Document:

<PAGE>   1

                                                                  Exhibit 10.144

                 FIFTH AMENDMENT TO LOAN AND SECURITY AGREEMENT

         This Fifth Amendment to Loan and Security Agreement (this "FIFTH
AMENDMENT") is entered into as of the 19th day of June, 2000, between RAMSAY
YOUTH SERVICES, INC., a Delaware corporation, f/k/a RAMSAY HEALTH CARE, INC.
("HOLDINGS"), with its principal place of business at Columbus Center, One
Alhambra Plaza, Suite 750, Coral Gables, Florida 33134, each of the Subsidiaries
of Holdings party to this Fifth Amendment and listed in EXHIBIT B to the Loan
Agreement referred to below (the "HOLDINGS SUBSIDIARIES"), each of which is a
corporation or other legal entity as indicated in EXHIBIT B, is organized under
the laws of the jurisdiction indicated in EXHIBIT B, and has its principal place
of business at the location indicated in EXHIBIT B (Holdings, the Holdings
Subsidiaries, and each other Subsidiary of Holdings or of any Subsidiary of
Holdings from time to time party to the Loan Agreement referred to below are
hereinafter collectively referred to as "BORROWERS" and each individually as a
"BORROWER"), and FLEET CAPITAL CORPORATION, a Rhode Island corporation (in its
individual capacity, "FCC"), with offices at 5950 Sherry Lane, Suite 300,
Dallas, Texas 75225, as a Lender, and as agent for all Lenders, in such
capacity, "AGENT"), and such Persons who are or hereafter become parties to the
Loan Agreement as Lenders. Capitalized terms used but not defined in this Fifth
Amendment have the meanings assigned to them in Appendix A of that certain Loan
and Security Agreement dated October 30, 1998, among Borrowers, Lenders and
Agent, as amended (the "LOAN AGREEMENT").

                              W I T N E S S E T H:

         WHEREAS, the Borrowers have requested certain amendments to the Loan
Agreement to permit Holdings and Holdings Subsidiaries to incur certain
subordinated debt in favor of ING (U.S.) CAPITAL, LLC ("ING"), in an aggregate
principal amount of $5,000,000; and

         WHEREAS, subject to the terms and conditions herein contained, Agent
and Lenders have agreed to the Borrowers' request.

         NOW, THEREFORE, for and in consideration of the mutual covenants and
agreements herein contained and other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged and confessed,
Borrowers, Agent and Lenders hereby agree as follows:

         SECTION 1. Subject to the satisfaction of each condition precedent set
forth in SECTION 2 hereof and in reliance on the representations, warranties,
covenants and agreements contained in this Fifth Amendment, the Loan Agreement
shall be amended effective June 19, 2000 (the "FIFTH AMENDMENT EFFECTIVE DATE")
in the manner provided in this SECTION 1:

         1.1 AMENDED DEFINITIONS. The following definitions contained in
APPENDIX A to the Loan Agreement shall be amended to read in their entirety as
follows:

                                       1
<PAGE>   2

         SUBORDINATED DEBT - (I) ALL INDEBTEDNESS EVIDENCED BY THE 2007
         SUBORDINATED DEBT DOCUMENTS, (II) ALL INDEBTEDNESS WITH RESPECT TO THE
         PREFERRED STOCK, AND (III) ALL OTHER INDEBTEDNESS OF ANY BORROWER THAT
         IS SUBORDINATED TO THE OBLIGATIONS IN A MANNER SATISFACTORY TO AGENT.

         SUBORDINATION AGREEMENT - THE JUNIOR SUBORDINATED DEBT SUBORDINATION
         AGREEMENT OR THE 2007 SUBORDINATION AGREEMENT, AS THE CASE MAY BE.

         1.2 ADDITIONAL DEFINITIONS. Appendix A to the Loan Agreement shall be
amended to add the following definitions to such Appendix:

         FIFTH AMENDMENT - THE FIFTH AMENDMENT TO LOAN AND SECURITY AGREEMENT
         AMONG BORROWERS, LENDERS AND AGENT DATED JUNE 19, 2000.

         FIFTH AMENDMENT EFFECTIVE DATE - AS DEFINED IN THE FIFTH AMENDMENT.

         ING - ING (U.S.) CAPITAL, LLC, A DELAWARE LIMITED LIABILITY COMPANY.

         ING SUBORDINATED NOTE - COLLECTIVELY, THAT CERTAIN SUBORDINATED NOTE
         DUE JANUARY 24, 2007, EXECUTED BY HOLDINGS, AS MAKER, ON OR ABOUT THE
         FIFTH AMENDMENT EFFECTIVE DATE, AND BEARING INTEREST AT AN INITIAL
         FIXED RATE OF TWELVE AND ONE-HALF PERCENT (12.5%) PER ANNUM, AND
         PAYABLE TO THE ORDER OF ING, IN THE AGGREGATE ORIGINAL PRINCIPAL AMOUNT
         OF $5,000,000.

         ING WARRANT AGREEMENT - THAT CERTAIN WARRANT AGREEMENT, DATED AS OF THE
         FIFTH AMENDMENT EFFECTIVE DATE, BETWEEN HOLDINGS AND ING IN ITS
         CAPACITY AS A HOLDER OF THE ING WARRANTS, TOGETHER WITH ALL AMENDMENTS
         AND MODIFICATIONS THERETO.

         ING WARRANTS - THAT (THOSE) CERTAIN WARRANT(S), CONVERTIBLE, UNDER
         CERTAIN CIRCUMSTANCES, INTO CAPITAL STOCK OF HOLDINGS, ACQUIRED BY ING
         PURSUANT TO THAT CERTAIN WARRANT AGREEMENT, DATED ON OR ABOUT THE FIFTH
         AMENDMENT EFFECTIVE DATE, BY AND BETWEEN ING AND HOLDINGS, AS MORE
         FULLY DESCRIBED THEREIN.

         2007 REGISTRATION AGREEMENT - THAT CERTAIN AMENDED AND RESTATED
         REGISTRATION RIGHTS AGREEMENT, DATED AS OF THE FIFTH AMENDMENT
         EFFECTIVE DATE AMONG HOLDINGS, SUNTRUST AND ING, TOGETHER WITH ALL
         AMENDMENTS AND MODIFICATIONS THERETO.

         2007 SUBORDINATION AGREEMENT - THAT CERTAIN AMENDED AND RESTATED
         SUBORDINATION AGREEMENT DATED ON OR ABOUT THE FIFTH AMENDMENT EFFECTIVE
         DATE, BY AND AMONG AGENT, SUNTRUST AND ING, AS THE SAME MAY BE AMENDED
         OR MODIFIED FROM TIME TO TIME.

         2007 SUBORDINATED DEBT - THE SUBORDINATED INDEBTEDNESS EVIDENCED BY THE
         2007 SUBORDINATED DEBT DOCUMENTS.

                                       2
<PAGE>   3

         2007 SUBORDINATED DEBT DOCUMENTS - THE 2007 PURCHASE AGREEMENT, THE
         SUNTRUST SUBORDINATED NOTES, THE SUNTRUST WARRANT AGREEMENT, THE 2007
         REGISTRATION AGREEMENT, THE SUNTRUST WARRANTS, THE ING SUBORDINATED
         NOTES, THE ING WARRANT AGREEMENT, THE ING WARRANTS, AND ALL OTHER
         INSTRUMENTS, DOCUMENTS AND AGREEMENTS EXECUTED BY OR ON BEHALF OF ANY
         LOAN PARTY AND DELIVERED CONCURRENTLY THEREWITH OR AT ANY TIME
         HEREAFTER TO OR FOR THE BENEFIT OF THE HOLDERS OF THE SUNTRUST
         SUBORDINATED NOTES OR THE ING SUBORDINATED NOTES OR THE HOLDERS OF THE
         SUNTRUST WARRANTS OR ING WARRANTS, OR ANY AGENT OR REPRESENTATIVE
         THEREOF IN CONNECTION WITH THE 2007 SUBORDINATED DEBT AND OTHER
         TRANSACTIONS CONTEMPLATED BY THE 2007 PURCHASE AGREEMENT, ALL AS
         AMENDED, SUPPLEMENTED OR MODIFIED FROM TIME TO TIME AS PERMITTED UNDER
         THE LOAN AGREEMENT; BUT EXCLUDING ALL LOAN DOCUMENTS.

         2007 PURCHASE AGREEMENT - THAT CERTAIN AMENDED AND RESTATED
         SUBORDINATED NOTE AND WARRANT PURCHASE AGREEMENT DATED ON OR ABOUT THE
         FIFTH AMENDMENT EFFECTIVE DATE, BY AND AMONG ING, SUNTRUST, HOLDINGS,
         AND HOLDINGS SUBSIDIARIES.

         1.3 DELETED DEFINITIONS. The following definitions contained in
APPENDIX A to the Loan Agreement shall be deleted in their entirety: SUNTRUST
REGISTRATION AGREEMENT, SUNTRUST SUBORDINATION AGREEMENT, SUNTRUST SUBORDINATED
DEBT, SUNTRUST SUBORDINATED DEBT DOCUMENTS and SUNTRUST PURCHASE AGREEMENT.

         1.4 AMENDMENT TO TOTAL INDEBTEDNESS. SECTION 8.2.3 of the Loan
Agreement is hereby amended to read in its entirety as follows:

                  8.2.3 TOTAL INDEBTEDNESS. CREATE, INCUR, ASSUME, OR SUFFER TO
EXIST, OR PERMIT ANY OF THEIR RESPECTIVE SUBSIDIARIES TO CREATE, INCUR OR SUFFER
TO EXIST, ANY INDEBTEDNESS, EXCEPT:

                           (I) OBLIGATIONS OWING TO AGENT AND LENDERS;

                           (II) THE 2007 SUBORDINATED DEBT AND INDEBTEDNESS, IF
         ANY, RELATING TO THE PREFERRED STOCK;

                           (III) INDEBTEDNESS OF A LOAN PARTY OR A SUBSIDIARY IF
         AND TO THE EXTENT PERMITTED BY SECTION 8.2.2;

                           (IV) ACCOUNTS PAYABLE TO TRADE CREDITORS AND CURRENT
         OPERATING EXPENSES(OTHER THAN FOR MONEY BORROWED) NINETY PERCENT (90%)
         OF WHICH ARE AGED NOT MORE THAN 45 DAYS FROM THE DUE DATE, OR, IF AGED
         OUTSIDE OF THE PRECEDING PARAMETERS, THAT ARE BEING PROPERLY CONTESTED,
         BUT IN EACH CASE INITIALLY INCURRED IN THE ORDINARY COURSE OF BUSINESS
         AND EITHER PAID WITHIN SUCH TIME PERIOD OR, IF BEING PROPERLY CONTESTED
         AT THE TIME AND IN THE MANNER CONTEMPLATED IN THE DEFINITION OF THE
         TERM "PROPERLY CONTESTED";

                           (V) OBLIGATIONS TO PAY RENTALS PERMITTED BY SECTION
         8.2.16;

                                       3
<PAGE>   4

                           (VI) PERMITTED PURCHASE MONEY INDEBTEDNESS;

                           (VII) CONTINGENT LIABILITIES ARISING OUT OF
         ENDORSEMENTS OF CHECKS AND OTHER NEGOTIABLE INSTRUMENTS FOR DEPOSIT OR
         COLLECTION IN THE ORDINARY COURSE OF BUSINESS;

                           (VIII) CAPITALIZED LEASE OBLIGATIONS TO THE EXTENT
         THE UNDERLYING CAPITAL LEASE IS PERMITTED BY THE TERMS OF SECTION
         8.2.9;

                           (IX) INDEBTEDNESS IN RESPECT TO DEFERRED TAXES;

                           (X) INDEBTEDNESS EXISTING ON THE CLOSING DATE AND
         DESCRIBED IN EXHIBIT T ATTACHED HERETO;

                           (XI) INDEBTEDNESS NOT TO EXCEED SIX HUNDRED THOUSAND
         DOLLARS ($600,000) INCURRED BY HOLDINGS WITH RESPECT TO ITS PURCHASE OF
         ALL OF THE CAPITAL STOCK OF RAMSAY HOSPITAL CORPORATION OF LOUISIANA,
         INC.; AND

                           (XII) INDEBTEDNESS NOT INCLUDED IN PARAGRAPHS (I)
         THROUGH (X) ABOVE WHICH BY ITS TERMS IS UNSECURED AND DOES NOT EXCEED
         AT ANY TIME, IN THE AGGREGATE, THE SUM OF FIVE HUNDRED THOUSAND DOLLARS
         ($500,000).

         1.5 AMENDMENT TO OTHER DEFAULTS. Section 10.1.6 of the Loan Agreement
is hereby amended in its entirety to read as follows:

                  10.1.6 OTHER DEFAULTS. (A) THERE SHALL OCCUR ANY DEFAULT OR
EVENT OF DEFAULT ON THE PART OF ANY LOAN PARTY UNDER ANY AGREEMENT, DOCUMENT OR
INSTRUMENT TO WHICH LOAN PARTY IS A PARTY OR BY WHICH ANY LOAN PARTY OR ANY
PROPERTY OF ANY LOAN PARTY IS BOUND, CREATING OR RELATING TO ANY INDEBTEDNESS IN
EXCESS OF $250,000 (OTHER THAN THE OBLIGATIONS AND THE 2007 SUBORDINATED DEBT,
BUT INCLUDING THE SUBORDINATED DEBT OTHER THAN THE 2007 SUBORDINATED DEBT) IF
THE PAYMENT OR MATURITY OF SUCH INDEBTEDNESS IS OR COULD BE ACCELERATED IN
CONSEQUENCE OF SUCH EVENT OF DEFAULT OR IF DEMAND FOR PAYMENT OF SUCH
INDEBTEDNESS IS MADE BY THE HOLDER OR HOLDERS THEREOF, OR (B) THERE SHALL OCCUR
ANY DEFAULT OR EVENT OF DEFAULT ON THE PART OF ANY LOAN PARTY UNDER ANY OF THE
2007 SUBORDINATED DEBT DOCUMENTS IF THE PAYMENT OR MATURITY OF SUCH INDEBTEDNESS
IS OR COULD BE ACCELERATED IN CONSEQUENCE OF SUCH DEFAULT OR EVENT OF DEFAULT OR
IF DEMAND FOR PAYMENT OF SUCH INDEBTEDNESS IS MADE BY THE HOLDER OR HOLDERS
THEREOF.

         1.6 AMENDMENT TO EXHIBITS. Exhibits B, D, E, F, G, L, U, V and W to the
Loan Agreement shall be amended in their entirety by substituting the attached
Exhibits B, D, E, F, G, L, U, V and W.

                                       4
<PAGE>   5

         SECTION 2. CONDITIONS PRECEDENT TO EFFECTIVENESS OF AMENDMENTS. The
amendments to the Loan Agreement contained in SECTION 1 of this Fifth Amendment
shall be effective only upon the satisfaction of each of the conditions set
forth in this SECTION 2. If each condition set forth in this SECTION 2 has not
been satisfied by June 19, 2000, this Fifth Amendment and all obligations of
Lenders contained herein shall, at the option of Lenders, terminate.

         2.1 DOCUMENTATION. Agent and Lenders shall have received, in form and
substance acceptable to Agent and Lenders and their counsel a duly executed copy
of this Fifth Amendment, copies of the 2007 Subordinated Debt Documents, and any
other documents, instruments and certificates as Agent and Lenders and their
counsel shall require in connection therewith prior to the date hereof, all in
form and substance satisfactory to Agent and Lenders and their counsel.

         2.2 2007 SUBORDINATION AGREEMENT. ING and SunTrust shall have executed
and delivered, and each Loan Party shall have acknowledged, the 2007
Subordination Agreement expressly subordinating the obligations of the Loan
Parties to ING and SunTrust under the 2007 Subordinated Debt Documents to the
Obligations, in form and substance satisfactory to Agent and Lenders and their
counsel.

         2.3 CORPORATE EXISTENCE AND AUTHORITY. Agent and Lenders shall have
received such resolutions, certificates and other documents as Agent and Lenders
shall request relative to the authorization, execution and delivery by each Loan
Party of this Fifth Amendment.

         2.4 NO DEFAULT. No Default or Event of Default shall exist.

         2.5 NO LITIGATION. No action, proceeding, investigation, regulation or
legislation shall have been instituted, threatened or proposed before any court,
governmental agency or legislative body to enjoin, restrain or prohibit, or to
obtain damages in respect of, or which is related to or arises out of this Fifth
Amendment, the Loan Agreement or the consummation of the transactions
contemplated hereby.

         SECTION 3. REPRESENTATIONS AND WARRANTIES OF BORROWERS. To induce Agent
and Lenders to enter into this Fifth Amendment, each Borrower hereby represents
and warrants to Agent and Lenders as follows:

         3.1 REAFFIRMATION OF REPRESENTATIONS AND WARRANTIES. Each
representation and warranty of any Loan Party contained in the Loan Agreement
and the other Loan Documents, as amended hereby, is true and correct on the date
hereof and will be true and correct after giving effect to the amendments set
forth in SECTION 1 hereof.

         3.2 NO OUTSTANDING JUNIOR SUBORDINATED DEBT OR PREFERRED STOCK. As of
the date hereof, there is no outstanding Indebtedness with respect to the Junior
Subordinated Debt Documents and no Preferred Stock is outstanding.

                                       5
<PAGE>   6

         3.3 CORPORATE AUTHORITY; NO CONFLICTS. The execution, delivery and
performance by each Borrower of this Fifth Amendment and all documents,
instruments and agreements contemplated herein are within each Borrower's
respective corporate powers, have been duly authorized by necessary action,
require no action by or in respect of, or filing with, any court or agency of
government and do not violate or constitute a default under any provision of
applicable Law or any material agreement binding upon any Loan Party or result
in the creation or imposition of any Lien upon any of the assets of any Loan
Party except as permitted in the Loan Agreement, as amended hereby.

         3.4 ENFORCEABILITY. This Fifth Amendment constitutes the valid and
binding obligation of each of the Borrowers enforceable in accordance with its
terms, except as (i) the enforceability thereof may be limited by bankruptcy,
insolvency or similar laws affecting creditor's rights generally, and (ii) the
availability of equitable remedies may be limited by equitable principles of
general application.

         3.5 NO DEFENSES. No Loan Party has any defenses to payment,
counterclaims or rights of set off with respect to the Obligations.

         SECTION 4. MISCELLANEOUS.

         4.1 REAFFIRMATION OF LOAN DOCUMENTS; EXTENSION OF LIENS. Any and all of
the terms and provisions of the Loan Agreement and the Loan Documents shall,
except as amended and modified hereby, remain in full force and effect.
Borrowers hereby extend the Liens securing the Obligations until the Obligations
have been paid in full, and agree that the amendments and modifications herein
contained shall in no manner affect or impair the Obligations or the Liens
securing the payment and performance thereof.

         4.2 PARTIES IN INTEREST. All of the terms and provisions of this Fifth
Amendment shall bind and inure to the benefit of the parties hereto and their
respective successors and assigns.

         4.3 LEGAL EXPENSES. The Borrowers hereby agree to pay promptly
following receipt of an invoice detailing all reasonable fees and expenses of
counsel to Agent and Lenders incurred by Agent or any Lender, in connection with
the preparation, negotiation and execution of this Fifth Amendment and all
related documents.

         4.4 COUNTERPARTS. This Fifth Amendment may be executed in counterparts,
and all parties need not execute the same counterpart. However, no party shall
be bound by this Fifth Amendment until all parties have executed a counterpart.
Facsimiles shall be effective as originals.

         4.5 COMPLETE AGREEMENT. THIS FIFTH AMENDMENT, THE LOAN AGREEMENT AND
THE OTHER LOAN DOCUMENTS REPRESENT THE FINAL AGREEMENT BETWEEN THE PARTIES AND
MAY NOT BE CONTRADICTED BY EVIDENCE OF PRIOR,

                                       6
<PAGE>   7

CONTEMPORANEOUS OR ORAL AGREEMENTS OF THE PARTIES. THERE ARE NO UNWRITTEN ORAL
AGREEMENTS BETWEEN THE PARTIES.

         4.6 HEADINGS. The headings, captions and arrangements used in this
Fifth Amendment are, unless specified otherwise, for convenience only and shall
not be deemed to limit, amplify or modify the terms of this Fifth Amendment, nor
affect the meaning thereof.

                            (SIGNATURE PAGES FOLLOW)

                                       7
<PAGE>   8

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

BORROWERS:

RAMSAY YOUTH SERVICES, INC.
BETHANY PSYCHIATRIC HOSPITAL, INC.
BOUNTIFUL PSYCHIATRIC HOSPITAL, INC.
EAST CAROLINA PSYCHIATRIC SERVICES CORPORATION
GREAT PLAINS HOSPITAL, INC.
GULF COAST TREATMENT CENTER, INC.
HAVENWYCK HOSPITAL, INC.
H. C. CORPORATION
HSA HILL CREST CORPORATION
HSA OF OKLAHOMA, INC.
MICHIGAN PSYCHIATRIC SERVICES, INC.
RAMSAY EDUCATIONAL SERVICES, INC.
RAMSAY LOUISIANA, INC.
RAMSAY MANAGED CARE, INC.
RAMSAY YOUTH SERVICES OF ALABAMA, INC.
RAMSAY YOUTH SERVICES OF FLORIDA, INC.
RAMSAY YOUTH SERVICES OF SOUTH CAROLINA, INC.
RHCI SAN ANTONIO, INC.
TRANSITIONAL CARE VENTURES, INC.
TRANSITIONAL CARE VENTURES (TEXAS), INC.

By: /s/ MARCIO CABRERA
    ----------------------
    Marcio Cabrera
    Executive Vice President

H. C. PARTNERSHIP
By:  H.C. CORPORATION, General Partner
By:  HSA HILL CREST CORPORATION, General Partner

      By: /s/ MARCIO CABRERA
         ----------------------
          Marcio Cabrera
          Executive Vice President

<PAGE>   9

AGENT AND LENDERS:

FLEET CAPITAL CORPORATION
("Agent" and a "Lender")

By: /s/ DENNIS M. HANSEN
   -------------------------------
Name:  Dennis M. Hansen
     -------------------------
Title: Senior Vice President
      -------------------------

SUNTRUST BANK
(a "Lender")

By: /s/ WILLIAM H. CRAWFORD
   -------------------------------
Name: William H. Crawford
     -------------------------
Title: Assistant Vice President
      -------------------------

<PAGE>   10

                            CONSENT AND REAFFIRMATION

         The undersigned (each a "GUARANTOR") hereby (i) acknowledges receipt of
a copy of the foregoing Fifth Amendment to Loan and Security Agreement (the
"FIFTH AMENDMENT"); (ii) consents to Borrowers' execution and delivery thereof;
(iii) agrees to be bound thereby; and (iv) affirms that nothing contained
therein shall modify in any respect whatsoever its guaranty of the obligations
of the Borrowers to Lenders pursuant to the terms of its Guaranty in favor of
Agent and the Lenders (the "GUARANTY") and reaffirms that the Guaranty is and
shall continue to remain in full force and effect. Although Guarantor has been
informed of the matters set forth herein and has acknowledged and agreed to
same, Guarantor understands that the Lenders have no obligation to inform
Guarantor of such matters in the future or to seek Guarantor's acknowledgment or
agreement to future amendments or waivers, and nothing herein shall create such
duty.

         IN WITNESS WHEREOF, the undersigned has executed this Consent and
Reaffirmation on and as of the date of the Fifth Amendment.

GUARANTOR:

RAMSAY HOSPITAL CORPORATION OF LOUISIANA, INC.
RAMSAY YOUTH SERVICES PUERTO RICO, INC.

By: /s/ MARCIO CABRERA
    ----------------------
    Marcio Cabrera
    Executive Vice President

<PAGE>   11

                              [REPLACEMENT EXHIBITS

                                TO BE PROVIDED BY

                                    BORROWER]<PAGE>   1
                                                                  EXHIBIT 10.145

                                                           EXECUTION COUNTERPART

THIS AMENDED AND RESTATED SUBORDINATED NOTE AND WARRANT PURCHASE AGREEMENT IS
SUBJECT TO THAT CERTAIN SUBORDINATION AGREEMENT, DATED AS OF THE DATE HEREOF,
AMONG RAMSAY YOUTH SERVICES, INC., THE GUARANTORS, SUNTRUST BANKS, INC., ING
(U.S.) CAPITAL, LLC AND FLEET CAPITAL CORPORATION, AS AGENT, AS AMENDED FROM
TIME TO TIME.

                     AMENDED AND RESTATED SUBORDINATED NOTE
                         AND WARRANT PURCHASE AGREEMENT

                            Dated as of June 19, 2000

                                  by and among

                          RAMSAY YOUTH SERVICES, INC.,
                                 as the Company,

                    THE SUBSIDIARIES OF THE COMPANY SET FORTH
                         ON THE SIGNATURE PAGES HERETO,
                                  as Guarantors

                                       and

                              SUNTRUST BANKS, INC.,

                                       and

                             ING (U.S.) CAPITAL, LLC
                                as the Purchasers

<PAGE>   2

                                TABLE OF CONTENTS
<TABLE>
<CAPTION>

<S>     <C>                                                                                                      <C>
ARTICLE 1. DEFINITIONS............................................................................................1
         Section 1.1         Definitions..........................................................................1

ARTICLE 2. ISSUANCE AND PURCHASE OF NOTE AND WARRANT.............................................................11
         Section 2.1         Authorization of Issuance of SunTrust Notes and Warrants............................11
         Section 2.2         Purchase and Sale of SunTrust Note and Warrants.....................................12
         Section 2.3         Authorization of Issuance of ING Notes and Warrants.................................12
         Section 2.4         Purchase and Sale of ING Note and Warrants..........................................12
         Section 2.5         Allocation of Purchase Price........................................................12
         Section 2.6         Interest on the Notes...............................................................12
         Section 2.7         Amortization and Maturity of Notes; Prepayments; Funding Losses.....................13

ARTICLE 3. OTHER PROVISIONS RELATING TO THE NOTES................................................................14
         Section 3.1         Making of Payments..................................................................14
         Section 3.2         Increased Costs.....................................................................14
         Section 3.3         Capital Adequacy....................................................................15
         Section 3.4         Default Rate of Interest............................................................15
         Section 3.5         Calculation of Interest.............................................................15
         Section 3.6         Usury...............................................................................16

ARTICLE 4. GUARANTY..............................................................................................16

ARTICLE 5. CONDITIONS PRECEDENT TO PURCHASE OF THE NOTES AND THE WARRANTS........................................18
         Section 5.1         Closing Date Conditions.............................................................18

ARTICLE 6. REPRESENTATIONS AND WARRANTIES........................................................................21
         Section 6.1         Representations and Warranties Generally............................................21
                  6.1.1    Corporate Existence; Subsidiaries.....................................................21
                  6.1.2    Authorization; No Conflict............................................................21
                  6.1.3    Approvals.............................................................................21
                  6.1.4    Tax Returns; Status...................................................................21
                  6.1.5    Binding Obligations...................................................................22
                  6.1.6    Litigation............................................................................22
                  6.1.7    No Defaults...........................................................................22
                  6.1.8    No Material Restrictions..............................................................22
                  6.1.9    Information...........................................................................22
                  6.1.10   Financial Statements..................................................................23
                  6.1.11   Title to Properties...................................................................23
                  6.1.12   Compliance with Laws..................................................................24
                  6.1.13   Possession of Franchises, Licenses, Etc...............................................24
                  6.1.14   Insurance.............................................................................24
                  6.1.15   Federal Reserve Regulations...........................................................24
                  6.1.16   Material Contracts....................................................................24
                  6.1.17   ERISA.................................................................................24
                  6.1.18   Broker's Fees.........................................................................25

</TABLE>

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<PAGE>   3

<TABLE>
<CAPTION>

<S>     <C>                                                                                                      <C>
                  6.1.19   Offering of Notes and Warrants........................................................25
                  6.1.20   Registration Rights...................................................................25
                  6.1.21   Solvency..............................................................................25
                  6.1.22   Continuing Business of Company........................................................25
                  6.1.23   Year 2000 Compliance..................................................................26
                  6.1.24   Disclosure............................................................................26
         Section 6.2         Representations and Warranties of each Purchaser....................................26

ARTICLE 7. AFFIRMATIVE COVENANTS.................................................................................27
         Section 7.1         Preservation of Corporate Existence.................................................27
         Section 7.2         Compliance with Laws................................................................27
         Section 7.3         Maintenance of Insurance............................................................28
         Section 7.4         Visitation Rights...................................................................28
         Section 7.5         Records and Accounts................................................................28
         Section 7.6         Payment of Debts, Taxes.............................................................28
         Section 7.7         Further Assurances..................................................................29
         Section 7.8         Maintenance of Properties...........................................................29
         Section 7.9         Business............................................................................29
         Section 7.10        Reporting Covenants.................................................................29
         Section 7.11        Use of Proceeds.....................................................................31
         Section 7.12        Compliance with Material Contracts..................................................31

ARTICLE 8. NEGATIVE COVENANTS....................................................................................31
         Section 8.1         Liens and Other Encumbrances........................................................31
         Section 8.2         Investments.........................................................................31
         Section 8.3         Merger and Sale of Assets...........................................................32
         Section 8.4         Creation or Issuance of Stock by Subsidiaries.......................................32
         Section 8.5         Transactions with Affiliates........................................................32
         Section 8.6         Debt................................................................................33
         Section 8.7         Lease Obligations...................................................................33
         Section 8.8         Restricted Payments.................................................................34
         Section 8.9         Sale and Leasebacks.................................................................34
         Section 8.10        Sale or Discount of Receivables.....................................................34
         Section 8.11        Compliance with ERISA...............................................................34
         Section 8.12        Financial Covenants.................................................................34
         Section 8.13        Fiscal Year.........................................................................34
         Section 8.14        Modifications to Material Contracts.................................................34
         Section 8.15        Inconsistent Agreement..............................................................34
         Section 8.16        No Repurchase Agreements............................................................35

ARTICLE 9. EVENTS OF DEFAULT.....................................................................................35
         Section 9.1         Events of Default...................................................................35
         Section 9.2         Remedies on Default.................................................................37

ARTICLE 10. MISCELLANEOUS........................................................................................37
         Section 10.1        Notices.............................................................................37
         Section 10.2        No Waiver...........................................................................39
         Section 10.3        Expenses............................................................................39
         Section 10.4        Amendments, Etc.....................................................................40
         Section 10.5        Successors and Assigns..............................................................40

</TABLE>

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<PAGE>   4
<TABLE>
<CAPTION>

<S>     <C>                                                                                                      <C>
         Section 10.6        GOVERNING LAW.......................................................................40
         Section 10.7        Survival of Representations and Warranties..........................................40
         Section 10.8        Severability........................................................................40
         Section 10.9        Counterparts........................................................................41
         Section 10.10     Set-Off...............................................................................41
         Section 10.11     Termination of Agreement..............................................................41
         Section 10.12     JURISDICTION AND VENUE................................................................41
         Section 10.13     WAIVER OF JURY TRIAL..................................................................41
         Section 10.14     Entire Agreement......................................................................42

</TABLE>

                                       iii

<PAGE>   5

EXHIBITS AND SCHEDULES

         Exhibit A - Form of Note
         Exhibit B - Form of Warrant Agreement
         Exhibit C - Form of Warrant
         Exhibit D - Form of Registration Rights Agreement

         Exhibit E - Compliance Certificate As To Financial Covenants
         Exhibit F - Subordination Agreement

         Schedule 6.1.1  - Subsidiaries
         Schedule 6.1.6  - Litigation
         Schedule 6.1.16 - Material Contracts
         Schedule 6.1.20 - Registration Rights
         Schedule 8.4    - Issuance of Stock
         Schedule 8.6    - Existing Debt
         Schedule 8.9    - Sale/Leaseback Agreement

                                       iv
<PAGE>   6

                     AMENDED AND RESTATED SUBORDINATED NOTE
                         AND WARRANT PURCHASE AGREEMENT

         THIS AMENDED AND RESTATED SUBORDINATED NOTE AND WARRANT PURCHASE
AGREEMENT dated as of June 19, 2000 by and between RAMSAY YOUTH SERVICES, INC.,
a corporation organized under the laws of the State of Delaware, as issuer of
the Notes and the Warrants (the "COMPANY"), each of the subsidiaries of the
Company listed on the signature pages hereto, as guarantors (individually, a
"GUARANTOR" and, collectively, the "GUARANTORS"), SUNTRUST BANKS, INC.,
("SUNTRUST"), ING (U.S.) CAPITAL, LLC ("ING"; ING and SunTrust individually a
"PURCHASER" and collectively the "PURCHASERS").

         WHEREAS, the Company has previously entered into that certain
Subordinated Note and Warrant Purchase Agreement, dated as of January 25, 2000,
by and among the Company, the Guarantors and SunTrust (the "ORIGINAL NOTE
PURCHASE AGREEMENT"), pursuant to which SunTrust made a $5,000,000 subordinated
debt investment in the Company and purchased warrants for 475,000 shares of
Common Stock of the Company;

         WHEREAS, the Company has requested that ING make a certain subordinated
debt investment in the Company, the proceeds of which will be used by the
Company to effect acquisition and expansion, to pay related fees and expenses,
and for general corporate purposes;

         WHEREAS, ING has agreed to make a $5,000,000 subordinated debt
investment in the Company on the terms and subject to the conditions set forth
herein, such investment to be evidenced by subordinated notes in such amount
from the Company and certain warrants issued by the Company as more fully
described below;

         WHEREAS, the Company has previously entered into that certain Loan and
Security Agreement, dated as of October 30, 1998, as amended, by and among the
Company (formerly known as Ramsey Health Care, Inc.), various subsidiaries of
the Company (such subsidiaries and the Company, collectively the "Borrowers"),
Fleet Capital Corporation, as Agent (in such capacity, the "Agent") for the
lenders party thereto (the "Senior Lenders") and the Senior Lenders, pursuant to
which the Borrowers may borrow up to $22,000,000.

         NOW, THEREFORE, for and in consideration of the mutual premises,
covenants and conditions contained herein, and other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, the
parties hereto, intending to be legally bound, agree to amend and restate the
Original Note Purchase Agreement as follows:

                                   ARTICLE 1.

                                   DEFINITIONS

SECTION 1.1 DEFINITIONS. In addition to the other terms defined herein, the
following terms used herein shall have the meanings herein specified (such
meanings to be equally applicable to both the singular and plural forms of the
terms defined):

<PAGE>   7

         "ADJUSTED NET EARNINGS FROM OPERATIONS (OR LOSS)" shall mean, with
respect to any fiscal period, the net earnings (or loss) after provision for
income taxes for such fiscal period of the Company, as reflected on the
financial statement of the Company supplied to the Purchasers pursuant to
SECTION 7.10, but excluding:

                  (i) any gain or loss arising from the sale of capital assets;

                  (ii) any gain or loss arising from any write-up or write-down
of assets;

                  (iii) earnings of any subsidiary of the Company accrued prior
to the date it became a Subsidiary;

                  (iv) earnings of any corporation, substantially all the assets
of which have been acquired in any manner by the Company or any Subsidiary of
the Company, realized by such corporation prior to the date of such acquisition;

                  (v) net earnings of any business entity (other than a domestic
Subsidiary of the Company) in which the Company has an ownership interest unless
such net earnings shall have actually been received by the Company in the form
of cash distributions;

                  (vi) any portion of the net earnings of any Subsidiary of the
Company which for any reason (other than the provisions of this Agreement) is
unavailable for payment of dividends to the Company;

                  (vii) any restoration to income of any reserve;

                  (viii) the earnings of any Person to which any assets of any
Consolidated Company shall have been sold, transferred or disposed of, or into
which such Consolidated company shall have merged, or been a party to any
consolidation or other form of reorganization, prior to the date of such
transaction;

                  (ix) any gain arising from the acquisition of any Securities
by any Borrower;

                  (x) the effect of the application of the rules of Purchase
Accounting (as set forth in APB No. 16, as amended); and

                  (xi) 1998 year end accruals arising from asset purchase price
adjustments related to the West Virginia University Hospitals Sale and the
Charter Sale;

                  (xii) any gain from extraordinary or non-recurring items.

                                       2
<PAGE>   8

         "AFFILIATE" shall mean with respect to any Person (the "Specified
Person"), any Person other than the Specified Person directly or indirectly
controlling, controlled by or under direct or indirect common control with, the
Specified Person. For purposes of this definition, the term "control" when used
with respect to any Person, means the possession, directly or indirectly, of the
power to direct or cause the direction of the management and policies of such
Person, whether through the ownership of voting securities, partnership
interests, by contract or otherwise; PROVIDED that the holding by Purchasers of
the Warrants (or the Stock into which such Warrants are converted) shall not be
deemed to constitute any Purchaser as an Affiliate of the Company hereunder.

         "AGENT" shall have the meaning given to such term in the recitals
hereof, or any successor thereof.

         "AGREEMENT" shall mean this Amended and Restated Subordinated Note and
Warrant Purchase Agreement, as the same may be amended, restated, supplemented
or modified from time to time in accordance with the terms hereof.

         "AMORTIZATION" shall mean, for any period, all amortization expense of
the Consolidated Companies determined on a consolidated basis in accordance with
GAAP.

         "APPLICABLE LAW" shall mean all applicable provisions of constitutions,
statutes, rules, regulations and orders of all governmental bodies and all
orders and decrees of all courts, tribunals and arbitrators.

         "BANKRUPTCY CODE" shall mean The Bankruptcy Code of 1978, as amended
and in effect from time to time (11 U.S.C.ss. 101 ET SEQ.).

         "BUSINESS DAY" shall mean any day on which commercial banks located in
Atlanta, Georgia are required or permitted by law to be open for the purpose of
conducting a commercial banking business.

         "CAPITAL LEASE" shall mean, as applied to any Person, any lease of any
property (whether real, personal or mixed) by such Person as lessee which would,
in accordance with GAAP, be required to be classified and accounted for as a
capital lease on a balance sheet of such Person, other than, in the case of the
Company or a Subsidiary, any such lease under which the Company or a wholly
owned Subsidiary is the lessor.

         "CAPITAL LEASE OBLIGATION" shall mean, with respect to any Capital
Lease, the amount of the obligation of the lessee thereunder which would, in
accordance with GAAP, appear on a balance sheet of such lessee in respect of
such Capital Lease.

         "CHANGE IN CONTROL" shall mean (a) any "person" or "group", other than
members of the Controlling Shareholder Group, becoming the "beneficial owner(s)"
(within the meaning of Sections 13(d) and 14(d)(2) of the Securities Exchange
Act of 1934, as amended, and the applicable rules and regulations thereunder) of
shares of Stock of the Company which entitle the holder thereof to control more
than fifty percent (50%) of all voting rights with respect to all shares of
Stock of the Company (excluding preferred stock) without the approval in advance
of the board of directors of the Company; (b) approval by the stockholders of

                                       3
<PAGE>   9

the Company of a merger, reorganization, consolidation, exchange of shares,
recapitalization, restructuring or other business combination which could result
in the occurrence of any event described in clause (a) of this definition or any
"person" or "group", other than members of the Controlling Shareholder Group,
becoming the "beneficial owner(s)" (within the meaning of Sections 13(d) and
14(d)2 of the Securities Exchange Act of 1934, as amended, and the applicable
rules and regulations thereunder) of shares of Stock of the surviving
corporation which entitle the holder thereof to control more than fifty percent
(50%) of all voting rights with respect to all shares of Stock of the surviving
corporation (excluding preferred stock) without the approval in advance of the
board of directors of the Company; (c) sale of all or substantially all of the
Company's assets; (d) any Controlling Shareholder or any member of the
Controlling Shareholder's Group selling or otherwise transferring shares of
Stock of the Company held by such Controlling Shareholder or member of the
Controlling Shareholder Group on the SunTrust Closing Date other than in
connection with a Permitted Transfer; (e) any recapitalization occurring in
which any dividends or other distributions, direct or indirect, on account of
any shares of the Stock of the Company or any of the Subsidiaries are not paid
to the Purchasers on a PARI PASSU basis with all other shareholders of the
Company as if the Warrants had been exercised for or converted into Stock; or
(f) after any transaction not approved in advance by the board of directors of
the Company, the Company's Common Stock is no longer required to be registered
under Section 12 of the Exchange Act.

         "CHARTER SALE" shall mean, the sale by the Company to Charter
Behavioral Health Systems, LLC and affiliates of the Company's contract
management business and Bayou Oaks, Coastal Carolina, The Haven and Desert Vista
psychiatric hospitals and certain transitional care units and other assets
pursuant to that certain Purchase Agreement and purchase and sale contracts of
even date therewith between the Company and Charter Behavioral Health Systems,
LLC and the other parties thereto dated as of June 24, 1998, as amended by
Amendment No. 1 dated as of September 30, 1998.

         "CLOSING DATE" shall mean, with respect to SunTrust, the SunTrust
Closing Date or, with respect to ING, the ING Closing Date.

         "CODE" shall mean the Internal Revenue Code of 1986, as amended from
time to time, and the regulations promulgated and the rulings issued thereunder.

         "COMMON STOCK" shall mean the Common Stock, par value $0.01 per share,
of the Company.

         "COMPANY" has the meaning set forth in the introductory paragraph
hereof and shall include the Company's successors and assigns.

         "CONSOLIDATED" shall mean consolidation in accordance with GAAP of the
accounts or other items as to which such term applies.

         "CONSOLIDATED COMPANIES" shall mean, collectively, the Company and all
of its Subsidiaries, and "Consolidated Company" shall mean, individually, the
Company or any of its Subsidiaries.

         "CONTROLLING SHAREHOLDER" shall mean Paul J. Ramsay.

                                       4
<PAGE>   10

         "CONTROLLING SHAREHOLDER GROUP" shall mean, collectively, (i) the
Controlling Shareholder, (ii) any lineal descendants (by birth or adoption) and
spouse, (iii) any trusts established for the sole benefit of the foregoing, (iv)
any charitable organization and (v) any Affiliate of the Controlling
Shareholder.

         "DEBT" of any Person shall mean, without duplication, (i) indebtedness
of such Person for borrowed money or for the deferred purchase price of property
or services (other than trade accounts payable on customary terms in the
ordinary course of business), (ii) financial obligations of such Person
evidenced by bonds, debentures, notes or similar instruments, (iii) Capital
Lease Obligations, (iv) all obligations of such Person under conditional sale or
other title retention agreements relating to property or assets purchased by
such Person, (v) any obligation or liability of others secured by a Lien (or for
which the holder of such Debt has an existing right, contingent or otherwise, to
be secured by any Lien) on property or assets owned or acquired by such Person,
(vi) all obligations of such Person in respect of interest rate protection
agreements, foreign currency exchange agreements or other interest or exchange
rate hedging agreements, (vii) any letter of credit issued for such Person or
its Subsidiaries as account debtor, or (viii) all obligations under direct or
indirect Guaranties in respect of, and obligations (contingent or otherwise) to
purchase or otherwise acquire, or otherwise to assure a creditor against loss in
respect of obligations of other Persons of the kinds referred to above.

         "DEFAULT" shall mean any event that, with notice or lapse of time or
both, would constitute an Event of Default.

         "DEPRECIATION" shall mean, for any period, all depreciation expense of
the Consolidated Companies determined on a consolidated basis in accordance with
GAAP.

         "DOLLAR" and the sign "$" shall mean the lawful money of the United
States of America.

         "EBIT" shall mean, with respect to any fiscal period, the Consolidation
Adjusted Net Earnings From Operations (or Loss) of the Company, before Interest
Expense and taxes for such period as determined in accordance with GAAP,
excluding the impact, if any, from purchase accounting.

         "EBITDA" with respect to any fiscal period shall mean EBIT PLUS
Depreciation and Amortization expense for such period.

         "ERISA" shall mean the Employee Retirement Income Security Act of 1974,
as amended from time to time, and the regulations promulgated and rulings issued
thereunder.

         "ERISA AFFILIATE" shall mean any trade or business (whether or not
incorporated) which, together with the Company, is treated as a single employer
under Section 414(b), (c), (m) or (o) of the Code.

         "EVENT OF DEFAULT" means any of the events specified in SECTION 9.1
hereof.

                                       5
<PAGE>   11

         "GAAP" shall mean generally accepted accounting principles set forth in
the opinions and pronouncements of the Accounting Principles Board of the
American Institute of Certified Public Accountants and statements and
pronouncements of the Financial Accounting Standards Board (or any successor
authority) that are applicable to the circumstances as of the date of
determination, consistently applied and maintained through the periods
indicated.

         "GUARANTY" shall mean any contractual obligation, contingent or
otherwise, of a Person with respect to any Debt or other obligation or liability
of another Person, including without limitation, any such Debt, obligation or
liability directly or indirectly guaranteed, endorsed, co-made or discounted or
sold with recourse by that Person, or in respect of which that Person is
otherwise directly or indirectly liable, including contractual obligations
(contingent or otherwise) arising through any agreement to purchase, repurchase,
or otherwise acquire such Indebtedness, obligation or liability or any security
therefor, or any agreement to provide funds for the payment or discharge thereof
(whether in the form of loans, advances, stock purchases, capital contributions
or otherwise), or to maintain solvency, assets, level of income, or other
financial condition, or to make any payment other than for value received. The
amount of any Guaranty shall be deemed to be an amount equal to the stated or
determinable amount of the primary obligation in respect of which guaranty is
made or, if not so stated or determinable, the maximum reasonably anticipated
liability in respect thereof (assuming such Person is required to perform
thereunder) as determined by such Person in good faith.

         "ING CLOSING DATE" shall mean June 19, 2000 or such later date that the
conditions set forth in SECTIONS 5.1 and 5.2 hereof are met.

         "ING FACILITY FEE" shall mean the non-refundable facility fee payable
by the Company to ING in accordance with the terms of the commitment letter
executed by ING and the Company.

         "ING NOTE" shall mean the subordinated promissory note issued by the
Company to ING pursuant to SECTION 2.3 or any other provision hereof, in
substantially the form of EXHIBIT A hereto, maturing on the Maturity Date, or
such earlier date as provided herein, at which time all principal, interest and
other amounts owing hereunder shall be due and payable in full, and bearing
interest as set forth in this Agreement, and each Note delivered in
substitution, amendment, modification, extension or exchange for any such Note
pursuant to the provisions of this Agreement.

         "ING WARRANT AGREEMENT" shall mean that certain Warrant Agreement,
dated as of the date hereof, between the Company and ING in its capacity as
holder of the ING Warrant, in substantially the form of EXHIBIT B-2 hereto,
together with all the amendments and modifications thereto.

         "ING WARRANT" shall mean the warrant to acquire 475,000 shares of
Common Stock to be issued and delivered to ING on the ING Closing Date, in the
form of Exhibit C-2, and each common stock purchase warrant issued and delivered
in substitution or exchange for any ING Warrant.

                                       6
<PAGE>   12

         "INTEREST EXPENSE" shall mean, for any period, all interest expense of
the Consolidated Companies (including without limitation, interest expense
attributable to capitalized leases in accordance with GAAP, all capitalized
interest, all commissions, discounts and other fees and charges owed with
respect to banker acceptance financing, and total interest expense (whether
shown as interest expense or as loss and expenses on sale of receivables) under
a receivables purchase facility) determined on a consolidated basis in
accordance with GAAP.

         "INVESTMENT" shall have the meaning set forth in SECTION 8.2 hereof.

         "LIEN" shall mean any mortgage, pledge, security interest, encumbrance,
lien or charge of any kind (including any written agreement to give any of the
foregoing), any conditional sale or other title retention agreement and the
filing of or agreement to give any financing statement under the Uniform
Commercial Code of any jurisdiction.

         "LOAN DOCUMENTS" shall mean, collectively, each of the Transaction
Documents other than the Warrant Documents, in each case either as originally
executed or as the same may from time to time be supplemented, modified,
amended, restated, extended or supplanted.

         "MATERIAL ADVERSE EFFECT" shall mean a material adverse effect on (a)
the properties, operations, business, condition (financial or otherwise) or
prospects of the Company and its Subsidiaries taken as a whole, (b) the
Company's ability to pay the Notes and the other Obligations in accordance with
the terms thereof, or (c) the Company's ability to perform its obligations under
the Transaction Documents to which it is a party.

         "MATERIAL CONTRACT" shall mean any contract or other arrangement (other
than Transaction Documents), whether written or oral, to which the Company or
any of its Subsidiaries is a party as to which the breach, nonperformance,
cancellation or failure to renew by any party thereto could reasonably likely
have a Material Adverse Effect, as the same are listed on SCHEDULE 6.1.16 as of
the date of this Agreement. The term "Material Contract" shall not include the
Senior Credit Agreement or the Senior Debt Documents.

         "MATURITY DATE" shall mean January 24, 2007.

         "MONEY BORROWED" shall mean, without duplication, (i) Debt arising from
the lending of money by any Person to the Company or any Subsidiary; (ii) Debt,
whether or not in any such case arising from the lending by any Person of money
to the Company or any Subsidiary, (A) which is represented by notes payable or
drafts accepted that evidence extensions of credit, (B) which constitutes
obligations evidenced by bonds, debentures, notes or similar instruments, or (C)
upon which interest charges are customarily paid (other than accounts payable)
or that was issued or assumed as full or partial payment for Property (as
defined in the Senior Credit Agreement); (iii) Debt that constitutes a Capital
Lease Obligation (as defined in the Senior Credit Agreement); (iv) reimbursement
obligations with respect to letters of credit or guaranties of letters of credit
and (v) Debt of the Company or any Subsidiary under any guaranty of obligations
that would constitute Debt for Money Borrowed under clauses (i) through (iii)
hereof, if owed directly by the Company or any Subsidiary. The calculation of
Money Borrowed shall exclude the Ramsay Group Payable.

                                       7
<PAGE>   13

         "MULTIEMPLOYER PLAN" shall mean, as of any date, a "multiemployer plan"
as defined in Section 4001(a)(3) of ERISA that is subject to Title IV of ERISA
to which the Company or any ERISA Affiliate is making or accruing an obligation
to make contributions, or has within any of the preceding seven plan years made
or accrued an obligation to make contributions.

         "NET SECURITIES PROCEEDS" means, with respect to the issuance or sale
by the Company or any Subsidiary of any securities representing Stock or
indebtedness of such Person, but not including the Notes, the excess of (a) the
gross cash proceeds received from such issuance and sale, MINUS (b) all
reasonable out-of-pocket fees and expenses incurred in connection with such
issuance and sale and paid to Persons that are not Affiliates of the Company.

         "NOTES" shall mean, collectively, the SunTrust Note and the ING Note.

         "OBLIGATIONS" shall mean all present and future debt, liabilities and
obligations of the Company owing to the Purchasers, or any Person entitled to
indemnification hereunder, or any of their respective successors, permitted
transferees or permitted assigns, arising under or in connection with this
Agreement, the Notes or any other Loan Document.

         "PERMITTED LIENS" shall mean the following Liens: (a) Liens securing
Senior Debt; (b) Liens for taxes, assessments or other governmental charges or
levies not yet due or which are being actively contested in good faith by
appropriate proceedings if adequate reserves with respect thereto are maintained
on the books of the Company in accordance with GAAP consistently applied; (c)
statutory Liens of landlords and Liens of carriers, warehousemen, mechanics,
material men and other Liens imposed by law created in the ordinary course of
business for amounts not yet due or which are being contested in good faith by
appropriate proceedings and with respect to which adequate reserves are being
maintained; (d) Liens (other than any Lien imposed by ERISA) incurred or
deposits made in the ordinary course of business in connection with workmen's
compensation, unemployment insurance or other types of social security; (e)
easements, rights-of-way, restrictions and other similar charges or encumbrances
not materially detracting from the value of the properties of the Company or any
of its Subsidiaries or materially interfering with the ordinary conduct of the
business of the Company, any of its Subsidiaries or any of their respective
properties; (f) UCC filings made in connection with the lease of equipment in
the ordinary course of business; (g) Liens securing purchase money indebtedness
permitted by SECTION 8.6(G) which Liens encumber only the asset financed by such
indebtedness; and (h) extensions, renewals or replacements of any Lien referred
to in clause (a) herein.

         "PERMITTED TRANSFER" shall mean the transfer by (i) any member of the
Controlling Shareholder Group of Stock to any other member of the Controlling
Shareholder Group, or (ii) any member of the Controlling Shareholder Group of
Stock to any Person, provided that following any such transfer or transfers
pursuant to clause (ii), the Controlling Shareholder Group, taken as a whole,
shall at no time own less than 95% of the Stock owned by the Controlling
Shareholder Group, taken as a whole, as of the SunTrust Closing Date.

                                       8
<PAGE>   14

         "PERSON" shall mean an individual, corporation, limited liability
company, partnership, joint venture, trust, unincorporated association, or other
entity, or a government or any political subdivision or agency thereof.

         "PLAN" shall mean any "employee pension benefit plan" maintained by or
on behalf of the Company or any ERISA Affiliate as defined in Section 3(3) of
ERISA, including, but not limited to, any defined benefit pension plan, profit
sharing plan, money purchase pension plan, 401(k) plan, employee stock ownership
plan or Multiemployer Plan.

         "PRINCIPAL OFFICE" for each Purchaser means the address set forth on
the signature pages hereto.

         "PURCHASERS" means, collectively, SunTrust Banks, Inc., a Georgia
corporation, together with its successors and assigns and ING (U.S.) Capital,
LLC, a Delaware limited liability company, together with its successors and
assigns.

         "RAMSAY GROUP" shall mean Paul Ramsay Holdings Pty. Limited, an
Australian corporation, Paul Ramsay Hospitals Pty. Limited, an Australian
corporation, Ramsay Holdings HSA Limited, a Barbados corporation, or any other
Affiliate of the Controlling Shareholder Group from time to time beneficially
holding Stock of the Company.

         "RAMSAY GROUP PAYABLE" shall mean the $600,000 payable of the Company
to the Ramsay Group in connection with the Company's prior purchase of Ramsay
Hospital Corporation of Louisiana, Inc., a Louisiana corporation.

         "REGISTRATION RIGHTS AGREEMENT" means that certain Amended and Restated
Registration Rights Agreement, dated as of the date hereof, between the Company
and the Purchasers in their capacity as holders of the Warrants, in
substantially the form of EXHIBIT D, together with all amendments and
modifications thereto.

         "REQUIRED PURCHASERS" shall mean Purchasers who individually or
collectively hold more than seventy-five (75%) of the outstanding principal
amount of the Note or Notes.

         "SECURITY" shall have the same meaning as in Section 2(1) of the
Securities Act of 1933, as amended.

         "SENIOR CREDIT AGREEMENT" shall mean that certain Loan and Security
Agreement, dated as of October 30, 1998, as amended, by and between the Senior
Lenders, the Agent, and the Borrowers, providing for an aggregate credit
facility to the Company of $22,000,000, as the same may be hereafter amended,
modified, restated, supplemented, refinanced or replaced in accordance with
SECTION 8.6(F) and the other provisions hereof.

         "SENIOR DEBT" shall have the meaning ascribed to the term "Senior
Indebtedness" in the Subordination Agreement.

         "SENIOR DEBT DOCUMENTS" shall mean the Senior Credit Agreement and all
other Transaction Documents (as defined in the Senior Credit Agreement).

                                       9
<PAGE>   15

         "SENIOR LENDERS" shall have the meaning given to such term in the
recitals hereof.

         "SOLVENT" shall mean, with respect to any Person at any time, that (i)
each of the fair value and the present fair saleable value of such Person's
assets (including any rights of subrogation or contribution to which such Person
is entitled, under any of the Transaction Documents or otherwise) is greater
than such Person's debts and other liabilities (including contingent, unmatured
and unliquidated debts and liabilities) and the maximum estimated amount
required to pay such debts and liabilities as such debts and liabilities mature
or otherwise become payable; (ii) such Person is able and expects to be able to
pay its debts and other liabilities (including, without limitation, contingent,
unmatured and unliquidated debts and liabilities) as they mature; and (iii) such
Person does not have unreasonably small capital to carry on its business as
conducted and as proposed to be conducted.

         "STOCK" means all shares of capital stock of or in a corporation,
whether voting or non-voting, and including, without limitation, common stock
and preferred stock.

         "SUBORDINATION AGREEMENT" shall mean that certain Amended and Restated
Subordination Agreement, dated as of the date hereof, by and among the Agent,
for the benefit of and on behalf of the Senior Lenders and the Purchasers, and
acknowledged by the Company and the Guarantors, either as originally executed or
as hereafter amended, modified or supplemented with the consent of the required
Purchasers.

         "SUBSIDIARY" shall mean, as to any person, any corporation, limited
liability company, partnership or joint venture, whether now existing or
hereafter organized or acquired: (i) in the case of a corporation, of which at
least a majority of the outstanding shares of stock having by the terms thereof
ordinary voting power to elect a majority of the board of directors of such
corporation (other than stock having such voting power by reason of the
happening of any contingency) is at the time directly or indirectly owned or
controlled by such Person and/or one or more of its Subsidiaries or (ii) in the
case of a limited liability company, partnership or joint venture, in which such
Person or a Subsidiary of such Person is a member, general partner or joint
venturer and of which a majority of the partnership or other ownership interests
are at the time owned by such Person or one or more of its Subsidiaries.

         "SUNTRUST CLOSING DATE" shall mean January 25, 2000.

         "SUNTRUST FACILITY FEE" shall mean the non-refundable facility fee
payable by the Company to SunTrust in accordance with the terms of the
commitment letter executed by SunTrust and the Company.

         "SUNTRUST NOTE" shall mean the subordinated promissory note issued by
the Company to SunTrust on January 25, 2000, maturing on the Maturity Date, or
such earlier date as provided herein, at which time all principal, interest and
other amounts owing hereunder shall be due and payable in full, and bearing

                                       10
<PAGE>   16

interest as set forth in this Agreement, and each Note delivered in
substitution, amendment, modification, extension or exchange for any such Note
pursuant to the provisions of this Agreement.

         "SUNTRUST WARRANT AGREEMENT" shall mean that certain Warrant Agreement,
dated as of January 25, 2000, between the Company and SunTrust in its capacity
as holder of the SunTrust Warrant, in substantially the form of EXHIBIT B-1
hereto, together with all amendments and modifications thereto.

         "SUNTRUST WARRANT" shall mean the warrant to acquire 475,000 shares of
Common Stock to be issued and delivered to SunTrust on the SunTrust Closing
Date, in the form of Exhibit C-1, and each common stock purchase warrant issued
and delivered in substitution or exchange for any SunTrust Warrant.

         "TOTAL DEBT TO EBITDA RATIO" shall mean, with respect to the Company
and its Subsidiaries on a consolidated basis, as of any calculation date, the
ratio of (a) Money Borrowed as of such date, to (b) EBITDA for the preceding
four fiscal quarter period then ending.

         "TRANSACTION DOCUMENTS" shall mean, collectively, this Agreement, the
Notes, each Warrant, the Warrant Agreements, the Registration Rights Agreement,
the Subordination Agreement and any other agreements of any type or nature in
any way relating to or in furtherance of this Agreement, in each case either as
originally executed or as the same may from time to time be supplemented,
modified, amended, restated, extended or supplanted.

         "WARRANT AGREEMENT" shall mean individually or collectively, the ING
Warrant Agreement and the SunTrust Warrant Agreement.

         "WARRANT DOCUMENTS" shall mean, collectively, the Warrant Agreement,
the Warrants and the Registration Rights Agreement.

         "WARRANTS" shall mean, collectively, the SunTrust Warrants and the Ing
Warrants.

         "WEST VIRGINIA UNIVERSITY HOSPITALS SALE" shall mean, the sale by the
Company to West Virginia University Hospitals, Inc. of Chestnut Ridge Hospital
and other assets pursuant to that certain Asset Purchase Agreement between the
Company, Psychiatric Institute of West Virginia, Inc. and West University
Hospitals, Inc. dated as of July 1, 1998, as amended by Amended No. 1 dated as
of September 30, 1998.

                                   ARTICLE 2.

                    ISSUANCE AND PURCHASE OF NOTE AND WARRANT

         SECTION 2.1 AUTHORIZATION OF ISSUANCE OF SUNTRUST NOTES AND WARRANTS.
The Company has duly authorized the issuance and sale to SunTrust, on the terms
and subject to the conditions set forth herein, of Notes in the aggregate
principal amount of $5,000,000, to be dated as of the SunTrust Closing Date. The
Company has duly authorized the issuance and sale, on the terms and subject to
the conditions set forth herein and in the SunTrust Warrant Agreement, of the
SunTrust Warrants for the purchase of 475,000 shares of the Common Stock of the
Company.

                                       11
<PAGE>   17

         SECTION 2.2 PURCHASE AND SALE OF SUNTRUST NOTE AND WARRANTS. Subject to
the terms and conditions contained herein and in reliance upon the
representations and warranties of SunTrust contained in the Original Note
Purchase Agreement, the Company has sold to SunTrust and, subject to the terms
and conditions set forth herein and in reliance upon the representations and
warranties of the Company contained in the Original Note Purchase Agreement,
SunTrust has purchased from the Company the SunTrust Notes with the Warrants for
an aggregate purchase price of $5,000,000. The purchase price paid by SunTrust
for the SunTrust Note was equal to the principal amount thereof and no
additional consideration.

         SECTION 2.3 AUTHORIZATION OF ISSUANCE OF ING NOTES AND WARRANTS. The
Company has duly authorized the issuance and sale to ING, on the terms and
subject to the conditions set forth herein, of the ING Note in the aggregate
principal amount of $5,000,000, to be dated as of the ING Closing Date. The
Company has duly authorized the issuance and sale, on the terms and subject to
the conditions set forth herein and in the ING Warrant Agreement, of the ING
Warrants for the purchase of 475,000 shares of the Common Stock of the Company.

         SECTION 2.4 PURCHASE AND SALE OF ING NOTE AND WARRANTS. Subject to the
terms and conditions contained herein and in reliance upon the representations
and warranties of ING contained herein, the Company hereby agrees to sell to ING
and, subject to the terms and conditions set forth herein and in reliance upon
the representations and warranties of the Company contained herein, ING agrees
to purchase from the Company the ING Notes with the ING Warrants for an
aggregate purchase price of $5,000,000. The purchase price paid by ING for the
ING Note shall be equal to the principal amount thereof and no additional
consideration.

         SECTION 2.5 ALLOCATION OF PURCHASE PRICE. Under both generally accepted
accounting standards consistently applied and the regulations of the Internal
Revenue Service, the issuance to each Purchaser of the Notes and the Warrants
for an aggregate purchase price equal to the aggregate principal amount of such
Notes being so purchased results in the creation of "original issue discount" on
such Notes (which original issue discount may also be deemed to constitute the
value of any Warrant issued in connection with the issuance of such Notes), and
such regulations require the determination of the value of any Warrant so
delivered. Pursuant to generally accepted accounting principles consistently
applied and applicable Treasury Regulations, the Company and each Purchaser
agree that the aggregate amount of such original issue discount and the
aggregate value of each Warrant for 475,000 shares of the Common Stock of the
Company is $461,000, which original issue discount and value of such Warrant
shall be allocated to the Note. The Company and each Purchaser agree to
recognize and adhere to the determinations and allocations of original issue
discount and valuation of each Warrant set forth herein for all federal and
state income tax purposes. In the event of any proposed transfer of any Note by
any Purchaser, such Purchaser shall, prior to such transfer, mark such Note with
a legend pertaining to the original issue discount in the form required by
Treasury Regulation Section 1.1275-3(b)(1).

         SECTION 2.6 INTEREST ON THE NOTES.

                  (a) Interest on the Notes shall accrue at a rate per annum
         equal to twelve and one-half percent (12.50%), subject to SECTION 3.5
         below; PROVIDED, HOWEVER, that if the definition of "Senior
         Indebtedness" in the Subordination Agreement is amended such that

                                       12
<PAGE>   18

         interest, fees, costs and charges accruing subsequent to the
         commencement of an Insolvency Event (as such term is defined in the
         Subordination Agreement) but not allowed as a claim in such Insolvency
         Event are excluded from such definition, then interest on the Notes
         shall accrue from the date of such amendment at a rate per annum equal
         to twelve percent (12.00%), subject to SECTION 3.5 below. Interest
         shall be payable (i) on the Business Day which is forty (40) days after
         the last day of each calendar quarter, commencing on August 9, 2000 and
         continuing thereafter until such Notes have been paid in full, (ii)
         upon any prepayment of any Note to the date of prepayment on the amount
         prepaid and (iii) at maturity of the Notes, whether by acceleration or
         otherwise.

                  (b) After maturity, whether by acceleration or otherwise,
         interest shall accrue on the Notes at the Default Rate set forth in
         SECTION 3.3 below.

         SECTION 2.7 AMORTIZATION AND MATURITY OF NOTES; PREPAYMENTS; FUNDING
LOSSES.

                  (a) The principal amount of the Notes shall be payable on the
         Maturity Date, unless sooner accelerated in accordance with the terms
         hereof.

                  (b) The Company may prepay the Notes in whole from time to
         time, PROVIDED THAT (i) the Company provides at least thirty (30) days'
         prior written notice to the Purchaser of such prepayment, and (ii) such
         prepayment is accompanied by all accrued and unpaid interest on the
         amount prepaid through the date of prepayment and all other amounts
         then owing by the Company hereunder in connection with the Notes.

                  (c) Prepayment of the Notes shall not preclude the Purchasers
         from continuing to own the Warrants or from exercising any of their
         rights pursuant to the Warrants, the Warrant Agreements or the
         Registration Rights Agreement at a later date.

         SECTION 2.8 PREPAYMENT FEE.

                  (a) Upon any prepayment of a Note in full on or prior to the
         first anniversary of the applicable Closing Date, the Company shall pay
         to the relevant Purchaser prior to or concurrently with such prepayment
         a prepayment fee in an amount equal to three percent (3%) of the amount
         of such prepayment.

                  (b) Upon any prepayment of a Note in full after the first
         anniversary of the applicable Closing Date and on or prior to the
         second anniversary of the applicable Closing Date, the Company shall
         pay to the relevant Purchaser prior to or concurrently with such
         prepayment a prepayment fee in an amount equal to two percent (2%) of
         the amount of such prepayment.

                  (c) Upon any prepayment of a Note in full after the second
         anniversary of the applicable Closing Date and on or prior to the third
         anniversary of the applicable Closing Date, the Company shall pay to
         the relevant Purchaser prior to or concurrently with such prepayment a
         prepayment fee in an amount equal to one percent (1%) of the amount of
         such prepayment.

                                       13
<PAGE>   19

                  (d) Upon any prepayment of a Note in full after the third
         anniversary of the applicable Closing Date, the Company shall pay to
         the relevant Purchaser prior to or concurrently with such prepayment a
         prepayment fee in an amount equal to zero percent (0%) of the amount of
         such prepayment.

         SECTION 2.9 MANDATORY PREPAYMENT. Subject to the prior written consent
of the Senior Lenders (or any requisite percentage thereof), the Company shall,
upon receipt of the Company or any of its Subsidiaries of any Net Securities
Proceeds in excess of $5,000,000, make a mandatory prepayment of the Notes in an
amount equal to twenty-five percent (25%) of the total amount of such Net
Securities Proceeds.

         SECTION 2.10 FUNDING OF THE LOANS. Subject to the terms and conditions
of this Agreement, each Purchaser severally and for itself alone agrees to
provide to the Company Loans as follows:

                  (a) On the SunTrust Closing Date, SunTrust made a loan to the
         Company in an aggregate principal amount equal to $5,000,000.

                  (b) Subject to the limitations set forth in this Agreement,
         ING will on the ING Closing Date make a loan to the Company in an
         aggregate principal amount of $5,000,000.

                                   ARTICLE 3.

                     OTHER PROVISIONS RELATING TO THE NOTES

         SECTION 3.1 MAKING OF PAYMENTS. The Company shall make each payment
hereunder and under the Notes not later than 1:00 p.m. (Atlanta, Georgia time)
on the day when due in Dollars in same day funds to each Purchaser at its
Principal Office. All payments received after that hour shall be deemed to have
been received by such Purchaser on the next following Business Day.

         SECTION 3.2 INCREASED COSTS. In the event that any change in any
Applicable Law, treaty or governmental regulation, or in the interpretation or
application thereof, or compliance by any Purchaser with any guideline, request
or directive (whether or not having the force of law) from any central bank or
other U.S. financial, monetary or other governmental authority, shall: (a)
subject any Purchaser to any tax of any kind whatsoever with respect to this
Agreement, the Notes or the Warrants or change the basis of taxation of payments
to any Purchaser of principal, interest, fees or any other amount payable
hereunder (except for changes in the rate of tax on the overall net income of
such Purchaser); (b) impose, modify, or hold applicable any reserve, special
deposit, assessment or similar requirement against assets held by, or deposits

                                       14
<PAGE>   20

in or for the account of, advances or loans by, or other credit extended by or
committed to be extended by any office of any Purchaser, including, without
limitation, pursuant to Regulation D of the Board of Governors of the Federal
Reserve System; or (c) impose on any Purchaser any other condition with respect
to this Agreement, the Notes or the Warrants hereunder; and the result of any of
the foregoing is to increase the cost to the Purchaser of making or maintaining
the Notes or the Warrants or to reduce the amount of any payment (whether of
principal, interest or otherwise) in respect of the Notes or the Warrants, then,
in any case, the Company shall promptly pay from time to time, upon demand of
such Purchaser, such additional amounts as will compensate such Purchaser for
such additional cost or such reduction, as the case may be. The Purchaser shall
certify the amount of such additional cost or reduced amount to the Company, and
such certification shall be conclusive absent manifest error.

         SECTION 3.3 CAPITAL ADEQUACY. If, after the date of this Agreement, any
Purchaser shall have determined that the adoption of any Applicable Law, rule or
regulation regarding capital adequacy, or any change therein, or any change in
the interpretation or administration thereof by any governmental authority,
central bank or comparable agency charged with the interpretation or
administration thereof, or compliance by any Purchaser with any request or
directive regarding capital adequacy (whether or not having the force of law) of
any such authority, central bank or comparable agency, has or would have the
effect of reducing the rate of return on such Purchaser's capital (whether on
this credit facility or otherwise) as a consequence of its obligations hereunder
to a level below that which the Purchaser could have achieved but for such
adoption, change or compliance (taking into consideration the Purchaser's
policies with respect to capital adequacy) by an amount deemed by such Purchaser
to be material, then from time to time, promptly upon demand by such Purchaser,
the Company shall pay such Purchaser such additional amount or amounts as will
compensate such Purchaser for such reduction. A certificate of such Purchaser
claiming compensation under this Section and setting forth the additional amount
or amounts to be paid to it hereunder shall be PRIMA FACIE evidence of the
matters contained therein. In determining any such amount, such Purchaser may
use any reasonable averaging and attribution methods. The Purchaser agrees to
make reasonable efforts to allocate any such cost increase among its similarly
situated customers in good faith and on an equitable basis; provided, however,
that such Purchaser shall not be entitled to such amounts unless similar
assessments are generally imposed by such Purchaser on other borrowers of such
Purchaser that Purchaser determines to be comparable to the Company.

         SECTION 3.4 DEFAULT RATE OF INTEREST. If the Company shall fail to pay
on the due date therefor, whether by acceleration or otherwise, any principal
owing under the Notes or any other Obligations, then interest shall accrue on
such unpaid principal or other Obligation from the due date until and including
the date on which such principal is paid in full at a rate per annum that is two
percent (2%) in excess of the rate of interest otherwise payable hereunder (the
"DEFAULT RATE"). Interest calculated at the Default Rate shall be due and
payable upon demand by the relevant Purchaser.

         SECTION 3.5 CALCULATION OF INTEREST. Interest payable on the Notes
shall be calculated on the basis of a year of 360 days and shall be payable for
the actual number of days elapsed. If the date for any payment of principal is
extended (whether by operation of this Agreement, any provision of law or
otherwise), interest shall be payable for such extended time at the rates
provided herein. Whenever any payment hereunder shall be stated to be due on a
day other than a Business Day, such payment shall be due on the next succeeding
Business Day.

                                       15
<PAGE>   21

         SECTION 3.6 USURY. In no event shall the amount of interest due or
payable on any Obligation to a Purchaser, when aggregated with all amounts
payable by the Company under any of the Transaction Documents to the Purchaser
that are deemed or construed to be interest, exceed the maximum rate of interest
allowed by Applicable Law and, in the event any such payment is paid by the
Company or received by such Purchaser, then such excess sum shall be credited as
a payment of principal, unless the Company, as applicable, shall notify such
Purchaser in writing that it elects to have such excess sum returned to it
forthwith. It is the express intent of the parties hereto that the Company not
pay, and the Purchasers not receive, directly or indirectly, in any manner
whatsoever, interest in excess of that which may be lawfully paid by the Company
under Applicable Law.

                                   ARTICLE 4.

                                    GUARANTY

         SECTION 4.1 THE GUARANTY.

         Each Guarantor hereby jointly and severally guarantees to the
Purchasers, as primary obligor and not as surety, the prompt payment of the
Obligations in full when due (whether at stated maturity, as a mandatory
prepayment, by acceleration, as a mandatory cash collateralization or otherwise)
strictly in accordance with the terms thereof. Each Guarantor hereby further
agrees that if any of the Obligations are not paid in full when due (whether at
stated maturity, as a mandatory prepayment, by acceleration, or otherwise), the
Guarantors will promptly pay the same, without any demand or notice whatsoever,
and that in the case of any extension of time of payment or renewal of any of
the Obligations, the same will be promptly paid in full when due (whether at
extended maturity, as a mandatory prepayment, by acceleration, as a mandatory
cash collateralization or otherwise) in accordance with the terms of such
extension or renewal.

         Notwithstanding any provision to the contrary contained herein or in
any other of the Transaction Documents, the obligations of the Guarantors under
this Agreement and the other Transaction Documents shall be limited to an
aggregate amount equal to the largest amount that would not render such
obligations subject to avoidance under Section 548 of the Bankruptcy Code or any
comparable provisions of any applicable state law.

         SECTION 4.2 OBLIGATIONS UNCONDITIONAL.

         The obligations of the Guarantors under SECTION 4.1 are joint and
several, absolute and unconditional, irrespective of the value, genuineness,
validity, regularity or enforceability of any of the Transaction Documents, or
any other agreement or instrument referred to therein, or any substitution,
release, impairment or exchange of any other guarantee of or security for any of
the Obligations, and, to the fullest extent permitted by applicable law,
irrespective of any other circumstance whatsoever which might otherwise
constitute a legal or equitable discharge or defense of a surety or guarantor,
it being the intent of this SECTION 4.2 that the obligations of each Guarantor
hereunder shall be absolute and unconditional under any and all circumstances.
Each Guarantor agrees that it shall have no right of subrogation, indemnity,

                                       16
<PAGE>   22

reimbursement or contribution against the Company or any other Guarantor for
amounts paid under this SECTION 4 until such time as the Purchasers have been
paid in full in respect of all Obligations, and no Person or governmental
authority shall have any right to request any return or reimbursement of funds
from the Purchasers in connection with monies received under the Transaction
Documents. Without limiting the generality of the foregoing, it is agreed that,
to the fullest extent permitted by law, the occurrence of any one or more of the
following shall not alter or impair the liability of any Guarantor hereunder
which shall remain absolute and unconditional as described above:

                  (a) at any time or from time to time, without notice to any
         Guarantor, the time for any performance of or compliance with any of
         the Obligations shall be extended, or such performance or compliance
         shall be waived;

                  (b) any of the acts mentioned in any of the provisions of any
         of the Transaction Documents, or any other agreement or instrument
         referred to in the Transaction Documents shall be done or omitted;

                  (c) the maturity of any of the Obligations shall be
         accelerated, or any of the Obligations shall be modified, supplemented
         or amended in any respect, or any right under any of the Transaction
         Documents, or any other agreement or instrument referred to in the
         Transaction Documents shall be waived or any other guarantee of any of
         the Obligations or any security therefor shall be released, impaired or
         exchanged in whole or in part or otherwise dealt with; or

                  (d) any of the Obligations shall be determined to be void or
         voidable (including, without limitation, for the benefit of any
         creditor of any Guarantor) or shall be subordinated to the claims of
         any Person (including, without limitation, any creditor of any
         Guarantor).

         With respect to its obligations hereunder, each Guarantor hereby
expressly waives diligence, presentment, demand of payment, protest and all
notices whatsoever, and any requirement that a Purchaser exhaust any rights,
powers or remedies or proceed against any Person under any of the Transaction
Documents, or any other agreement or instrument referred to in the Transaction
Documents, or against any other Person under any other guarantee of, or security
for, any of the Obligations.

         SECTION 4.3 REINSTATEMENT.

         The obligations of each Guarantor under this SECTION 4 shall be
automatically reinstated if and to the extent that for any reason any payment by
or on behalf of any Person in respect of the Obligations is rescinded or must be
otherwise restored by any holder of any of the Obligations, whether as a result
of any proceedings in bankruptcy or reorganization or otherwise, and each
Guarantor agrees that it will indemnify the Purchasers on demand for all
reasonable costs and expenses (including, without limitation, fees and expenses
of counsel) incurred by any Purchaser in connection with such rescission or
restoration, including any such costs and expenses incurred in defending against
any claim alleging that such payment constituted a preference, fraudulent
transfer or similar payment under any bankruptcy, insolvency or similar law.

         SECTION 4.4 CERTAIN ADDITIONAL WAIVERS.

                                       17
<PAGE>   23

         Without limiting the generality of the provisions of this SECTION 4,
each Guarantor hereby specifically waives the benefits of O.C.G.A. ss.10-7-24 to
the extent applicable. Each Guarantor further agrees that it shall have no right
of recourse to security for the Obligations, except through the exercise of
rights of subrogation and contribution pursuant to SECTION 4.2.

         SECTION 4.5 REMEDIES.

         Each Guarantor agrees that, to the fullest extent permitted by law, as
between any Guarantor, on the one hand, and the Purchasers, on the other hand,
the Obligations may be declared to be forthwith due and payable as provided in
SECTION 9.2 (and shall be deemed to have become automatically due and payable in
the circumstances provided in said SECTION 9.2) for purposes of SECTION 4.1
notwithstanding any stay, injunction or other prohibition preventing such
declaration (or preventing the Obligations from becoming automatically due and
payable) as against any other Person and that, in the event of such declaration
(or the Obligations being deemed to have become automatically due and payable),
the Obligations (whether or not due and payable by any other Person) shall
forthwith become due and payable by the Guarantors for purposes of SECTION 4.1.

         SECTION 4.6 GUARANTEE OF PAYMENT; CONTINUING GUARANTEE.

         The guarantee in this SECTION 4 is a guaranty of payment and not of
collection, is a continuing guarantee, and shall apply to all Obligations
whenever arising.

         SECTION 4.7 SUBORDINATION OF GUARANTEES.

         Each Guarantor, for itself and its successors, and each Purchaser, by
its acceptance of this Agreement, agrees that the obligations of the Guarantors
to the Purchasers pursuant to Article 4 of this Agreement are expressly
subordinate and subject in right of payment to the prior payment in full in cash
of all Senior Debt as provided in the Subordination Agreement.

                                   ARTICLE 5.

         CONDITIONS PRECEDENT TO PURCHASE OF THE NOTES AND THE WARRANTS

         SECTION 5.1 CLOSING DATE CONDITIONS. The obligations of the
Consolidated Companies and the Purchasers under this Agreement are subject to
the satisfaction of each of the following conditions on the ING Closing Date:

         (A) NO INJUNCTION, ETC. No action, proceeding, investigation,
regulation or legislation shall have been instituted, threatened or proposed
before any court, governmental agency or legislative body to enjoin, restrain,
or prohibit, or to obtain substantial damages in respect of, or which is related
to or arises out of, this Agreement or the Warrant Agreements or the
consummation of the transactions contemplated hereby or thereby, or which, in
each Purchaser's sole discretion, would make it inadvisable to consummate the
transactions contemplated by this Agreement.

                                       18
<PAGE>   24

         (B) DOCUMENTATION. Purchasers shall have received, on or prior to the
ING Closing Date, the following, each in the form and substance satisfactory to
Purchasers and their counsel:

                  (1) duly executed counterparts of this Agreement;

                  (2) the ING Note, in the principal amount of $5,000,000;

                  (3) the duly executed Warrant Agreements;

                  (4) duly executed ING Warrant, for the purchase of 475,000
         shares of the Common Stock of the Company;

                  (5) the duly executed Registration Rights Agreement;

                  (6) a certificate signed by a senior officer of each
         Consolidated Company stating that the representations and warranties
         set forth in SECTION 6.1 hereof are true and correct in all material
         respects, stating that each Consolidated Company is on such date in
         compliance with all the terms and provisions of the Transaction
         Documents, to which it is a party, to be observed or performed by it,
         and stating that on such date, no Default or Event of Default, has
         occurred or is continuing;

                  (7) (a) copies of the articles of incorporation of the Company
         and all amendments thereto Certified by the Secretary of State of
         Delaware; and (b) good standing certificates for each Consolidated
         Company (other than Ramsay Youth Services Puerto Rico, Inc.) issued by
         the relevant Secretary of State and any other States in which each
         Consolidated Company's qualification is required, in each case as of a
         recent date;

                  (8) a certificate of the Secretary or an Assistant Secretary
         of each Consolidated Company, certifying (a) that the articles of
         incorporation and by-laws delivered on the SunTrust Closing Date remain
         in full force and effect, unamended; (b) that attached thereto is a
         true and complete copy of resolutions adopted by the Board of Directors
         of such Consolidated Company, authorizing the execution, delivery and
         performance of this Agreement and the other Transaction Documents to
         which such Consolidated Company is a party; (c) as to the incumbency
         and genuineness of the signatures of the officers of such Consolidated
         Company executing this Agreement or any of the other Transaction
         Documents;

                  (9) a favorable legal opinion of counsel to each Consolidated
         Company, addressed to the Purchasers, covering such matters relating to
         the transactions contemplated hereby as the Purchasers may request;

                  (10) certified copies of the executed Senior Credit Agreement;

                  (11) copies of all consents and waivers, if any, required
         under the Company's Material Contracts in connection with the

                                       19
<PAGE>   25

         transactions contemplated hereby, including, without limitation, copies
         of amendments or waivers of any agreements currently prohibiting
         payment of interest on the Notes unless a default has occurred under
         such agreement;

                  (12) a duly executed solvency certificate of the Company with
         respect to the Consolidated Companies;

                  (13) written instructions from the Company to the Purchasers
         as to the disbursements of the proceeds of the Notes;

                  (14) the duly executed Subordination Agreement;

                  (15) evidence satisfactory to the Purchasers that the Company
         is in compliance with the covenant set forth in Section 8.12 hereof,
         calculated on a pro forma basis as of the last day of the most recent
         fiscal quarter as if the indebtedness evidenced by the ING Note had
         been created, incurred or assumed on the last day of such period;

                  (16) payment to ING of the balance of the ING Facility Fee;

                  (17) such other documents, instruments and agreements as
         Purchaser shall reasonably request.

         (C) CORPORATE ACTIONS. All corporate and other action required
hereunder shall be satisfactory.

         (D) NO MATERIAL ADVERSE EFFECT. No Material Adverse Effect has occurred
since December 31, 1999.

         (E) NO DEFAULT, ETC. No Default or Event of Default shall exist.

         (F) NO INJUNCTION, ETC. No action, proceeding, investigation,
regulation or legislation shall have been instituted, threatened or proposed
before any court, governmental agency or legislative body to enjoin, restrain,
prohibit, or to obtain substantial damages in respect of, or which is related to
or arises out of, this Agreement, the Warrant Agreements or the consummation of
the transactions contemplated hereby or thereby, or which, in the Company's
reasonable discretion, would make it inadvisable to consummate the transactions
contemplated by this Agreement.

         (G) ACCURACY OF REPRESENTATIONS AND WARRANTIES. All representations and
warranties made by the Purchasers contained herein or in any of the other
Transaction Documents shall be true and correct in all material respects with
the same effect as though such representations and warranties had been made on
and as of the ING Closing Date.

                                       20
<PAGE>   26

                                   ARTICLE 6.

                         REPRESENTATIONS AND WARRANTIES

         SECTION 6.1 REPRESENTATIONS AND WARRANTIES GENERALLY. Each Consolidated
Company (as to itself and all other Consolidated Companies) hereby represents
and warrants to the Purchasers that the following statements are true and
correct as of the date hereof and as of the ING Closing Date:

                  6.1.1 CORPORATE EXISTENCE; SUBSIDIARIES. Each of the Company
         and its Subsidiaries is a corporation duly organized, validly existing
         and in good standing under the laws of the state of its incorporation
         and has all requisite corporate power and authority to conduct its
         business and to own its properties. Each of the Company and its
         Subsidiaries has all requisite corporate power and authority to execute
         and deliver and to perform all of its obligations under this Agreement
         and the other Transaction Documents to which it is a party. Each of the
         Company and its Subsidiaries is duly qualified and in good standing as
         a foreign corporation authorized to do business in each jurisdiction
         (other than the jurisdiction of its incorporation) in which the nature
         of its activities or the character of the properties it owns or leases
         makes such qualification necessary and in which the failure to be so
         qualified would have a Material Adverse Effect. Except as set forth on
         Schedule 6.1.1, the Company has no Subsidiaries.

                  6.1.2 AUTHORIZATION; NO CONFLICT. The execution, delivery and
         performance by each of the Company and its Subsidiaries of this
         Agreement and each of the other Transaction Documents to which it is a
         party are within the corporate powers of the Company and its
         Subsidiaries, have been duly authorized by all necessary corporate
         action, and do not and will not (a) violate any provision of any
         applicable law, rule or regulation, any judgment, order, or ruling of
         any court or governmental agency applicable to the Company or any of
         its Subsidiaries, the articles of incorporation or bylaws of the
         Company or any of its Subsidiaries or any Material Contract or other
         instrument to which the Company or any of its Subsidiaries is a party
         or by which the Company, any of its Subsidiaries, or any of their
         respective properties is bound, (b) be in conflict with, result in a
         breach of or constitute with notice or lapse of time or both a default
         under any such indenture, agreement or other instrument, or (c) result
         in or require the creation of any material Lien upon or with respect to
         any of the properties of the Company or any of its Subsidiaries, other
         than Liens granted pursuant to the Senior Debt Documents.

                  6.1.3 APPROVALS. No consent of any Person and no authorization
         or approval or other action by, and no notice to or filing with, any
         governmental authority or regulatory body is required in connection
         with the borrowings hereunder or with the execution, delivery,
         performance, validity or enforcement of any Transaction Document
         (including, without limitation, the issuance of the Notes or the
         Warrants), which has not been obtained or made as of the date hereof.

                  6.1.4 TAX RETURNS; STATUS. The Company and its Subsidiaries
         have filed all federal, state and other tax returns which are required
         to have been filed, and each has paid all taxes due and payable except
         such as are being actively contested in good faith by appropriate

                                       21
<PAGE>   27

         proceedings and with respect to which adequate reserves are being
         maintained on the books of the Company in accordance with GAAP
         consistently applied. None of the Company's or its Subsidiaries' tax
         returns are under audit. No tax liens have been filed and, to the
         Company's knowledge, no claims are being assessed with respect to any
         such taxes.

                  6.1.5 BINDING OBLIGATIONS. Each of the Transaction Documents
         to which the Company is a party constitutes a legal, valid and binding
         obligation of the Company, enforceable against the Company in
         accordance with its terms, except as such enforceability may be limited
         by bankruptcy, insolvency, reorganization, moratorium or other similar
         laws affecting the enforcement of creditors' rights generally and by
         general equitable principles (whether enforcement is sought by
         proceedings in equity or at law).

                  6.1.6 LITIGATION. Except as set forth on Schedule 6.1.6, no
         action, suit or proceeding is pending or, to the knowledge of the
         Company, threatened against or affecting the Company, any of its
         Subsidiaries or the properties of the Company or any of its
         Subsidiaries before any court or governmental department, commission,
         board, bureau, agency or instrumentality which, if determined adversely
         to the Company or such Subsidiary, would have a Material Adverse
         Effect, or which questions the validity of any Transaction Document or
         any action taken or to be taken pursuant thereto.

                  6.1.7 NO DEFAULTS. Neither the Company nor any of its
         Subsidiaries is in violation of any applicable statute or other law or
         in default under any order, regulation or ruling of any court or other
         tribunal or governmental or administrative authority or agency binding
         on the Company or any of its Subsidiaries, or in default under their
         respective articles of incorporation or bylaws, any material indenture,
         agreement, lease, instrument or other undertaking to which the Company
         or any of its Subsidiaries is a party or by which it or its property or
         assets may be bound or affected, which could have a Material Adverse
         Effect.

                  6.1.8 NO MATERIAL RESTRICTIONS. Neither the Company nor any of
         its Subsidiaries is subject to any charter, corporate or, to the
         knowledge of the Company and its Subsidiaries, other legal restriction,
         or any contract, lease or other agreement, or any judgment, decree,
         order, law, rule or regulation which, in the judgment of the Company,
         currently has a Material Adverse Effect or any effect on the ability of
         the Company to carry out its obligations under any Transaction
         Document.

                  6.1.9 INFORMATION. No certificate, report or other paper
         furnished by the Company to any Purchaser in connection with the
         Transaction Documents, and to the best knowledge of the Company after
         due inquiry, no certificate, report or other paper furnished by any
         other Person at the request of the Company, in connection with the
         Transaction Documents contains as of its effective date any material
         misstatement of fact or fails to state a material fact or any fact
         necessary to make the statements contained therein not misleading in
         any material respect as of such date, and all of the information
         contained therein is true, accurate and complete in all material

                                       22
<PAGE>   28

         respects as of such date; PROVIDED, HOWEVER, that any projections and
         PRO FORMA financial information contained in the materials referenced
         in the preceding sentence are based upon reasonable estimates of
         management of the Company and reasonable assumptions at the time made,
         it being recognized by the Purchasers that such financial information
         as it relates to future events is not to be viewed as fact and that
         actual results during the period or periods covered by any such
         financial information may differ substantially from the projected
         results set forth therein.

                  6.1.10 FINANCIAL STATEMENTS. (a) The Company has furnished the
         Purchasers with (i) the consolidated balance sheet and related
         consolidated statements of operations, stockholder's equity and cash
         flows of the Company for the year ending December 31, 1999, audited by
         Deloitte & Touche, LLP, and (ii) the internally prepared consolidated
         balance sheet and related consolidated statement of operations of the
         Company for the fiscal quarter ending March 31, 2000, in each case as
         certified by the chief financial officer of the Company. All such
         financial statements (including any related schedules and/or notes)
         fairly present in all material respects in accordance with GAAP the
         financial position of the Company as of such dates (subject, as to
         interim statements, to changes resulting from audits and normal year
         end adjustments and the absence of footnotes) and reflect all
         liabilities, direct and contingent, of the Company and its Subsidiaries
         required to be shown in accordance with such principles (subject, as to
         interim statements, to changes resulting from audits and normal year
         end adjustments and the absence of footnotes). There has been no
         material adverse change in the business, financial condition, results
         of operations or prospects of the Company and its Subsidiaries since
         December 31, 1999, nor to the Company's knowledge any other event which
         could reasonably be expected to have a Material Adverse Effect.

                  (b) The unaudited pro forma balance sheet of the Company
         setting forth as of June 15, 2000 the pro forma financial position of
         the Company, a copy of which has been delivered to the Purchasers,
         fairly present in all material respects, on a pro forma basis, in
         conformity with generally accepted accounting principles applied on a
         basis consistent with the financial statements referred to in clause
         (a) above (except for adjustments consistent with purchase price
         accounting methods), the financial position of the Company as of such
         date and time. The Company does not have any material contingent
         obligations, contingent liabilities or other obligations which are not
         reflected in the balance sheet referenced above which would be required
         to be reflected in accordance with GAAP (subject, as to interim
         statements, to changes resulting from audits and normal year end
         adjustments and the absence of footnotes) (the "Pro Forma Financial
         Statements").

                  6.1.11 TITLE TO PROPERTIES. Each of the Company and its
         Subsidiaries has good and marketable title to its real properties
         (other than real properties that it leases), and good title to all of
         its other properties and assets, including the properties and assets
         reflected in the balance sheet of the Company (other than properties
         and assets disposed of in the ordinary course of business), subject to
         no Lien of any kind except Permitted Liens. Each of the Company and its
         Subsidiaries enjoys peaceful and undisturbed possession under all
         leases necessary in any material respect for the operation of its
         properties and assets, none of which contains in the reasonable

                                       23
<PAGE>   29

         judgment of the Company any unusual or burdensome provisions which
         might materially affect or impair the operations of such properties and
         assets. All such leases are valid and subsisting and in full force and
         effect.

                  6.1.12 COMPLIANCE WITH LAWS. Each of the Company and its
         Subsidiaries is in compliance with all applicable laws and regulations,
         including all laws and regulations relating to ERISA and environmental
         matters, except where the failure to comply would not have a Material
         Adverse Effect.

                  6.1.13 POSSESSION OF FRANCHISES, LICENSES, ETC. Each of the
         Company and its Subsidiaries possesses all franchises, certificates,
         licenses, permits and other authorizations from governmental political
         subdivisions or regulatory authorities, and all patents, trademarks,
         service marks, trade names, copyrights, licenses and other rights, free
         from burdensome restrictions, that are necessary for the ownership,
         maintenance and operation of any of its properties and assets as
         currently maintained, and neither the Company nor any of its
         Subsidiaries is in material violation of any provision thereof except
         where the failure to comply or have any such franchise, certificate,
         license, permits or other authorization would not have a Materially
         Adverse Effect.

                  6.1.14 INSURANCE. The Company has in place, with financially
         sound and reputable insurance companies or associations, casualty,
         public liability and other insurance, including without limitation,
         product liability insurance, in such amounts and covering such risks as
         are customarily maintained by other companies operating similar
         businesses in similar locations and of similar size.

                  6.1.15 FEDERAL RESERVE REGULATIONS. The proceeds of the Notes
         will be used solely for the purposes set forth in this Agreement and
         none of such proceeds will be used, directly or indirectly, for the
         purpose of purchasing or carrying any "margin security" or "margin
         stock" or for the purpose of reducing or retiring any debt that
         originally was incurred to purchase or carry a "margin security" or
         "margin stock" or for any other purpose that might constitute this
         transaction a "purpose credit" within the meaning of the regulations of
         the Board of Governors of the Federal Reserve System.

                  6.1.16 MATERIAL CONTRACTS. SCHEDULE 6.1.16 sets forth a
         complete list of all of the Material Contracts of the Company and its
         Subsidiaries. Each of the Material Contracts is in full force and
         effect and, to the best knowledge of the Company, no default exists
         thereunder.

                  6.1.17 ERISA.

                           (1) IDENTIFICATION OF PLANS. Neither the Company or
                  any ERISA Affiliate maintains or contributes to, or has
                  maintained or contributed to, any Plan, other than its 401(k)
                  plan.

                           (2) LIABILITIES. Neither the Company nor any
                  Subsidiary is currently subject to any liability (other than
                  routine Plan expenses or contributions), tax or penalty which
                  liability, tax or penalty is directly or indirectly related to
                  any Plan including, but not limited to, any penalty or
                  liability arising under Title I or Title IV of ERISA, or any

                                       24
<PAGE>   30

                  tax or penalty under Chapter 43 of the Code, except such
                  liabilities, taxes, or penalties (when taken as a whole) as
                  will not have a Material Adverse Effect; and

                           (3) FUNDING. The Company and each ERISA Affiliate has
                  made full and timely payment of all amounts required to be
                  contributed under the terms of each Plan.

                  6.1.18 BROKER'S FEES. Except for the SunTrust Facility Fee,
         the ING Facility Fee and except for fees paid to SunTrust Equitable
         Securities, Inc., no broker's or finder's fee, commission or similar
         compensation will be payable with respect to the transactions
         contemplated by this Agreement. No other similar fees or commissions
         will be payable by the Company for any other services rendered to any
         Consolidated Company or any Subsidiaries ancillary to the transactions
         contemplated hereby.

                  6.1.19 OFFERING OF NOTES AND WARRANTS. Neither the Company
         nor, to the best knowledge of the Company, anyone acting on its behalf
         has offered the Notes or the Warrants for sale to, or solicited any
         offer to buy any of the same from, or otherwise approached or
         negotiated in respect thereof with, any person other than each
         Purchaser. Subject to the representations of each Purchaser in SECTION
         6.2, neither the Company nor any of its Subsidiaries nor, to the best
         of knowledge of the Company, anyone acting on their behalf has taken,
         or will take, any action which would subject the issuance or sale of
         the Notes and the Warrants to Section 5 of the Securities Act of 1933,
         as amended or the registration or qualification provisions of the blue
         sky laws of any state.

                  6.1.20 REGISTRATION RIGHTS. Except as set forth on Schedule
         6.1.20, as of the Closing Date, except as described in the Warrant
         Agreements, the Company is under no obligation to register under the
         Securities Act of 1933, as amended, or the Trust Indenture Act of 1939,
         as amended, any of its presently outstanding securities or any of its
         securities that may subsequently be issued.

                  6.1.21 SOLVENCY. Before and after giving effect to the
         transactions contemplated by this Agreement, the Company shall be
         Solvent and, after excluding any Debt owed by any Subsidiary Guarantor
         to any other Subsidiary Guarantor from the calculation of Solvent, each
         Subsidiary Guarantor shall be Solvent.

                  6.1.22 CONTINUING BUSINESS OF COMPANY. (a) Except as set forth
         on SCHEDULE 6.1.22, there exists no actual or, to the knowledge of any
         Consolidated Company, threatened termination, cancellation or
         limitation of, or any material modification or change since April 18,
         2000, in, (i) the business relationships of any Consolidated Company
         with any customer or group of customers of such Consolidated Company
         whose business individually or in the aggregate is material to the
         operations or financial condition of such Consolidated Company, (ii)
         the business relationships of any Consolidated Company with any of its
         material suppliers or (iii) any Material Contract; and each
         Consolidated Company reasonably anticipates that after the consummation
         of the transactions contemplated by this Agreement, all such material
         customers and suppliers will continue a business relationship with such
         Consolidated Company on a basis no less favorable to such Consolidated
         Company than as heretofore conducted.

                                       25
<PAGE>   31

                  6.1.23 YEAR 2000 COMPLIANCE. To the Company's best knowledge,
         the operating systems for the Company's computers and all software
         applications that run on its computers are Year 2000 Compliant, except
         where a failure to be Year 2000 Compliant would not have a Material
         Adverse Effect. "Year 2000 Compliant" shall mean neither the
         performance nor functionality of the operating systems for the
         Company's computers and all software applications that run on the
         Company's computers is affected by dates prior to, during, spanning or
         after January 1, 2000, and shall include, but not be limited to (a)
         accurately processing (including, but not limited to calculating,
         comparing and sequencing) date and time data from, into, and between
         the years 1999 and 2000 and leap year calculations, (b) functioning
         without error, interruption or decreased performance relating to such
         date and time data, (c) accurately processing such date and time data
         when used in combination with other technology, if the other technology
         properly exchanges date and time data, (d) accurate date and time data
         century recognition, (e) calculations that accurately use same century
         and multi-century formulas and date and time values, (f) date and time
         data interface values which reflect the correct century, and (g)
         processing, storing, receiving and outputting all date and time data in
         a format that accurately indicates the century of the date and time
         data.

                  6.1.24 DISCLOSURE. To the Company's best knowledge, neither
         this Agreement nor any other document, certificate or statement
         furnished to the Purchasers by or on behalf of the Company in
         connection herewith contains any untrue statement of a material fact or
         omits to state a material fact necessary in order to make the
         statements contained herein and therein not misleading. There is no
         fact of which the Company is aware and that is peculiar to the Company
         and its Subsidiaries which materially adversely affects the business,
         property or assets, or financial condition of the Company and its
         Subsidiaries which has not been set forth in this Agreement or in the
         other documents, certificates and statements furnished to the
         Purchasers by or on behalf of the Company or any of its Subsidiaries
         prior to the date hereof in connection with the transactions
         contemplated hereby.

SECTION 6.2 REPRESENTATIONS AND WARRANTIES OF EACH PURCHASER. Each Purchaser
hereby represents and warrants to the Company and the other Consolidated
Companies that the following statements are true and correct, as of the date
hereof and as of the ING Closing Date.

                  6.2.1 AUTHORITY. The Purchaser has full corporate power and
         authority to execute and deliver this Agreement and to perform all of
         its obligations hereunder and under the other Transaction Documents,
         and no consent or approval of any other person or governmental
         authority is required therefor. The execution and delivery of this
         Agreement by it, the performance by it of its covenants and agreements
         hereunder and the consummation by it of the transactions contemplated
         hereby have been duly authorized by all necessary corporate action.
         This Agreement constitutes a valid and legally binding obligation of
         it, enforceable against it in accordance with its terms, except as such
         enforceability may be limited by bankruptcy, insolvency or other
         similar laws of general application relating to or affecting the
         enforcement of creditors' rights or by general principles of equity.

                  6.2.2 INVESTMENT IN THE COMPANY.

                                       26
<PAGE>   32

                  (i) ING understands that the Company proposes to issue and
deliver to it the ING Note and the ING Warrant pursuant to this Agreement
without compliance with the registration requirements of the Securities Act of
1933, as amended (the "Securities Act"); that for such purpose the Company will
rely upon the relevant Purchaser's representations and warranties contained
herein; and that such non-compliance with registration requirements is not
permissible unless such representations and warranties are correct.

                  (ii) ING understands that, under existing rules of the
Securities and Exchange Commission (the "SEC"), it may be unable to sell the ING
Note or the ING Warrant except to the extent that the ING Note or the ING
Warrant may be sold (i) pursuant to an effective registration statement covering
such sale pursuant to the Securities Act of 1933 and applicable state securities
laws or an applicable exemption therefrom or (ii) in a bona fide private
placement to a purchaser who shall be subject to the same restrictions on any
resale or (iii) subject to the restrictions contained in Rule 144 under the
Securities Act of 1933 ("Rule 144").

                  (iii) ING is not relying on the Company respecting the
financial, tax and other economic considerations of an investment in the ING
Note or the ING Warrant, and ING has relied on the advice of, or has consulted
with, only its own advisors.

                  (iv) ING is familiar with the provisions of Rule 144 and the
limitations upon the availability and applicability of such rule.

                  (v) ING is purchasing the ING Note and the ING Warrant as an
investment for its sole account, and without any present view towards the resale
or other distribution thereof.

                  (vi) ING is an "accredited investor," within the meaning of
Rule 501 promulgated by the Securities and Exchange Commission under the
Securities Act of 1933.

                                   ARTICLE 7.

                              AFFIRMATIVE COVENANTS

         So long as any Note or any other Obligations shall remain outstanding
pursuant to the Loan Documents, unless the Required Purchasers shall otherwise
consent in the manner set forth in SECTION 10.4, each Consolidated Company shall
and shall cause each of its Subsidiaries to:

         SECTION 7.1 PRESERVATION OF CORPORATE EXISTENCE. Do or cause to be done
all things necessary to (a) preserve and maintain its corporate existence and
all material rights and franchises and (b) qualify and remain qualified to
conduct business in each jurisdiction where the nature of the business or
ownership of property by the Company or any of its Subsidiaries may legally
require such qualification and where failure to be so qualified would have a
Material Adverse Effect.

         SECTION 7.2 COMPLIANCE WITH LAWS. Comply with all applicable federal,
state and local laws, rules, regulations and orders of any governmental
authority, noncompliance with which would have a Material Adverse Effect, such
compliance to include, without limitation, (a) paying before the same become
delinquent all material taxes, assessments and governmental charges imposed upon

                                       27
<PAGE>   33

it or upon its property (unless such taxes, assessments or charges are being
contested in good faith and by proper proceedings diligently pursued, and the
Company has obtained an adequate bond or adequate insurance or established
therefor a reserve of an adequate amount), and (b) complying in all material
respects with all federal, state and local laws, rules, regulations and orders
relating to pollution, reclamation, or protection of the environment, including
laws relating to emissions, discharges, releases or threatened releases of
pollutants, contaminants, or hazardous or toxic materials or wastes into air,
water, or land, or otherwise relating to the manufacture, processing,
distribution, use, treatment, storage, disposal, transport, or handling of
pollutants, contaminants or hazardous or toxic materials or wastes.

         SECTION 7.3 MAINTENANCE OF INSURANCE. Maintain with financially sound
and reputable insurance companies or associations casualty, public liability and
other insurance in such amounts and covering such risks as are customarily
maintained by other companies operating similar businesses in similar locations
and of similar size, and, at the written request of a Purchaser, provide
evidence of compliance with this covenant to the Purchaser in the form of
certificates of insurance.

         SECTION 7.4 VISITATION RIGHTS. At any reasonable time and from time to
time upon reasonable notice and without unreasonable interruption of the
Company's operations of business (provided that no notice shall be required upon
the occurrence and during the continuance of an Event of Default; provided
further that only one (1) business days' notice shall be required after the
occurrence and during the continuance of a Default), permit each Purchaser or
any agents or representatives of such Purchaser to examine and make copies of
and abstracts from the records and books of account of, and visit the properties
of the Company and its Subsidiaries and discuss the general business affairs of
the Company and its Subsidiaries (including, without limitation, significant
changes in personnel, compensation of employees, business ventures, important
acquisition and disposition of assets and significant litigation) with its
officers and its independent public accountants.

         SECTION 7.5 RECORDS AND ACCOUNTS. Keep true records and books of
account in which entries will be made in accordance with GAAP consistently
applied and maintain accounts and reserves adequate in the opinion of the
Company for all taxes (including income taxes), all depreciation, depletion,
obsolescence and amortization of its properties, all other contingencies and all
other proper reserves.

         SECTION 7.6 PAYMENT OF DEBTS, TAXES. Pay, or cause to be paid, all of
its debts and perform, or cause to be performed, all of its obligations promptly
and in accordance with the respective terms thereof, and promptly pay and
discharge, or cause to be paid and discharged, all taxes, assessments and
governmental charges or levies imposed upon it, upon its income or receipts or
upon any of its assets or properties before the same shall become in default, as
well as pay all lawful claims for labor, materials and supplies or otherwise
that, if not so paid, could or would result in the imposition of a Lien upon
such assets or properties or any part thereof; PROVIDED, that it shall not
constitute an Event of Default hereunder if the Company fails to perform any
such debt (except for any indebtedness serving under or in respect of any Loan
Document), tax, assessment, governmental or other charge, levy or claim that is

                                       28
<PAGE>   34

being contested in good faith and by proper proceedings diligently pursued, if
the effect of such failure to pay or perform has not been to accelerate the
maturity of any other material debt or obligation of the Company or to subject
any part of the assets and properties of the Company to forfeiture or a Lien,
and if the Company has obtained therefor an adequate bond or adequate insurance
or established therefor a reserve of an adequate amount.

         SECTION 7.7 FURTHER ASSURANCES. Execute and deliver to each Purchaser
such further instruments, provide it with such further data and information and
take such further action as the Purchasers may reasonably request or as may be
reasonably necessary further to effect the purposes of the Loan Documents.

         SECTION 7.8 MAINTENANCE OF PROPERTIES. Cause all of its properties used
or useful in the conduct of its business to be maintained and kept in good
condition, repair and working order, reasonable wear and tear excepted, and
supplied with all necessary equipment and cause to be made all necessary
repairs, renewals, replacements, betterments and improvements thereof, all as in
the judgment of the Company may be necessary so that the business carried on in
connection therewith may be conducted at all times in the ordinary course of
business consistent with past practice.

         SECTION 7.9 BUSINESS. Remain substantially in the business in which it
is engaged as of the date of this Agreement.

         SECTION 7.10 REPORTING COVENANTS. Deliver to each Purchaser:

                  7.10.1 as soon as available and in any event within one
         hundred fifteen (115) days after the end of each fiscal year of the
         Company, a consolidated audited balance sheet of the Company and its
         Subsidiaries as of the end of such fiscal year and the related
         consolidated audited statements of income, retained earnings and cash
         flow for such fiscal year, setting forth in each case in comparative
         form the figures for the previous fiscal year, all in reasonable detail
         and accompanied by a report thereon of Deloitte & Touche or other
         independent public accountants acceptable to each Purchaser, which
         report will be unqualified as to scope of audit and shall state that
         such consolidated financial statements present fairly the consolidated
         financial condition of the Company and its Subsidiaries as at the end
         of such fiscal year, and the consolidated results of operations and
         statements of cash flow of the Company and its Subsidiaries for such
         fiscal year in accordance with GAAP and that the audit by such
         accountants in connection with such consolidated financial statements
         was made in accordance with GAAP;

                  7.10.2 as soon as available and in any event within
         thirty-five (35) days after the end of each fiscal quarter in each
         fiscal year of the Company, a consolidated balance sheet of the Company
         and its Subsidiaries as of the end of such fiscal quarter and the
         related consolidated statements of income, retained earnings and cash
         flows for such fiscal quarter and for the portion of the Company's
         fiscal year ended at the end of such fiscal quarter, setting forth in
         each case in comparative form the figures for the corresponding fiscal
         quarter and the corresponding portion of the Company's previous fiscal

                                       29
<PAGE>   35

         year, all certified (subject to normal year end adjustments and absence
         of notes) as to fairness of presentation, preparation in accordance
         with GAAP by the chief financial officer of the Company;

                  7.10.3 simultaneously with the delivery of each set of
         financial statements referred to in SECTIONS 7.10.1 and 7.10.2 above, a
         certificate of the chief financial officer of the Company substantially
         in the form of EXHIBIT E hereto (i) setting forth in reasonable detail
         the calculations required to establish whether the Company was in
         compliance with the requirements of SECTION 8.12, on the date of such
         financial statements and (ii) stating whether there exists on the date
         of such certificate any Default or Event of Default and, if any Default
         or Event of Default then exists, setting forth the details thereof and
         the action which the Company is taking or proposes to take with respect
         thereto;

                  7.10.4 forthwith upon the Company having knowledge of the
         occurrence of any Default or Event of Default hereunder or any "Event
         of Default" under any Senior Debt Documents (as such terms are defined
         in the Senior Debt Documents), a certificate of the president or chief
         financial officer of the Company setting forth the details thereof and
         the action which the Company is taking or proposes to take with respect
         thereto;

                  7.10.5 promptly upon the filing thereof or otherwise becoming
         available, copies of all financial statements, annual, quarterly and
         special reports, proxy statements and notices sent or made available
         generally by the Company to its security holders, of all regular and
         periodic reports and all registration statements and prospectuses, if
         any, filed by any of them with any securities exchange, and of all
         press releases and other statements made available generally to the
         public containing material developments in the business or financial
         condition of the Company;

                  7.10.6 promptly after receipt thereof, copies of all financial
         statements of, and all reports and management letters submitted by,
         independent public accountants to the Company in connection with each
         annual, interim, or special audit of the Company's financial
         statements;

                  7.10.7 within thirty (30) days prior to the end of the
         Company's fiscal year, the Company shall deliver to the Purchaser the
         annual budget for the Company and its Subsidiaries, including forecasts
         of the income statement, the balance sheet and a cash flow statement
         for the immediately succeeding year on a month by month basis and
         thereafter, shall promptly deliver any amendment thereto;

                  7.10.8 promptly after the sending thereof, copies of all
         financial statements, reports or other information sent to any holder
         of the Senior Debt;

                  7.10.9 promptly after becoming aware of (i) the occurrence
         thereof, notice of the institution by any Person of any action, suit or
         proceeding or any governmental investigation or any arbitration, before
         any court or arbitrator or any governmental or administrative body,
         agency, or official, against the Company or any of its Subsidiaries or
         material properties of any of the foregoing, and which if adversely
         determined is likely to have a Material Adverse Effect, or (ii) the
         receipt of actual knowledge thereof, notice of the threat of any such

                                       30
<PAGE>   36

         action, suit, proceeding, investigation or arbitration, each such
         notice under this subsection to specify, if known, the amount of
         damages being claimed or other relief being sought, the nature of the
         claim, the Person instituting the action, suit, proceeding,
         investigation or arbitration, and any other significant features of the
         claim; and

                  7.10.10 such other information respecting the condition or
         operations, financial or otherwise, of the Company or any of its
         Subsidiaries as each Purchaser may from time to time reasonably
         request, including, without limitation budget, projections, and
         presentations to lenders or investor groups.

         SECTION 7.11 USE OF PROCEEDS. Use proceeds from the sale of the Notes
and the Warrants (i) to finance acquisition and expansion, (ii) to partially
repay the Senior Debt, and (iii) for general corporate purposes; and the Company
shall not use any part of such proceeds to purchase or carry, or to reduce or
retire or refinance any credit incurred to purchase or carry, any margin stock
(within the meaning of Regulations U and X of the Board of Governors of the
Federal Reserve System) or to extend credit to others for the purpose of
purchasing or carrying any such margin stock.

         SECTION 7.12 COMPLIANCE WITH MATERIAL CONTRACTS. Comply in all material
respects with all material terms and conditions of the Senior Debt Documents and
all other Material Contracts.

                                   ARTICLE 8.

                               NEGATIVE COVENANTS

         For so long as any Note or any of the other Obligations remains unpaid
or unperformed, unless the Required Purchasers (or, if required pursuant to
SECTION 10.4, all Purchasers) shall otherwise consent in the manner set forth in
SECTION 10.4, each Consolidated Company shall not, directly or indirectly, and
shall not allow any Subsidiary to:

         SECTION 8.1 LIENS AND OTHER ENCUMBRANCES. Create, assume, incur or
permit to exist, or to be created, assumed, incurred or permitted to exist,
directly or indirectly, any Lien upon any of its property or assets, whether now
owned or hereafter acquired, or any income or profits therefrom except Permitted
Liens.

         SECTION 8.2 INVESTMENTS. Make any loan or advance, or otherwise acquire
for a consideration, evidences of indebtedness, capital stock or other
securities of any Person or acquire any Subsidiary (an "INVESTMENT"), except
that, so long as no Default or Event of Default then exists or would be caused
thereby, the Company may:

                  (a) make (i) draws to sales persons in the ordinary course of
         business, (ii) net advances to branches in the ordinary course of
         business, and (iii) other loans or advances to officers and employees
         for expenses incurred in the ordinary course of business in an
         aggregate amount at any time outstanding not to exceed $15,000;

                                       31
<PAGE>   37

                  (b) acquire and own prime commercial paper and certificates of
         deposit in United States commercial banks (whose long-term debt is
         rated "A" or better by Moody's Investors Service or Standard and Poor's
         Corporation), in each case due within one year from the date of
         purchase and payable in the United States in dollars;

                  (c) acquire and own direct obligations of the United States of
         America or any agency thereof, or obligations fully guaranteed as to
         principal and interest by the United States of America or any agency
         thereof, in each case maturing within one year from the date of
         creation of such obligation;

                  (d) endorse negotiable instruments for collection in the
         ordinary course of business;

                  (e) create or form new Subsidiaries pursuant to Section 8.4.

         SECTION 8.3 MERGER AND SALE OF ASSETS. (a) Enter into any transaction
of merger, consolidation, pooling of interest, joint venture, syndicate or other
combination with any other Person other than any merger or consolidation of (i)
any Subsidiary with another Subsidiary of the Company or (ii) of the Company
with another Person; PROVIDED THAT (A) the Company is the surviving entity, (B)
the Company is Solvent, (C) the Total Net Worth (as such term is defined in the
Senior Credit Agreement) of the Company equals or exceeds the Total Net Worth
(as such term is defined in the Senior Credit Agreement) of the Company,
immediately preceding such merger or consolidation, (D) any consideration for
stock or assets paid in connection therewith equals the fair market value of
such property and (E) no Change of Control or other Default or Event of Default
exists or is continuing; or

         (b) Sell, lease, transfer or otherwise dispose of a substantial part of
its assets (whether now owned or hereafter acquired) in any single transaction
or series of related transactions, to any Person except for fair consideration
(as determined by the board of directors of the Company) where the net proceeds
of such sale are used to repay Senior Debt, or following the repayment thereof
in full, the Obligations. Nothing set forth in this subsection (b) shall limit
the rights and remedies of the Purchasers under the Transaction Documents upon
the occurrence of a Change of Control.

         SECTION 8.4 CREATION OR ISSUANCE OF STOCK BY SUBSIDIARIES. Create any
Subsidiary other than wholly-owned Subsidiaries of the Company or any other
Consolidated Company (provided that any Subsidiary created shall execute and
deliver to the Purchasers a Guaranty Agreement in substantially the form of
ARTICLE 4 hereof, at the time such Subsidiary is created) or, except as set
forth on SCHEDULE 8.4, permit any Subsidiary (either directly or indirectly by

                                       32
<PAGE>   38

the issuance of rights or options for, or securities convertible into such
shares) to issue, sell or dispose of any shares of its stock of any class (other
than directors' qualifying shares, if any) except to the Company or another
Subsidiary.

         SECTION 8.5 TRANSACTIONS WITH AFFILIATES. Enter into any material
transaction or series of related transactions (other than the payment of
ordinary fees and expenses of members of the Board of Directors of the Company,
and other than payment of the Ramsay Group Payable) which in the aggregate would
be material, whether or not in the ordinary course of business, with any
Affiliate of the Company or any of its Subsidiaries, other than on terms and
conditions substantially as favorable to the Company or such Subsidiary as would
be obtained by the Company or such Subsidiary at the time in a comparable arm's
length transaction with a Person other than an Affiliate.

         SECTION 8.6 DEBT. Incur, create, assume, guarantee, suffer to exist or
otherwise become liable on or with respect to, directly or indirectly, any Debt,
other than:

                  (a) any Debt owing to any Purchaser or an Affiliate of any
         Purchaser, including, without limitation, the Senior Debt described in
         Section 1 of SCHEDULE 8.6;

                  (b) Debt outstanding on the ING Closing Date (other than the
         Senior Debt) and listed on SCHEDULE 8.6 hereof;

                  (c) endorsements of negotiable or similar instruments for
         collection or deposit in the ordinary course of business;

                  (d) trade payables, current liabilities or similar obligations
         (other than for borrowed money or purchase money obligations) from time
         to time incurred in the ordinary course of business;

                  (e) taxes, assessments, or other governmental charges that are
         not assessed or are being contested in good faith by appropriate action
         promptly initiated and diligently conducted and for which the Company
         shall have made adequate reserves for in accordance with generally
         accepted accounting principles;

                  (f) Senior Debt; PROVIDED, HOWEVER, that in no event shall the
         principal amount of the Senior Debt exceed the sum of (i)
         $19,557,233.32 reduced by the amounts of any repayments and commitment
         reductions under the Senior Credit Agreement (after the SunTrust
         Closing Date) to the extent that such payments and reductions may not
         be reborrowed, plus (ii) $2,000,000;

                  (g) purchase money Debt incurred by the Company in the
         ordinary course of business, provided that, after incurring such Debt,
         the aggregate principal amount of such Debt outstanding shall not
         exceed $750,000 and no Default or Event of Default shall occur
         hereunder;

                  (h) Capital Lease Obligations to the extent the underlying
         Capital Lease is permitted pursuant to the terms of the Senior Credit
         Agreement;

                  (i) Debt not included in paragraphs (a) through (h) above
         which by its terms is unsecured and does not exceed at any time, in the
         aggregate, the sum of $750,000.

         SECTION 8.7 LEASE OBLIGATIONS. Create or suffer to exist any
obligations for the payment of rent for any property under operating leases or

                                       33
<PAGE>   39

agreements to lease (other than Capital Leases) except for rental obligations of
the Company and its Subsidiaries, on a consolidated basis, not to exceed
$750,000 in any twelve month period.

         SECTION 8.8 RESTRICTED PAYMENTS. Pay or declare any dividend or make
any other distribution on or on account of any class of its stock or other
equity or make cash distributions of equity, or make interest payments on
equity, or redeem, purchase, or otherwise acquire, directly or indirectly, any
shares of its stock or other equity, or make any other payments with respect to
Debt owed to shareholders except: (i) dividends paid, or distributions made, in
the stock of the Company; (ii) dividends paid, or distributions made, in cash
with respect to Stock of the Company to the extent that the holders of the
Warrants concurrently receives a special distribution equal to their pro rata
share of such dividend or distribution; (iii) dividends paid, or distributions
made, by a Subsidiary to another Subsidiary or to the Company; or (iv) the
repurchase of its Common Stock from an employee; (v) payment of ordinary fees
and expenses of members of the Board of Directors of the Company; and (vi)
payment of the Ramsay Group Payable.

         SECTION 8.9 SALE AND LEASEBACKS. Except as set forth on Schedule 8.9,
enter into or permit any Subsidiary to enter into any arrangement, with any
lender or investor or under which such lender or investor is a party, providing
for the leasing by the Company or any Subsidiary of real or personal property,
used by the Company or any Subsidiary in the operations of the Company or any
Subsidiary, which has been or is sold or transferred by the Company or any
Subsidiary to such lender or investor or to any Person to whom funds have been
or are to be advanced by such lender or investor on the security of such rental
obligations of the Company or such Subsidiary.

         SECTION 8.10 SALE OR DISCOUNT OF RECEIVABLES. Sell with recourse or
discount or otherwise sell for less than the face value thereof, any of its
notes or accounts receivable.

         SECTION 8.11 COMPLIANCE WITH ERISA. Take or fail to take, nor permit
any ERISA Affiliate to take or fail to take, any action with respect to a Plan
including, but not limited to (i) establishing any Plan, (ii) amending any Plan,
(iii) terminating or withdrawing from any Plan, or (iv) incurring an amount of
unfunded benefit liabilities, as defined in Section 4001(a)(18) of ERISA, or any
withdrawal liability under Title IV of ERISA, where such action or failure could
reasonably likely have a Material Adverse Effect.

         SECTION 8.12 FINANCIAL COVENANTS. At any time during the term of this
Agreement, have a Total Debt to EBITDA Ratio, calculated on the last day of each
fiscal quarter of the Company, commencing with the quarter ending December 31,
1999, of more than 3.80:1.0.

         SECTION 8.13 FISCAL YEAR. Change its Fiscal Year from that in effect as
of the ING Closing Date.

         SECTION 8.14 MODIFICATIONS TO MATERIAL CONTRACTS. Permit any Material
Contract to be terminated prior to its stated maturity in the event such
termination would result in a Material Adverse Effect.

         SECTION 8.15 INCONSISTENT AGREEMENT. Enter into any contract or
agreement which would violate the terms hereof or any other Transaction
Document.

                                       34
<PAGE>   40

         SECTION 8.16 NO REPURCHASE AGREEMENTS. Enter into any agreements to
repurchase any of its Stock upon the death or disability of any of its
shareholders, nor shall it maintain life insurance policies on any of its
shareholders for such purpose.

                                   ARTICLE 9.

                                EVENTS OF DEFAULT

         SECTION 9.1 EVENTS OF DEFAULT. Each of the following shall constitute
an Event of Default, whatever the reason for such event and whether or not it
shall be voluntary or involuntary or be effected by operation of law or pursuant
to any judgment or order of any court or any order, rule, or regulation of any
governmental or nongovernmental body:

                  (a) failure of the Company to pay any principal or interest on
         any of the Notes or any other amount payable hereunder or under any
         other Loan Document when due; or

                  (b) failure on the part of the Company to perform or observe
         any covenant contained in ARTICLE 8 or SECTIONS 7.1, 7.3 OR 7.10
         hereof; or

                  (c) failure on the part of the Company to perform or observe
         any other term, covenant or agreement contained in this Agreement not
         specifically referred to in this ARTICLE 9, and any such failure
         remains unremedied for 30 days after the earlier of (i) the discovery
         thereof by the Company or (ii) written notice thereof to the Company by
         the Purchaser; or

                  (d) any warranty or representation made by or on behalf of the
         Company contained herein or in any instrument furnished in compliance
         with or in reference to this Agreement is false or misleading in any
         material respect on the date as of which made; or

                  (e) the Company or any of its Subsidiaries shall fail to pay
         its debts generally as they come due, or shall file any petition or
         action for relief under any bankruptcy, reorganization, insolvency or
         moratorium law, or any other law or laws for the relief of, or relating
         to, debtors; or

                  (f) an involuntary petition shall be filed under any
         bankruptcy statute against the Company or any of its Subsidiaries, or a
         custodian, receiver, trustee, assignee for the benefit of creditors (or
         other similar official) shall be appointed to take possession, custody,
         or control of the properties of the Company or any of its Subsidiaries,
         unless such petition or appointment is set aside or withdrawn or ceases
         to be in effect within sixty (60) days from the date of said filing or
         appointment or an order for relief shall be entered in any such
         involuntary action; or

                  (g) the Company or any of its Subsidiaries (i) shall fail to
         make any payment when due (whether by scheduled maturity, required
         prepayment, acceleration or otherwise) with respect to any Debt (other

                                       35
<PAGE>   41

         than Senior Debt) in excess of $500,000 in the aggregate, or (ii) shall
         fail to perform or observe any other agreement, term or condition
         contained in any agreement under which any Debt described in clause (i)
         is created (or if any other event shall occur and be continuing
         thereunder) and the effect of such failure or other event set forth in
         clause (i) or (ii) above is to cause the holders thereof to cause such
         obligation to become due prior to any stated maturity; or

                  (h)      a Change of Control shall occur; or

                  (i) any order or judgment for the payment of money in excess
         of $600,000 shall be rendered against the Company or any of its
         Subsidiaries, and such order or judgment shall continue unsatisfied and
         unstayed for more than thirty (30) days, unless (i) defense of the
         action, suit or proceeding has been tendered to the Company's or such
         Subsidiary's insurance carrier, and (ii) the company's or such
         Subsidiary's insurance carrier has not denied or disputed coverage; or

                  (j) any material default shall occur and be continuing
         pursuant to the terms of any of the other Loan Documents or any Senior
         Debt shall be declared to be due and payable or required to be prepaid,
         redeemed, purchased or defeased, or an offer to prepay, redeem,
         purchase or defease such Debt shall be required to be made, in each
         case prior to the stated maturity thereof and, in each case, other than
         pursuant to the mandatory prepayment or optional prepayment provisions
         of the Senior Debt Documents, or the maturity of any or all of such
         Senior Debt is otherwise accelerated, or the Company or any of its
         Subsidiaries shall fail to pay all or any portion of the Senior Debt in
         full upon the final stated maturity of such Senior Debt; or

                  (k) the Company shall disavow, revoke or terminate any
         Transaction Document to which it is a party or shall otherwise
         challenge or contest in any action, suit or proceeding in any court or
         before any arbitrator or governmental body the validity or
         enforceability of this Agreement, the Notes or any other Transaction
         Document; or

                  (l) a warrant or writ of attachment or execution or similar
         process shall be issued against any property of the Company or any of
         its Subsidiaries which exceeds, individually or together with all other
         such warrants, writs and processes since the SunTrust Closing Date,
         $600,000 in amount and such warrant, writ or process shall not be
         discharged, vacated, stayed or bonded for a period of 60 days;
         PROVIDED, HOWEVER, that in the event a bond has been issued in favor of
         the claimant or other Person obtaining such attachment or writ, the
         issuer of such bond shall execute a waiver or subordination agreement
         in form and substance satisfactory to the Purchaser pursuant to which
         the issuer of such bond subordinates its right of reimbursement,
         contribution or subrogation to the Obligations and waives or
         subordinates any Lien it may have on the assets of the Company or any
         Subsidiary; or

                  (m) the Company or any of its Subsidiaries is enjoined,
         restrained or in any way prevented by the order of any court or any
         administrative or regulatory agency from conducting all or any material
         part of its business and such order continues for more than thirty (30)
         days; or

                                       36
<PAGE>   42

                  (n) the loss, suspension or revocation or failure to renew of,
         any license, permit or Material Contract now held or hereafter acquired
         by the Company or any of its Subsidiaries, if such loss, suspension,
         revocation or failure to renew could reasonably likely have a Material
         Adverse Effect; or

                  (o) any order, judgment or decree is entered against the
         Company or any of its Subsidiaries decreeing the dissolution or split
         up of the Company or that Subsidiary and such order remains
         undischarged or unstayed for a period in excess of sixty (60) days; or

         SECTION 9.2 REMEDIES ON DEFAULT. (a) Upon the occurrence and
continuation of an Event of Default (other than an Event of Default described in
SECTION 9.1 (E) and (F)), the Required Purchasers, subject to the Subordination
Agreement, may, in their sole discretion, but shall not be obligated to, declare
all amounts payable by the Company under the Notes to be forthwith due and
payable, including, without limitation, costs of collection (including
reasonable attorneys' fees if collected by or through an attorney at law or in
bankruptcy, receivership or other judicial proceedings) and the same shall
thereupon become immediately due and payable without demand, presentment,
protest or further notice of any kind, all of which are hereby expressly waived,
and may exercise all of its rights and remedies under the Loan Documents or
under applicable law.

                  (b) Upon the occurrence of any Event of Default set forth in
         clause (E) or (F) above, without any notice to the Company or any other
         act by the Required Purchasers, all amounts payable by the Company
         under the Notes, including, without limitation, all costs of collection
         (including reasonable attorneys' fees if collected by or through an
         attorney at law or in bankruptcy, receivership or other judicial
         proceedings) shall be immediately due and payable, without presentment,
         demand, protest or notice of any kind, all of which are hereby
         expressly waived by the Company.

                  (c) No remedy herein conferred or reserved is intended to be
         exclusive of any other available remedy or remedies, but each and every
         such remedy shall be cumulative and shall be in addition to every other
         remedy given under this Agreement or now or hereafter existing at law
         or in equity or by statute. No delay or omission to exercise any right
         or power accruing upon any default, omission or failure of performance
         hereunder shall impair any such right or power or shall be construed to
         be a waiver thereof, but any such right or power may be exercised from
         time to time and as often as may be deemed expedient. In order to
         exercise any remedy reserved to the Purchaser in this Agreement, it
         shall not be necessary to give any notice, other than such notice as
         may be herein expressly required.

                                  ARTICLE 10.

                                  MISCELLANEOUS

         SECTION 10.1 NOTICES. All notices, requests and other communications to
any party hereunder shall be in writing (including telecopier) and shall be
effective (a) if given by mail, when deposited in the mails or (b) if given by

                                       37
<PAGE>   43

telecopier, when so telecopied. Notices hereunder shall be mailed or telecopied
as follows:

         If to the Company or any other Consolidated Company:

         If to the Company:

                  Ramsay Youth Services, Inc.
                  One Alhambra Plaza
                  Suite 750
                  Coral Gables, Florida  33134
                  Attn:  Mr. Marcio C. Cabrera
                  Telecopy Number:  (305) 569-4647
                  Telephone Number: (305) 569-4652

         with a copy to:

                  Torys
                  237 Park Avenue
                  New York, New York 10017
                  Attn:  Joseph J. Romagnoli, Esq.
                  Telecopy Number:  (212) 682-0200
                  Telephone Number: (212) 880-6000

         If to SunTrust:

                  SunTrust Banks, Inc.
                  303 Peachtree Street, Suite 2500
                  Atlanta, Georgia 30308
                  Attn:  Mr. Robert L. Dudiak
                  Telecopy Number:   (404) 724-3754
                  Telephone Number: (404) 588-8735

         with a copy to:

                  King & Spalding
                  191 Peachtree Street
                  Atlanta, Georgia 30303
                  Attn:  Hector E. Llorens, Jr., Esq.
                  Telecopy Number:  (404) 572-4600
                  Telephone Number:  (404) 572-5100

                                       38
<PAGE>   44

         If to ING:

                  ING (U.S.) Capital, LLC
                  200 Galleria Parkway, N.W.
                  Suite 950
                  Atlanta, Georgia 30339
                  Attn:  Mr. Steven G. Fleenor
                  Telecopy Number:  (770) 951-1005
                  Telephone Number:  (770) 956-9200

         with a copy to:

                  King & Spalding
                  191 Peachtree Street
                  Atlanta, Georgia 30303
                  Attn:  Hector E. Llorens, Jr., Esq.
                  Telecopy Number:  (404) 572-4600
                  Telephone Number:  (404) 572-5100

         SECTION 10.2 NO WAIVER. No delay or failure on the part of any
Purchaser or any holder of the Notes and the exercise of any right, power or
privilege granted under this Agreement or any other Transaction Document or
available at law or in equity, shall impair any such right, power or privilege
or be construed as a waiver of any Event of Default or any acquiescence therein.
No single or partial exercise of any such right, power or privilege shall
preclude the further exercise of such right, power or privilege. No waiver shall
be valid against any Purchaser unless made in writing and signed by such
Purchaser, and then only to the extent expressly specified therein.

         SECTION 10.3 EXPENSES.

                  (1) The Company agrees to pay on demand all costs, expenses,
         (i) incurred by the Purchasers in connection with the preparation,
         execution and delivery of this Agreement and all other Transaction
         Documents, including the reasonable fees and disbursements of counsel
         for the Purchasers in an amount not to exceed $50,000; (ii) incurred by
         the Purchasers in connection with the preparation, execution and
         delivery of any waiver, amendment or consent by the Purchasers relating
         to the Transaction Documents, including the reasonable costs and fees
         of counsel for the Purchasers; and (iii) incurred by the Purchasers,
         including the reasonable costs and fees of its counsel, in connection
         with the enforcement of the Transaction Documents.

                  (2) The Company agrees to indemnify, pay and hold the
         Purchaser and any holder of any of the Notes and the Warrants and the
         officers, directors, employees and agents of the Purchasers and such
         holders (the "INDEMNIFIED PERSONS") harmless from and against any and
         all liabilities, losses, damages, costs and expenses of any kind
         (including, without limitation, the reasonable fees and disbursements
         of counsel for any Indemnified Person in connection with any
         investigative, administrative or judicial proceeding, whether or not
         such Indemnified Person shall be designated a party thereto) which may
         be incurred by any Indemnified Person, relating to or arising out of
         the enforcement of this Agreement, the Notes, the Warrants or any other

                                       39
<PAGE>   45

         Transaction Document or any actual or proposed use of proceeds of the
         Notes; PROVIDED, that no Indemnified Person shall have the right to be
         indemnified hereunder for its own gross negligence or willful
         misconduct, as determined by a court of competent jurisdiction.

         SECTION 10.4 AMENDMENTS, ETC. Any provision of this Agreement, the
Notes, or any other Transaction Document to which the Company is a party may be
amended or waived, if such amendment or waiver is in writing and is signed by
the Company, as the case may be, and the Required Purchasers; PROVIDED THAT,
without the approval in writing of each Purchaser with respect to its Note, no
amendment, modification, supplement, termination, waiver, or consent may be
effective:

                  (a) to amend or modify the principal of such Note, or the
         amount of principal payments or prepayments required hereunder, or the
         rate of interest payable on any Note;

                  (b) to postpone any date fixed for any payment of principal
         of, prepayment of principal of, or any installment of interest on, any
         Note or to extend the term of any Note;

                  (c) to amend or modify the definitions of "Required
         Purchasers," or the provisions of this SECTION 10.4;

Any amendment, modification, supplement, termination, waiver or consent effected
in accordance with this SECTION 10.4 shall apply equally to, and shall be
binding upon, all Purchasers.

         SECTION 10.5 SUCCESSORS AND ASSIGNS. The provisions of this Agreement
shall be binding upon and inure to the benefit of the parties hereto and their
respective successors and assigns; PROVIDED, that the Company may not assign or
otherwise transfer any of its rights or obligations under this Agreement, the
Notes or any other Transaction Document to any Person without the prior written
consent of the Purchasers. Such assignee shall have, to the extent of such
assignment (unless otherwise provided therein), the same rights, obligations and
benefits as it would have if it were the Purchaser hereunder and under the other
Loan Documents. Notwithstanding the foregoing, any Purchaser may sell or
otherwise grant participations in all or any part of the Notes. The holder of
any such participation, if the participation agreement so provides, shall have
the same rights and benefits of the Purchasers hereunder.

         SECTION 10.6 GOVERNING LAW. THIS AGREEMENT, THE NOTES AND THE WARRANTS
SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF
GEORGIA (WITHOUT REGARD TO THE PRINCIPLES THEREOF REGARDING CONFLICTS OF LAWS).

         SECTION 10.7 SURVIVAL OF REPRESENTATIONS AND WARRANTIES. All
representations and warranties contained herein or made by or furnished on
behalf of the Company in connection herewith shall survive the execution and
delivery of this Agreement.

         SECTION 10.8 SEVERABILITY. If any part of any provision contained in
this Agreement shall be invalid or unenforceable under applicable law, said part
shall be ineffective to the extent of such invalidity only, without in any way
affecting the remaining parts of said provision or the remaining provisions.

                                       40
<PAGE>   46

         SECTION 10.9 COUNTERPARTS. This Agreement may be executed in any number
of counterparts, each of which shall be deemed to be an original and all of
which, taken together, shall constitute one and the same instrument.

         SECTION 10.10 SET-OFF. Upon the occurrence and during the continuation
of an Event of Default, each Consolidated Company authorizes each Purchaser,
without notice or demand, to apply any indebtedness due or to become due to such
Consolidated Company from such Purchaser in satisfaction of any of the
indebtedness, liabilities or obligations of such Consolidated Company under this
Agreement or under any other Loan Document, including, without limitation, the
right to set-off against any deposits or other cash collateral of the Company
held by such Purchaser or an Affiliate thereof.

         SECTION 10.11 TERMINATION OF AGREEMENT. This Agreement shall terminate
upon the payment in full of the Notes and all Obligations relating thereto;
provided that, SECTIONS 3.2, 3.3 and 10.3 shall survive the termination of this
Agreement.

         SECTION 10.12 JURISDICTION AND VENUE. EACH CONSOLIDATED COMPANY AGREES,
WITHOUT POWER OF REVOCATION, THAT ANY CIVIL SUIT OR ACTION BROUGHT AGAINST IT AS
A RESULT OF ANY OF ITS OBLIGATIONS UNDER THIS AGREEMENT OR UNDER ANY OTHER
TRANSACTION DOCUMENT TO WHICH IT IS A PARTY MAY BE BROUGHT AGAINST IT EITHER IN
THE IN THE CIRCUIT COURT OF FULTON COUNTY, GEORGIA, OR IN THE UNITED STATES
DISTRICT COURT FOR THE NORTHERN DISTRICT OF GEORGIA, AND THAT SERVICE OF PROCESS
MAY BE MADE UPON IT IN ANY SUCH SUIT OR ACTION BY SERVICE OF PROCESS AS PROVIDED
BY GEORGIA LAW. EACH CONSOLIDATED COMPANY HEREBY IRREVOCABLY SUBMITS TO THE
JURISDICTION OF SUCH COURTS AND IRREVOCABLY WAIVES, TO THE FULLEST EXTENT
PERMITTED BY LAW, ANY OBJECTIONS THAT IT MAY NOW OR HEREAFTER HAVE TO THE LAYING
OF THE VENUE OF SUCH CIVIL SUIT OR ACTION AND ANY CLAIM THAT SUCH CIVIL SUIT OR
ACTION HAS BEEN BROUGHT IN AN INCONVENIENT FORUM. EACH CONSOLIDATED COMPANY
AGREES THAT FINAL JUDGMENT IN ANY SUCH CIVIL SUIT OR ACTION SHALL BE CONCLUSIVE
AND BINDING UPON IT AND SHALL BE ENFORCEABLE AGAINST IT BY SUIT UPON SUCH
JUDGMENT IN ANY COURT OF COMPETENT JURISDICTION.

         SECTION 10.13 WAIVER OF JURY TRIAL. EACH OF THE COMPANY, THE GUARANTORS
AND EACH PURCHASER KNOWINGLY, VOLUNTARILY, INTENTIONALLY, AND IRREVOCABLY WAIVE
THE RIGHT EITHER OF THEM MAY HAVE TO A TRIAL BY JURY IN RESPECT TO ANY
LITIGATION, WHETHER IN CONTRACT OR TORT, AT LAW OR EQUITY, BASED HEREON, OR
ARISING OUT OF, UNDER OR IN CONNECTION WITH THIS AGREEMENT AND ANY OTHER
DOCUMENT OR INSTRUMENT CONTEMPLATED TO BE EXECUTED IN CONJUNCTION HEREWITH, OR
ANY COURSE OF CONDUCT, COURSE OF DEALING, STATEMENTS (WHETHER VERBAL OR WRITTEN)
OR ACTIONS OF ANY PARTY HERETO. THIS PROVISION IS A MATERIAL INDUCEMENT FOR ANY

                                       41
<PAGE>   47

PURCHASER ENTERING INTO THIS AGREEMENT. FURTHER, EACH CONSOLIDATED COMPANY
HEREBY CERTIFIES THAT NO REPRESENTATIVE OR AGENT OF ANY PURCHASER, NOR SUCH
PURCHASER'S COUNSEL, HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT ANY PURCHASER
WOULD NOT, IN THE EVENT OF SUCH LITIGATION, SEEK TO ENFORCE THIS WAIVER OF RIGHT
TO JURY TRIAL PROVISION, NO REPRESENTATIVE OR AGENT OF ANY PURCHASER, NOR SUCH
PURCHASER'S COUNSEL HAS THE AUTHORITY TO WAIVE, CONDITION, OR MODIFY THIS
PROVISION.

         SECTION 10.14 ENTIRE AGREEMENT. This Agreement, the Notes, the Warrants
and the other Transaction Documents to which the Company is a party, together
with any exhibits and schedules attached hereto and thereto, constitute the
entire understanding of the parties with respect to the subject matter hereof
and thereof, and any other prior or contemporaneous agreements, whether written
or oral, with respect hereto or thereto are expressly superseded hereby. The
execution of this Agreement, the Notes, the Warrants and the other Transaction
Documents to which the Company is a party by the Company was not based upon any
facts or materials provided by any Purchaser, nor was the Company induced to
execute this Agreement, the Note, the Warrants or the other Transaction
Documents to which the Company is a party by any representation, statement or
analysis made by any Purchaser.

                         [SIGNATURES ON FOLLOWING PAGES]

                                       42
<PAGE>   48

         IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
executed by their authorized officers all as of the day and year first above
written.

                               COMPANY:

                                  RAMSAY YOUTH SERVICES, INC.

                                  By:  /s/ Marcio C. Cabrera
                                       ------------------------------
                                       Marcio C. Cabrera
                                       Executive Vice President

                               SUBSIDIARY GUARANTORS:

                                  BETHANY PSYCHIATRIC HOSPITAL, INC.,
                                  an Oklahoma corporation

                                  BOUNTIFUL PSYCHIATRIC HOSPITAL, INC.,
                                  a Utah corporation

                                  EAST CAROLINA PSYCHIATRIC
                                  SERVICES CORPORATION, a North
                                  Carolina corporation

                                  GREAT PLAINS HOSPITAL, INC.,
                                  a Missouri corporation

                                  GULF COAST TREATMENT CENTER, INC.,
                                  a Florida corporation

                                  H.C. CORPORATION, an Alabama corporation

                                  HAVENWYCK HOSPITAL, INC.,
                                  a Michigan corporation

                                  HSA HILL CREST CORPORATION,
                                  an Alabama corporation

                                  HSA OF OKLAHOMA, INC., an Oklahoma
                                  corporation

                                  MICHIGAN PSYCHIATRIC SERVICES, INC.,
                                  a Michigan corporation

                                       43
<PAGE>   49

                                  RAMSAY EDUCATIONAL SERVICES, INC.,
                                  a Delaware corporation

                                  RAMSAY HOSPITAL CORPORATION OF
                                  LOUISIANA, INC., a Louisiana corporation

                                  RAMSAY LOUISIANA, INC., a Delaware
                                  corporation

                                  RAMSAY MANAGED CARE, INC., a Delaware
                                  corporation

                                  RAMSAY YOUTH SERVICES OF ALABAMA, INC.,
                                  a Delaware corporation

                                  RAMSAY YOUTH SERVICES OF FLORIDA, INC.,
                                  a Delaware corporation

                                  RAMSAY YOUTH SERVICES OF SOUTH CAROLINA, INC.
                                  a Delaware corporation

                                  RAMSAY YOUTH SERVICES PUERTO RICO, INC.,
                                  a Puerto Rico corporation

                                  RHCI SAN ANTONIO, INC., a Delaware corporation

                                  TRANSITIONAL CARE VENTURES, INC., a
                                  Delaware corporation

                                  TRANSITIONAL CARE VENTURES (TEXAS), INC., a
                                  Delaware corporation

                                  By: /s/ Marcio C. Cabrera
                                    ------------------------------
                                       Marcio C. Cabrera
                                       Vice President

                                        Address For all Subsidiary's:

                                         c/o Ramsay Youth Services
                                         One Alhambra Plaza
                                         Suite 750
                                         Coral Gables, Florida 33134
                                         Attention: Mr. Marcio C. Cabrera

                             [SIGNATURE PAGE TO THE
               SUBORDINATED NOTE AND WARRANT PURCHASE AGREEMENT]

                                       44
<PAGE>   50

                                H.C. PARTNERSHIP

                                 By:  H.C. CORPORATION, an Alabama
                                       corporation, as a general partner

                                         By: /s/ Marcio C. Cabrera
                                            -----------------------
                                            Marcio C. Cabrera
                                            Vice President

                                 By:  HSA HILL CREST CORPORATION,
                                         an Alabama corporation, as a general
                                         partner

                                         By: /s/ Marcio C. Cabrera
                                            -----------------------
                                            Marcio C. Cabrera
                                            Vice President

                                      Address for both:

                                       c/o Ramsay Youth Services, Inc.
                                       One Alhambra Plaza
                                       Suite 750
                                       Coral Gables, Florida  33134
                                       Attention: Mr. Marcio C. Cabrera

                             [SIGNATURE PAGE TO THE
               SUBORDINATED NOTE AND WARRANT PURCHASE AGREEMENT]

                                       45
<PAGE>   51

                                  PURCHASERS:

                                  SUNTRUST BANKS, INC.

                                   By: /s/ Robert L. Dudiak
                                        -----------------------------------
                                        Robert L. Dudiak
                                        Group Vice President

                                        PRINCIPAL OFFICE

                                        303 Peachtree Street
                                        Suite 2500
                                        Atlanta, Georgia 30308

                                   ING (U.S.) CAPITAL, LLC

                                   By:  /s/ Steven G. Fleenor
                                       ------------------------------------
                                        Steven G. Fleenor
                                        Director

                                        PRINCIPAL OFFICE

                                        200 Galleria Parkway, N.W.
                                        Suite 950
                                        Atlanta, Georgia 30339

                             [SIGNATURE PAGE TO THE
               SUBORDINATED NOTE AND WARRANT PURCHASE AGREEMENT]

                                       46

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