 2.1 Deletions from the Indenture. The Indenture is hereby amended by deleting
the following sections of the Indenture and all references thereto in the Indenture in their
entirety:

	 	•	 	Section 3.2 (Limitation on Indebtedness)
	 
	 	•	 	Section 3.3 (Limitation on Restricted Payments)
	 
	 	•	 	Section 3.4 (Limitation on Restrictions on Distributions from Restricted Subsidiaries)
	 
	 	•	 	Section 3.5 (Limitation on Sales of Assets and Subsidiary Stock)
	 
	 	•	 	Section 3.6 (Limitation on Liens)
	 
	 	•	 	Section 3.7 (Limitation on Layering)
	 
	 	•	 	Section 3.8 (Limitation on Affiliate transactions)
	 
	 	•	 	Section 3.9 (Limitation on Sale of Capital Stock of Restricted Subsidiaries)
	 
	 	•	 	Section 3.10 (Change of Control)
	 
	 	•	 	Section 3.12 (Future Subsidiary Guarantors)
	 
	 	•	 	Section 3.13 (Maintenance of Office or Agency)

2

 

	 	•	 	Section 3.14 (Corporate Existence)
	 
	 	•	 	Section 3.15 (Payment of Taxes and other Claims)
	 
	 	•	 	Section 3.16 (Payments for Consents)
	 
	 	•	 	Section 3.18 (Further Instruments and Acts)
	 
	 	•	 	Section 3.19 (Statement by Officers as to Default)
	 
	 	•	 	Section 3.20 (Effectiveness of Covenants)
	 
	 	•	 	Section 6.1(3) (failure to comply with obligations under Merger and Consolidation provision)
	 
	 	•	 	Section 6.1(4) (failure to observe or perform other covenants in the Indenture or Notes)
	 
	 	•	 	Section 6.1(5) (failure to comply with other agreements in the Indenture)
	 
	 	•	 	Section 6.1(6) (failure to pay certain indebtedness)
	 
	 	•	 	Section 6.1(7) (defaults related to certain bankruptcy events)
	 
	 	•	 	Section 6.1(8) (failure to pay certain judgments)
	 
	 	•	 	Section 6.1(9) (enforceability of guarantee or assertions of invalidity)
	 
	 	•	 	Section 8.2(2) (delivery of certificate of accountant with respect to Legal Defeasance and tax matters)
	 
	 	•	 	Section 8.2(5) (delivery of Opinion of Counsel with respect to Legal Defeasance and creditors’ rights)
	 
	 	•	 	Section 8.2(6) (delivery of Opinion of Counsel with respect to Legal Defeasance and the Investment Company Act of 1940)
	 
	 	•	 	Section 8.2(7) (delivery of Opinion of Counsel with respect to Legal Defeasance and certain other tax matters)
	 
	 	•	 	Section 8.2(8) (delivery of Opinion of Counsel with respect to Legal Defeasance and certain other tax matters)
	 
	 	•	 	Section 8.6 (reinstatement of obligations under the Indenture)

               Section 2.2 Modifications to the Indenture. The Indenture is hereby amended by
deleting the following sections of the Indenture in their entirety and replacing them with the
following:

	 	(a)	 	Section 3.11. Reports.

          The Company shall comply with Section 314(a) of the Trust Indenture Act of
1939, as amended, and the rules and regulations promulgated thereunder (the “TIA”).

	 	(b)	 	Section 3.17. Compliance Certificate.

          The Company shall deliver to the Trustee, within 90 days after the end of each
fiscal year, an Officers’ Certificate in accordance with Section 314(a)(4) of the
TIA.

	 	(c)	 	Section 4.1. Successor Corporation Substituted.

          Upon any consolidation or merger, or any sale, assignment, transfer, conveyance
or other disposition of all or substantially all of the assets of the Company, the
predecessor Company shall be relieved from all obligations to pay the principal of
and interest and Additional Interest, if any, on the Notes, and the successor
corporation formed by such consolidation or into or with which the Company is merged
or to which such sale, assignment, transfer, conveyance or other disposition is made
shall succeed to, and be substituted for (so that from and after the date of such
consolidation, merger, sale, conveyance or other disposition, the provisions of this
Indenture referring to the “Company” shall refer instead to the successor corporation
and not to the Company), and may exercise every right and power of the Company under
this Indenture with the same effect as if such successor Person had been named as the
Company herein.

3

 

ARTICLE III

MISCELLANEOUS PROVISIONS

               Section 3.1 Ratification of Indenture; Supplemental Indenture Part of Indenture.
Except as expressly amended hereby, the Indenture is in all respects ratified and confirmed and all
the terms, conditions and provisions thereof shall remain in full force and effect. This
Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of
Notes heretofore or hereafter authenticated and delivered shall be bound hereby. In the case of
conflict between the Indenture and this Supplemental Indenture, the provisions of this Supplemental
Indenture shall control.

               Section 3.2 Severability. In case any provision in this Supplemental Indenture or in
the Notes shall be invalid, illegal or unenforceable, the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby.

               Section 3.3 Capitalized Terms. Capitalized terms used herein but not defined shall
have the meanings assigned to them in the Indenture.

               Section 3.4 Effect of Headings. The Article and Section headings used herein are for
convenience only and shall not affect the construction of this Supplemental Indenture.

               Section 3.5 The Trustee. The Trustee shall not be responsible for any statement or
recital in this Supplemental Indenture.

               Section 3.6 Certain Duties and Responsibilities of the Trustee. In entering into this
Supplemental Indenture, the Trustee shall be entitled to the benefit of every provision of the
Indenture relating to the conduct or affecting the liability or affording protection to the
Trustee, whether or not elsewhere herein so provided.

               Section 3.7 NEW YORK LAW TO GOVERN. THE INTERNAL LAW OF THE STATE OF NEW YORK SHALL
GOVERN AND BE USED TO CONSTRUE THIS SUPPLEMENTAL INDENTURE BUT WITHOUT GIVING EFFECT TO APPLICABLE
PRINCIPLES OF CONFLICTS OF LAW TO THE EXTENT THAT THE APPLICATION OF THE LAWS OF ANOTHER
JURISDICTION WOULD BE REQUIRED THEREBY.

               Section 3.8 Counterparts. The parties may sign any number of copies of this
Supplemental Indenture. Each signed copy shall be an original, but all of them together represent
one and the same agreement.

               Section 3.9 Successors. All agreements of the Issuer in this Supplemental Indenture
and the Notes shall bind its successors. All agreements of the Trustee in this Supplemental
Indenture shall bind its successors.

               Section 3.10 Effectiveness. The provisions of Articles I and II of this Supplemental
Indenture shall be effective at the time all conditions to the tender offer and consent
solicitation as set forth in the Offer to Purchase and Consent Solicitation Statement (as it may be
amended or supplemented from time to time) of the Issuer dated May 31, 2007 have been satisfied or
waived by the Issuer, the Issuer accepts for purchase at least a majority in aggregate principal
amount of the outstanding Notes issued under the Indenture and this Supplemental Indenture has been
executed by the Issuer.

               Section 3.11 Endorsement and Change of Form of Notes. Any Notes authenticated and
delivered after the close of business on the date that this Supplemental Indenture becomes
effective may be affixed to, stamped, imprinted or otherwise legended by the Trustee, with a
notation as follows:

“Effective as of July 25, 2007, the restrictive covenants of the Issuer and certain of the
Events of Default have been eliminated, as provided in the Supplemental Indenture, dated as of July
24, 2007. Reference is hereby made to such Supplemental Indenture, copies of which are on file
with the Trustee, for a description of the amendments made therein.”

4

 

IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly
executed as of the day and year written above.

	 	 	 	 	 
	 	COMMUNITY HEALTH SYSTEMS, INC.

 	 
	 	By:  	/s/ W. Larry Cash
 	 
	 	 	Name:  	W. Larry Cash 	 
	 	 	Title:  	Executive Vice President and Chief Financial
Officer 	 
	 

Supplemental Indenture — 6 1/2% Senior Subordinated Notes due 2012

5

 

	 	 	 	 	 
	 	U.S. BANK NATIONAL ASSOCIATION, as Trustee

 	 
	 	By:  	/s/ Wally Jones
 	 
	 	 	Name:  	Wally Jones 	 
	 	 	Title:  	Assistant Vice President 	 
	 

Supplemental Indenture — 6 1/2% Senior Subordinated Notes due 2012

6

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