Document:

TENET HEALTHCARE CORPORATION

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                                  $400,000,000

                          7 7/8 % SENIOR NOTES due 2003

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                        --------------------------------

                                    INDENTURE

                          Dated as of January 15, 1997

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                        --------------------------------

                              THE BANK OF NEW YORK

                        --------------------------------

                                   as Trustee
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                                TABLE OF CONTENTS

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                                                                            ----
                                    ARTICLE I
                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

SECTION 1.01. DEFINITIONS .................................................   1
SECTION 1.02. OTHER DEFINITIONS ...........................................  10
SECTION 1.03. INCORPORATION BY REFERENCE OF TIA ...........................  10
SECTION 1.04. RULES OF CONSTRUCTION .......................................  11

                                    ARTICLE 2
                                 THE SECURITIES

SECTION 2.01. FORM AND DATING .............................................  11
SECTION 2.02. FORM OF LEGEND FOR GLOBAL SECURITY ..........................  12
SECTION 2.03. EXECUTION AND AUTHENTICATION ................................  12
SECTION 2.04. REGISTRAR AND PAYING AGENT ..................................  12
SECTION 2.05. PAYING AGENT TO HOLD MONEY IN TRUST .........................  13
SECTION 2.06. HOLDER LISTS ................................................  13
SECTION 2.07. TRANSFER AND EXCHANGE .......................................  13
SECTION 2.08. PERSONS DEEMED OWNERS .......................................  14
SECTION 2.09. REPLACEMENT SECURITIES ......................................  15
SECTION 2.10. OUTSTANDING SECURITIES ......................................  15
SECTION 2.11. TREASURY SECURITIES .........................................  15
SECTION 2.12. TEMPORARY SECURITIES ........................................  15
SECTION 2.13. CANCELLATION ................................................  16
SECTION 2.14. DEFAULTED INTEREST ..........................................  16
SECTION 2.15. RECORD DATE .................................................  16
SECTION 2.16. CUSIP NUMBER ................................................  16

                                    ARTICLE 3
                                    COVENANTS

SECTION 3.01. PAYMENT OF SECURITIES .......................................  17
SECTION 3.02. MAINTENANCE OF OFFICE OR AGENCY .............................  17
SECTION 3.03. COMMISSION REPORTS ..........................................  17
SECTION 3.04. COMPLIANCE CERTIFICATE ......................................  18
SECTION 3.05. TAXES .......................................................  19
SECTION 3.06. STAY, EXTENSION AND USURY LAWS ..............................  19
SECTION 3.07. LIMITATIONS ON RESTRICTED PAYMENTS ..........................  19
SECTION 3.08. LIMITATIONS ON DIVIDEND AND OTHER PAYMENT RESTRICTIONS
              AFFECTING SUBSIDIARIES ......................................  21
SECTION 3.09. LIMITATIONS ON INCURRENCE OF INDEBTEDNESS AND ISSUANCE
              OF PREFERRED STOCK ..........................................  22
SECTION 3.10. LIMITATIONS ON TRANSACTIONS WITH AFFILIATES .................  23
SECTION 3.11. LIMITATIONS ON LIENS ........................................  24
SECTION 3.12. CHANGE OF CONTROL ...........................................  24

                                      -i-
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SECTION 3.13. CORPORATE EXISTENCE .........................................  26
SECTION 3.14. LINE OF BUSINESS ............................................  26
SECTION 3.15. LIMITATIONS ON ISSUANCES OF GUARANTEES OF INDEBTEDNESS
              BY SUBSIDIARIES .............................................  26
SECTION 3.16. NO AMENDMENT TO SUBORDINATION PROVISIONS OF SENIOR
              SUBORDINATED NOTE INDENTURE .................................  26

                                    ARTICLE 4
                                   SUCCESSORS

SECTION 4.01. LIMITATIONS ON MERGERS, CONSOLIDATIONS OR SALES
              OF ASSETS ...................................................  27
SECTION 4.02. SUCCESSOR CORPORATION SUBSTITUTED ...........................  27

                                    ARTICLE 5
                              DEFAULTS AND REMEDIES

SECTION 5.01. EVENTS OF DEFAULT ...........................................  28
SECTION 5.02. ACCELERATION ................................................  29
SECTION 5.03. OTHER REMEDIES ..............................................  30
SECTION 5.04. WAIVER OF PAST DEFAULTS .....................................  30
SECTION 5.05. CONTROL BY MAJORITY .........................................  30
SECTION 5.06. LIMITATION ON SUITS .........................................  31
SECTION 5.07. RIGHTS OF HOLDERS TO RECEIVE PAYMENT ........................  31
SECTION 5.08. COLLECTION SUIT BY TRUSTEE ..................................  31
SECTION 5.09. TRUSTEE MAY FILE PROOFS OF CLAIM ............................  31
SECTION 5.10. PRIORITIES ..................................................  32
SECTION 5.11. UNDERTAKING FOR COSTS .......................................  32

                                    ARTICLE 6
                                     TRUSTEE

SECTION 6.01. DUTIES OF TRUSTEE ...........................................  32
SECTION 6.02. RIGHTS OF TRUSTEE ...........................................  33
SECTION 6.03. INDIVIDUAL RIGHTS OF TRUSTEE ................................  34
SECTION 6.04. TRUSTEE'S DISCLAIMER ........................................  34
SECTION 6.05. NOTICE OF DEFAULTS ..........................................  34
SECTION 6.06. REPORTS BY TRUSTEE TO HOLDERS ...............................  34
SECTION 6.07. COMPENSATION AND INDEMNITY ..................................  35
SECTION 6.08. REPLACEMENT OF TRUSTEE ......................................  35
SECTION 6.09. SUCCESSOR TRUSTEE OR AGENT BY MERGER, ETC. ..................  36
SECTION 6.10. ELIGIBILITY; DISQUALIFICATION ...............................  36
SECTION 6.11. PREFERENTIAL COLLECTION OF CLAIMS AGAINST COMPANY ...........  37

                                    ARTICLE 7
                             DISCHARGE OF INDENTURE

SECTION 7.01. DEFEASANCE AND DISCHARGE OF THIS INDENTURE AND THE
              SECURITIES ..................................................  37
SECTION 7.02. LEGAL DEFEASANCE AND DISCHARGE ..............................  37

                                      -ii-
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SECTION 7.03. COVENANT DEFEASANCE .........................................  37
SECTION 7.04. CONDITIONS TO LEGAL OR COVENANT DEFEASANCE ..................  38
SECTION 7.05. DEPOSITED MONEY AND GOVERNMENT SECURITIES TO BE HELD
              IN TRUST; OTHER MISCELLANEOUS PROVISIONS ....................  39
SECTION 7.06. REPAYMENT TO COMPANY ........................................  40
SECTION 7.07. REINSTATEMENT ...............................................  40

                                    ARTICLE 8
                        AMENDMENT, SUPPLEMENT AND WAIVER

SECTION 8.01. WITHOUT CONSENT OF HOLDERS ..................................  40
SECTION 8.02. WITH CONSENT OF HOLDERS .....................................  41
SECTION 8.03. COMPLIANCE WITH TIA .........................................  42
SECTION 8.04. REVOCATION AND EFFECT OF CONSENTS ...........................  42
SECTION 8.05. NOTATION ON OR EXCHANGE OF SECURITIES .......................  42
SECTION 8.06. TRUSTEE TO SIGN AMENDMENTS, ETC. ............................  43

                                    ARTICLE 9
                                  MISCELLANEOUS

SECTION 9.01. TIA CONTROLS ................................................  43
SECTION 9.02. NOTICES .....................................................  43
SECTION 9.03. COMMUNICATION BY HOLDERS WITH OTHER HOLDERS .................  44
SECTION 9.04. CERTIFICATE AND OPINION AS TO CONDITIONS PRECEDENT ..........  44
SECTION 9.05. STATEMENTS REQUIRED IN CERTIFICATE OR OPINION ...............  45
SECTION 9.06. RULES BY TRUSTEE AND AGENTS .................................  45
SECTION 9.07. LEGAL HOLIDAYS ..............................................  45
SECTION 9.08. NO PERSONAL LIABILITY OF DIRECTORS, OFFICERS, EMPLOYEES
              AND SHAREHOLDERS ............................................  45
SECTION 9.09. DUPLICATE ORIGINALS .........................................  45
SECTION 9.10. GOVERNING LAW ...............................................  46
SECTION 9.11. NO ADVERSE INTERPRETATION OF OTHER AGREEMENTS ...............  46
SECTION 9.12. SUCCESSORS ..................................................  46
SECTION 9.13. SEVERABILITY ................................................  46
SECTION 9.14. COUNTERPART ORIGINALS .......................................  46
SECTION 9.15. TABLE OF CONTENTS, HEADINGS, ETC. ...........................  46

SIGNATURES

EXHIBIT A     FORM OF SECURITY
EXHIBIT B     FORM OF SUPPLEMENTAL INDENTURE

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                             CROSS-REFERENCE TABLE*

TRUST INDENTURE
  ACT SECTION                                                  INDENTURE SECTION
---------------                                                -----------------
  310 (a)(1) .................................................     6.10
      (a)(2) .................................................     6.10
      (a)(3) .................................................     N.A.
      (a)(4) .................................................     N.A.
      (a)(5) .................................................     6.10
      (b) ....................................................     6.08; 6.10
      (c) ....................................................     N.A.
  311 (a) ....................................................     6.11
      (b) ....................................................     6.11
      (c) ....................................................     N.A.
  312 (a) ....................................................     2.06
      (b) ....................................................     9.03
      (c) ....................................................     9.03
  313 (a) ....................................................     6.06
      (b)(1) .................................................     N.A.
      (b)(2) .................................................     6.06
      (c) ....................................................     6.06; 9.02
      (d) ....................................................     N.A.
  314 (a) ....................................................     3.03; 9.02
      (b) ....................................................     N.A.
      (c)(1) .................................................     9.04
      (c)(2) .................................................     9.04
      (c)(3) .................................................     N.A.
      (d) ....................................................     N.A.
      (e) ....................................................     9.05
      (f) ....................................................     N.A.
  315 (a) ....................................................     6.01(iii)(b)
      (b) ....................................................     6.05; 9.02
      (c) ....................................................     6.01(i)
      (d) ....................................................     6.01(iii)
      (e) ....................................................     5.11
  316 (a)(last sentence) .....................................     2.11
      (a)(1)(A) ..............................................     5.05
      (a)(1)(B) ..............................................     5.04
      (a)(2) .................................................     N.A.
      (b) ....................................................     5.07
      (c) ....................................................     2.15; 8.04
  317 (a)(1) .................................................     5.08
      (a)(2) .................................................     5.09
      (b) ....................................................     2.05

-------------------------

        *This Cross-Reference Table is not part of the indenture.

                                      -iv-
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   318 (a) ...................................................     9.01
       (b) ...................................................     N.A.
       (c) ...................................................     9.01

N.A. means not applicable

                                       -v-
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         INDENTURE dated as of January 15, 1997 between Tenet Healthcare
Corporation, a Nevada corporation (the "COMPANY"), and The Bank of New York, as
trustee (the "TRUSTEE").

         The Company and the Trustee agree as follows for the benefit of each
other and for the equal and ratable benefit of the Holders of the 7-7/8% Senior
Notes due 2003 (the "SECURITIES"):

                                    ARTICLE I
                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

SECTION 1.01. DEFINITIONS.

         "ACQUIRED DEBT" means, with respect to any specified Person, (i)
Indebtedness of any other Person existing at the time such other Person is
merged with or into or became a Subsidiary of such specified Person, including,
without limitation, Indebtedness incurred in connection with, or in
contemplation of, such other Person merging with or into or becoming a
Subsidiary of such specified Person, and (ii) Indebtedness secured by a Lien
encumbering any asset acquired by such specified Person.

         "AFFILIATE" of any specified Person means any other Person directly or
indirectly controlling or controlled by or under direct or indirect common
control with such specified Person. For purposes of this definition, "control"
(including, with correlative meanings, the terms "controlling," "controlled by"
and "under common control with"), as used with respect to any Person, shall
mean the possession, directly or indirectly, of the power to direct or cause the
direction of the management or policies of such Person, whether through the
ownership of voting securities, by agreement or otherwise; PROVIDED that
beneficial ownership of 10% or more of the voting securities of a Person shall
be deemed to be control.

         "AGENT" means any Registrar, Paying Agent or co-registrar.

         "ASSET SALE" means (i) the sale, lease, conveyance or other disposition
of any assets (including, without limitation, by way of a sale and leaseback)
other than in the ordinary course of business consistent with past practices and
(ii) the issuance or sale by the Company or any of its Subsidiaries of Equity
Interests of any of the Company's Subsidiaries, in the case of either clause (i)
or (ii), whether in a single transaction or a series of related transactions (a)
that have a fair market value in excess of $25.0 million or (b) for net proceeds
in excess of $25.0 million. Notwithstanding the foregoing: (a) a transfer of
assets by the Company to a Subsidiary or by a Subsidiary to the Company or to
another Subsidiary, (b) an issuance of Equity Interests by a Subsidiary to the
Company or to another Subsidiary, (c) a Restricted Payment that is permitted by
Section 3.07 hereof and (d) a Hospital Swap shall not be deemed to be an Asset
Sale.

         "BOARD OF DIRECTORS" means the Board of Directors of the Company or any
authorized committee thereof.

         "BUSINESS Day" means any day other than a Legal Holiday.

         "CAPITAL LEASE" means, at the time any determination thereof is to be
made, any lease of property, real or personal, in respect of which the present
value of the minimum rental commitment would be capitalized on a balance sheet
of the lessee in accordance with GAAP.

<PAGE>

         "CAPITAL LEASE OBLIGATION" means, at the time any determination thereof
is to be made, the amount of the liability in respect of a Capital Lease that
would at such time be required to be capitalized on a balance sheet in
accordance with GAAP.

         "CAPITAL STOCK" means (i) in the case of a corporation, corporate
stock, (ii) in the case of an association or business entity, any and all
shares, interests, participations, rights or other equivalents (however
designated) of corporate stock, (iii) in the case of a partnership, partnership
interests (whether general or limited) and (iv) any other interest or
participation that confers on a Person the right to receive a share of the
profits and losses of, or distributions of assets of, the issuing Person.

         "CHANGE OF CONTROL" means the occurrence of any of the following: (i)
the sale, lease, transfer, conveyance or other disposition, in one or a series
of related transactions, of all or substantially all of the assets of the
Company and its Subsidiaries taken as a whole to any Person or group (as such
term is used in Sections 13(d)(3) and 14(d)(2) of the Exchange Act) other than
to a Person or group who, prior to such transaction, held a majority of the
voting power of the voting stock of the Company, (ii) the acquisition by any
Person or group (as defined above) of a direct or indirect interest in more than
50% of the voting power of the voting stock of the Company, by way of merger or
consolidation or otherwise, or (iii) the first day on which a majority of the
members of the Board of Directors of the Company are not Continuing Directors.

         "CHANGE OF CONTROL TRIGGERING EVENT" means the occurrence of both a
Change of Control and a Rating Decline.

         "CLOSING DATE" means January 30, 1997.

         "COMMISSION" means the Securities and Exchange Commission.

         "Company" means Tenet Healthcare Corporation, as obligor under the
Securities, unless and until a successor replaces Tenet Healthcare Corporation,
in accordance with Article 4 hereof and thereafter includes such successor.

         "CONSOLIDATED CASH FLOW" means, with respect to any Person for any
period, the Consolidated Net Income of such Person for such period PLUS (i) an
amount equal to any extraordinary loss plus any net loss realized in connection
with an Asset Sale (to the extent such losses were deducted in computing such
Consolidated Net Income), PLUS (ii) provision for taxes based on income or
profits of such Person and its Subsidiaries for such period, to the extent that
such provision for taxes was included in computing such Consolidated Net Income,
PLUS (iii) the Fixed Charges of such Person and its Subsidiaries for such
period, to the extent that such Fixed Charges were deducted in computing such
Consolidated Net Income, PLUS (iv) depreciation and amortization (including
amortization of goodwill and other intangibles but excluding amortization of
prepaid cash expenses that were paid in a prior period) of such Person and its
Subsidiaries for such period to the extent that such depreciation and
amortization were deducted in computing such Consolidated Net Income, in each
case, on a consolidated basis and determined in accordance with GAAP.
Notwithstanding the foregoing, the provision for taxes on the income or profits
of, and the depreciation and amortization of, a Subsidiary of the referent
Person shall be added to Consolidated Net Income to compute Consolidated Cash
Flow only to the extent (and in same proportion) that the Net Income of such
Subsidiary was included in calculating the Consolidated Net Income of such
Person and only if a corresponding amount would be permitted at the date of
determination to be dividended to the Company by such Subsidiary without prior
approval (that has not been obtained), pursuant to the terms of its charter and
all agreements, instruments, judgments, decrees, orders, statutes, rules and
governmental regulations applicable to that Subsidiary or its stockholders.

                                       -2-
<PAGE>

         "CONSOLIDATED NET INCOME" means, with respect to any Person for any
period, the aggregate of the Net Income of such Person and its Subsidiaries for
such period, on a consolidated basis, determined in accordance with GAAP but
excluding any one-time charge or expense incurred in order to consummate the
Refinancing; PROVIDED that (i) the Net Income of any Person that is not a
Subsidiary or that is accounted for by the equity method of accounting shall be
included only to the extent of the amount of dividends or distributions paid in
cash to the referent Person or a Wholly Owned Subsidiary thereof, (ii) the Net
Income of any Subsidiary shall be excluded to the extent that the declaration or
payment of dividends or similar distributions by that Subsidiary of that Net
Income is not at the date of determination permitted without any prior
governmental approval (that has not been obtained) or, directly or indirectly,
by operation of the terms of its charter or any agreement, instrument, judgment,
decree, order, statute, rule or governmental regulation applicable to that
Subsidiary or its stockholders, (iii) the Net Income of any Person acquired in a
pooling of interests transaction for any period prior to the date of such
acquisition shall be excluded and (iv) the cumulative effect of a change in
accounting principles shall be excluded.

         "CONSOLIDATED NET WORTH" means, with respect to any Person as of any
date, the sum of (i) the consolidated equity of the common stockholders of such
Person and its consolidated Subsidiaries as of such date PLUS (ii) the
respective amounts reported on such Person's balance sheet as of such date with
respect to any series of preferred stock (other than Disqualified Stock), LESS
all write-ups (other than write-ups resulting from foreign currency translations
and write-ups of tangible assets of a going concern business made in accordance
with GAAP as a result of the acquisition of such business) subsequent to the
Closing Date in the book value of any asset owned by such Person or a
consolidated Subsidiary of such Person, and excluding the cumulative effect of a
change in accounting principles, all as determined in accordance with GAAP.

         "CONTINUING DIRECTORS" means, as of any date of determination, any
member of the Board of Directors of the Company who (i) was a member of such
Board of Directors on the Closing Date or (ii) was nominated for election or
elected to such Board of Directors with the approval of a majority of the
Continuing Directors who were members of such Board at the time of such
nomination or election.

         "CORPORATE TRUST OFFICE OF THE TRUSTEE" shall be at the address of the
Trustee specified in Section 9.02 hereof or such other address as to which the
Trustee may give notice to the Company.

         "DEFAULT" means any event that is or with the passage of time or the
giving of notice or both would be an Event of Default.

         "DEPOSITARY" means a clearing agency registered under the Exchange Act
that is designated to act as Depositary for the Securities.

         "DISQUALIFIED STOCK" means any Capital Stock that, by its terms (or by
the terms of any security into which it is convertible or for which it is
exchangeable), or upon the happening of any event, matures or is mandatorily
redeemable, pursuant to a sinking fund obligation or otherwise, or redeemable at
the option of the Holder thereof, in whole or in part, on or prior to January
15, 2003.

         "EQUITY INTERESTS" means Capital Stock and all warrants, options or
other rights to acquire Capital Stock (but excluding any debt security that is
convertible into, or exchangeable for, Capital Stock).

         "EXCHANGE ACT" means the Securities Exchange Act of 1934, as amended.

                                       -3-
<PAGE>

         "EXISTING INDEBTEDNESS" means Indebtedness of the Company and its
Subsidiaries (other than Indebtedness under the New Credit Facility) in
existence on the Closing Date, until such amounts are repaid, including all
reimbursement obligations with respect to letters of credit outstanding as of
the Closing Date.

         "FIXED CHARGE COVERAGE RATIO" means with respect to any Person for any
period, the ratio of the Consolidated Cash Flow of such Person for such period
to the Fixed Charges of such Person for such period. In the event that the
Company or any of its Subsidiaries incurs, assumes, Guarantees or redeems any
Indebtedness (other than revolving credit borrowings) or issues preferred stock
subsequent to the commencement of the period for which the Fixed Charge Coverage
Ratio is being calculated but prior to the date on which the event for which the
calculation of the Fixed Charge Coverage Ratio is made (the "CALCULATION DATE"),
then the Fixed Charge Coverage Ratio shall be calculated giving PRO FORMA effect
to such incurrence, assumption, Guarantee or redemption of Indebtedness, or such
issuance or redemption of preferred stock, as if the same had occurred at the
beginning of the applicable four-quarter reference period. In addition, for
purposes of making the computation referred to above, (i) acquisitions that have
been made by the Company or any of its Subsidiaries, including through mergers
or consolidations and including any related financing transactions, during the
four-quarter reference period or subsequent to such reference period and on or
prior to the Calculation Date shall be deemed to have occurred on the first day
of the four-quarter reference period, and (ii) the Consolidated Cash Flow and
Fixed Charges attributable to discontinued operations, as determined in
accordance with GAAP, and operations or businesses disposed of prior to the
Calculation Date, shall be excluded.

         "FIXED CHARGES" means, with respect to any Person for any period, the
sum of (i) the consolidated interest expense of such Person and its Subsidiaries
for such period, whether paid or accrued (including, without limitation,
amortization of original issue discount, non-cash interest payments, the
interest component of any deferred payment obligations, the interest component
of all payments associated with Capital Lease Obligations, commissions,
discounts and other fees and charges incurred in respect of letters of credit or
bankers' acceptance financings, and net payments or receipts (if any) pursuant
to Hedging Obligations) and (ii) the consolidated interest expense of such
Person and its Subsidiaries that was capitalized during such period, and (iii)
any interest expense on Indebtedness of another Person that is Guaranteed by
such Person or one of its Subsidiaries or secured by a Lien on assets of such
Person or one of its Subsidiaries (whether or not such Guarantee or Lien is
called upon) and (iv) the product of (a) all cash dividend payments (and
non-cash dividend payments in the case of a Person that is a Subsidiary) on any
series of preferred stock of such Person, TIMES (b) a fraction, the numerator of
which is one and the denominator of which is one minus the then current combined
federal, state and local statutory tax rate of such Person, expressed as a
decimal, in each case, on a consolidated basis and in accordance with GAAP.

         "GAAP" means 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 in such other statements by such
other entity as have been approved by a significant segment of the accounting
profession, as in effect from time to time.

         "GLOBAL SECURITY" means a Security that evidences all or part of the
Securities of any series and bears the legend set forth in Section 2.02.

         "GOVERNMENT SECURITIES" means direct obligations of, or obligations
guaranteed by, the United States of America for the payment of which guarantee
or obligations the full faith and credit of the United States is pledged.

                                       -4-
<PAGE>

         "GUARANTEE" means a guarantee (other than by endorsement of negotiable
instruments for collection in the ordinary course of business), direct or
indirect, in any manner (including, without limitation, letters of credit and
reimbursement agreements in respect thereof), of all or any part of any
Indebtedness.

         "HEDGING OBLIGATIONS" means, with respect to any Person, the
obligations of such Person under (i) interest rate swap agreements, interest
rate cap agreements and interest rate collar agreements, (ii) forward foreign
exchange contracts or currency swap agreements and (iii) other agreements or
arrangements designed to protect such Person against fluctuations in interest
rates or currency values.

         "HOLDER" means a Person in whose name a Security is registered.

         "HOSPITAL" means a hospital, outpatient clinic, long-term care facility
or other facility or business that is used or useful in or related to the
provision of healthcare services.

         "HOSPITAL SWAP" means an exchange of assets by the Company or a
Subsidiary of the Company for one or more Hospitals and/or one or more Related
Businesses or for the Capital Stock of any Person owning one or more Hospitals
and/or one or more Related Businesses.

         "INDEBTEDNESS" means, with respect to any Person, any indebtedness of
such Person, whether or not contingent, in respect of borrowed money or
evidenced by bonds, notes, debentures or similar instruments or letters of
credit (or reimbursement agreements in respect thereof) or banker's acceptances
or representing Capital Lease Obligations or the balance deferred and unpaid of
the purchase price of any property or representing any Hedging Obligations,
except any such balance that constitutes an accrued expense or trade payable, if
and to the extent any of the foregoing indebtedness (other than letters of
credit and Hedging Obligations) would appear as a liability upon a balance sheet
of such Person prepared in accordance with GAAP, as well as all indebtedness of
others secured by a Lien on any asset of such Person (whether or not such
indebtedness is assumed by such Person) and, to the extent not otherwise
included, the Guarantee by such Person of any indebtedness of any other Person.

         "INDENTURE" means this Indenture, as amended or supplemented from time
to time.

         "INVESTMENT GRADE" means a rating of BBB- or higher by S&P or Baa3 or
higher by Moody's or the equivalent of such ratings by S&P or Moody's. In the
event that the Company shall select any other Rating Agency, the equivalent of
such ratings by such Rating Agency shall be used.

         "LIEN" means, with respect to any asset, any mortgage, lien, pledge,
charge, security interest or encumbrance of any kind in respect of such asset
given to secure Indebtedness, whether or not filed, recorded or otherwise
perfected under applicable law (including any conditional sale or other title
retention agreement, any lease in the nature thereof, any option or other
agreement to sell or give a security interest in and any filing of or agreement
to give any financing statement under the Uniform Commercial Code (or equivalent
statutes) of any jurisdiction with respect to any such lien, pledge, charge or
security interest).

         "MOODY'S" means Moody's Investors Services, Inc. and its successors.

         "NET INCOME" means, with respect to any Person, the net income (loss)
of such Person, determined in accordance with GAAP and before any reduction in
respect of preferred stock dividends, excluding, however, (i) any gain (but not
loss), together with any related provision for taxes on such gain (but not
loss), realized in connection with (a) any Asset Sale (including, without
limitation, dispositions

                                       -5-
<PAGE>

pursuant to sale and leaseback transactions) or (b) the disposition of any
securities by such Person or any of its Subsidiaries or the extinguishment of
any Indebtedness of such Person or any of its Subsidiaries and (ii) any
extraordinary or nonrecurring gain (but not loss), together with any related
provision for taxes on such extraordinary or nonrecurring gain (but not loss).

         "NEW CREDIT FACILITY" means that certain Credit Agreement by and among
the Company and Morgan Guaranty Trust Company of New York and the other banks
that are party thereto, providing for $2.8 billion in aggregate principal amount
of Indebtedness, including any related notes, instruments and agreements
executed in connection therewith, and in each case as amended, modified,
extended, renewed, refunded, replaced or refinanced, in whole or in part, from
time to time.

         "OBLIGATIONS" means any principal, interest, penalties, fees,
indemnifications, reimbursements, damages and other liabilities payable under
the documentation governing any Indebtedness.

         "OFFICERS" means the Chairman of the Board, the Chief Executive
Officer, the President, the Chief Operating Officer, the Chief Financial
Officer, the Treasurer, any Assistant Treasurer, the Controller, the Secretary
and any Vice President of the Company or any Subsidiary, as the case may be.

         "OFFICERS' CERTIFICATE" means a certificate signed by two Officers, one
of whom must be the principal executive officer, principal financial officer or
principal accounting officer of the Company.

         "OPINION OF COUNSEL" means an opinion from legal counsel who is
reasonably acceptable to the Trustee. The counsel may be an employee of or
counsel to the Company, any Subsidiary or the Trustee.

         "PAYMENT DEFAULT" means, any failure to pay any scheduled installment
of interest or principal on any Indebtedness within the grace period provided
for such payment in the documentation governing such Indebtedness.

         "PERMITTED LIENS" means (i) Liens in favor of the Company; (ii) Liens
on property of a Person existing at the time such Person is merged into or
consolidated with the Company or any Subsidiary of the Company or becomes a
Subsidiary of the Company; PROVIDED that such Liens were in existence prior to
the contemplation of such merger, consolidation or acquisition (unless such
Liens secure Indebtedness that was incurred in connection with or in
contemplation of such acquisition and is used to refinance tax-exempt
Indebtedness) and do not extend to any assets or the Company or its Subsidiaries
other than those of the Person merged into or consolidated with the Company or
that becomes a Subsidiary of the Company; (iii) Liens on property existing at
the time of acquisition thereof by the Company or any Subsidiary of the Company;
PROVIDED that such Liens were in existence prior to the contemplation of such
acquisition (unless such Liens secure Indebtedness that was incurred in
connection with or in contemplation of such acquisition and is used to refinance
tax-exempt Indebtedness); (iv) Liens to secure the performance of statutory
obligations, tender, bid, performance, government contract, surety or appeal
bonds or other obligations of a like nature incurred in the ordinary course of
business; (v) Liens existing on the Closing Date; (vi) Liens for taxes,
assessments or governmental charges or claims that are not yet delinquent or
that are being contested in good faith by appropriate proceedings promptly
instituted and diligently concluded; PROVIDED that any reserve or other
appropriate provision as shall be required in conformity with GAAP shall have
been made therefor; (vii) other Liens on assets of the Company or any Subsidiary
of the Company securing Indebtedness that is permitted by the terms hereof to be
outstanding having an aggregate principal amount at any one time outstanding not
to exceed 10% of the Stockholders' Equity of the Company; and (viii) Liens to
secure

                                       -6-
<PAGE>

Permitted Refinancing Indebtedness incurred to refinance Indebtedness that was
secured by a Lien permitted hereunder and that was incurred in accordance with
the provisions hereof, PROVIDED that such Liens do not extend to or cover any
property or assets of the Company or any Subsidiary other than assets or
property securing the Indebtedness so refinanced.

         "PERMITTED REFINANCING INDEBTEDNESS" means any Indebtedness of the
Company or any of its Subsidiaries issued in exchange for, or the net proceeds
of which are used solely to extend, refinance, renew, replace, defease or
refund, other Indebtedness of the Company or any of its Subsidiaries; PROVIDED
that, except in the case of Indebtedness of the Company issued in exchange for,
or the net proceeds of which are used solely to extend, refinance, renew,
replace, defease or refund, Indebtedness of a Subsidiary of the Company: (i) the
principal amount of such Permitted Refinancing Indebtedness does not exceed the
principal amount of the Indebtedness so extended, refinanced, renewed, replaced,
defeased or refunded (plus the amount of any premiums paid and reasonable
expenses incurred in connection therewith); (ii) such Permitted Refinancing
Indebtedness has a final maturity date later than the final maturity date of,
and has a Weighted Average Life to Maturity equal to or greater than the
Weighted Average Life to Maturity of, the Indebtedness being extended,
refinanced, renewed, replaced, defeased or refunded; (iii) if the Indebtedness
being extended, refinanced, renewed, replaced, defeased or refunded is
subordinated in right of payment to the Securities, such Permitted Refinancing
Indebtedness has a final maturity date later than the final maturity date of,
and is subordinated in right of payment to, the Securities on subordination
terms at least as favorable to the Holders of Securities as those contained in
the documentation governing the Indebtedness being extended, refinanced,
renewed, replaced, defeased or refunded; (iv) such Indebtedness is incurred by
the Company if the Company is the obligor on the Indebtedness being extended,
refinanced, renewed, replaced, defeased or refunded; and (v) such Indebtedness
is incurred by the Company or a Subsidiary if a Subsidiary is the obligor on the
Indebtedness being extended, refinanced, renewed, replaced, defeased or
refunded.

         "PERSON" means any individual, corporation, partnership, joint venture,
association, joint-stock company, trust or unincorporated organization
(including any subdivision or ongoing business of any such entity or
substantially all of the assets of any such entity, subdivision or business).

         "PHYSICIAN JOINT VENTURE DISTRIBUTIONS" means distributions made by the
Company or any of its Subsidiaries to any physician, pharmacist or other allied
healthcare professional in connection with the unwinding, liquidation or other
termination of any joint venture or similar arrangement between any such Person
and the Company or any of its Subsidiaries.

         "PHYSICIAN SUPPORT OBLIGATIONS" means any obligation or Guarantee
incurred in the ordinary course of business by the Company or a Subsidiary of
the Company in connection with any advance, loan or payment to, or on behalf of
or for the benefit of any physician, pharmacist or other allied healthcare
professional for the purpose of recruiting, redirecting or retaining the
physician, pharmacist or other allied healthcare professional to provide service
to patients in the service area of any Hospital or Related Business owned or
operated by the Company or any of its Subsidiaries; EXCLUDING, HOWEVER,
compensation for services provided by physicians, pharmacists or other allied
healthcare professionals to any Hospital or Related Business owned or operated
by the Company or any of its Subsidiaries.

         "QUALIFIED EQUITY INTERESTS" shall mean all Equity Interests of the
Company other than Disqualified Stock of the Company.

         "RATING AGENCIES" means (i) S&P and (ii) Moody's or (iii) if S&P or
Moody's or both shall not make a rating of the Securities publicly available, a
nationally recognized securities rating

                                       -7-
<PAGE>

agency or agencies, as the case may be, selected by the Company, which shall be
substituted for S&P or Moody's or both, as the case may be.

         "RATING CATEGORY" means (i) with respect to S&P, any of the following
categories: BB, B, CCC, CC, C and D (or equivalent successor categories); (ii)
with respect to Moody's, any of the following categories: Ba, B, Caa, Ca, C and
D (or equivalent successor categories); and (iii) the equivalent of any such
category of S&P or Moody's used by another Rating Agency. In determining whether
the rating of the Securities has decreased by one or more gradations, gradations
within Rating Categories (+ and - for S&P; 1, 2 and 3 for Moody's; or the
equivalent gradations for another Rating Agency) shall be taken into account
(e.g., with respect to S&P, a decline in a rating from BB+ to BB, as well as
from BB- to B+, shall constitute a decrease of one gradation).

         "RATING DATE" means the date which is 90 days prior to the earlier of
(i) a Change of Control and (ii) the first public notice of the occurrence of a
Change of Control or of the intention by the Company to effect a Change of
Control.

         "RATING DECLINE" means the occurrence on or within 90 days after the
date of the first public notice of the occurrence of a Change of Control or of
the intention by the Company to effect a Change of Control (which period shall
be extended so long as the rating of the Securities is under publicly announced
consideration for possible downgrade by any of the Rating Agencies) of: (a) in
the event the Securities are rated by either Moody's or S&P on the Rating Date
as Investment Grade, a decrease in the rating of the Securities by both Rating
Agencies to a rating that is below Investment Grade, or (b) in the event the
Securities are rated below Investment Grade by both Rating Agencies on the
Rating Date, a decrease in the rating of the Securities by either Rating Agency
by one or more gradations (including gradations within Rating Categories as well
as between Rating Categories).

         "REFINANCING" has the meaning ascribed to it in the prospectus dated
January 27, 1997 relating to the Company's 8% Senior Notes due 2005, the
Securities and the Senior Subordinated Notes.

         "RELATED BUSINESS" means a healthcare business affiliated or associated
with a Hospital or any business related or ancillary to the provision of
healthcare services or information or the investment in, management, leasing or
operation of a Hospital.

         "RESPONSIBLE OFFICER" when used with respect to the Trustee, means any
officer within the corporate trust department of the Trustee (or any successor
group of the Trustee) or any other officer of the Trustee customarily performing
functions similar to those performed by any of the above designated officers and
also means, with respect to a particular corporate trust matter, any other
officer to whom such matter is referred because of his knowledge of and
familiarity with the particular subject.

         "SECURITIES" means the securities described above, issued under this
Indenture.

         "SECURITIES ACT" means the Securities Act of 1933, as amended.

         "SENIOR SUBORDINATED NOTES" means the 8-5/8% Senior Subordinated Notes
due 2007 of the Company in an aggregate principal amount of $700.0 million,
issued pursuant to the Senior Subordinated Note Indenture.

         "SENIOR SUBORDINATED NOTE INDENTURE" means the Indenture dated as of
January 15, 1997 between the Company and The Bank of New York, as trustee, as
amended or supplemented from time to time, under which the Senior Subordinated
Notes were issued.

                                      -8-
<PAGE>

         "SIGNIFICANT SUBSIDIARY" means any Subsidiary that would be a
"significant subsidiary" as defined in Article 1, Rule 1-02 of Regulation S-X,
promulgated pursuant to the Securities Act, as such Regulation is in effect on
the Closing Date.

         "S&P" means Standard & Poor's Corporation and its successors.

         "SPECIFIED EXCHANGE" means any retirement of Indebtedness upon the
exercise by a holder of such Indebtedness, pursuant to the terms thereof, of any
right to exchange such Indebtedness for shares of common stock of Vencor, Inc.
or any successor thereto or any other equity securities, other than Equity
Interests of a Subsidiary, owned by the Company as of October 11, 1995, or for
any securities or other property received with respect to such common stock or
equity securities or cash in lieu thereof, whether or not such right is subject
to the Company's ability to pay an amount in cash in lieu thereof.

         "STOCKHOLDERS' EQUITY" means, with respect to any Person as of any
date, the stockholders' equity of such Person determined in accordance with GAAP
as of the date of the most recent available internal financial statements of
such Person, and calculated on a PRO FORMA basis to give effect to any
acquisition or disposition by such Person consummated or to be consummated since
the date of such financial statements and on or prior to the date of such
calculation.

         "SUBSIDIARY" means, with respect to any Person, (i) any corporation,
association or other business entity of which more than 50% of the total voting
power of shares of Capital Stock entitled (without regard to the occurrence of
any contingency) to vote in the election of directors, managers or trustees
thereof is at the time owned or controlled, directly or indirectly, by such
Person or one or more of the other Subsidiaries of that Person (or a combination
thereof) and (ii) any partnership (a) the sole general partner or the managing
general partner of which is such Person or a Subsidiary of such Person or (b)
the only general partners of which are such Person or of one or more
Subsidiaries of such Person (or any combination thereof).

         "TIA" means the Trust Indenture Act of 1939, as amended (15 U.S.C.
Section 77aaa-77bbbb) as in effect on the date on which this Indenture is
qualified under the TIA, except as provided in Section 8.03 hereof.

         "TRANSFER RESTRICTION" means, with respect to the Company's
Subsidiaries, any encumbrance or restriction on the ability of any Subsidiary to
(i)(a) pay dividends or make any other distributions to the Company or any of
its Subsidiaries (1) on its Capital Stock or (2) with respect to any other
interest or participation in, or measured by, its profits, or (b) pay any
Indebtedness owed to the Company or any of its Subsidiaries, (ii) make loans or
advances to the Company or any of its Subsidiaries, or (iii) transfer any of its
properties or assets to the Company or any of its Subsidiaries.

         "TRUSTEE" means the party named as such above until a successor
replaces it in accordance with the applicable provisions of this Indenture and
thereafter means the successor serving hereunder.

         "WEIGHTED AVERAGE LIFE TO MATURITY" means, when applied to any
Indebtedness at any date, the number of years obtained by dividing (i) the sum
of the products obtained by multiplying (a) the amount of each then remaining
installment, sinking fund, serial maturity or other required payments of
principal, including payment at final maturity, in respect thereof, by (b) the
number of years (calculated to the nearest one-twelfth) that will elapse between
such date and the making of such payment, by (ii) the then outstanding principal
amount of such Indebtedness.

                                       -9-
<PAGE>

         "WHOLLY OWNED SUBSIDIARY" OF any Person means a Subsidiary of such
Person all of the outstanding Capital Stock or other ownership interests of
which (other than directors' qualifying shares) shall at the time be owned by
such Person or by one or more Wholly Owned Subsidiaries of such Person or by
such Person and one or more Wholly Owned Subsidiaries of such Person.

         "2005 EXCHANGEABLE SUBORDINATED NOTES" means the 6% Exchangeable
Subordinated Notes due 2005 of the Company in an aggregate principal amount of
$320.0 million, issued pursuant to the Indenture dated as of January 10, 1996,
between the Company and The Bank of New York, as trustee, as amended or
supplemented from time to time.

         "2005 SENIOR SUBORDINATED NOTES" means the 10-1/8% Senior Subordinated
Notes due 2005 of the Company in an aggregate principal amount of $900.0
million, issued pursuant to the Indenture dated as of March 1, 1995, between the
Company and The Bank of New York, as trustee, as amended or supplemented from
time to time.

SECTION 1.02. OTHER DEFINITIONS.
                                                                     DEFINED IN
 TERM                                                                 SECTION
 ----                                                                ----------
 "Affiliate Transaction" ............................................   3.10
 "Bankruptcy Law" ...................................................   5.01
 "Change of Control Offer" ..........................................   3.12
 "Change of Control Payment" ........................................   3.12
 "Change of Control Payment Date" ...................................   3.12
 "Covenant Defeasance" ..............................................   7.03
 "Custodian" ........................................................   5.01
 "Event of Default" .................................................   5.01
 "incur" ............................................................   3.09
 "Legal Defeasance" .................................................   7.02
 "Legal Holiday" ....................................................   9.07
 "Notice of Default" ................................................   5.01
 "Paying Agent" .....................................................   2.03
 "Registrar" ........................................................   2.03
 "Restricted Payments" ..............................................   3.07

SECTION 1.03. INCORPORATION BY REFERENCE OF TIA

         Whenever this Indenture refers to a provision of the TIA, the provision
is incorporated by reference in and made a part of this Indenture.

         The following TIA terms used in this Indenture have the following
meanings:

         "INDENTURE SECURITIES" means the Securities;

         "INDENTURE SECURITY HOLDER" means a Holder;

         "INDENTURE TO BE QUALIFIED" means this Indenture;

         "INDENTURE TRUSTEE" or "INSTITUTIONAL TRUSTEE" means the Trustee;

                                       -10-
<PAGE>

         "OBLIGOR" on the Securities means the Company and any successor obligor
upon the Securities.

         All other terms used in this Indenture that are defined by the TIA,
defined by TIA reference to another statute or defined by the Commission rule
under the TIA have the meanings so assigned to them.

SECTION 1.04. RULES OF CONSTRUCTION

         Unless the context otherwise requires:

                  (1) a term has the meaning assigned to it;

                  (2) an accounting term not otherwise defined has the meaning
         assigned to it in accordance with GAAP;

                  (3) "or" is not exclusive;

                  (4) words in the singular include the plural, and in the
         plural include the singular; and

                  (5) provisions apply to successive events and transactions.

                                    ARTICLE 2
                                 THE SECURITIES

SECTION 2.01. FORM AND DATING.

         The Securities and the Trustee's certificate of authentication shall be
substantially in the form of Exhibit A hereto, the terms of which are
incorporated in and made a part of this Indenture. The Securities may have
notations, legends or endorsements approved as to form by the Company and
required by law, stock exchange rule, agreements to which the Company is subject
or usage. Each Security shall be dated the date of its authentication. The
Securities shall be issuable only in registered form, without coupons, in
denominations of $1,000 and integral multiples thereof. The Securities may be
Global Securities, as determined by the officers executing such Securities, as
evidenced by their execution of such Securities.

SECTION 2.02. FORM OF LEGEND FOR GLOBAL SECURITY.

         Every Global Security authenticated and delivered hereunder shall bear
a legend in substantially the following form:

                  "This Security is a Global Security within the meaning of the
         Indenture hereinafter referred to and is registered in the name of a
         Depositary or a nominee thereof. This Security may not be exchanged in
         whole or in part for a Security registered, and no transfer of this
         Security in whole or in part may be registered, in the name of any
         person other than such Depositary or a nominee thereof, except in the
         limited circumstances described in the Indenture."

                                      -11-
<PAGE>

SECTION 2.03. EXECUTION AND AUTHENTICATION.

         An Officer of the Company shall sign the Securities for the Company by
manual or facsimile signature.

         If an Officer whose signature is on a Security no longer holds that
office at the time the Security is authenticated, the Security shall
nevertheless be valid.

         A Security shall not be valid until authenticated by the manual
signature of the Trustee. The signature of the Trustee shall be conclusive
evidence that the Security has been authenticated under this Indenture. The form
of Trustee's certificate of authentication to be borne by the Securities shall
be substantially as set forth in Exhibit A hereto.

         The Trustee shall, upon a written order of the Company signed by two
Officers of the Company, authenticate Securities for original issue up to the
aggregate principal amount stated in paragraph 4 of the Securities. The
aggregate principal amount of Securities outstanding at any time shall not
exceed the amount set forth herein except as provided in Section 2.09 hereof.

         The Trustee may appoint an authenticating agent acceptable to the
Company to authenticate Securities. Unless limited by the terms of such
appointment, an authenticating agent may authenticate Securities whenever the
Trustee may do so. Each reference in this Indenture to authentication by the
Trustee includes authentication by such agent. An authenticating agent has the
same rights as an Agent to deal with the Company or an Affiliate of the
Company.

         Each Global Security authenticated under this Indenture shall be-
registered in the name of the Depositary designated for such Global Security or
a nominee thereof and delivered to such Depositary or a nominee thereof or
custodian therefor, and each such Global Security shall constitute a single
Security for all purposes of this Indenture.

         The Company initially appoints The Depository Trust Company as the
Depositary.

SECTION 2.04. REGISTRAR AND PAYING AGENT.

         The Company shall maintain (i) an office or agency where Securities may
be presented for registration of transfer or for exchange (including any
co-registrar, the "REGISTRAR") and (ii) an office or agency where Securities may
be presented for payment (the "PAYING AGENT"). The Registrar shall keep a
register of the Securities and of their transfer and exchange. The Company may
appoint one or more co-registrars and one or more additional paying agents. The
term "Paying Agent" includes any additional paying agent. The Company may change
any Paying Agent, Registrar or co-registrar without prior notice to any Holder.
The Company shall notify the Trustee and the Trustee shall notify the Holders of
the name and address of any Agent not a party to this Indenture. If the Company
fails to appoint or maintain another entity as Registrar or Paying Agent, the
Trustee shall act as such. The Company or any of its Subsidiaries may act as
Paying Agent, Registrar or co-registrar. The Company shall enter into an
appropriate agency agreement with any Agent not a party to this Indenture, which
shall incorporate the provisions of the TIA. The agreement shall implement the
provisions of this Indenture that relate to such Agent. The Company shall notify
the Trustee of the name and address of any such Agent. If the Company fails to
maintain a Registrar or Paying Agent, or fails to give the foregoing

                                      -12-
<PAGE>

notice, the Trustee shall act as such, and shall be entitled to appropriate
compensation in accordance with Section 6.07 hereof.

         The Company initially appoints the Trustee as Registrar, Paying Agent
and agent for service of notices and demands in connection with the Securities.

SECTION 2.05. PAYING AGENT TO HOLD MONEY IN TRUST.

         On or prior to the due date of principal of, premium, if any, and
interest on any Securities, the Company shall deposit with the Trustee or the
Paying Agent money sufficient to pay such principal, premium, if any, and
interest becoming due. The Company shall require each Paying Agent other than
the Trustee to agree in writing that the Paying Agent shall hold in trust for
the benefit of the Holders or the Trustee all money held by the Paying Agent for
the payment of principal of, premium, if any, and interest on the Securities,
and shall notify the Trustee of any Default by the Company in making any such
payment. While any such Default continues, the Trustee may require a Paying
Agent to pay all money held by it to the Trustee. The Company at any time may
require a Paying Agent to pay all money held by it to the Trustee. Upon payment
over to the Trustee, the Paying Agent (if other than the Company) shall have no
further liability for the money delivered to the Trustee. If the Company acts as
Paying Agent, it shall segregate and hold in a separate trust fund for the
benefit of the Holders all money held by it as Paying Agent.

SECTION 2.06. HOLDER LISTS.

         The Trustee shall preserve in as current a form as is reasonably
practicable the most recent list available to it of the names and addresses of
Holders and shall otherwise comply with TIA Section 312(a). If the Trustee is
not the Registrar, the Company shall furnish to the Trustee at least seven
Business Days before each interest payment date and at such other times as the
Trustee may request in writing a list in such form and as of such date as the
Trustee may reasonably require of the names and addresses of Holders, including
the aggregate principal amount of the Securities held by each thereof, and the
Company shall otherwise comply with TIA Section 312(a).

SECTION 2.07. TRANSFER AND EXCHANGE.

         When Securities are presented to the Registrar with a request to
register the transfer or to exchange them for an equal principal amount of
Securities of other denominations, the Registrar shall register the transfer or
make the exchange if its requirements for such transactions are met; PROVIDED,
HOWEVER, that any Security presented or surrendered for registration of transfer
or exchange shall be duly endorsed or accompanied by a written instruction of
transfer in form satisfactory to the Registrar and the Trustee duly executed by
the Holder thereof or by his attorney duly authorized in writing. To permit
registrations of transfer and exchanges, the Company shall issue and the Trustee
shall authenticate Securities at the Registrar's request, subject to such rules
as the Trustee may reasonably require.

         Neither the Company nor the Registrar shall be required to register the
transfer or exchange of a Security between the record date and the next
succeeding interest payment date.

         No service charge shall be made to any Holder for any registration of
transfer or exchange (except as otherwise expressly permitted herein), but the
Company may require payment of a sum sufficient to cover any transfer tax or
similar governmental charge payable in connection therewith (other than such
transfer tax or similar governmental charge payable upon exchanges pursuant to
Sections 2.12 or 8.05 hereof, which shall be paid by the Company).

                                      -13-
<PAGE>

         Notwithstanding the foregoing, a Global Security may not be transferred
except as a whole by the Depositary to a nominee of the Depositary or any such
nominee to a successor of the Depositary or a nominee of such successor, unless:

                  (i) the Depositary is at any time unwilling or unable to
         continue as depository or if at any time the Depositary ceases to be a
         clearing agency registered under the Exchange Act and a successor
         depository is not appointed by the Company within 90 days,

                  (ii) an Event of Default under this Indenture with respect to
         the Securities has occurred and is continuing and the beneficial owners
         representing a majority in principal amount of the Securities advise
         the Depositary to cease acting as depositary or

                  (iii) the Company, in its sole discretion, determines at any
         time that the Securities shall no longer be represented by a Global
         Security, the Company will issue individual Securities of the
         applicable amount and in certificated form in exchange for a Global
         Security. In any such instance, an owner of a beneficial interest in
         the Global Security will be entitled to physical delivery of individual
         securities in certificated form of like tenor, equal in principal
         amount to such beneficial interest and to have such Securities in
         certificated form registered in its name.

SECTION 2.08. PERSONS DEEMED OWNERS.

         Prior to due presentment for registration of transfer of any Security,
the Trustee, any Agent and the Company may deem and treat the Person in whose
name any Security is registered as the absolute owner of such Security for the
purpose of receiving payment of principal of, premium, if any, and interest on
such Security and for all other purposes whatsoever, whether or not such
Security is overdue, and neither the Trustee, any Agent nor the Company shall be
affected by notice to the contrary.

         So long as the Depositary or its nominee is the registered Holder of a
Global Security, the Depositary or its nominee, as the case may be, will be
treated as the sole owner of it for all purposes under the Indenture and the
beneficial owners of the Securities will be entitled only to those rights and
benefits afforded to them in accordance with the Depositary's regular operating
procedures. Except as provided in Section 2.07, owners of beneficial interests
in a Global Security will not be entitled to have Securities represented by a
Global Security registered in their names, will not receive or be entitled to
receive physical delivery of Securities in certificated form and will not be
considered the registered Holders thereof under the Indenture.

         None of the Company, the Trustee, any Paying Agent or the Registrar
will have any responsibility or liability for any aspect of the records relating
to or payments made on account of beneficial ownership interests of a Global
Security or for maintaining, supervising or reviewing any records relating to
such beneficial ownership interests.

SECTION 2.09. REPLACEMENT SECURITIES.

         If any mutilated Security is surrendered to the Trustee or the Company,
or the Trustee receives evidence to its satisfaction of the destruction, loss or
theft of any Security, the Company shall issue and the Trustee, upon the written
order of the Company signed by two Officers of the Company, shall authenticate a
replacement Security if the Trustee's requirements for replacements of
Securities are met. If required by the Trustee or the Company, an indemnity bond
must be supplied by the Holder that is sufficient in the judgment of the Trustee
and the Company to protect the Company, the Trustee, any

                                       -14-
<PAGE>

Agent and any authenticating agent from any loss which any of them may suffer if
a Security is replaced. Each of the Company and the Trustee may charge for its
expenses in replacing a Security.

         Every replacement Security is an additional obligation of the Company.

SECTION 2.10. OUTSTANDING SECURITIES.

         The Securities outstanding at any time are all the Securities
authenticated by the Trustee except for those cancelled by it, those delivered
to it for cancellation and those described in this Section as not outstanding.

         If a Security is replaced pursuant to Section 2.09 hereof, it ceases to
be outstanding unless the Trustee receives proof satisfactory to it that the
replaced Security is held by a bona fide purchaser.

         If the principal amount of any Security is considered paid under
Section 3.01 hereof, it ceases to be outstanding and interest on it ceases to
accrue.

         Subject to Section 2.11 hereof, a Security does not cease to be
outstanding because the Company or an Affiliate of the Company holds the
Security.

SECTION 2.11. TREASURY SECURITIES.

         In determining whether the Holders of the required principal amount of
Securities then outstanding have concurred in any demand, direction, waiver or
consent, Securities owned by the Company or any Affiliate of the Company shall
be considered as though not outstanding, except that for purposes of determining
whether the Trustee shall be protected in relying on any such demand, direction,
waiver or consent, only Securities that a Responsible Officer actually knows to
be so owned shall be so considered. Notwithstanding the foregoing, Securities
that are to be acquired by the Company or an Affiliate of the Company pursuant
to an exchange offer, tender offer or other agreement shall not be deemed to be
owned by the Company or an Affiliate of the Company until legal title to such
Securities passes to the Company or such Affiliate, as the case may be.

SECTION 2.12. TEMPORARY SECURITIES.

         Until definitive Securities are ready for delivery, the Company may
prepare and the Trustee, upon receipt of the written order of the Company signed
by two Officers of the Company, shall authenticate temporary Securities.
Temporary Securities shall be substantially in the form of definitive Securities
but may have variations that the Company and the Trustee consider appropriate
for temporary Securities. Without unreasonable delay, the Company shall prepare
and the Trustee, upon receipt of the written order of the Company signed by two
Officers of the Company, shall authenticate definitive Securities in exchange
for temporary Securities. Until such exchange, temporary Securities shall be
entitled to the same rights, benefits and privileges as definitive Securities.

SECTION 2.13. CANCELLATION.

         The Company at any time may deliver Securities to the Trustee for
cancellation. The Registrar and Paying Agent shall forward to the Trustee any
Securities surrendered to them for registration of transfer, exchange or
payment. The Trustee shall cancel all Securities surrendered for registration of
transfer, exchange, payment, replacement or cancellation and shall return such
cancelled

                                      -15-
<PAGE>

Securities to the Company. The Company may not issue new Securities to replace
Securities that it has paid or that have been delivered to the Trustee for
cancellation.

SECTION 2.14. DEFAULTED INTEREST.

         If the Company defaults in a payment of interest on the Securities, it
shall pay the defaulted interest in any lawful manner plus, to the extent
lawful, interest payable on the defaulted interest, to the Persons who are
Holders on a subsequent special record date, which date shall be at the earliest
practicable date but in all events at least five Business Days prior to the
related payment date, in each case at the rate provided in the Securities and in
Section 3.01 hereof. The Company shall, with the consent of the Trustee, fix or
cause to be fixed each such special record date and payment date. At least 15
days before the special record date, the Company (or the Trustee, in the name of
and at the expense of the Company) shall mail to Holders a notice that states
the special record date, the related payment date and the amount of such
interest to be paid.

SECTION 2.15. RECORD DATE.

         The record date for purposes of determining the identity of Holders
entitled to vote or consent to any action by vote or consent authorized or
permitted under this Indenture shall be determined as provided for in TIA
Section 316(c).

SECTION 2.16. CUSIP NUMBER.

         The Company in issuing the Securities may use a "CUSIP" number, and if
it does so, the Trustee shall use the CUSIP number in notices to Holders;
PROVIDED that any such notice may state that no representation is made as to the
correctness or accuracy of the CUSIP number printed in the notice or on the
Securities and that reliance may be placed only on the other identification
numbers printed on the Securities. The Company shall promptly notify the Trustee
of any change in the CUSIP number.

                                    ARTICLE 3
                                    COVENANTS

SECTION 3.01. PAYMENT OF SECURITIES.

         The Company shall pay or cause to be paid the principal of, premium, if
any, and interest on the Securities on the dates and in the manner provided in
this Indenture and the Securities. Principal, premium, if any, and interest
shall be considered paid on the date due if the Paying Agent, if other than the
Company or a Subsidiary of the Company, holds as of 10:00 a.m. Eastern Time on
the due date money deposited by the Company in immediately available funds and
designated for and sufficient to pay all principal, premium, if any, and
interest then due. Such Paying Agent shall return to the Company, no later than
five days following the date of payment, any money (including accrued interest)
that exceeds such amount of principal, premium, if any, and interest to be paid
on the Securities.

         The Company shall pay interest (including post-petition interest in any
proceeding under any Bankruptcy Law) on overdue principal at the rate equal to
1% per annum in excess of the interest rate then applicable to the Securities to
the extent lawful. In addition, it shall pay interest (including post-petition
interest in any proceeding under any Bankruptcy Law) on overdue installments of
interest (without regard to any applicable grace period) at the same rate to the
extent lawful.

                                       -16-
<PAGE>

SECTION 3.02. - MANTENANCE OF OFFICE OR AGENCY

         The Company shall maintain in the Borough of Manhattan, the City of New
York, an office or agency (which may be an office of the Trustee or an affiliate
of the Trustee, Registrar or co-registrar) where Securities may be surrendered
for registration of transfer or exchange and where notices and demands to or
upon the Company in respect of the Securities and this Indenture may be served.
The Company shall give prompt written notice to the Trustee of the location, and
any change in the location, of such office or agency. If at any time the Company
shall fail to maintain any such required office or agency or shall fail to
furnish the Trustee with the address thereof, such presentations, surrenders,
notices and demands may be made or served at the Corporate Trust Office of the
Trustee.

         The Company may also from time to time designate one or more other
offices or agencies where the Securities may be presented or surrendered for any
or all such purposes and may from time to time rescind such designations;
PROVIDED, HOWEVER, that no such designation or rescission shall in any manner
relieve the Company of its obligation to maintain an office or agency in the
Borough of Manhattan, the City of New York for such purposes. The Company shall
give prompt written notice to the Trustee of any such designation or rescission
and of any change in the location of any such other office or agency.

         The Company hereby designates The Bank of New York, 101 Barclay Street,
21 West, New York, New York 10286 as one such office or agency of the Company in
accordance with Section 2.04 hereof

SECT10N 3.03. COMMISSION REPORTS

                  (i) So long as any of the Securities remain outstanding, the
         Company shall provide to the Trustee within 15 days after the filing
         thereof with the Commission copies of the annual reports and of the
         information, documents and other reports (or copies of such portions of
         any of the foregoing as the Commission may by rules and regulations
         prescribe) that the Company is required to file with the Commission
         pursuant to Section 13 or 15(d) of the Exchange Act. All obligors on
         the Securities shall comply with the provisions of TIA Section 314(a).
         Notwithstanding that the Company may not be subject to the reporting
         requirements of Section 13 or 15(d) of the Exchange Act or otherwise
         report on an annual and quarterly basis on forms provided for such
         annual and quarterly reporting pursuant to rules and regulations
         promulgated by the Commission, the Company shall file with the
         Commission and provide to the Trustee (a) within 90 days after the end
         of each fiscal year, annual reports on Form I O-K (or any successor or
         comparable form) containing the information required to be contained
         therein (or required in such successor or comparable form), including a
         "MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND
         RESULTS of OPERATIONS" and a report thereon by the Company's certified
         public accountants; (b) within 45 days after the end of each of the
         first three fiscal quarters of each fiscal year, reports on Form IO-Q
         (or any successor or comparable form) containing the information
         required to be contained therein (or required in any successor or
         comparable form), including a "Management's Discussion and Analysis of
         Financial Condition and Results of Operations"; and (c) promptly from
         time to time after the occurrence of an event required to be therein
         reported, such other reports on Form 8-K (or any successor or
         comparable form) containing the information required to be contained
         therein (or required in any successor or comparable form); PROVIDED,
         HOWEVER, that the Company shall not be in default of the provisions of
         this Section 3.03(i) for any failure to file reports with the
         Commission solely by the refusal of the Commission to accept the same
         for filing. Each of the financial statements contained in such reports
         shall be prepared in accordance with GAAP.

                                       -17-
<PAGE>

                  (ii) The Trustee, at the Company's request and expense, shall
         promptly mail copies of all such annual reports, information, documents
         and other reports provided to the Trustee pursuant to Section 3.03(i)
         hereof to the Holders at their addresses appearing in the register of
         Securities maintained by the Registrar.

                  (iii) Whether or not required by the rules and regulations of
         the Commission, the Company shall file a copy of all such information
         and reports with the Commission for public availability and make such
         information available to securities analysts and prospective investors
         upon request.

                  (iv) The Company shall provide the Trustee with a sufficient
         number of copies of all reports and other documents and information
         that the Trustee may be required to deliver to the Holders under this
         Section 3.03.

                  (v) Delivery of such reports, information and documents to the
         Trustee is for informational purposes only and the Trustee's receipt of
         such shall not constitute constructive notice of any information
         contained therein or determinable from information contained therein,
         including the Company's compliance with any of its covenants hereunder
         (as to which the Trustee is entitled to rely exclusively on Officers'
         Certificates).

SECTION 3.04. COMPLIANCE CERTIFICATE.

                  i) The Company shall deliver to the Trustee, within 120 days
         after the end of each fiscal year, an Officers' Certificate stating
         that a review of the activities of the Company and its Subsidiaries
         during the preceding fiscal year has been made under the supervision of
         the signing Officers with a view to determining whether each has kept,
         observed, performed and fulfilled its obligations under this Indenture,
         and further stating, as to each such Officer signing such certificate,
         that to the best of his or her knowledge each entity has kept,
         observed, performed and fulfilled each and every covenant contained in
         this Indenture and is not in default in the performance or observance
         of any of the terms, provisions and conditions of this Indenture (or,
         if a Default or Event of Default shall have occurred, describing all
         such Defaults or Events of Default of which he or she may have
         knowledge and what action each is taking or proposes to take with
         respect thereto), all without regard to periods of grace or notice
         requirements, and that to the best of his or her knowledge no event has
         occurred and remains in existence by reason of which payments on
         account of the principal of or interest, if any, on the Securities is
         prohibited or if such event has occurred, a description of the event
         and what action each is taking or proposes to take with respect
         thereto.

                  (ii) So long as not contrary to the then current
         recommendations of the American Institute of Certified Public
         Accountants, the year-end financial statements delivered pursuant to
         Section 3.03 above shall be accompanied by a written statement of the
         Company's certified independent public accountants (who shall be a firm
         of established national reputation) that in making the examination
         necessary for certification of such financial statements nothing has
         come to their attention which would lead them to believe that the
         Company or any Subsidiary of the Company has violated any provisions of
         Article 3 or of Article 4 of this Indenture or, if any such violation
         has occurred, specifying the nature and period of existence thereof, it
         being understood that such accountants shall not be liable directly or
         indirectly to any person for any failure to obtain knowledge of any
         such violation.

                                       -18-
<PAGE>

                  (iii) The Company shall, so long as any of the Securities are
         outstanding, deliver to the Trustee, forthwith upon any Officer
         becoming aware of (a) any Default or Event of Default or (b) any event
         of default under any other mortgage, indenture or instrument referred
         to in Section 5.01(v) hereof, an Officers' Certificate specifying such
         Default, Event of Default or event of default and what action the
         Company is taking or proposes to take with respect thereto.

SECTION 3.05. TAXES.

         The Company shall pay, and shall cause each of its Subsidiaries to pay,
prior to delinquency, all material taxes, assessments, and governmental levies
except (i) as contested in good faith by appropriate proceedings and with
respect to which appropriate reserves have been taken in accordance with GAAP or
(ii) where the failure to effect such payment is not adverse in any material
respect to the Holders.

SECTION 3.06. STAY, EXTENSION AND USURY LAWS.

         The Company covenants (to the extent that it may lawfully do so) that
it shall not at any time insist upon, plead, or in any manner whatsoever claim
or take the benefit or advantage of, any stay, extension or usury law wherever
enacted, now or at any time hereafter in force, that may affect the covenants or
the performance of this Indenture; and the Company (to the extent that it may
lawfully do so) hereby expressly waives all benefit or advantage of any such
law, and covenants that it shall not, by resort to any such law, hinder, delay
or impede the execution of any power herein granted to the Trustee, but shall
suffer and permit the execution of every such power as though no such law has
been enacted.

SECTION 3.07. LIMITATIONS ON RESTRICTED PAYMENTS.

         The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly: (i) declare or pay any dividend or make any distribution
on account of the Company's or any of its Subsidiaries' Equity Interests (other
than (w) Physician Joint Venture Distributions (x) dividends or distributions
payable in Qualified Equity Interests of the Company, (y) dividends or
distributions payable to the Company or any Subsidiary of the Company, and (z)
dividends or. distributions by any Subsidiary of the Company payable to all
holders of a class of Equity Interests of such Subsidiary on a PRO RATA basis);
(ii) purchase, redeem or otherwise acquire or retire for value any Equity
Interests of the Company; or (iii) make any principal payment on, or purchase,
redeem, defease or otherwise acquire or retire for value any Indebtedness that
is subordinated to the Securities, except at the original final maturity date
thereof or pursuant to a Specified Exchange or the Refinancing (all such
payments and other actions set forth in clauses (i) through (iii) above being
collectively referred to as "RESTRICTED PAYMENTS"), unless, at the time of and
after giving effect to such Restricted Payment (the amount of any such
Restricted Payment, if other than cash, shall be the fair market value (as
conclusively evidenced by a resolution of the Board of Directors set forth in an
Officers' Certificate delivered to the Trustee within 60 days prior to the date
of such Restricted Payment) of the asset(s) proposed to be transferred by the
Company or such Subsidiary, as the case may be, pursuant to such Restricted
Payment):

                  (a) no Default or Event of Default shall have occurred and be
         continuing or would occur as a consequence thereof; and

                  (b) the Company would, at the time of such Restricted Payment
         and after giving PRO FORMA effect thereto as if such Restricted Payment
         had been made at the beginning of the most recently ended four full
         fiscal quarter period for which internal financial statements are
         available immediately preceding the date of such Restricted Payment,
         have been permitted to incur at least

                                      -19-
<PAGE>

         $1.00 of additional Indebtedness pursuant to the Fixed Charge Coverage
         Ratio test set forth in the first paragraph of Section 3.09 hereof; and

                  (c) such Restricted Payment, together with the aggregate of
         all other Restricted Payments made by the Company and its Subsidiaries
         after March 1, 1995 (excluding Restricted Payments permitted by clauses
         (ii), (iii) and (iv) of the next succeeding paragraph), is less than
         the sum of (1) 50% of the Consolidated Net Income of the Company for
         the period (taken as one accounting period) from the beginning of the
         first fiscal quarter commencing after March 1, 1995 to the end of the
         Company's most recently ended fiscal quarter for which internal
         financial statements are available at the time of such Restricted
         Payment (or, if such Consolidated Net Income for such period is a
         deficit, less 100% of such deficit), PLUS (2) 100% of the aggregate net
         cash proceeds received by the Company from the issue or sale (other
         than to a Subsidiary of the Company) since March 1, 1995 of Qualified
         Equity Interests of the Company or of debt securities of the Company or
         any of its Subsidiaries that have been converted into or exchanged for
         such Qualified Equity Interests of the Company, PLUS (3) $20.0 million.

                  If no Default or Event of Default has occurred and is
continuing, or would occur as a consequence thereof, the foregoing provisions
shall not prohibit the following Restricted Payments:

                  (i) the payment of any dividend within 60 days after the date
         of declaration thereof, if at said date of declaration such payment
         would have complied with the provisions hereof;

                  (ii) the payment of cash dividends on any series of
         Disqualified Stock issued after the Closing Date in an aggregate amount
         not to exceed the cash received by the Company since the Closing Date
         upon issuance of such Disqualified Stock;

                  (iii) the redemption, repurchase, retirement or other
         acquisition of any Equity Interests of the Company or any Subsidiary in
         exchange for, or out of the net cash proceeds of, the substantially
         concurrent sale (other than to a Subsidiary of the Company) of
         Qualified Equity Interests of the Company; PROVIDED that the amount of
         any such net cash proceeds that are utilized for any such redemption,
         repurchase, retirement or other acquisition shall be excluded from
         clause (c)(2) of the preceding paragraph;

                   (iv) the defeasance, redemption or repurchase of subordinated
          Indebtedness with the net cash proceeds from an incurrence of
          Permitted Refinancing Indebtedness or in exchange for or out of the
          net cash proceeds from the substantially concurrent sale (other than
          to a Subsidiary of the Company) of Qualified Equity Interests of the
          Company; PROVIDED that the amount of any such net cash proceeds that
          are utilized for any such redemption, repurchase, retirement or other
          acquisition shall be excluded from clause (c)(2) of the preceding
          paragraph;

                  (v) the repurchase, redemption or other acquisition or
         retirement for value of any Equity Interests of the Company or any
         Subsidiary of the Company held by any member of the Company's (or any
         of its Subsidiaries') management pursuant to any management equity
         subscription agreement or stock option agreement; PROVIDED that the
         aggregate price paid for all such repurchased, redeemed, acquired or
         retired Equity Interests shall not exceed $15.0 million in any
         twelve-month period; and

                   (vi) the making and consummation of (A) a senior subordinated
          asset sale offer in accordance with the provisions of the indenture
          relating to the 2005 Senior Subordinated Notes or (B) a Change of
          Control Offer with respect to the Senior Subordinated Notes in
          accordance

                                        -20-
<PAGE>

         with the provisions of the Senior Subordinated Note Indenture or
         change of control offer with respect to the 2005 Senior Subordinated
         Notes or the 2005 Exchangeable Subordinated Notes in accordance with
         the provisions of the indentures relating thereto.

                  Not later than the date of making any Restricted Payment, the
Company shall deliver to the Trustee an Officers' Certificate stating that such
Restricted Payment is permitted and setting forth the basis upon which the
calculations required by this covenant were computed.

SECTION 3.08. LIMITATIONS ON DIVIDEND AND 0THER PAYMENT RESTRICTIONS
              AFFECTING SUBSIDIARIES

         The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly, create or otherwise cause or suffer to exist or become
effective any consensual Transfer Restriction, except for such Transfer
Restrictions existing under or by reason of:

                  (a) Existing Indebtedness as in effect on the Closing Date,

                  (b) this Indenture, the Senior Subordinated Note Indenture and
         the Indenture relating to the Company's 8% Senior Notes due 2005,

                  (c) applicable law,

                  (d) any instrument governing Indebtedness or Capital Stock of
         a Person acquired by the Company or any of its Subsidiaries as in
         effect at the time of such acquisition (except to the extent such
         Indebtedness was incurred in connection with or in contemplation of
         such acquisition, unless such Indebtedness was incurred in connection
         with or in contemplation of such acquisition for the purpose of
         refinancing Indebtedness which was tax-exempt, or in violation of
         Section 3.09 hereof), which encumbrance or restriction is not
         applicable to any Person, or the properties or assets of any Person,
         other than the Person, or the property or assets of the Person, so
         acquired, PROVIDED that the Consolidated Cash Flow of such Person shall
         not be taken into account in determining whether such acquisition was
         permitted by the terms hereof except to the extent that such
         Consolidated Cash Flow would be permitted to be dividends to the
         Company without the prior consent or approval of any third party,

                  (e) customary non-assignment provisions in leases entered into
         in the ordinary course of business,

                  (f) purchase money obligations for property acquired in the
         ordinary course of business that impose restrictions on the ability of
         any of the Company's Subsidiaries to transfer the property so acquired
         to the Company or any of its Subsidiaries,

                  (g) Permitted Refinancing Indebtedness, PROVIDED that the
         restrictions contained in the agreements governing such Permitted
         Refinancing Indebtedness are no more restrictive than those contained
         in the agreements governing the Indebtedness being refinanced, or

                  (h) the New Credit Facility and related documentation as the
         same is in effect on the Closing Date as amended or replaced from time
         to time, PROVIDED that no such amendment or replacement is more
         restrictive as to Transfer Restrictions than the New Credit Facility
         and related documentation as in effect on the Closing Date.

                                         -21-
<PAGE>

SECTION 3.09. LIMITATIONS ON INCURRENCE OF INDEBTEDNESS AND ISSUANCE OF
              PREFERRED STOCK.

         The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly, create, incur, issue, assume, Guarantee or otherwise
become directly or indirectly liable, contingently or otherwise, with respect to
(collectively, "INCUR") after the Closing Date any Indebtedness (including
Acquired Debt), and the Company shall not issue any Disqualified Stock and shall
not permit any of its Subsidiaries to issue any shares of preferred stock;
PROVIDED, HOWEVER, that the Company may incur Indebtedness (including Acquired
Debt) and the Company may issue shares of Disqualified Stock if the Fixed Charge
Coverage Ratio for the Company's most recently ended four full fiscal quarters
for which internal financial statements are available immediately preceding the
date on which, such additional Indebtedness is incurred or such Disqualified
Stock is issued would have been" at least 2.5 to 1, determined on a pro forma
basis (including a PRO FORMA application of the net proceeds therefrom), as if
the additional Indebtedness had been incurred or the Disqualified Stock had been
issued, as the case may be, at the beginning of such four-quarter period.
Indebtedness consisting of reimbursement obligations in respect of a letter of
credit shall be deemed to be incurred when the letter of credit is first issued.

         The foregoing provisions shall not apply to:

                  (a) the incurrence by the Company of Indebtedness pursuant to
         the New Credit Facility in an aggregate principal amount at any time
         outstanding not to exceed an amount equal to $2.8 billion less the
         aggregate amount of all mandatory repayments applied to permanently
         reduce the commitments with respect to such Indebtedness;

                  (b) the incurrence by the Company of Indebtedness represented
         by the Securities, the 8% Senior Notes due 2005 and the Senior
         Subordinated Notes;

                  (c) the incurrence by the Company and its Subsidiaries of the
         Existing Indebtedness;

                  (d) the incurrence by the Company or any of its Subsidiaries
         of Permitted Refinancing Indebtedness in exchange for, or the net
         proceeds of which are used to extend, refinance, renew, replace,
         defease or refund, Indebtedness that was permitted by this Indenture to
         be incurred (including, without limitation, Existing Indebtedness);

                  (e) the incurrence by the Company of Hedging Obligations that
         are incurred for the purpose of fixing or hedging interest rate or
         currency risk with respect to any fixed or floating rate Indebtedness
         that is permitted by the terms hereof to be outstanding or any
         receivable or liability the payment of which is determined by reference
         to a foreign currency; PROVIDED that the notional principal amount of
         any such Hedging Obligation does not exceed the principal amount of the
         Indebtedness to which such Hedging Obligation relates;

                  (f) the incurrence by the Company or any of its Subsidiaries
         of Physician Support Obligations;

                  (g) the incurrence by the Company or any of its Subsidiaries
         of intercompany Indebtedness between or among the Company and any of
         its Subsidiaries;

                  (h) the incurrence by the Company or any of its Subsidiaries
         of Indebtedness represented by tender, bid, performance, government
         contract, surety or appeal bonds, standby

                                       -22-
<PAGE>

         letters of credit or warranty or contractual service obligations of
         like nature, in each case to the extent incurred in the ordinary course
         of business of the Company or such Subsidiary;

                  (i) the incurrence by any Subsidiary of the Company of
         Indebtedness, the aggregate principal amount of which, together with
         all other Indebtedness of the Company's Subsidiaries at the time
         outstanding (excluding the Existing Indebtedness until repaid or
         refinanced and excluding Physician Support Obligations), does not
         exceed the greater of (1) 10% of the Company's Stockholders' Equity as
         of the date of incurrence or (2) $ 10.0 million; PROVIDED that, in the
         case of clause (1) only, the Fixed Charge Coverage Ratio for the
         Company's most recently ended four full fiscal quarters for which
         internal financial statements are available immediately preceding the
         date on which such Indebtedness is incurred would have been at least
         2.5 to 1, determined on a PRO FORMA basis (including a PRO FORMA
         application of the net proceeds therefrom), as if such Indebtedness had
         been incurred at the beginning of such four-quarter period; and

                  j) the incurrence by the Company of Indebtedness (in addition
         to Indebtedness permitted by any other clause of this covenant) in an
         aggregate principal amount at any time outstanding not to exceed $250.0
         million.

SECTION 3.10. LIMITATIONS ON TRANSACTIONS WITH AFFILIATES

         The Company shall not, and shall not permit any of its Subsidiaries to,
sell, lease, transfer or otherwise dispose of any of its properties or assets
to, or purchase any property or assets from, or enter into or make any contract,
agreement, understanding, loan, advance or Guarantee with, or for the benefit
of, any Affiliate (each of the foregoing, an "AFFILIATE TRANSACTION", unless (i)
such Affiliate Transaction, is on terms that are no less favorable to the
Company or the relevant Subsidiary than those that could have been obtained in a
comparable transaction by the Company or such Subsidiary with an unrelated
Person and (ii) the Company delivers to the Trustee (a) with respect to any
Affiliate Transaction involving aggregate consideration in excess of $5.0
million, a resolution of the Board of Directors set forth in an Officers'
Certificate certifying that such Affiliate Transaction complies with clause (i)
above and that such Affiliate Transaction was approved by a majority of the
disinterested members of the Board of Directors and (b) with respect to any
Affiliate Transaction involving aggregate consideration in excess of $15.0
million, an opinion as to the fairness to the Company or such Subsidiary of such
Affiliate Transaction from a financial point of view issued by an investment
banking firm of national standing; PROVIDED that (x) transactions or payments
pursuant to any employment arrangements or employee or director benefit plans
entered into by the Company or any of its Subsidiaries in the ordinary course of
business and consistent with the past practice of the Company or such
Subsidiary, (y) transactions between or among the Company and/or its
Subsidiaries and (z) transactions permitted under Section 3.07 hereof, in each
case, shall not be deemed to be Affiliate Transactions.

SECTION 3.11. LIMITATIONS ON LIENS.

         The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly, create, incur, assume or suffer to exist any Lien
(except Permitted Liens) on any asset now owned or hereafter acquired, or any
income or profits therefrom or assign or convey any right to receive income
therefrom unless all payments due hereunder and under the Securities are secured
on an equal and ratable basis with the Obligations so secured until such time as
such Obligations are no longer secured by a Lien.

                                      -23-
<PAGE>

SECTION 3.12. CHANGE OF CONTROL.

         Upon the occurrence of a Change of Control Triggering Event, each
Holder of Securities shall have the right to require the Company to repurchase
all or any part (equal to $1,000 or an integral multiple thereof) of such
Holder's Securities pursuant to the offer described below (the "CHANGE OF
CONTROL OFFER") at an offer price in cash equal to 101% of the aggregate
principal amount thereof plus accrued and unpaid interest, if any, thereon to
the date of purchase (the "CHANGE OF CONTROL PAYMENT") on a date that is not
more than 90 days after the occurrence of such Change of Control Triggering
Event (the "CHANGE OF CONTROL PAYMENT DATE").

         Within 30 days following any Change of Control Triggering Event, the
Company shall mail, or at the Company's request the Trustee shall mail, a notice
of a Change of Control to each Holder (at its last registered address with a
copy to the Trustee and the Paying Agent) offering to repurchase the
Securities held by such Holder pursuant to the procedure specified in such
notice. The Change of Control Offer shall remain open from the time of mailing
until the close of business on the Business Day next preceding the Change of
Control Payment Date. The notice, which shall govern the terms of the Change of
Control Offer, shall contain all instructions and materials necessary to enable
the Holders to tender Securities pursuant to the Change of Control Offer and
shall state:

                  (1) that the Change of Control Offer is being made pursuant to
         this Section 3.12 and that all Securities tendered will be accepted for
         payment;

                  (2) the Change of Control Payment and the Change of Control
         Payment Date, which date shall be no earlier than 30 days nor later
         than 60 days from the date such notice is mailed;

                  (3) that any Security not tendered will continue to accrue
         interest in accordance with the terms of this Indenture;

                  (4) that, unless the Company defaults in the payment of the
         Change of Control Payment, all Securities accepted for payment pursuant
         to the Change of Control Offer will cease to accrue interest after the
         Change of Control Payment Date;

                  (5) that Holders electing to have a Security purchased
         pursuant to any Change of Control Offer will be required to surrender
         the Security, with the form entitled "Option of Holder to Elect
         Purchase" on the reverse of the Security completed, to the Company, a
         depositary, if appointed by the Company, or a Paying Agent at the
         address specified in the notice prior to the close of business on the
         Business Day next preceding the Change of Control Payment Date;

                  (6) that Holders will be entitled to withdraw their election
         if the Company, depositary or Paying Agent, as the case may be,
         receives, not later than the close of business on the Business Day next
         preceding the Change of Control Payment Date, a facsimile transmission
         or letter setting forth the name of the Holder, the principal amount of
         the Security the Holder delivered for purchase, and a statement that
         such Holder is withdrawing his election to have such Security
         purchased;

                  (7) that Holders whose Securities are being purchased only in
         part will be issued new Securities equal in principal amount to the
         unpurchased portion of the securities surrendered, which unpurchased
         portion must be equal to $1,000 in principal amount or an integral
         multiple thereof, and

                                      -24-
<PAGE>

                  (8) the circumstances and relevant facts regarding such Change
         of Control (including, but not limited to, information with respect to
         PRO FORMA historical financial information after giving effect to such
         Change of Control, information regarding the Person or Persons
         acquiring control and such Person's or Persons' business plans going
         forward) and any other information that would be material to a decision
         as to whether to tender a Security pursuant to the Change of Control
         Offer.

         On the Change of Control Payment Date, the Company shall, to the extent
lawful, (i) accept for payment all Securities or portions thereof properly
tendered and not withdrawn pursuant to the Change of Control Offer, (ii) deposit
with the Paying Agent an amount equal to the Change of Control Payment in
respect of all Securities or portions thereof so tendered and (iii) deliver or
cause to be delivered to the Trustee the Securities so accepted together with an
Officers' Certificate stating the aggregate principal amount of Securities or
portions thereof being purchased by the Company. The Paying Agent shall promptly
mail to each Holder of Securities so tendered the Change of Control Payment for
such Securities, and the Trustee shall promptly authenticate and mail (or cause
to be transferred by book entry) to each Holder a new Security equal in
principal amount to any unpurchased portion of the Securities surrendered, if
any; PROVIDED that each such new Security shall be in a principal amount of
$1,000 or an integral multiple thereof. The Company shall publicly announce the
results of the Change of Control Offer on or as soon as practicable after the
Change of Control Payment Date.

         The Company shall comply with the requirements of Rule 14e-1 under the
Exchange Act and any other securities laws and regulations thereunder to the
extent such laws and regulations are applicable in connection with the
repurchase of Securities as a result of a Change of Control Triggering Event.

SECTION 3.13. CORPORATE EXISTENCE.

         Subject to Section 3.12 and Article 4 hereof, the Company shall do or
cause to be done all things necessary to preserve and keep in full force and
effect (i) its corporate existence, and the corporate, partnership or other
existence of each of its Subsidiaries, in accordance with the respective
organizational documents (as the same may be amended from time to time) of each
Subsidiary and (ii) the rights (charter and statutory), licenses and franchises
of the Company and its Subsidiaries; PROVIDED, HOWEVER, that the Company shall
not be required to preserve any such right, license or franchise, or the
corporate, partnership or other existence of any of its Subsidiaries, if the
Board of Directors shall determine that the preservation thereof is no longer
desirable in the conduct of the business of the Company and its Subsidiaries,
taken as a whole, and that the loss thereof is not adverse in any material
respect to the Holders.

SECTION 3.14. LINE OF BUSINESS.

         The Company shall not, and shall not permit any of its Subsidiaries to,
engage in any material extent in any business other than the ownership,
operation and management of Hospitals and Related Businesses.

SECTION 3.15. LIMITATIONS ON ISSUANCES OF GUARANTEES OF INDEBTEDNESS BY
              SUBSIDIARIES.

         The Company shall not permit any Subsidiary, directly or indirectly, to
Guarantee or secure the payment of any other Indebtedness of the Company or any
of its Subsidiaries (except Indebtedness of a Subsidiary of such Subsidiary or
Physician Support Obligations) unless such

                                      -25-
<PAGE>

Subsidiary simultaneously executes and delivers a supplemental indenture to this
Indenture, in substantially the form attached hereto as Exhibit B, providing for
the Guarantee of the payment of the Securities by such Subsidiary, which
Guarantee shall be senior to or PARI PASSU with such Subsidiary's Guarantee of
or pledge to secure such other Indebtedness. Notwithstanding the foregoing, any
such Guarantee by a Subsidiary of the Securities shall provide by its terms that
it shall be automatically and unconditionally released and discharged upon the
sale or other disposition, by way of merger or otherwise, to any Person not an
Affiliate of the Company, of all of the Company's stock in, or all or
substantially all the assets of, such Subsidiary. The foregoing provisions shall
not be applicable to any one or more Guarantees that otherwise would be
prohibited of up to $25.0 million in aggregate principal amount of Indebtedness
of the Company or its Subsidiaries at any time outstanding.

SECTION 3.16. NO AMENDMENT TO SUBORDINATION PROVISIONS OF SENIOR SUBORDINATED
              NOTE INDENTURE.

         The Company shall not amend, modify or alter the Senior Subordinated
Note Indenture or the indentures relating to the 2005 Senior Subordinated Notes
or the 2005 Exchangeable Subordinated Notes in any way that would (i) increase
the principal of, advance the final maturity date of or shorten the Weighted
Average Life to Maturity of (a) any 2005 Senior Subordinated Notes or 2005
Exchangeable Subordinated Notes or (b) any Senior Subordinated Notes such that
the final maturity date of the Senior Subordinated Notes is earlier than the
91st day following the final maturity date of the Senior Notes or (ii) amend the
provisions of Article 10 of the Senior Subordinated Note Indenture (which
relates to subordination) or the subordination provisions of the indentures
relating to the 2005 Senior Subordinated Notes or the 2005 Exchangeable
Subordinated Notes or any of the defined terms used therein in a manner that
would be adverse to the Holders of the Securities.

                                    ARTICLE 4

                                   SUCCESSORS

SECTION 4.01. LIMITATIONS ON MERGERS, CONSOLIDATIONS OR SALES OF ASSETS.

         The Company may not consolidate or merge with or into (whether or not
the Company is the surviving corporation), or sell, assign, transfer, lease,
convey or otherwise dispose of all or substantially all of its properties or
assets in one or more related transactions, to another corporation, Person or
entity unless:

                  (i) the Company is the surviving corporation or the entity or
         the Person formed by or surviving any such consolidation or merger (if
         other than the Company) or to which such sale, assignment, transfer,
         lease, conveyance or other disposition shall have been made is a
         corporation organized or existing under the laws of the United States,
         any state thereof or the District of Columbia;

                  (ii) the entity or Person formed by or surviving any such
         consolidation or merger (if other than the Company) or the entity or
         Person to which such sale, assignment, transfer, lease, conveyance or
         other disposition shall have been made assumes all the Obligations of
         the Company under this Indenture and the Securities pursuant to a
         supplemental indenture in a form reasonably satisfactory to the
         Trustee; and

                  (iii) immediately after such transaction no Default or Event
         of Default exists,

                                      -26-
<PAGE>

                  (iv) the Company or the entity or Person formed by or
         surviving any such consolidation or merger (if other than the Company),
         or to which such sale, assignment, transfer, lease, conveyance or other
         disposition shall have been made (A) shall have a Consolidated Net
         Worth immediately after the transaction equal to or greater than the
         Consolidated Net Worth of the Company immediately preceding the
         transaction and (B) shall, at the time of such transaction and after
         giving PRO FORMA effect thereto as if such transaction had occurred at
         the beginning of the applicable four-quarter period, be permitted to
         incur at least $1.00 of additional Indebtedness pursuant to the Fixed
         Charge Coverage Ratio test set forth in the first paragraph of Section
         3.09 hereof.

         The Company shall deliver to the Trustee prior to the consummation of
the proposed transaction an Officers' Certificate to the foregoing effect and an
Opinion of Counsel, covering clauses (i) through (iv) above, stating that the
proposed transaction and such supplemental indenture comply with this Indenture.
The Trustee shall be entitled to conclusively rely upon such Officers'
Certificate and Opinion of Counsel.

SECTION 4.02. SUCCESSOR CORPORATION SUBSTITUTED.

         Upon any consolidation or merger, or any sale, assignment, transfer,
lease, conveyance or other disposition of all or substantially all of the assets
of the Company in accordance with Section 4.01 hereof, the successor corporation
formed by such consolidation or into or with which the Company is merged or to
which such sale, assignment, transfer, lease, conveyance or other disposition is
made shall succeed to, and be substituted for (so that from and after the date
of such consolidation, merger, sale, assignment, transfer, lease, conveyance or
other disposition, the provisions of this Indenture referring to the "Company"
shall refer instead to the successor corporation), and may exercise every right
and power of, the Company under this Indenture with the same effect as if such
successor Person has been named as the Company, herein.

                                    ARTICLE 5
                              DEFAULTS AND REMEDIES

SECTION 5.01. EVENTS OF DEFAULT

         Each of the following constitutes an "EVENT OF DEFAULT":

                  (i) default for 30 days in the payment when due of interest on
         the Securities;

                  (ii) default in payment when due of the principal of or
         premium, if any, on the Securities at maturity or otherwise;

                  (iii) failure by the Company to comply with the provisions of
         Sections 3.07, 3.09 or 3.12 hereof;

                  (iv) failure by the Company to comply with any other covenant
         or agreement in the Indenture or the Securities for the period and
         after the notice specified below;

                  (v) any default that occurs under any mortgage, indenture or
         instrument under which there may be issued or by which there may be
         secured or evidenced any Indebtedness for money borrowed by the Company
         or any of its Significant Subsidiaries (or the payment of which is

                                         -27-
<PAGE>

         Guaranteed by the Company or any of its Significant Subsidiaries),
         whether such Indebtedness or Guarantee exists on the Closing Date or is
         created after the Closing Date, which default (a) constitutes a Payment
         Default or (b) results in the acceleration of such Indebtedness prior
         to its express maturity and, in each case, the principal amount of any
         such Indebtedness, together with the principal amount of any other such
         Indebtedness under which there has been a Payment Default or that has
         been so accelerated, aggregates $25.0 million or more;

                  (vi) failure by the Company or any of its Significant
         Subsidiaries to pay a final judgment or final judgments aggregating in
         excess of $25.0 million entered by a court or courts of competent
         jurisdiction against the Company or any of its Significant Subsidiaries
         if such final judgment or judgments remain unpaid or undischarged for a
         period (during which execution shall not be effectively stayed) of 60
         days after their entry;

                  (vii) the Company or any Significant Subsidiary thereof
         pursuant to or within the meaning of any Bankruptcy Law:

                           (a) commences a voluntary case,

                           (b) consents to the entry of an order for relief
                  against it in an involuntary case in which it is the debtor,

                           (c) consents to the appointment of a Custodian of it
                  or for all or substantially all of its property,

                           (d) makes a general assignment for the benefit of its
                  creditors, or

                           (e) admits in writing its inability generally to pay
                  its debts as the same become due; and

                  (viii) a court of competent jurisdiction enters an order or
         decree under any Bankruptcy Law that:

                           (a) is for relief against the Company or any
                  Significant Subsidiary thereof in an involuntary case in which
                  it is the debtor,

                           (b) appoints a Custodian of the Company or any
                  Significant Subsidiary thereof or for all or substantially all
                  of the property of the Company or any Significant Subsidiary
                  thereof, or

                           (c) orders the liquidation of the Company or any
                  Significant Subsidiary thereof, and the order or decree
                  remains unstayed and in effect for 60 days.

         The term "BANKRUPTCY LAW" means title 11, U.S. Code or any similar
federal or state law for the relief of debtors. The term "CUSTODIAN " means any
receiver, trustee, assignee, liquidator or similar official under any Bankruptcy
Law.

         A Default under clause (iv) is not an Event of Default until the
Trustee notifies the Company in writing, or the Holders of at least 25% in
principal amount of the then outstanding Securities notify the Company and the
Trustee in writing, of the Default and the Company does not cure the Default

                                      -28-
<PAGE>

within 60 days after receipt of such notice. The written notice must specify the
Default, demand that it be remedied and state that the notice is a "NOTICE OF
DEFAULT.

SECTION 5.02. ACCELERATION.

         If any Event of Default (other than an Event of Default specified in
clause (vii) or (viii) of Section 5.01 hereof) occurs and is continuing, the
Trustee by notice to the Company, or the Holders of at least 25% in principal
amount of the then outstanding Securities by written notice to the Company and
the Trustee, may declare the unpaid principal of, premium, if any, and any
accrued and unpaid interest on all the Securities to be due and payable
immediately. Upon such declaration the principal, premium, if any, and interest
shall be due and payable immediately. If an Event of Default specified in clause
(vii) or (viii) of Section 5.01 hereof occurs with respect to the Company or any
Significant Subsidiary thereof such an amount shall IPSO FACTO become and be
immediately due and payable without further action or notice on the part of the
Trustee or any Holder.

         If an Event of Default occurs under this Indenture prior to the
maturity of the Securities by reason of any willful action (or inaction) taken
(or not taken) by or on behalf of the Company with the intention of avoiding the
prohibition on redemption of such Securities prior to the date of maturity, then
a premium with respect thereto (expressed as a percentage of the amount that
would otherwise be due but for the provisions of this sentence) shall also
become and be immediately due and payable to the extent permitted by law upon
the acceleration of such Securities if such Event of Default occurs during the
twelve-month period beginning on January 15 of the years set forth below:

       Year                                                 Percentage
       ----                                                 ----------
       1997 .................................................107.875%
       1998 .................................................106.300%
       1999 .................................................104.725%
       2000 .................................................103.150%
       2001 .................................................101.575%
       2002 .................................................100.000%

         Any determination regarding the primary purpose of any such action or
inaction, as the case may be, shall be made by and set forth in a resolution of
the Board of Directors (including the concurrence of a majority of the
independent directors of the Company then serving) delivered to the Trustee
after consideration of the business reasons for such action or inaction, other
than the avoidance of payment of such premium or prohibition on redemption. In
the absence of fraud, each such determination shall be final and binding upon
the Holders of Securities. Subject to Section 6.01 hereof, the Trustee shall be
entitled to rely on the determination set forth in any such resolutions
delivered to the Trustee.

SECTION 5.03. OTHER REMEDIES.

         If an Event of Default occurs and is continuing, the Trustee may pursue
any available remedy to collect the payment of principal or interest on the
Securities or to enforce the performance of any provision of the Securities or
this Indenture.

         The Trustee may maintain a proceeding even if it does not possess any
of the Securities or does not produce any of them in the proceeding. A delay or
omission by the Trustee or any Holder in exercising any right or remedy accruing
upon an Event of Default shall not impair the right or remedy or

                                      -29-
<PAGE>

constitute a waiver of or acquiescence in the Event of Default. All remedies are
cumulative to the extent permitted by law.

SECTION 5.04. WAIVER OF PAST DEFAULTS

         The Holders of not less than a majority in aggregate principal amount
of the Securities then outstanding by written notice to the Trustee may on
behalf of the Holders of all of the Securities waive any existing Default or
Event of Default and its consequences under this Indenture except a continuing
Default or Event of Default in the payment of the principal of, premium, if any,
or interest on any Security. Upon any such waiver, such Default shall cease to
exist, and any Event of Default arising therefrom shall be deemed to have been
cured for every purpose of this Indenture; but no such waiver shall extend to
any subsequent or other Default or impair any right consequent thereon.

SECTION 5.05. CONTROL BY MAJORITY

         Holders of a majority in principal amount of the then outstanding
Securities shall have the right to direct the time, method and place of
conducting any proceeding for exercising any remedy available to the Trustee or
exercising any trust or power conferred on it. However, the Trustee may refuse
to follow any direction that conflicts with law or this Indenture that the
Trustee determines may be unduly prejudicial to the rights of other Holders or
that may involve the Trustee in personal liability. The Trustee may take any
other action which it deems proper which is not inconsistent with any such
direction.

SECTION 5.06. LIMITATION ON SUITS.

         A Holder may pursue a remedy with respect to this Indenture or the
Securities only if:

                  (i) the Holder gives to the Trustee written notice of a
         continuing Event of Default;

                  (ii) the Holders of at least 25% in principal amount of the
         then outstanding Securities make a written request to the Trustee to
         pursue the remedy;

                  (iii) such Holder or Holders offer and, if requested, provide
         to the Trustee indemnity satisfactory to the Trustee against any loss,
         liability or expense;

                  (iv) the Trustee does not comply with the request within 60
         days after receipt of the request and the offer and, if requested, the
         provision of indemnity; and

                  (v) during such 60-day period the Holders of a majority in
         principal amount of the then outstanding Securities do not give the
         Trustee a direction inconsistent with the request.

         A Holder may not use this Indenture to prejudice the rights of another
Holder or to obtain a preference or priority over another Holder.

SECTION 5.07. RIGHTS OF HOLDERS TO RECEIVE PAYMENT

         Notwithstanding any other provision of this Indenture, the right of any
Holder to receive payment of principal, premium, if any, and interest on the
Security, on or after the respective due dates expressed in the Security, or to
bring suit for the enforcement of any such payment on or after such respective
dates, shall not be impaired or affected without the consent of the Holder.

                                      -30-
<PAGE>

SECTION 5.08. COLLECTION SUIT BY TRUSTEE.

         If an Event of Default specified in Section 5.01(i) or (ii) hereof
occurs and is continuing, the Trustee is authorized to recover judgment in its
own name and as trustee of an express trust against the Company or any other
obligor for the whole amount of principal, premium, if any, and interest
remaining unpaid on the Securities and interest on overdue principal and, to the
extent lawful, interest and such further amount as shall be sufficient to cover
amounts due the Trustee under Section 6.07 hereof, including the costs and
expenses of collection, including the reasonable compensation, expenses,
disbursements and advances of the Trustee, its agents and counsel.

SECTION 5.09. TRUSTEE MAY FILE PROOFS OF CLAIM.

         The Trustee is authorized to file such proofs of claim and other papers
or documents as may be necessary or advisable in order to have the claims of the
Trustee (including any claim for the reasonable compensation, expenses,
disbursements and advances of the Trustee, its agents and counsel) and the
Holders allowed in any judicial proceedings relative to the Company (or any
other obligor upon the Securities), its creditors or its property and shall be
entitled and empowered to collect, receive and distribute any money or other
property payable or deliverable on any such claims and any custodian in any such
judicial proceeding is hereby authorized by each Holder to make such payments to
the Trustee, and in the event that the Trustee shall consent to the making of
such payments directly to the Holders, to pay to the Trustee any amount due to
it for the reasonable compensation, expenses, disbursements and advances of the
Trustee, its agents and counsel, and any other amounts due the Trustee under
Section 6.07 hereof. To the extent that the payment of any such compensation,
expenses, disbursements and advances of the Trustee, its agents and counsel, and
any other amounts due the Trustee under Section 6.07 hereof out of the estate in
any such proceeding, shall be denied for any reason, payment of the same shall
be secured by a Lien on, and shall be paid out of, any and all distributions,
dividends, money, securities and other properties which the Holders may be
entitled to receive in such proceeding whether in liquidation or under any plan
of reorganization or arrangement or otherwise. Nothing herein contained shall be
deemed to authorize the Trustee to authorize or consent to or accept or adopt on
behalf of any Holder any plan of reorganization, arrangement, adjustment or
composition affecting the Securities or the rights of any Holder thereof, or to
authorize the Trustee to vote in respect of the claim of any Holder in any such
proceeding.

SECTION 5.10. PRIORITIES.

         If the Trustee collects any money pursuant to this Article, it shall
pay out the money in the following order:

         First: to the Trustee, its agents and attorneys for amounts due under
Section 6.07, including payment of all compensation, expense and liabilities
incurred, and all advances made, by the Trustee and the costs and expenses of
collection;

         Second: to Holders for amounts due and unpaid on the Securities for
principal, premium, if any, and interest, ratably, without preference or
priority of any kind, according to the amounts due and payable on the Securities
for principal, premium, if any and interest, respectively; and

         Third: to the Company or to such party as a court of competent
jurisdiction shall direct.

         The Trustee may fix a record date and payment date for any payment to
Holders pursuant to this Section 5.10 upon five Business Days prior notice to
the Company.

                                      -31-
<PAGE>

SECTION 5.11. UNDERTAKING FOR COSTS.

         In any suit for the enforcement of any right or remedy under this
Indenture or in any suit against the Trustee for any action taken or omitted by
it as a Trustee, a court in its discretion may require the filing by any party
litigant in the suit of an undertaking to pay the costs of the suit, and the
court in its discretion may assess reasonable costs, including reasonable
attorneys' fees and expenses, against any party litigant in the suit, having due
regard to the merits and good faith of the claims or defenses made by the party
litigant. This Section does not apply to a suit by the Trustee, a suit by a
Holder pursuant to Section 5.07 hereof, or a suit by Holders of more than 10% in
principal amount of the then outstanding Securities.

                                    ARTICLE 6
                                     TRUSTEE

SECTION 6.01. DUTIES OF TRUSTEE.

                  (i) If an Event of Default has occurred and is continuing, the
         Trustee shall exercise such of the rights and powers vested in it by
         this Indenture, and use the same degree of care and skill in their
         exercise, as a prudent man would exercise or use under the
         circumstances in the conduct of his own affairs.

                  (ii) Except during the continuance of an Event of Default
         known to the Trustee:

                           (a) the duties of the Trustee shall be determined
                  solely by the express provisions of this Indenture or the TIA
                  and the Trustee need perform only those duties that are
                  specifically set forth in this Indenture or the TIA and no
                  others, and no implied covenants or obligations shall be read
                  into this Indenture against the Trustee, and

                           (b) in the absence of bad faith on its part, the
                  Trustee may conclusively rely, as to the truth of the
                  statements and the correctness of the opinions expressed
                  therein, upon certificates or opinions furnished to the
                  Trustee and conforming to the requirements of this Indenture.
                  However, in the case of any such certificates or opinions
                  which by any provisions hereof are required to be furnished to
                  the Trustee, the Trustee shall examine the certificates and
                  opinions to determine whether or not they conform to the
                  requirements of this Indenture.

                  (iii) The Trustee may not be relieved from liabilities for its
         own negligent action, its own negligent failure to act, or its own
         willful misconduct, except that:

                           (a) this paragraph does not limit the effect of
                  paragraph (ii) of this Section;

                           (b) the Trustee shall not be liable for any error of
                  judgment made in good faith by a Responsible Officer, unless
                  it is proved that the Trustee was negligent in ascertaining
                  the pertinent facts; and

                           (c) the Trustee shall not be liable with respect to
                  any action it takes or omits to take in good faith in
                  accordance with a direction received by it pursuant to Section
                  5.05 hereof.

                                      -32-
<PAGE>

                  (iv) Whether or not therein expressly so provided every
         provision of this Indenture that in any way relates to the Trustee is
         subject to paragraphs (i), (ii), and (iii) of this Section.

                  (v) No provision of this Indenture shall require the Trustee
         to expend or risk its own funds or incur any liability. The Trustee may
         refuse to perform any duty or exercise any right or power unless it
         receives security and indemnity satisfactory to it against any loss,
         liability or expense.

                  (vi) The Trustee shall not be liable for interest on any money
         received by it except as the Trustee may agree in writing with the
         Company. Absent written instruction from the Company, the Trustee shall
         not be required to invest any such money. Money held in trust by the
         Trustee need not be segregated from other funds except to the extent
         required by law.

                  (vii) The Trustee shall not be deemed to have knowledge of any
         matter unless such matter is actually known to a Responsible Officer.

SECTION 6.02. RIGHTS OF TRUSTEE.

                  (i) The Trustee may conclusively rely upon any document
         believed by it to be genuine and to have been signed or presented by
         the proper Person. The Trustee need not investigate any fact or matter
         stated in the document.

                  (ii) Before the Trustee acts or refrains from acting, it may
         require an Officers' Certificate or an Opinion of Counsel or both. The
         Trustee shall not be liable for any action it takes or omits to take in
         good faith in reliance on such Officers' Certificate or Opinion of
         Counsel. The Trustee may consult with counsel and the written advice of
         such counsel or any Opinion of Counsel shall be full and complete
         authorization and protection from liability in respect of any action
         taken, suffered or omitted by it hereunder in good faith and in
         reliance thereon.

                  (iii) The Trustee may act through its attorneys and agents and
         shall not be responsible for the misconduct or negligence of any agent
         appointed with due care.

                  (iv) The Trustee shall not be liable for any action it takes
         or omits to take in good faith which it believes to be authorized or
         within its rights or powers conferred upon it by this Indenture. A
         permissive right granted to the Trustee hereunder shall not be deemed
         an obligation to act.

                  (v) Unless otherwise specifically provided in this Indenture,
         any demand, request, direction or notice from the Company shall be
         sufficient if signed by an Officer of the Company.

SECTION 6.03. INDIVIDUAL RIGHTS OF TRUSTEE.

         The Trustee in its individual or any other capacity may become the
owner or pledge of Securities and may otherwise deal with the Company or any
Affiliate of the Company with the same rights it would have if it were not
Trustee. Any Agent may do the same with like rights. However, the Trustee is
subject to Sections 6.10 and 6.11 hereof

                                      -33-
<PAGE>

SECTION 6.04. TRUSTEE'S DISCLAIMER.

         The Trustee shall not be responsible for and makes no representation as
to the validity or adequacy of this Indenture or the Securities, nor shall it be
accountable for the Company's use of the proceeds from the Securities or any
money paid to the Company or upon the Company's direction under any provision of
this Indenture, nor shall it be responsible for the use or application of any
money received by any Paying Agent other than the Trustee, nor shall it be
responsible for any statement or recital herein or any statement in the
Securities or any other document in connection with the sale of the Securities
or pursuant to this Indenture other than its certificate of authentication.

SECTION 6.05. NOTICE OF DEFAULTS.

         If a Default or Event of Default occurs and is continuing and if it is
known to the Trustee, the Trustee shall mail to Holders a notice of the Default
or Event of Default within 90 days after it occurs. Except in the case of a
Default or Event of Default in payment on any Security, the Trustee may withhold
the notice if and so long as a committee of its Responsible Officers in good
faith determines that withholding the notice is in the interests of the Holders.

SECTION 6.06. REPORTS BY TRUSTEE TO HOLDERS.

         Within 60 days after each December 31 beginning with the December 31
following the Closing Date, the Trustee shall mail to the Holders a brief report
dated as of such reporting date that complies with TIA Section 313(a) (but if no
event described in TIA Section 313(a) has occurred within the twelve months
preceding the reporting date, no report need be transmitted). The Trustee also
shall comply with TIA Section 313(b). The Trustee shall also transmit by mail
all reports as required by TIA Section 313(c).

         A copy of each report at the time of its mailing to the Holders shall
be mailed to the Company and filed with the Commission and each stock exchange
on which the Securities are listed. The Company shall promptly notify the
Trustee when the Securities are listed on any stock exchange.

SECTION 6.07. COMPENSATION AND INDEMNITY.

         The Company shall pay to the Trustee from time to time such
compensation for its acceptance of this Indenture and services hereunder as the
Company and Trustee shall agree in writing. The Trustee's compensation shall not
be limited by any law on compensation of a trustee of an express trust. The
Company shall reimburse the Trustee promptly upon request for all reasonable
disbursements, advances and expenses incurred or made by it in addition to the
compensation for its services. Such expenses shall include the reasonable
compensation, disbursements and expenses of the Trustee's agents and counsel.

         The Company shall indemnify the Trustee against any and all losses,
liabilities, damages, claims or expenses incurred by it arising out of or in
connection with the acceptance of its duties and the administration of the
trusts under this Indenture, except as set forth below. The Trustee shall notify
the Company promptly of any claim for which it may seek indemnity. Failure by
the Trustee to so notify the Company shall not relieve the Company of its
obligations hereunder. The Company shall defend the claim and the Trustee shall
cooperate in the defense. The Trustee may have separate counsel and the Company
shall pay the reasonable fees and expenses of such counsel. The Company need not
pay for any settlement made without its consent, which consent shall not be
unreasonably withheld.

                                      -34-
<PAGE>

         The obligations of the Company under this Section 6.07 shall survive
the satisfaction and discharge of this Indenture.

         The Company need not reimburse any expense or indemnify against any
loss or liability incurred by the Trustee through its own negligence or bad
faith.

         To secure the Company's payment obligations in this Section, the
Trustee shall have a Lien prior to the Securities on all money or property held
or collected by the Trustee, except that held in trust to pay principal and
interest on particular Securities. Such Lien shall survive the satisfaction and
discharge of this Indenture.

         When the Trustee incurs expenses or renders services after an Event of
Default specified in Section 5.01 (vii) or (viii) hereof occurs, the expenses
and the compensation for the services (including the fees and expenses of its
agents and counsel) are intended to constitute expenses of administration under
any Bankruptcy Law.

SECTION 6.08. REPLACEMENT OF TRUSTEE.

         A resignation or removal of the Trustee and appointment of a successor
Trustee shall become effective only upon the successor Trustee's acceptance of
appointment as provided in this Section.

         The Trustee may resign in writing at any time and be discharged from
the trust hereby created by so notifying the Company. The Holders of a majority
in principal amount of the then outstanding Securities may remove the Trustee by
so notifying the Trustee and the Company in writing. The Company may remove the
Trustee if:

                  (1) the Trustee fails to comply with Section 6.10 hereof;

                  (2) the Trustee is adjudged a bankrupt or an insolvent or an
         order for relief is entered with respect to the Trustee under any
         Bankruptcy Law,

                  (3) a Custodian or public officer takes charge of the Trustee
         or its property; or

                  (4) the Trustee becomes incapable of acting.

         If the Trustee resigns or is removed or if a vacancy exists in the
office of Trustee for any reason, the Company shall promptly appoint a successor
Trustee. Within one year after the successor Trustee takes office, the Holders
of a majority in principal amount of the then outstanding Securities may appoint
a successor Trustee to replace the successor Trustee appointed by the Company.

         If a successor Trustee does not take office within 60 days after the
retiring Trustee resigns or is removed, the retiring Trustee, the Company, or
the Holders of at least 10% in principal amount of the then outstanding
Securities may petition any court of competent jurisdiction for the appointment
of a successor Trustee.

         If the Trustee after written request by any Holder who has been a
Holder for at least six months fails to comply with Section 6.10 hereof, such
Holder may petition any court of competent jurisdiction for the removal of the
Trustee and the appointment of a successor Trustee.

                                      -35-
<PAGE>

         A successor Trustee shall deliver a written acceptance of its
appointment to the retiring Trustee and to the Company. Thereupon, the
resignation or removal of the retiring Trustee shall become effective, and the
successor Trustee shall have all the rights, powers and duties of the Trustee
under this Indenture. The successor Trustee shall mail a notice of its
succession to Holders. The retiring Trustee shall promptly transfer all property
held by it as Trustee to the successor Trustee, provided all sums owing to the
Trustee hereunder have been paid and subject to the Lien provided for in Section
6.07 hereof. Notwithstanding replacement of the Trustee pursuant to this Section
6,08, the Company's obligations under Section 6.07 hereof shall continue for the
benefit of the retiring Trustee.

SECTION 6.09. SUCCESSOR TRUSTEE OR AGENT BY MERGER, ETC.

         If the Trustee or any Agent consolidates, merges or converts into, or
transfers all or substantially all of its corporate trust business to, another
corporation, the successor corporation without any further act shall be the
successor Trustee or Agent.

SECTION 6.10. ELIGIBILITY; DISQUALIFICATION.

         There shall at all times be a Trustee hereunder which shall be a
corporation organized and doing business under the laws of the United States of
America or of any state thereof authorized under such laws to exercise corporate
trustee power, shall be subject to supervision or examination by federal or
state authority and shall have a combined capital and surplus of at least $100.0
million as set forth in its most recent published annual report of condition.

         This Indenture shall always have a Trustee who satisfies the
requirements of TIA Section 310(a)(1),(2) and (5). The Trustee is subject to
TIA Section 310(b).

SECTION 6.11. PREFERENTIAL COLLECTION OF CLAIMS AGAINST COMPANY.

         The Trustee is subject to TIA Section 311 (a), excluding any creditor
relationship listed in TIA Section 31l(b). A Trustee who has resigned or been
removed shall be subject to TIA Section 311(a) to the extent indicated
therein.

                                    ARTICLE 7
                             DISCHARGE OF INDENTURE

SECTION 7.01. DEFEASANCE AND DISCHARGE OF THIS INDENTURE AND THE SECURITIES.

         The Company may, at the option of its Board of Directors evidenced by a
resolution set forth in an Officers' Certificate, at any time, with respect to
the Securities, elect to have either Section 7.02 or 7.03 hereof be applied to
all outstanding Securities upon compliance with the conditions set forth below
in this Article 7.

SECTION 7.02. LEGAL DEFEASANCE AND DISCHARGE.

         Upon the Company's exercise under Section 7.01 hereof of the option
applicable to this Section 7.02, the Company shall be deemed to have been
discharged from its obligations with respect to all outstanding Securities on
the date the conditions set forth below are satisfied (hereinafter, "LEGAL
DEFEASANCE "). For this purpose, such Legal Defeasance means that the
Company shall be deemed to

                                      -36-
<PAGE>

have paid and discharged the entire Indebtedness represented by the outstanding
Securities, which shall thereafter be deemed to be "outstanding" only for the
purposes of Section 7.05 hereof and the other Sections of this Indenture
referred to in clauses (i) and (ii) of this Section 7.02, and to have satisfied
all its other obligations under such Securities and this Indenture (and the
Trustee, on demand of and at the expense of the Company, shall execute proper
instruments acknowledging the same), except for the following provisions which
shall survive until otherwise terminated or discharged hereunder: (i) the rights
of Holders of outstanding Securities to receive solely from the trust fund
described in Section 7.04 hereof, and as more fully set forth in such Section,
payments in respect of the principal of, premium, if any, and interest on such
Securities when such payments are due, (ii) the Company's obligations with
respect to such Securities under Sections 2.04, 2.06, 2.07 and 3.02 hereof,
(iii) the rights, powers, trusts, duties and immunities of the Trustee
hereunder, including, without limitation, the Trustee's rights under Section
6.07 hereof, and the Company's obligations in connection therewith and (iv) this
Article 7. Subject to compliance with this Article 7, the Company may exercise
its option under this Section 7.02 notwithstanding the prior exercise of its
option under Section 7.03 hereof with respect to the Securities.

SECTION 7.03. COVENANT DEFEASANCE.

         Upon the Company's exercise under Section 7.01 hereof of the option
applicable to this Section 7.03, the Company shall be released from its
obligations under the covenants contained in Sections 3.07, 3.08, 3.09, 3.10,
3.11, 3.12, 3.14, 3.15, and 3.16 and Article 4 hereof with respect to the
outstanding Securities on and after the date the conditions set forth below are
satisfied (hereinafter, "COVENANT DEFEASANCE "), and the Securities shall
thereafter be deemed not "outstanding" for the purposes of any direction,
waiver, consent or declaration or act of Holders (and the consequences of any
thereof) in connection with such covenants, but shall continue to be deemed
"outstanding" for all other purposes hereunder (it being understood that such
Securities shall not be deemed outstanding for accounting purposes). For this
purpose, such Covenant Defeasance means that, with respect to the outstanding
Securities, the Company may omit to comply with and shall have no liability in
respect of any term, condition or limitation set forth in any such covenant,
whether directly or indirectly, by reason of any reference elsewhere herein to
any such covenant or by reason of any reference in any such covenant to any
other provision herein or in any other document and such omission to comply
shall not constitute a Default or an Event of Default under Section 5.01(iii)
hereof, but, except as specified above, the remainder of this Indenture and such
Securities shall be unaffected thereby. In addition, upon the Company's exercise
under Section 7.01 hereof of the option applicable to this Section 7.03,
Sections 5.01(iv) through 5.01(vi) hereof shall not constitute Events of
Default.

SECTION 7.04. CONDITIONS TO LEGAL OR COVENANT DEFEASANCE.

         The following shall be the conditions to application of either Section
7.02 or Section 7.03 hereof to the outstanding Securities:

                  (i) The Company shall irrevocably have deposited or caused to
         be deposited with the Trustee (or another trustee satisfying the
         requirements of Section 6.10 who shall agree to comply with the
         provisions of this Article 7 applicable to it) as trust funds in trust
         for the purpose of making the following payments, specifically pledged
         as security for, and dedicated solely to, the benefit of the Holders of
         such Securities, (a) cash in U.S. Dollars in an amount, or (b)
         non-callable Government Securities that through the scheduled payment
         of principal and interest in respect thereof in accordance with their
         terms will provide, not later than one day before the due date of any
         payment, cash in U.S. Dollars in an amount, or (c) a combination
         thereof, in such amounts as will be sufficient, in the opinion of a
         nationally recognized firm of independent public accountants expressed
         in a written certification thereof delivered to the Trustee, to pay

                                      -37-
<PAGE>

         and discharge and which shall be applied by the Trustee (or other
         qualifying trustee) to pay and discharge the principal of, premium, if
         any, and interest on such outstanding Securities on the stated maturity
         date of such principal or installment of principal, premium, if any, or
         interest.

                  (ii) In the case of an election under Section 7.02 hereof, the
         Company shall have delivered to the Trustee an Opinion of Counsel in
         the United States confirming that (a) the Company has received from, or
         there has been published by, the Internal Revenue Service a ruling or
         (b) since the Closing Date, there has been a change in the applicable
         federal income tax law, in either case to the effect that, and based
         thereon such Opinion of Counsel shall confirm that, the Holders of the
         outstanding Securities will not recognize income, gain or loss for
         federal income tax purposes as a result of such Legal Defeasance and
         will be subject to federal income tax on the same amounts, in the same
         manner and at the same times as would have been the case if such Legal
         Defeasance had not occurred.

                  (iii) In the case of an election under Section 7.03 hereof
         before the date that is one year prior to the final maturity of the
         Securities, the Company shall have delivered to the Trustee an Opinion
         of Counsel in the United States confirming that the Holders of the
         outstanding Securities will not recognize income, gain or loss for
         federal income tax purposes as a result of such Covenant Defeasance and
         will be subject to federal income tax on the same amounts, in the same
         manner and at the same times as would have been the case if such
         Covenant Defeasance had not occurred.

                  (iv) No Default or Event of Default with respect to the
         Securities shall have occurred and be continuing on the date of such
         deposit (other than a Default or Event of Default resulting from the
         borrowing of funds to be applied to such deposit) or, insofar as
         Section 5.01(vii) or 5.01(viii) hereof is concerned, at any time in
         the period ending on the 91st day after the date of such deposit (it
         being understood that this condition shall not be deemed satisfied
         until the expiration of such period).

                  (v) Such Legal Defeasance or Covenant Defeasance shall not
         result in a breach or violation of, or constitute a default under any
         material agreement or instrument (other than this Indenture) to which
         the Company or any of its Subsidiaries is a party or by which the
         Company or any of its Subsidiaries is bound (other than a breach,
         violation or default resulting from the borrowing of funds to be
         applied to such deposit).

                  (vi) The Company shall have delivered to the Trustee an
         Opinion of Counsel to the effect that after the 91st day following the
         deposit, the trust funds will not be subject to the effect of any
         applicable bankruptcy, insolvency, reorganization or similar laws
         affecting creditors' rights generally.

                  (vii) The Company shall have delivered to the Trustee an
         Officers' Certificate stating that the deposit made by the Company
         pursuant to its election under Section 7.02 or 7.03 hereof was not made
         by the Company with the intent of preferring the Holders of the
         Securities over the other creditors of the Company with the intent of
         defeating, hindering, delaying or defrauding creditors of the Company
         or others.

                  (viii) The Company shall have delivered to the Trustee an
         Officers' Certificate stating that all conditions precedent provided
         for relating to either the Legal Defeasance under Section 7.02 hereof
         or the Covenant Defeasance under Section 7.03 hereof (as the case may
         be) have been complied with as contemplated by this Section 7.04.

                                      -38-
<PAGE>

SECTION 7.05. DEPOSITED MONEY AND G0VERNMENT SECURITIES TO BE HELD IN
              TRUST; OTHER MISCELLANEOUS PROVISIONS.

         Subject to Section 7.06 hereof, all money and non-callable Government
Securities (including the proceeds thereof) deposited with the Trustee (or other
qualifying trustee, collectively for purposes of this Section 7.05, the
"Trustee") pursuant to Section 7.04 hereof in respect of the outstanding
Securities shall be held in trust and applied by the Trustee, in accordance with
the provisions of such Securities and this Indenture, to the payment, either
directly or through any paying Agent (including the Company acting as Paying
Agent) as the Trustee may determine, to the Holders of such Securities of all
sums due and to become due thereon in respect of principal, premium, if any, and
interest, but such money need not be segregated from other funds except to the
extent required by law.

         The Company shall pay and indemnify the Trustee against any tax, fee or
other charge imposed on or assessed against the cash or non-callable Government
Securities deposited pursuant to Section 7.04 hereof or the principal and
interest received in respect thereof other than any such tax, fee or other
charge which by law is for the account of the Holders of the outstanding
Securities.

         Anything in this Article 7 to the contrary notwithstanding, the Trustee
shall deliver or pay to the Company from time to time upon the Company's request
any money or non-callable Government Securities held by it as provided in
Section 7.04 hereof which, in the opinion of a nationally recognized firm of
independent public accountants expressed in a written certification thereof
delivered to the Trustee (which may be the opinion delivered under Section
7.04(i) hereof), are in excess of the amount thereof which would then be
required to be deposited to effect an equivalent Legal Defeasance or Covenant
Defeasance.

SECTION 7.06. REPAYMENT TO COMPANY.

         Any money deposited with the Trustee or any Paying Agent, or then held
by the Company, in trust for the payment of the principal of, premium, if any,
or interest on any Security and remaining unclaimed for two years after such
principal, and premium, if any, or interest has become due and payable shall be
paid to the Company on its written request or (if then held by the Company)
shall be discharged from such trust; and the Holder of such Security shall
thereafter, as an unsecured general creditor, look only to the Company for
payment thereof, and all liability of the Trustee or such Paying Agent with
respect to such trust money, and all liability of the Company as trustee
thereof, shall thereupon cease; PROVIDED, HOWEVER, THAT the Trustee or such
Paying Agent, before being required to make any such repayment, may at the
expense of the Company cause to be published once, in the NEW YORK TIMES and THE
WALL STREET JOURNAL National edition), notice that such money remains unclaimed
and that, after a date specified therein, which shall not be less than 30 days
from the date of such notification or publication, any unclaimed balance of such
money then remaining will be repaid to the Company.

SECTION 7.07. REINSTATEMENT.

                  If the Trustee or Paying Agent is unable to apply any U.S.
Dollars or non-callable Government Securities in accordance with Section 7.02 or
7.03 hereof, as the case may be, by reason of any order or judgment of any court
or governmental authority enjoining, restraining or otherwise prohibiting such
application, then the Company's obligations under this Indenture and the
Securities shall be revived and reinstated as though no deposit had occurred
pursuant to Section 7.02 or 7.03 hereof until such time as the Trustee or Paying
Agent is permitted to apply all such money in accordance with Section 7.02 or
7.03 hereof, as the case may be; PROVIDED, HOWEVER, that, if the Company makes
any payment of

                                      -39-
<PAGE>

principal of, premium, if any, or interest on any Security following the
reinstatement of its obligations, the Company shall be subrogated to the rights
of the Holders of such Security to receive such payment from the money held by
the Trustee or Paying Agent.

                                    ARTICLE 8
                        AMENDMENT, SUPPLEMENT AND WAIVER

SECTION 8.01. WITHOUT CONSENT OF HOLDERS.

         The Company and the Trustee may amend or supplement this Indenture or
the Securities without the consent of any Holder:

                  (i) to cure any ambiguity, defect or inconsistency;

                  (ii) to provide for uncertificated Securities in addition to
         or in place of certificated Securities;

                  (iii) to provide for any supplemental indenture required
         pursuant to Section 3.15 hereof;

                  (iv) to provide for the assumption of the Company's
         obligations to Holders of Securities in the case of a merger,
         consolidation or sale of assets pursuant to Article 4 hereof;

                  (v) to make any change that would provide any additional
         rights or benefits to the Holders of the Securities or that does not
         adversely affect the legal rights hereunder of any such Holder; or

                  (vi) to comply with requirements of the Commission in order to
         effect or maintain the qualification of this Indenture under the TIA.

         Upon the request of the Company accompanied by a resolution of its
Board of Directors authorizing the execution of any such supplemental indenture,
and upon receipt by the Trustee of the documents described in Section 8.06
hereof, the Trustee shall join with the Company in the execution of any
supplemental indenture authorized or permitted by the terms of this Indenture
and to make any further appropriate agreements and stipulations which may be
therein contained, but the Trustee shall not be obligated to enter into such
supplemental indenture which affects its own rights, duties or immunities under
this Indenture or otherwise.

SECTION 8.02. WITH CONSENT OF HOLDERS.

         Except as provided in Section 8.01 and the next succeeding paragraphs,
this Indenture or the Securities may be amended or supplemented with the consent
of the Holders of at least a majority in principal amount of the Securities then
outstanding (including consents obtained in connection with a tender offer or
exchange offer for such Securities), and any existing default or compliance with
any provision of this Indenture or the Securities may be waived with the consent
of the Holders of a majority in principal amount of the then outstanding
Securities (including consents obtained in connection with a tender offer or
exchange offer for such Securities).

                                      -40-
<PAGE>

         Upon the request of the Company accompanied by a resolution of its
Board of Directors authorizing the execution of any such supplemental indenture,
and upon the filing with the Trustee of evidence satisfactory to the Trustee of
the consent of the Holders as aforesaid, and upon receipt by the Trustee of the
documents described in Section 8.06 hereof, the Trustee shall join with the
Company in the execution of such supplemental indenture unless such supplemental
indenture affects the Trustee's own rights, duties or immunities under this
Indenture or otherwise, in which case the Trustee may in its discretion, but
shall not be obligated to, enter into such supplemental indenture.

         It shall not be necessary for the consent of the Holders under this
Section 8.02 to approve the particular form of any proposed amendment or waiver,
but it shall be sufficient if such consent approves the substance thereof.

         After an amendment, supplement or waiver under this Section becomes
effective, the Company shall mail to the Holders affected thereby a notice
briefly describing the amendment, supplement or waiver. Any failure of the
Company to mail such notice, or any defect therein, shall not, however, in any
way impair or affect the validity of any such supplemental indenture or waiver.
Subject to Sections 5.04 and 5.07 hereof, the Holders of a majority in aggregate
principal amount of the Securities then outstanding may waive compliance in a
particular instance by the Company with any provision of this Indenture or the
Securities. Without the consent of each Holder affected, however, an amendment
or waiver may not (with respect to any Security held by a non-consenting
Holder):

                  (i) reduce the principal amount of Securities whose Holders
         must consent to an amendment, supplement or waiver;

                  (ii) reduce the principal of or change the fixed maturity of
         any Security;

                  (iii) reduce the rate of or change the time for payment of
         interest on any Security;

                  (iv) waive a Default or Event of Default in the payment of
         principal of or premium, if any, or interest on the Securities (except
         a rescission of acceleration of the Securities by the Holders of at
         least a majority in aggregate principal amount thereof and a waiver of
         the payment default that resulted from such acceleration);

                  (v) make any Security payable in money other than that stated
         in the Securities;

                  (vi) make any change in Section 5.04 or 5.07 hereof, or

                  (vii) make any change in this sentence of this Section 8.02.

SECTION 8.03. COMPLIANCE WITH TIA.

         Every amendment to this Indenture or the Securities- shall be set forth
in a supplemental indenture that complies with the TIA as then in effect.

SECTION 8.04. REVOCATION AND EFFECT OF CONSENTS.

         Until an amendment or waiver becomes effective, a consent to it by a
Holder is a continuing consent by the Holder and every subsequent Holder of a
Security or portion of a Security that evidences the same debt as the consenting
Holder's Security, even if notation of the consent is not made on any Security.
However, any such Holder or subsequent Holder may revoke the consent as to its

                                      -41-
<PAGE>

Security if the Trustee receives written notice of revocation before the date
the waiver or amendment becomes effective. An amendment or waiver becomes
effective in accordance with its terms and thereafter binds every Holder.

         The Company may, but shall not be obligated to, fix a record date for
determining which Holders must consent to such amendment or waiver. If the
Company fixes a record date, the record date shall be fixed at (i) the later of
30 days prior to the first solicitation of such consent or the date of the most
recent list of Holders furnished to the Trustee prior to such solicitation
pursuant to Section 2.06 hereof or (ii) such other date as the Company shall
designate.

SECTION 8.05. NOTATION ON OR EXCHANGE OF SECURITIES.

         The Trustee may place an appropriate notation about an amendment or
waiver on any Security thereafter authenticated. The Company in exchange for all
Securities may issue and the Trustee shall authenticate new Securities that
reflect the amendment or waiver.

         Failure to make the appropriate notation or issue a new Security shall
not affect the validity and effect of such amendment or waiver.

SECTION 8.06. TRUSTEE TO SIGN AMENDMENTS, ETC.

         The Trustee shall sign any amendment or supplemental indenture
authorized pursuant to this Article 8 if the amendment does not adversely affect
the rights, duties, liabilities or immunities of the Trustee. If it does, the
Trustee may, but need not, sign it. In signing or refusing to sign such
amendment or supplemental indenture, the Trustee shall be entitled to receive
and, subject to Section 6.01, shall be fully protected in relying upon, an
Officers' Certificate and an Opinion of Counsel as conclusive evidence that such
amendment or Supplemental Indenture is authorized or permitted by this
Indenture, that it is not inconsistent herewith, and that it shall be valid and
binding upon the Company in accordance with its terms. The Company may not sign
an amendment or supplemental indenture until the Board of Directors approves it.

                                    ARTICLE 9
                                  MISCELLANEOUS

SECTION 9.01. TIA CONTROLS.

         If any provision of this Indenture limits, qualifies or conflicts with
the duties imposed by TIA Section 318(c), the imposed duties shall control.

SECTION 9.02. NOTICES.

         Any notice or communication by the Company or the Trustee to the other
is duly given if in writing and delivered in person or mailed by first class
mail (registered or certified, return receipt requested), telex, telecopier or
overnight air courier guaranteeing next day delivery, to the other's address:

                                      -42-
<PAGE>

         If to the Company:

         Tenet Healthcare Corporation
         3820 State Street
         Santa Barbara, California 93105
         Telecopier No.: (805) 563-7070
         Attention: Treasurer

         With a copy to:

         Skadden, Arps, Slate, Meagher & Flom
         300 South Grand Avenue, Suite 3400
         Los Angeles, California 90071
         Telecopier No.: (213) 687-5600
         Attention: Brian J. McCarthy

         If to the Trustee:

         The Bank of New York
         101 Barclay Street, 21 West
         New York, New York 10286
         Telecopier No.: (212) 815-5915
         Attention: Corporate Trust Trustee Administration

         The Company or the Trustee, by notice to the others may designate
additional or different addresses for subsequent notices or communications.

         All notices and communications (other than those sent to Holders) shall
be deemed to have been duly given: at the time delivered by hand, if personally
delivered; five Business Days after being deposited in the mail, postage
prepaid, if mailed; when answered back, if telexed; when receipt acknowledged,
if telecopied; and the next Business Day after timely delivery to the courier,
if sent by overnight air courier guaranteeing next day delivery.

         Unless otherwise set forth above, any notice or communication to a
Holder shall be mailed by first class mail, or by overnight air courier
guaranteeing next day delivery to its address shown on the register kept by the
Registrar. Any notice or communication shall also be so mailed to any Person
described in TIA Section 313(c), to the extent required by the TIA. Failure to
mail a notice or communication to a Holder or any defect in it shall not affect
its sufficiency with respect to other Holders.

         If a notice or communication is mailed in the manner provided above
within the time prescribed, it is duly given, whether or not the addressee
receives it.

         If the Company mails a notice or communication to Holders, it shall
mail a copy to the Trustee and each Agent at the same time.

                                      -43-
<PAGE>

SECTION 9.03. COMMUNICATION BY HOLDERS WITH OTHER HOLDERS.

         Holders may communicate pursuant to TIA Section 312(b) with other
Holders with respect to their rights under this Indenture or the Securities. The
Company, the Trustee, the Registrar and anyone else shall have the protection
of TIA Section 312(c).

SECTION 9.04. CERTIFICATE AND OPINION AS TO CONDITIONS PRECEDENT.

         Upon any request or application by the Company to the Trustee to take
any action under this Indenture, the Company shall furnish to the Trustee:

                  (1) an Officers' Certificate (which shall include the
         statements set forth in Section 9.05 hereof) stating that, in the
         opinion of the signers, all conditions precedent and covenants, if any,
         provided for in this Indenture relating to the proposed action have
         been satisfied; and

                  (2) an Opinion of Counsel (which shall include the statements
         set forth in Section 9.05 hereof) stating that, in the opinion of such
         counsel, all such conditions precedent and covenants have been
         satisfied.

SECTION 9.05. STATEMENTS REQUIRED IN CERTIFICATE OR OPINION.

         Each certificate or opinion with respect to compliance with a condition
or covenant provided for in this Indenture (other than a certificate provided
pursuant to TIA Section 314(a)(4)) shall include:

                  (1) a statement that the person making such certificate or
         opinion has read such covenant or condition;

                  (2) a brief statement as to the nature and scope of the
         examination or investigation upon which the statements or opinions
         contained in such certificate or opinion are based;

                  (3) a statement that, in the opinion of such person, he has
         made such examination or investigation as is necessary to enable him to
         express an informed opinion as to whether or not such covenant or
         condition has been satisfied; and

                  (4) a statement as to whether or not, in the opinion of such
         person, such condition or covenant has been satisfied; PROVIDED,
         HOWEVER, that with respect to matters of fact, an Opinion of Counsel
         may rely on an Officers' Certificate or certificates of public
         officials.

SECTION 9.06. RULES BY TRUSTEE AND AGENTS.

         The Trustee may make reasonable rules for action by or at a meeting of
Holders. The Registrar or Paying Agent may make reasonable rules and set
reasonable requirements for its functions.

SECTION 9.07. LEGAL HOLIDAYS.

         A "LEGAL HOLIDAY" is a Saturday, a Sunday or a day on which banking
institutions in The City of New York or at a place of payment are authorized or
obligated by law, regulation or executive order to remain closed. If a payment
date is a Legal Holiday at a place of payment, payment

                                      -44-
<PAGE>

may be made at that place on the next succeeding day that is not a Legal
Holiday, and no interest shall accrue for the intervening period.

SECTION 9.08. NO PERSONAL LIABILITY OF DIRECTORS, OFFICERS, EMPLOYEES AND
              SHAREHOLDERS.

         No director, officer, employee, incorporator or shareholder of the
Company, as such, shall have any liability for any obligations of the Company
under the Securities, the Indenture or for any claim based on, in respect of, or
by reason of, such obligations or their creation. Each Holder of the Securities
by accepting a Security waives and releases all such liability. The waiver and
release are part of the consideration for the issuance of the Securities. Such
waiver may not be effective to waive liabilities under the federal securities
laws and it is the view of the Commission that such a waiver is against public
policy.

SECTION 9.09. DUPLICATE ORIGINALS.

         The parties may sign any number of copies of this Indenture. One signed
copy is enough to prove this Indenture.

SECTION 9.10. GOVERNING LAW.

         The internal law of the State of New York, shall govern and be used to
construe this Indenture and the Securities, without regard to the conflict of
laws provisions thereof.

SECTION 9.11. NO ADVERSE INTERPRETATION OF OTHER AGREEMENTS.

         This Indenture may not be used to interpret another indenture, loan or
debt agreement of the Company or its Subsidiaries. Any such indenture, loan or
debt agreement may not be used to interpret this Indenture.

SECTION 9.12. SUCCESSORS.

         All agreements of the Company in this Indenture and the Securities
shall bind its successors. All agreements of the Trustee in this Indenture shall
bind its successor.

SECTION 9.13. SEVERABIL1TY.

         In case any provision in this Indenture or in the Securities shall be
invalid, illegal or unenforceable, the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby,
it being intended that all of the provisions hereof shall be enforceable to the
full extent permitted by law.

SECTION 9.14. COUNTERPART ORIGINALS.

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

                                      -45-
<PAGE>

SECTION 9.15. TABLE OF CONTENTS, HEADINGS, ETC.

         The Table of Contents, Cross-Reference Table and Headings of the
Articles and Sections of this Indenture have been inserted for convenience of
reference only, are not to be considered a part of this Indenture and shall in
no way modify or restrict any of the terms or provisions hereof.

                                      -46-
<PAGE>

                            Intentionally Left Blank

                                        -47-
<PAGE>

                                   SIGNATURES

Dated as of January 15, 1997                      TENET HEALTHCARE CORPORATION

                                                  By:    /s/ Terence P. McMullen
                                                         -----------------------
                                                  Name:  Terence P. McMullen
                                                  Title: Vice President

Attest:

/s/ Richard B. Silver        (SEAL)
----------------------------
    Richard B. Silver

Dated as of January 15, 1997                      THE BANK OF NEW YORK,
                                                  as Trustee

                                                  By:    (illegible)
                                                         -----------------------
                                                  Name:
                                                  Title:

Attest:

                             (SEAL)
----------------------------

By: (illegible)
    ------------------------
    Authorized Signatory

                                      -48-
<PAGE>

                                                                       EXHIBIT A

                               (Face of Security)

                     7-7/8% Senior Note due January 15, 2003

CUSIP: 88033G AE 0
No.                                                                   $ ________

                          TENET HEALTHCARE CORPORATION

promises to pay to
________________________________________________________

or its registered assigns, the principal sum of _____________________ Dollars on
January 15, 2003.

Interest Payment Dates: January 15 and July 15, commencing July 15, 1997.

Record Dates: January 1 and July 1 (whether or not a Business Day).

[(If Security is a Global Security--) This Security is a Global Security within
the meaning of the Indenture hereinafter referred to and is registered in the
name of a Depositary or a nominee thereof. This Security may not be exchanged in
whole or in part for a Security registered, and no transfer of this Security in
whole or in part may be registered, in the name of any person other than such
Depositary or a nominee thereof, except in the limited circumstances described
in the Indenture.]

TENET HEALTHCARE CORPORATION

By:_________________________

(SEAL)

Dated: _______________, ____

Trustee's Certificate of Authentication:

This is one of the Securities referred
to in the within-mentioned Indenture:

The Bank of New York, as Trustee

By:_________________________
   Authorized Signatory

                                       A-1
<PAGE>

                               (Back of Security)

                               7-7/8% SENIOR NOTE
                              due January 15, 2003

         Capitalized terms used herein have the meanings assigned to them in the
Indenture (as defined below) unless otherwise indicated.

         1. INTEREST. Tenet Healthcare Corporation, a Nevada corporation (the
"Company"), promises to pay interest on the principal amount of this Security at
the rate and in the manner specified below.

              The Company shall pay interest in cash on the principal amount of
this Security at the rate per annum of 7-7/8%. The Company shall pay interest
semiannually in arrears on January 15 and July 15 of each year, commencing July
15, 1997 to Holders of record on the immediately preceding January 1 and July 1,
respectively, or if any such date of payment is not a Business Day on the next
succeeding Business Day (each an "Interest Payment Date").

              Interest shall be computed on the basis of a 360-day year
comprised of twelve 30-day months. Interest shall accrue from the most recent
date to which interest has been paid or, if no interest has been paid, from the
date of the original issuance of the Securities. To the extent lawful, the
Company shall pay interest on overdue principal at the rate of 1% per annum in
excess of the interest rate then applicable to the Securities; it shall pay
interest on overdue installments of interest (without regard to any applicable
grace periods) at the same rate to the extent lawful.

         2. METHOD OF PAYMENT. The Company shall pay interest on the Securities
(except defaulted interest) to the Persons who are registered Holders of
Securities at the close of business on the record date next preceding the
Interest Payment Date, even if such Securities are canceled after such record
date and on or before such Interest Payment Date. The Holder hereof must
surrender this Security to a Paying Agent to collect principal payments. The
Company shall pay principal and interest in money of the United States that at
the time of payment is legal tender for payment of public and private debts.
Principal, premium, if any, and interest shall be payable at the office or
agency of the Company maintained for such purpose within the City and State of
New York or, at the option of the Company, payment of interest may be made by
check mailed to the Holder's registered address. Notwithstanding the foregoing,
all payments with respect to Securities, the Holders of which have given
appropriate written wire transfer instructions, on or before the relevant record
date, to the Paying Agent shall be made by wire transfer of immediately
available funds to the accounts specified by such Holders.

         3. PAYING AGENT AND REGISTRAR. Initially, the Trustee shall act as
Paying Agent and Registrar. The Company may change any Paying Agent or Registrar
or co-registrar without prior notice to any Holder. The Company and any of its
Subsidiaries may act in any such capacity.

         4. INDENTURE. The Company issued the Securities under an Indenture,
dated as of January 15, 1997 (the "Indenture"), between the Company and the
Trustee. The terms of the Securities include those stated in the Indenture and
those made part of the Indenture by reference to the Trust Indenture Act of
1939, as amended (15 U.S. Code Sections 77aaa-77bbbb) (the "TIA") as in effect
on the date of the Indenture. The Securities are subject to all such terms, and
Holders are referred to the Indenture and such act for a statement of such
terms. The terms of the Indenture shall govern any inconsistencies between the
Indenture and the Securities. The Securities are unsecured general obligations
of the Company. The Securities are limited to $400,000,000 in aggregate
principal amount.

                                       A-2
<PAGE>

         5. MANDATORY REDEMPTION. Subject to the Company's obligation to make an
offer to repurchase Securities under certain circumstances pursuant to Section
3.12 of the Indenture (as described in paragraph 6 below), the Company shall not
be required to make any mandatory redemption or sinking fund payments with
respect to the Securities.

         6. REPURCHASE AT OPTION OF HOLDER. If there is a Change of Control
Triggering Event, the Company shall offer to repurchase on the Change of Control
Payment Date all outstanding Securities at 101 % of the aggregate principal
amount thereof plus accrued and unpaid interest thereon to the Change of Control
Payment Date. Holders that are subject to an offer to purchase shall receive a
Change of Control Offer from the Company prior to any related Change of Control
Payment Date and may elect to have such Securities purchased by completing the
form entitled "Option of Holder to Elect Purchase" appearing below.

         7. DENOMINATIONS, TRANSFER, EXCHANGE. The Securities are in registered
form without coupons, and in denominations of $1,000 and integral multiples of
$1,000. The transfer of Securities may be registered and Securities may be
exchanged as provided in the Indenture. The Registrar and the Trustee may
require a Holder, among other things, to furnish appropriate endorsements and
transfer documents and to pay any taxes and fees required by law or permitted by
the Indenture. The Registrar need not exchange or register the transfer of any
Securities between a record date and the corresponding Interest Payment Date.

         8. PERSONS DEEMED OWNERS. Prior to due presentment to the Trustee for
registration of the transfer of this Security, the Trustee, any Agent and the
Company may deem and treat the Person in whose name this Security is registered
as its absolute owner for the purpose of receiving payment of principal of,
premium, if any, and interest on this Security and for all other purposes
whatsoever, whether or not this Security is overdue, and neither the Trustee,
any Agent nor the Company shall be affected by notice to the contrary. The
registered Holder of a Security shall be treated as its owner for all purposes.

         9. AMENDMENT, SUPPLEMENT AND WAIVERS. Except as provided in the next
succeeding paragraphs, the Indenture or the Securities may be amended or
supplemented with the consent of the Holders of at least a majority in principal
amount of the Securities then outstanding (including consents obtained in
connection with a tender offer or exchange offer for such Securities), and any
existing default or compliance with any provision of the Indenture or the
Securities may be waived with the consent of the Holders of a majority in
principal amount of the then outstanding Securities (including consents obtained
in connection with a tender offer or exchange offer for such Securities).

              Without the consent of each Holder affected, an amendment or
waiver may not (with respect to any Security held by a non-consenting Holder):
(i) reduce the principal amount of Securities whose Holders must consent to an
amendment, supplement or waiver; (ii) reduce the principal of or change the
fixed maturity of any Security; (iii) reduce the rate of or change the time for
payment of interest on any Security; (iv) waive a Default or Event of Default in
the payment of principal of or premium, if any, or interest on the Securities,
(except a rescission of acceleration of the Securities by the Holders of at
least a majority in aggregate principal amount thereof and a waiver of the
payment default that resulted from such acceleration); (v) make any Security
payable in money other than that stated in the Securities; (vi) make any change
in the provisions of the Indenture relating to waivers of past Defaults or the
rights of Holders of Securities to receive payments of principal of or premium,
if any, or interest on the Securities; or (vii) make any change in the foregoing
amendment and waiver provisions.

              Notwithstanding the foregoing, without the consent of any Holder
of Securities, the Company and the Trustee may amend or supplement the Indenture
or the Securities to cure any

                                       A-3
<PAGE>

ambiguity, defect or inconsistency, to provide for uncertificated Securities in
addition to or in place of certificated Securities, to provide for any
supplemental indenture required pursuant to Section 3.15 of the Indenture, to
provide for the assumption of the Company's obligations to Holders of Securities
in the case of a merger, consolidation or sale of assets pursuant to Article 4
of the Indenture, to make any change that would provide any additional rights or
benefits to the Holders of the Securities or that does not adversely affect the
legal rights under the Indenture of any such Holder, or to comply with
requirements of the Commission in order to effect or maintain the qualification
of the Indenture under the TIA.

         10. DEFAULTS AND REMEDIES. Events of Default under the Indenture
include: (i) a default for 30 days in the payment when due of interest on the
Securities; (ii) a default in payment when due of the principal of or premium,
if any, on the Securities, at maturity or otherwise; (iii) a failure by the
Company to comply with the provisions of Sections 3.07, 3.09 or 3.12 of the
Indenture; (iv) a failure by the Company for 60 days after notice to comply with
any of its other agreements in the Indenture or the Securities; (v) any default
occurs under any mortgage, indenture or instrument under which there may be
issued or by which there may be secured or evidenced any Indebtedness for money
borrowed by the Company or any of its Significant Subsidiaries (or the payment
of which is Guaranteed by the Company or any of its Significant Subsidiaries),
whether such Indebtedness or Guarantee exists on the date of the Indenture or is
created after the date of the Indenture, which default (a) constitutes a Payment
Default or (b) results in the acceleration of such Indebtedness prior to its
express maturity and, in each case, the principal amount of any such
Indebtedness, together with the principal amount of any other such Indebtedness
under which there has been a Payment Default or that has been so accelerated,
aggregates $25.0 million or more; (vi) failure by the Company or any of its
Significant Subsidiaries to pay a final judgment or final judgments aggregating
in excess of $25.0 million, which judgment or judgments are not paid, discharged
or stayed for a period of 60 days; and (vii) certain events of bankruptcy or
insolvency with respect to the Company or any of its Significant Subsidiaries.

              If any Event of Default occurs and is continuing, the Trustee or
the Holders of at least 25% in principal amount of the then outstanding
Securities by written notice to the Company and the Trustee, may declare all the
Securities to be due and payable immediately. Notwithstanding the foregoing, in
the case of an Event of Default arising from certain events of bankruptcy or
insolvency with respect to the Company or any of its Significant Subsidiaries,
all outstanding Securities shall become due and payable without further action
or notice. Holders of the Securities may not enforce the Indenture or the
Securities except as provided in the Indenture. Subject to certain limitations,
Holders of a majority in principal amount of the then outstanding Securities may
direct the Trustee in its exercise of any trust or power. The Trustee may
withhold from Holders of the Securities notice of any continuing Default or
Event of Default (except a Default or Event of Default relating to the payment
of principal or interest) if it determines that withholding notice is in the
Holders' interest.

              If an Event of Default occurs under the Indenture prior to
maturity by reason of any willful action (or inaction) taken (or not taken) by
or on behalf of the Company with the intention of avoiding the prohibition on
redemption of such Securities prior to the date of maturity, then the premium
specified in Section 5.02 of the Indenture shall also become immediately due and
payable to the extent permitted by law upon the acceleration of such Securities.

              The Holders of not less than a majority in aggregate principal
amount of the Securities then outstanding by written notice to the Trustee may
on behalf of the Holders of all of the Securities waive any existing Default or
Event of Default and its consequences under the Indenture except a continuing
Default or Event of Default in the payment of the principal of, premium, if any,
or interest on the Securities.

                                       A-4
<PAGE>

              The Company is required to deliver to the Trustee annually a
statement regarding compliance with the Indenture, and the Company is required
upon becoming aware of any Default or Event of Default, to deliver to the
Trustee a statement specifying such Default or Event of Default.

              The above description of Events of Default and remedies is
qualified by reference, and subject in its entirety, to the more complete
description thereof contained in the Indenture.

         11. RESTRICTIVE COVENANTS. The Indenture imposes certain limitations on
the ability of the Company and its Subsidiaries to incur additional indebtedness
and issue preferred stock, pay dividends or make other distributions, repurchase
Equity Interests or subordinated indebtedness, create certain liens, enter into
certain transactions with affiliates, issue or sell Equity Interests of the
Company's Subsidiaries, issue Guarantees of Indebtedness by the Company's
Subsidiaries and enter into certain mergers and consolidations.

         12. TRUSTEE DEALINGS WITH COMPANY. The Trustee under the Indenture, in
its individual or any other capacity, may make loans to, accept deposits from,
and perform services for the Company or its Affiliates, and may otherwise deal
with the Company or its Affiliates, as if it were not Trustee.

         13. NO PERSONAL LIABILITY OF DIRECTORS, OFFICERS, EMPLOYEES AND
SHAREHOLDERS. No director, officer, employee, incorporator or shareholder of the
Company, as such, shall have any liability for any obligations of the Company
under the Securities, the Indenture or for any claim based on, in respect of, or
by reason of, such obligations or their creation. Each Holder of Securities by
accepting a Security waives and releases all such liability. The waiver and
release are part of the consideration for the issuance of the Securities. Such
waiver may not be effective to waive liabilities under the federal securities
laws and it is the view of the Commission that such a waiver is against public
policy.

         14. AUTHENTICATION. This security shall not be valid until
authenticated by the manual signature of the Trustee or an authenticating agent.

         15. ABBREVIATIONS. Customary abbreviations may be used in the name of a
Holder or an assignee, such as: TEN COM (= tenants in common), TEN ENT (=
tenants by the entireties), JT TEN = joint tenants with right of survivorship
and not as tenants in common), CUST (= Custodian), and U/G/M/A (= Uniform Gifts
to Minors Act).

         16. CUSIP NUMBERS. Pursuant to a recommendation promulgated by the
Committee on Uniform Security Identification Procedures, the Company has caused
CUSIP numbers to be printed on the Securities and has directed the Trustee to
use CUSIP numbers as a convenience to Holders. No representation is made as to
the accuracy of such numbers either as printed on the Securities and reliance
may be placed only on the other identification numbers placed thereon.

              The Company will furnish to any Holder upon written request and
without charge a copy of the Indenture. Request may be made to:

              Tenet Healthcare Corporation
              3820 State Street
              Santa Barbara, California 93105
              Attention: Treasurer

         17. GOVERNING LAW. The internal laws of the State of New York shall
govern and be used to construe the Indenture and the Securities, without regard
to conflict of laws provisions thereof.

                                       A-5
<PAGE>

                                 ASSIGNMENT FORM

         To assign this Security, fill in the form below: For value received (I)
or (we) hereby sell, assign and transfer this Security to

--------------------------------------------------------------------------------
                  (Insert assignee's soc. sec. or tax I.D. no.)

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------
              (Print or type assignee's name, address and zip code)

and do hereby irrevocably constitute and appoint __________________________
Attorney to transfer this Security on the books of the Company with full power
of substitution in the premises.

________________________________________________________________________________

Date: ___________________

                Your Signature: _________________________________
                (Sign exactly as your name appears on the face of this Security)

Signature Guarantee.*

_________________________

       *NOTICE: The Signature must be guaranteed by an Institution which is a
member of one of the following recognized Signature Guaranty Programs: (i) The
Securities Transfer Agent Medallion Program (Stamp); (ii) The New York Stock
Exchange Medallion Program (MSP); (iii) The Stock Exchange Medallion Program
(SEMP); or (iv) such other guarantee program acceptable to the Trustee.

                                       A-6
<PAGE>

                       OPTION OF HOLDER TO ELECT PURCHASE

         If you want to elect to have all or any part of this Security purchased
by the Company pursuant to Section 3.12 of the Indenture, check the box below:

                                    [ ]  Section 3.12
                                         (Change of Control)

         If you want to have only part of the Security purchased by the Company
pursuant to Section 3.12 of the Indenture, state the amount you elect to have
purchased:

$ __________________

Date: ______________

                Your Signature: _________________________________
                (Sign exactly as your name appears on the face of this Security)

Signature Guarantee.*

_________________________

       *NOTICE: The Signature must be guaranteed by an Institution which is a
member of one of the following recognized Signature Guaranty Programs: (i) The
Securities Transfer Agent Medallion Program (Stamp); (ii) The New York Stock
Exchange Medallion Program (MSP); (iii) The Stock Exchange Medallion Program
(SEMP); or (iv) such other guarantee program acceptable to the Trustee.

                                       A-7
<PAGE>

                                                                       EXHIBIT B

                         FORM OF SUPPLEMENTAL INDENTURE

              SUPPLEMENTAL INDENTURE (this "Supplemental Indenture"), dated as
of _____________, between __________________________(the "Guarantor"), a
subsidiary of Tenet Healthcare Corporation (or its successor), a Nevada
corporation (the "Company"), and The Bank of New York, as trustee under the
indenture referred to below (the "Trustee").

                               W I T N E S S E T H

              WHEREAS, the Company has heretofore executed and delivered to the
Trustee an indenture (the "Indenture"), dated as of January 15, 1997, providing
for the issuance of an aggregate principal amount of $400,000,000 of 7-7/8%
Senior Notes due 2003 (the "Securities");

              WHEREAS, Section 3.15 of the Indenture provides that under
certain circumstances the Company is required to cause the Guarantor to execute
and deliver to the Trustee a supplemental indenture pursuant to which the
Guarantor shall guarantee the payment of the Securities pursuant to a Guarantee
on the terms and conditions set forth herein; and

              WHEREAS, pursuant to Section 8.01 of the Indenture, the Trustee is
authorized to execute and deliver this Supplemental Indenture.

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

         1. CAPITALIZED TERMS. Capitalized terms used herein without definition
shall have the meanings assigned to them in the Indenture.

         2. AGREEMENT TO GUARANTEE. The Guarantor hereby unconditionally
guarantees to each Holder of a Security authenticated and delivered by the
Trustee and to the Trustee and its successors and assigns, irrespective of the
validity and enforceability of the Indenture, the Securities or the Obligations
of the Company hereunder and thereunder, that: (a) the principal of, premium, if
any, and interest on the Securities will be promptly paid in full when due,
whether at maturity, by acceleration, redemption or otherwise, and interest on
the overdue principal, premium, if any, and (to the extent permitted by law)
interest on any interest on the Securities and all other payment Obligations of
the Company to the Holders or the Trustee hereunder or thereunder will be
promptly paid in full, all in accordance with the terms hereof and thereof; and
(b) in case of any extension of time of payment or renewal of any Securities or
any of such other payment Obligations, that same will be promptly paid in full
when due or performed in accordance with the terms of the extension or renewal,
whether at stated maturity, by acceleration, redemption or otherwise. Failing
payment when due of any amount so guaranteed for whatever reason the Guarantor
shall be obligated to pay the same immediately. An Event of Default under the
Indenture or the Securities shall constitute an event of default under this
Guarantee, and shall entitle the Holders of Securities to accelerate the
Obligations of the Guarantor hereunder in the same manner and to the same extent
as the Obligations of the Company. The Guarantor hereby agrees that its
Obligations hereunder shall be unconditional, irrespective of the validity,
regularity or enforceability of the Securities or the Indenture, the absence of
any action to enforce the same, any waiver or consent by any Holder of the
Securities with respect to any provisions hereof or thereof, the recovery of any

                                       B-1
<PAGE>

judgment against the Company, any action to enforce the same or any other
circumstance which might otherwise constitute a legal or equitable discharge or
defense of the Guarantor. The Guarantor hereby waives diligence, presentment,
demand of payment, filing of claims with a court in the event of insolvency or
bankruptcy of the Company, any right to require a proceeding first against the
Company, protest, notice and all demands whatsoever and covenant that this
Guarantee will not be discharged except by complete performance of the
Obligations contained in the Securities and the Indenture. If any Holder or the
Trustee is required by any court or otherwise to return to the Company, the
Guarantor, or any Custodian, Trustee, liquidator or other similar official
acting in relation to either the Company or the Guarantor, any amount paid by
either to the Trustee or such Holder, this Guarantee, to the extent theretofore
discharged, shall be reinstated in full force and effect. The Guarantor agrees
that it shall not be entitled to, and hereby waives, any right of subrogation in
relation to the Holders in respect of any Obligations guaranteed hereby. The
Guarantor further agrees that, as between the Guarantor, on one hand, and the
Holders and the Trustee, on the other hand, (x) the maturity of the Obligations
guaranteed hereby may be accelerated as provided in Article 5 of the Indenture
for the purposes of this Guarantee, notwithstanding any stay, injunction or
other prohibition preventing such acceleration in respect of the Obligations
guaranteed hereby, and (y) in the event of any declaration of acceleration of
such Obligations as provided in Article 5 of the Indenture, such Obligations
(whether or not due and payable) shall forthwith become due and payable by the
Guarantor for the purpose of this Guarantee.

         3. EXECUTION AND DELIVERY OF GUARANTEE. To evidence its Guarantee set
forth in Section 2, the Guarantor hereby agrees that a notation of such
Guarantee substantially in the form of EXHIBIT A shall be endorsed by an officer
of such Guarantor on each Security authenticated and delivered by the Trustee
and that this Supplemental Indenture shall be executed on behalf of such
Guarantor, by manual or facsimile signature, by its President or one of its Vice
Presidents.

              The Guarantor hereby agrees that its Guarantee set forth in
Section 2 shall remain in full force and effect notwithstanding any failure to
endorse on each Security a notation of such Guarantee.

              If an Officer whose signature is on this Supplemental Indenture or
on the Guarantee no longer holds that office at the time the Trustee
authenticates the Security on which a Guarantee is endorsed, the Guarantee shall
be valid nevertheless.

              The delivery of any Security by the Trustee, after the
authentication thereof hereunder, shall constitute due delivery of the Guarantee
set forth in this Indenture on behalf of the Guarantors.

         4. GUARANTORS MAY CONSOLIDATE, ETC. ON CERTAIN TERMS.

              (a) Except as set forth in Articles 3 and 4 of the Indenture,
nothing contained in this Supplemental Indenture or in the Securities shall
prevent any consolidation or merger of the Guarantor with or into the Company or
any Subsidiary of the Company that has executed and delivered a supplemental
indenture substantially in the form hereof or shall prevent any sale or
conveyance of the property of the Guarantor as an entirety or substantially as
an entirety, to the Company or any such Subsidiary of the Company.

              (b) Except as provided in Section 4(a) hereof or in a transaction
referred to in Section 5 hereof, the Guarantor shall not consolidate with or
merge with or into, or sell, assign, transfer, lease, convey or otherwise
dispose of all or substantially all of its assets to, another Person unless (1)
either (x) the Guarantor shall be the surviving Person of such merger or
consolidation or (y) the surviving Person or transferee is a corporation,
partnership or trust organized and existing under the laws of the United States,
any state thereof or the District of Columbia and such surviving Person or
transferee shall

                                       B-2
<PAGE>

expressly assume all the obligations of the Guarantor under this Guarantee and
the Indenture pursuant to a supplemental indenture substantially in the form
hereof; (2) immediately after giving effect to such transaction (including the
incurrence of any Indebtedness incurred or anticipated to be incurred in
connection with such transaction) no Default or Event of Default shall have
occurred and be continuing; and (3) the Company has delivered to the Trustee an
Officers' Certificate and Opinion of Counsel, each stating that such
consolidation, merger or transfer complies with the Indenture, that the
surviving Person agrees to be bound thereby, and that all conditions precedent
in the Indenture relating to such transaction have been satisfied. For purposes
of the foregoing, the transfer (by lease, assignment, sale or otherwise, in a
single transaction or series of related transactions) of all or substantially
all of the properties and assets of one or more Subsidiaries of the Guarantor,
the Capital Stock of which constitutes all or substantially all of the
properties and assets of the Guarantor, shall be deemed to be the transfer of
all or substantially all of the properties and assets of the Guarantor.

              Upon any consolidation or merger, or any sale, assignment,
transfer, lease, conveyance or other disposition of all or substantially all of
the assets of the Guarantor in accordance with this Section 4(b) hereof, the
successor corporation shall succeed to and be substituted for the Guarantor with
the same effect as if it had been named herein as a Guarantor. Such successor
corporation thereupon may cause to be signed any or all of the Guarantees to be
endorsed upon all of the Securities issuable hereunder which theretofore shall
not have been signed by the Company and delivered to the Trustee. All Guarantees
so issued shall in all respects have the same legal rank and benefit under the
Indenture as the Guarantees theretofore and thereafter issued in accordance with
the terms of the Indenture as though all of such Guarantees had been issued at
the date of the execution hereof.

         5. RELEASES FOLLOWING SALE OF ASSETS. Concurrently with any sale,
lease, conveyance or other disposition (by merger, consolidation or otherwise)
of assets of the Guarantor (including, if applicable, disposition of all of the
Capital Stock of the Guarantor), any Liens in favor of the Trustee in the assets
sold, leased, conveyed or otherwise disposed of shall be released. If the assets
sold, leased, conveyed or otherwise disposed of (by merger, consolidation or
otherwise) include all or substantially all of the assets of the Guarantor or
all of the Capital Stock of the Guarantor in each case, in compliance with the
terms of the Indenture, then the Guarantor shall be automatically and
unconditionally released from and relieved of its Obligations under its
Guarantee. Upon delivery by the Company to the Trustee of an Officers'
Certificate to the effect that such sale, lease, conveyance or other disposition
was made by the Company in accordance with the provisions of the Indenture, the
Trustee shall execute any documents reasonably required in order to evidence the
release of the Guarantor from its Obligations under its Guarantee.

         6. LIMITATION ON GUARANTOR LIABILITY. For purposes hereof, the
Guarantor's liability will be that amount from time to time equal to the
aggregate liability of the Guarantor hereunder, but shall be limited to the
lesser of (i) the aggregate amount of the Obligations of the Company under the
Securities and the Indenture and (ii) the amount, if any, which would not have
(A) rendered the Guarantor "insolvent" (as such term is defined in the federal
Bankruptcy Law and in the Debtor and Creditor Law of the State of New York) or
(B) left it with unreasonably small capital at the time its Guarantee of the
Securities was entered into, after giving effect to the incurrence of existing
Indebtedness immediately prior to such time; PROVIDED that it shall be a
presumption in any lawsuit or other proceeding in which the Guarantor is a party
that the amount guaranteed pursuant to its Guarantee is the amount set forth in
clause (i) above unless any creditor, or representative of creditors of the
Guarantor, or debtor in possession or trustee in bankruptcy of the Guarantor,
otherwise proves in such a lawsuit that the aggregate liability of the Guarantor
is limited to the amount set forth in clause (ii). In making any determination
as to the solvency or sufficiency of capital of the Guarantor in accordance with
the previous sentence, the right of the Guarantor to contribution from other
Subsidiaries of the Company that

                                       B-3
<PAGE>

have executed and delivered a supplemental indenture substantially in the form
hereof and any other rights the Guarantor may have, contractual or otherwise,
shall be taken into account.

         7. "TRUSTEE" TO INCLUDE PAYING AGENT. In case at any time any Paying
Agent other than the Trustee shall have been appointed by the Company and be
then acting under the Indenture, the term "Trustee" as used in this Supplemental
Indenture shall in each case (unless the context shall otherwise require) be
construed as extending to and including such Paying Agent within its meaning as
fully and for all intents and purposes as if such Paying Agent were named in
this Supplemental Indenture in place of the Trustee.

         8. NO RECOURSE AGAINST OTHERS. No director, officer, employee,
incorporator or stockholder of the Guarantor, as such, shall have any liability
for any obligations of the Company or the Guarantor under the Securities, any
Guarantees, the Indenture or this Supplemental Indenture or for any claim based
on, in respect of, or by reason of, such obligations or their creation. Each
Holder of the Securities by accepting a Security waives and releases all such
liability. The waiver and release are part of the consideration for issuance of
the Securities. Such waiver may not be effective to waive liabilities under the
federal securities laws and it is the view of the Commission that such a waiver
is against public policy.

         9. NEW YORK LAW TO GOVERN. The internal law of the State of New York
shall govern and be used to construe this Supplemental Indenture.

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

         11. EFFECT OF HEADINGS. The Section headings herein are for convenience
only and shall not affect the construction hereof.

                                       B-4
<PAGE>

         IN WITNESS WHEREOF, the parties hereto have caused this Supplemental
Indenture to be duly executed and attested, all as of the date first above
written.

Dated:___________ ___, ____

[Guarantor]

By: _______________________
Name:
Title:

The Bank of New York,
  as Trustee

By: _______________________
Name:
Title:

                                       B-5
<PAGE>

                       EXHIBIT A TO SUPPLEMENTAL INDENTURE
                                    GUARANTEE

         The Guarantor hereby unconditionally guarantees to each Holder of a
Security authenticated and delivered by the Trustee and to the Trustee and its
successors and assigns, irrespective of the validity and enforceability of the
Indenture, the Securities or the Obligations of the Company to the Holders or
the Trustee under the Securities or under the Indenture, that: (a) the principal
of, and premium, if any, and interest on the Securities will be promptly paid in
full when due, whether at maturity, by acceleration, redemption or otherwise,
and interest on overdue principal, premium, if any, and (to the extent permitted
by law) interest on any interest on the Securities and all other payment
Obligations of the Company to the Holders or the Trustee under the Indenture or
under the Securities will be promptly paid in full, all in accordance with the
terms thereof, and (b) in case of any extension of time of payment or renewal of
any Securities or any of such other payment Obligations, the same will be
promptly paid in full when due in accordance with the terms of the extension or
renewal, whether at stated maturity, by acceleration, redemption or otherwise.
Failing payment when due of any amount so guaranteed, for whatever reason, the
Guarantor shall be obligated to pay the same immediately.

         The obligations of the Guarantor to the Holders of Securities and to
the Trustee pursuant to this Guarantee and the Indenture are expressly set forth
in a Supplemental Indenture, dated as of ___________ __, ____ I to the
Indenture, and reference is hereby made to the Indenture, as supplemented, for
the precise terms of this Guarantee.

         This is a continuing Guarantee and shall remain in full force and
effect and shall be binding upon the Guarantor and its respective successors and
assigns to the extent set forth in the Indenture until full and final payment of
all of the Company's Obligations under the Securities and the Indenture and
shall inure to the benefit of the successors and assigns of the Trustee and the
Holders of Securities and, in the event of any transfer or assignment of rights
by any Holder of Securities or the Trustee, the rights and privileges herein
conferred upon that party shall automatically extend to and be vested in such
transferee or assignee, all subject to the terms and conditions hereof. This a
Guarantee of payment and not a guarantee of collection.

         This Guarantee shall not be valid or obligatory for any purpose until
the certificate of authentication on the Security upon which this Guarantee is
noted shall have been executed by the Trustee under the Indenture by the manual
signature of one of its authorized signatories.

         For purposes hereof, the Guarantor's liability will be that amount from
time to time equal to the aggregate liability of the Guarantor hereunder, but
shall be limited to the lesser of (i) the aggregate amount of the Obligations of
the Company under the Securities and the Indenture and (ii) the amount, if any,
which would not have (A) rendered the Guarantor "insolvent" (as such term is
defined in the federal Bankruptcy Law and in the Debtor and Creditor Law of the
State of New York) or (B) left it with unreasonably small capital at the time
its Guarantee of the Securities was entered into, after giving effect to the
incurrence of existing Indebtedness immediately prior to such time; PROVIDED
that it shall be a presumption in any lawsuit or other proceeding in which the
Guarantor is a party that the amount guaranteed pursuant to its Guarantee is the
amount set forth in clause (i) above unless any creditor, or representative of
creditors of the Guarantor, or debtor in possession or trustee in bankruptcy of
the Guarantor, otherwise proves in such a lawsuit that the aggregate liability
of the Guarantor is limited to the amount set forth in clause (ii). The
Indenture provides that, in making any determination as to the solvency or
sufficiency of capital of a Guarantor in accordance with the previous sentence,
the right of

                                       B-6
<PAGE>

the Guarantor to contribution from other Subsidiaries of the Company that have
become Guarantors and any other rights the Guarantor may have, contractual or
otherwise, shall be taken into account.

         Capitalized terms used herein have the same meanings given in the
Indenture unless otherwise indicated.

                                                     [GUARANTOR]

                                                     By: _______________________
                                                        Name:
                                                        Title:

                                       B-7EXHIBIT 4(g)

                          TENET HEALTHCARE CORPORATION

                        --------------------------------

                                  $900,000,000

                            8% SENIOR NOTES due 2005

                          -----------------------------

                          -----------------------------

                                    INDENTURE

                          Dated as of January 15, 1997

                          -----------------------------

                          -----------------------------

                              THE BANK OF NEW YORK

                          -----------------------------

                                   as Trustee

<PAGE>

                                TABLE OF CONTENTS

                                                                          Page
                                                                          ----

                                    ARTICLE 1
                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

 SECTION 1.01.   DEFINITIONS ............................................   1
 SECTION 1.02.   OTHER DEFINITIONS ......................................  10
 SECTION 1.03.   INCORPORATION BY REFERENCE OF TIA ......................  10
 SECTION 1.04.   RULES OF CONSTRUCTION ....................................11

                                    ARTICLE 2
                                 THE SECURITIES

 SECTION 2.01.   FORM AND DATING ........................................  11
 SECTION 2.02.   FORM OF LEGEND FOR GLOBAL SECURITY .....................  11
 SECTION 2.03.   EXECUTION AND AUTHENTICATION ...........................  12
 SECTION 2.04.   REGISTRAR AND PAYING AGENT .............................  12
 SECTION 2.05.   PAYING AGENT TO HOLD MONEY IN TRUST ....................  13
 SECTION 2.06.   HOLDER LISTS ...........................................  13
 SECTION 2.07.   TRANSFER AND EXCHANGE ..................................  13
 SECTION 2.08.   PERSONS DEEMED OWNERS ..................................  14
 SECTION 2.09.   REPLACEMENT SECURITIES .................................  14
 SECTION 2.10.   OUTSTANDING SECURITIES .................................  15
 SECTION 2.11.   TREASURY SECURITIES ....................................  15
 SECTION 2.12.   TEMPORARY SECURITIES ...................................  15
 SECTION 2.13.   CANCELLATION ...........................................  16
 SECTION 2.14.   DEFAULTEDINTEREST ......................................  16
 SECTION 2.15.   RECORD DATE ............................................  16
 SECTION 2.16.   CUSIP NUMBER ...........................................  16

                                    ARTICLE 3
                                    COVENANTS

SECTION 3.01.    PAYMENT OF SECURITIES ..................................  16
SECTION 3.02.    MAINTENANCE OF OFFICE OR AGENCY ........................  17
SECTION 3.03.    COMMISSION REPORTS .....................................  17
SECTION 3.04.    COMPLIANCE CERTIFICATE .................................  18
SECTION 3.05.    TAXES ..................................................  19
SECTION 3.06.    STAY, EXTENSION AND USURY LAWS .........................  19
SECTION 3.07.    LIMITATIONS ON RESTRICTED PAYMENTS .....................  19
SECTION 3.08.    LIMITATIONS ON DIVIDEND AND OTHER PAYMENT
                   RESTRICTIONS AFFECTING SUBSIDIARIES ..................  21
SECTION 3.09.    LIMITATIONS ON INCURRENCE OF INDEBTEDNESS
                   AND ISSUANCE OF PREFERRED STOCK ......................  22
SECTION 3.10.    LIMITATIONS ON TRANSACTIONS WITH AFFILIATES ............  23

                                      -i-
<PAGE>

                                                                          Page
                                                                          ----

SECTION 3.11.    LIMITATIONS ON LIENS ...................................  24
SECTION 3.12.    CHANGE OF CONTROL ......................................  24

SECTION 3.13.    CORPORATE EXISTENCE ....................................  25
SECTION 3.14.    LINE OF BUSINESS .......................................  26
SECTION 3.15.    LIMITATIONS ON ISSUANCES OF GUARANTEES OF INDEBTEDNESS
                   BY SUBSIDIARIES ......................................  26
SECTION 3.16.    NO AMENDMENT TO SUBORDINATION PROVISIONS OF SENIOR
                   SUBORDINATED NOTE INDENTURE ..........................  26

                                    ARTICLE 4
                                   SUCCESSORS

SECTION 4.01.    LIMITATIONS ON MERGERS, CONSOLIDATIONS OR
                   SALES OF ASSETS ......................................  27
SECTION 4.02.    SUCCESSOR CORPORATION SUBSTITUTED ......................  27

                                      ARTICLE 5
                                DEFAULTS AND REMEDIES

SECTION 5.01.    EVENTS OF DEFAULT ......................................  28
SECTION 5.02.    ACCELERATION ...........................................  29
SECTION 5.03.    OTHER REMEDIES  ........................................  30
SECTION 5.04.    WAIVER OF PAST DEFAULTS ................................  30
SECTION 5.05.    CONTROL BY MAJORITY ....................................  30
SECTION 5.06.    LIMITATION ON SUITS ....................................  31
SECTION 5.07.    RIGHTS OF HOLDERS TO RECEIVE PAYMENT ...................  31
SECTION 5.08.    COLLECTION SUIT BY TRUSTEE .............................  31
SECTION 5.09.    TRUSTEE MAY FILE PROOFS OF CLAIM .......................  31
SECTION 5.10.    PRIORITIES  ............................................  32
SECTION 5.11.    UNDERTAKING FOR COSTS ..................................  32

                                      ARTICLE 6
                                       TRUSTEE

SECTION 6.01.    DUTIES OF TRUSTEE ......................................  32
SECTION 6.02.    RIGHTS OF TRUSTEE ......................................  33
SECTION 6.03.    INDIVIDUAL RIGHTS OF TRUSTEE ...........................  34
SECTION 6.04.    TRUSTEE'S DISCLAIMER ...................................  34
SECTION 6.05.    NOTICE OF DEFAULTS .....................................  34
SECTION 6.06.    REPORTS BY TRUSTEE TO HOLDERS ..........................  34
SECTION 6.07.    COMPENSATION AND INDEMNITY .............................  35
SECTION 6.08.    REPLACEMENT OF TRUSTEE .................................  35
SECTION 6.09.    SUCCESSOR TRUSTEE OR AGENT BY MERGER, ETC. .............  36
SECTION 6.10.    ELIGIBILITY; DISQUALIFICATION ..........................  36

                                      -ii-

<PAGE>

                                                                          Page
                                                                          ----

SECTION 6.11.    PREFERENTIAL COLLECTION OF CLAIMS AGAINST
                    COMPANY .............................................  37

                                    ARTICLE 7
                             DISCHARGE OF INDENTURE

SECTION 7.01.    DEFEASANCE AND DISCHARGE OF THIS
                   INDENTURE AND THE SECURITIES ........................  37
SECTION 7.02.    LEGAL DEFEASANCE AND DISCHARGE ........................  37
SECTION 7.03.    COVENANT DEFEASANCE ...................................  37
SECTION 7.04.    CONDITIONS TO LEGAL OR COVENANT
                   DEFEASANCE ..........................................  38
SECTION 7.05.    DEPOSITED MONEY AND GOVERNMENT SECURITIES
                   TO BE HELD IN TRUST; OTHER MISCELLANEOUS
                   PROVISIONS ..........................................  39
SECTION 7.06.    REPAYMENT TO COMPANY ..................................  40
SECTION 7.07.    REINSTATEMENT .........................................  40

                                    ARTICLE 8
                        AMENDMENT, SUPPLEMENT AND WAIVER

SECTION 8.01.    WITHOUT CONSENT OF HOLDERS .............................  40
SECTION 8.02.    WITH CONSENT OF HOLDERS ................................  41
SECTION 8.03.    COMPLIANCE WITH TIA ....................................  42
SECTION 8.04.    REVOCATION AND EFFECT OF CONSENTS ......................  42
SECTION 8.05.    NOTATION ON OR EXCHANGE OF SECURITIES ..................  42
SECTION 8.06.    TRUSTEE TO SIGN AMENDMENTS, ETC. .......................  43

                                    ARTICLE 9
                                  MISCELLANEOUS

SECTION 9.01.    TIA CONTROLS ...........................................  43
SECTION 9.02.    NOTICES ................................................  43
SECTION 9.03.    COMMUNICATION BY HOLDERS WITH OTHER
                   HOLDERS ..............................................  44
SECTION 9.04.    CERTIFICATE AND OPINION AS TO CONDITIONS
                   PRECEDENT ............................................  44
SECTION 9.05.    STATEMENTS REQUIRED IN CERTIFICATE OR
                  OPINION ...............................................  44
SECTION 9.06.    RULES BY TRUSTEE AND AGENTS ............................  45
SECTION 9.07.    LEGAL HOLIDAYS .........................................  45
SECTION 9.08.    NO PERSONAL LIABILITY OF DIRECTORS, OFFICERS,
                   EMPLOYEES AND SHAREHOLDERS ...........................  45
SECTION 9.09.    DUPLICATE ORIGINALS ....................................  45
SECTION 9.10.    GOVERNING LAW ..........................................  45
SECTION 9.11.    NO ADVERSE INTERPRETATION OF OTHER
                   AGREEMENTS ...........................................  46

                                      -iii-

<PAGE>

                                                                          Page
                                                                          ----

SECTION 9.12.    SUCCESSORS .............................................  46
SECTION 9.13.    SEVERABILITY ...........................................  46
SECTION 9.14.    COUNTERPART ORIGINALS ..................................  46
SECTION 9.15.    TABLE OF CONTENTS, HEADINGS, ETC. ......................  46

SIGNATURES

EXHIBIT A        FORM OF SECURITY
EXHIBIT B        FORM OF SUPPLEMENTAL INDENTURE

                                      -iv-

<PAGE>

                             CROSS-REFERENCE TABLE*

  TRUST INDENTURE
    ACT SECTION                                          INDENTURE SECTION
    -----------                                          -----------------

   310 (a)(1) ...........................................     6.10
       (a)(2) ...........................................     6.10
       (a)(3) ...........................................     N.A.
       (a)(4) ...........................................     N.A.
       (a)(5) ...........................................     6.10
       (b) ..............................................     6.08; 6.10
       (c) ..............................................     N.A.
   311 (a) ..............................................     6.11
       (b) ..............................................     6.11
       (c) ..............................................     N.A.
   312 (a) ..............................................     2.06
       (b) ..............................................     9.03
       (c) ..............................................     9.03
   313 (a) ..............................................     6.06
       (b)(1) ...........................................     N.A.
       (b)(2) ...........................................     6.06
       (c) ..............................................     6.06; 9.02
       (d) ..............................................     N.A.
   314 (a) ..............................................     3.03; 9.02
       (b) ..............................................     N.A.
       (c)(1) ...........................................     9.04
       (c)(2) ...........................................     9.04
       (c)(3) ...........................................     N.A.
       (d) ..............................................     N.A.
       (e) ..............................................     9.05
       (f) ..............................................     N.A.
   315 (a) ..............................................     6.01(iii)(b)
       (b) ..............................................     6.05; 9.02
       (c) ..............................................     6.01(i)
       (d) ..............................................     6.01(iii)
       (e) ..............................................     5.11
   316 (a)(1ast sentence) ...............................     2.11
       (a)(1)(A) ........................................     5.05
       (a)(1)(B).........................................     5.04
       (a)(2) ...........................................     N.A.
       (b) ..............................................     5.07
       (c)...............................................     2.15; 8.04
   317 (a)(1) ...........................................     5.08
       (a)(2) ...........................................     5.09
       (b) ..............................................     2.05

----------------------

     * This Cross-Reference Table is not part of the indenture.

                                      -v-

<PAGE>

   318 (a) ..............................................     9.01
       (b) ...............................................    N.A.
       (c) ...............................................    9.01

N.A. means not applicable

                                      -vi-

<PAGE>

       INDENTURE dated as of January 15, 1997 between Tenet Healthcare
Corporation, a Nevada corporation (the "COMPANY"), and The Bank of New York, as
trustee (the "TRUSTEE").

       The Company and the Trustee agree as follows for the benefit of each
other and for the equal and ratable benefit of the Holders of the 8% Senior
Notes due 2005 (the "SECURITIES").

                                    ARTICLE 1
                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

SECTION 1.01. DEFINITIONS.

       "ACQUIRED DEBT" means, with respect to any specified Person, (i)
Indebtedness of any other Person existing at the time such other Person is
merged with or into or became a Subsidiary of such specified Person, including,
without limitation, Indebtedness incurred in connection with, or in
contemplation of, such other Person merging with or into or becoming a
Subsidiary of such specified Person, and (ii) Indebtedness secured by a Lien
encumbering any asset acquired by such specified Person.

       "AFFILIATE" of any specified Person means any other Person directly or
indirectly controlling or controlled by or under direct or indirect common
control with such specified Person. For purposes of this definition, "control"
(including, with correlative meanings, the terms "controlling," "controlled by"
and "under common control with"), as used with respect to any Person, shall
mean the possession, directly or indirectly, of the power to direct or cause the
direction of the management or policies of such Person, whether through the
ownership of voting securities, by agreement or otherwise; PROVIDED that
beneficial ownership of 10% or more of the voting securities of a Person shall
be deemed to be control.

       "AGENT" means any Registrar, Paying Agent or co-registrar.

       "ASSET SALE" means (i) the sale, lease, conveyance or other disposition
of any assets (including, without limitation, by way of a sale and leaseback)
other than in the ordinary course of business consistent with past practices and
(ii) the issuance or sale by the Company or any of its Subsidiaries of Equity
Interests of any of the Company's Subsidiaries, in the case of either clause (i)
or (ii), whether in a single transaction or a series of related transactions (a)
that have a fair market value in excess of $25.0 million or (b) for net proceeds
in excess of $25.0 million. Notwithstanding the foregoing: (a) a transfer of
assets by the Company to a Subsidiary or by a Subsidiary to the Company or to
another Subsidiary, (b) an issuance of Equity Interests by a Subsidiary to the
Company or to another Subsidiary, (c) a Restricted Payment that is permitted by
Section 3.07 hereof and (d) a Hospital Swap shall not be deemed to be an Asset
Sale.

       "BOARD OF DIRECTORS" means the Board of Directors of the Company or any
authorized committee thereof.

       "BUSINESS DAY" means any day other than a Legal Holiday.

       "CAPITAL LEASE" means, at the time any determination thereof is to be
made, any lease of property, real or personal, in respect of which the present
value of the minimum rental commitment would be capitalized on a balance sheet
of the lessee in accordance with GAAP.

<PAGE>

       "CAPITAL LEASE OBLIGATION" means, at the time any determination thereof
is to be made, the amount of the liability in respect of a Capital Lease that
would at such time be required to be capitalized on a balance sheet in
accordance with GAAP.

       "CAPITAL STOCK" means (i) in the case of a corporation, corporate stock,
(ii) in the case of an association or business entity, any and all shares,
interests, participations, rights or other equivalents (however designated) of
corporate stock, (iii) in the case of a partnership, partnership interests
(whether general or limited) and (iv) any other interest or participation that
confers on a Person the right to receive a share of the profits and losses of,
or distributions of assets of, the issuing Person.

       "CHANGE OF CONTROL" means the occurrence of any of the following: (i) the
sale, lease, transfer, conveyance or other disposition, in one or a series of
related transactions, of all or substantially all of the assets of the Company
and its Subsidiaries taken as a whole to any Person or group (as such term is
used in Sections 13(d)(3) and 14(d)(2) of the Exchange Act) other than to a
Person or group who, prior to such transaction, held a majority of the voting
power of the voting stock of the Company, (ii) the acquisition by any Person or
group (as defined above) of a direct or indirect interest in more than 50% of
the voting power of the voting stock of the Company, by way of merger or
consolidation or otherwise, or (iii) the first day on which a majority of the
members of the Board of Directors of the Company are not Continuing Directors.

       "CHANGE OF CONTROL TRIGGERING EVENT" means the occurrence of both a
Change of Control and a Rating Decline.

       "CLOSING DATE" means January 30, 1997.

       "COMMISSION" means the Securities and Exchange Commission.

       "COMPANY" means Tenet Healthcare Corporation, as obligor under the
Securities, unless and until a successor replaces Tenet Healthcare Corporation,
in accordance with Article 4 hereof and thereafter includes such successor.

       "CONSOLIDATED CASH FLOW" means, with respect to any Person for any
period, the Consolidated Net Income of such Person for such period PLUS (i) an
amount equal to any extraordinary loss plus any net loss realized in connection
with an Asset Sale (to the extent such losses were deducted in computing such
Consolidated Net Income), PLUS (ii) provision for taxes based on income or
profits of such Person and its Subsidiaries for such period, to the extent that
such provision for taxes was included in computing such Consolidated Net Income,
PLUS (iii) the Fixed Charges of such Person and its Subsidiaries for such
period, to the extent that such Fixed Charges were deducted in computing such
Consolidated Net Income, PLUS (iv) depreciation and amortization (including
amortization of goodwill and other intangibles but excluding amortization of
prepaid cash expenses that were paid in a prior period) of such Person and its
Subsidiaries for such period to the extent that such depreciation and
amortization were deducted in computing such Consolidated Net Income, in each
case, on a consolidated basis and determined in accordance with GAAP.
Notwithstanding the foregoing, the provision for taxes on the income or profits
of, and the depreciation and amortization of, a Subsidiary of the referent
Person shall be added to Consolidated Net Income to compute Consolidated Cash
Flow only to the extent (and in same proportion) that the Net Income of such
Subsidiary was included in calculating the Consolidated Net Income of such
Person and only if a corresponding amount would be permitted at the date of
determination to be dividended to the Company by such Subsidiary without prior
approval (that has not been obtained), pursuant to the terms of its charter and
all agreements, instruments, judgments, decrees, orders, statutes, rules and
governmental regulations applicable to that Subsidiary or its stockholders.

                                      -2-
<PAGE>

       "CONSOLIDATED NET INCOME" means, with respect to any Person for any
period, the aggregate of the Net Income of such Person and its Subsidiaries for
such period, on a consolidated basis, determined in accordance with GAAP but
excluding any one-time charge or expense incurred in order to consummate the
Refinancing; PROVIDED that (i) the Net Income of any Person that is not a
Subsidiary or that is accounted for by the equity method of accounting shall be
included only to the extent of the amount of dividends or distributions paid in
cash to the referent Person or a Wholly Owned Subsidiary thereof, (ii) the Net
Income of any Subsidiary shall be excluded to the extent that the declaration or
payment of dividends or similar distributions by that Subsidiary of that Net
Income is not at the date of determination permitted without any prior
governmental approval (that has not been obtained) or, directly or indirectly,
by operation of the terms of its charter or any agreement, instrument, judgment,
decree, order, statute, rule or governmental regulation applicable to that
Subsidiary or its stockholders, (iii) the Net Income of any Person acquired in a
pooling of interests transaction for any period prior to the date of such
acquisition shall be excluded and (iv) the cumulative effect of a change in
accounting principles shall be excluded.

       "CONSOLIDATED NET WORTH" means, with respect to any Person as of any
date, the sum of (i) the consolidated equity of the common stockholders of such
Person and its consolidated Subsidiaries as of such date PLUS (ii) the
respective amounts reported on such Person's balance sheet as of such date with
respect to any series of preferred stock (other than Disqualified Stock), LESS
all write-ups (other than write-ups resulting from foreign currency translations
and write-ups of tangible assets of a going concern business made in accordance
with GAAP as a result of the acquisition of such business) subsequent to the
Closing Date in the book value of any asset owned by such Person or a
consolidated Subsidiary of such Person, and excluding the cumulative effect of a
change in accounting principles, all as determined in accordance with GAAP.

       "CONTINUING DIRECTORS" means, as of any date of determination, any member
of the Board of Directors of the Company who (i) was a member of such Board of
Directors on the Closing Date or (ii) was nominated for election or elected to
such Board of Directors with the approval of a majority of the Continuing
Directors who were members of such Board at the time of such nomination or
election.

       "CORPORATE TRUST OFFICE OF THE TRUSTEE" shall be at the address of the
Trustee specified in Section 9.02 hereof or such other address as to which the
Trustee may give notice to the Company.

       "DEFAULT" means any event that is or with the passage of time or the
giving of notice or both would be an Event of Default.

       "DEPOSITARY" means a clearing agency registered under the Exchange Act
that is designated to act as Depositary for the Securities.

       "DISQUALIFIED STOCK" means any Capital Stock that, by its terms (or by
the terms of any security into which it is convertible or for which it is
exchangeable), or upon the happening of any event, matures or is mandatorily
redeemable, pursuant to a sinking fund obligation or otherwise, or redeemable at
the option of the Holder thereof, in whole or in part, on or prior to January
15, 2005.

       "EQUITY INTERESTS" means Capital Stock and all warrants, options or other
rights to acquire Capital Stock (but excluding any debt security that is
convertible into, or exchangeable for, Capital Stock).

       "EXCHANGE ACT" means the Securities Exchange Act of 1934, as amended.

                                      -3-
<PAGE>

       "EXISTING INDEBTEDNESS" means Indebtedness of the Company and its
Subsidiaries (other than Indebtedness under the New Credit Facility) in
existence on the Closing Date, until such amounts are repaid, including all
reimbursement obligations with respect to letters of credit outstanding as of
the Closing Date.

       "FIXED CHARGE COVERAGE RATIO" means with respect to any Person for any
period, the ratio of the Consolidated Cash Flow of such Person for such period
to the Fixed Charges of such Person for such period. In the event that the
Company or any of its Subsidiaries incurs, assumes, Guarantees or redeems any
Indebtedness (other than revolving credit borrowings) or issues preferred stock
subsequent to the commencement of the period for which the Fixed Charge Coverage
Ratio is being calculated but prior to the date on which the event for which the
calculation of the Fixed Charge Coverage Ratio is made (the "CALCULATION DATE"),
then the Fixed Charge Coverage Ratio shall be calculated giving PRO FORMA effect
to such incurrence, assumption, Guarantee or redemption of Indebtedness, or such
issuance or redemption of preferred stock, as if the same had occurred at the
beginning of the applicable four-quarter reference period. In addition, for
purposes of making the computation referred to above, (i) acquisitions that have
been made by the Company or any of its Subsidiaries, including through mergers
or consolidations and including any related financing transactions, during the
four-quarter reference period or subsequent to such reference period and on or
prior to the Calculation Date shall be deemed to have occurred on the first day
of the four-quarter reference period, and (ii) the Consolidated Cash Flow and
Fixed Charges attributable to discontinued operations, as determined in
accordance with GAAP, and operations or businesses disposed of prior to the
Calculation Date, shall be excluded.

       "FIXED CHARGES" means, with respect to any Person for any period, the sum
of (i) the consolidated interest expense of such Person and its Subsidiaries for
such period, whether paid or accrued (including, without limitation,
amortization of original issue discount, non-cash interest payments, the
interest component of any deferred payment obligations, the interest component
of all payments associated with Capital Lease Obligations, commissions,
discounts and other fees and charges incurred in respect of letters of credit or
bankers' acceptance financings, and net payments or receipts (if any) pursuant
to Hedging Obligations) and (ii) the consolidated interest expense of such
Person and its Subsidiaries that was capitalized during such period, and (iii)
any interest expense on Indebtedness of another Person that is Guaranteed by
such Person or one of its Subsidiaries or secured by a Lien on assets of such
Person or one of its Subsidiaries (whether or not such Guarantee or Lien is
called upon) and (iv) the product of (a) all cash dividend payments (and
non-cash dividend payments in the case of a Person that is a Subsidiary) on any
series of preferred stock of such Person, TIMES (b) a fraction, the numerator of
which is one and the denominator of which is one minus the then current combined
federal, state and local statutory tax rate of such Person, expressed as a
decimal, in each case, on a consolidated basis and in accordance with GAAP.

       "GAAP" means 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 in such other statements by such
other entity as have been approved by a significant segment of the accounting
profession, as in effect from time to time.

       "GLOBAL SECURITY" means a Security that evidences all or part of the
Securities of any series and bears the legend set forth in Section 2.02.

       "GOVERNMENT SECURITIES" means direct obligations of, or obligations
guaranteed by, the United States of America for the payment of which guarantee
or obligations the full faith and credit of the United States is pledged.

                                      -4-
<PAGE>

       "GUARANTEE" means a guarantee (other than by endorsement of negotiable
instruments for collection in the ordinary course of business), direct or
Indirect, in any manner (including, without limitation, letters of credit and
reimbursement agreements in respect thereof), of all or any part of any
Indebtedness.

       "HEDGING OBLIGATIONS" means, with respect to any Person, the obligations
of such Person under (i) interest rate swap agreements, interest rate cap
agreements and interest rate collar agreements, (ii) forward foreign exchange
contracts or currency swap agreements and (iii) other agreements or arrangements
designed to protect such Person against fluctuations in interest rates or
currency values.

       "HOLDER" means a Person in whose name a Security is registered.

       "HOSPITAL" means a hospital, outpatient clinic, long-term care facility
or other facility or business that is used or useful in or related to the
provision of healthcare services.

       "HOSPITAL SWAP" means an exchange of assets by the Company or a
Subsidiary of the Company for one or more Hospitals and/or one or more Related
Businesses or for the Capital Stock of any Person owning one or more Hospitals
and/or one or more Related Businesses.

       "INDEBTEDNESS" means, with respect to any Person, any indebtedness of
such Person, whether or not contingent, in respect of borrowed money or
evidenced by bonds, notes, debentures or similar instruments or letters of
credit (or reimbursement agreements in respect thereof) or banker's acceptances
or representing Capital Lease Obligations or the balance deferred and unpaid of
the purchase price of any property or representing any Hedging Obligations,
except any such balance that constitutes an accrued expense or trade payable, if
and to the extent any of the foregoing indebtedness (other than lenders of
credit and Hedging Obligations) would appear as a liability upon a balance sheet
of such Person prepared in accordance with GAAP, as well as all indebtedness of
others secured by a Lien on any asset of such Person (whether or not such
indebtedness is assumed by such Person) and, to the extent not otherwise
included, the Guarantee by such Person of any indebtedness of any other Person.

       "INDENTURE" means this Indenture, as amended or supplemented from time to
time.

       "INVESTMENT GRADE" means a rating of BBB- or higher by S&P or Baa3 or
higher by Moody's or the equivalent of such ratings by S&P or Moody's. In the
event that the Company shall select any other Rating Agency, the equivalent of
such ratings by such Rating Agency shall be used.

       "LIEN" means, with respect to any asset, any mortgage, lien, pledge,
charge, security interest or encumbrance of any kind in respect of such asset
given to secure Indebtedness, whether or not filed, recorded or otherwise
perfected under applicable law (including any conditional sale or other title
retention agreement, any lease in the nature thereof, any option or other
agreement to sell or give a security interest in and any filing of or agreement
to give any financing statement under the Uniform Commercial Code (or equivalent
statutes) of any jurisdiction with respect to any such lien, pledge, charge or
security interest).

       "MOODY'S" means Moody's Investors Services, Inc. and its successors.

       "NET INCOME" means, with respect to any Person, the net income (loss) of
such Person, determined in accordance with GAAP and before any reduction in
respect of preferred stock dividends, excluding, however, (i) any gain (but not
loss), together with any related provision for taxes on such gain (but not
loss), realized in connection with (a) any Asset Sale (including, without
limitation, dispositions

                                      -5-
<PAGE>

pursuant to sale and leaseback transactions) or (b) the disposition of any
securities by such Person or any of its Subsidiaries or the extinguishment of
any Indebtedness of such Person or any of it Subsidiaries and (ii) any
extraordinary or nonrecurring gain (but not loss), together with any related
provision for taxes on such extraordinary or nonrecurring gain (but not loss).

       "NEW CREDIT FACILITY" means that certain Credit Agreement by and among
the Company and Morgan Guaranty Trust Company of New York and the other banks
that are party thereto, providing for $2.8 billion in aggregate principal amount
of Indebtedness, including any related notes, instruments and agreements
executed in connection therewith, and in each case as amended, modified,
extended, renewed, refunded, replaced or refinanced, in whole or in part, from
time to time.

       "OBLIGATIONS" means any principal, interest, penalties, fees,
indemnifications, reimbursements, damages and other liabilities payable under
the documentation governing any Indebtedness.

       "OFFICERS" means the Chairman of the Board, the Chief Executive Officer,
the President, the Chief Operating Officer, the Chief Financial Officer, the
Treasurer, any Assistant Treasurer, the Controller, the Secretary and any Vice
President of the Company or any Subsidiary, as the case may be.

       "OFFICERS' CERTIFICATE" means a certificate signed by two Officers, one
of whom must be the principal executive officer, principal financial officer or
principal accounting officer of the Company.

       "OPINION OF COUNSEL" means an opinion from legal counsel who is
reasonably acceptable to the Trustee. The counsel may be an employee of or
counsel to the Company, any Subsidiary or the Trustee.

       "PAYMENT DEFAULT" means any failure to pay any scheduled installment of
interest or principal on any Indebtedness within the grace period provided for
such payment in the documentation governing such Indebtedness.

       "PERMITTED LIENS" means (i) Liens in favor of the Company; (ii) Liens on
property of a Person existing at the time such Person is merged into or
consolidated with the Company or any Subsidiary of the Company or becomes a
Subsidiary of the Company; PROVIDED that such Liens were in existence prior to
the contemplation of such merger, consolidation or acquisition (unless such
Liens secure Indebtedness that was incurred in connection with or in
contemplation of such acquisition and is used to refinance tax-exempt
Indebtedness) and do not extend to any assets or the Company or its Subsidiaries
other than those of the Person merged into or consolidated with the Company or
that becomes a Subsidiary of the Company; (iii) Liens on property existing at
the time of acquisition thereof by the Company or any Subsidiary of the Company;
PROVIDED that such Liens were in existence prior to the contemplation of such
acquisition (unless such Liens secure Indebtedness that was incurred in
connection with or in contemplation of such acquisition and is used to refinance
tax-exempt Indebtedness); (iv) Liens to secure the performance of statutory
obligations, tender, bid, performance, government contract, surety or appeal
bonds or other obligations of a like nature incurred in the ordinary course of
business; (v) Liens existing on the Closing Date; (vi) Liens for taxes,
assessments or governmental charges or claims that are not yet delinquent or
that are being contested in good faith by appropriate proceedings promptly
instituted and diligently concluded; PROVIDED that any reserve or other
appropriate provision as shall be required in conformity with GAAP shall have
been made therefore; (vii) other Liens on assets of the Company or any
Subsidiary of the Company securing Indebtedness that is permitted by the terms
hereof to be outstanding having an aggregate principal amount at any one time
outstanding not to exceed 10% of the Stockholders' Equity of the Company; and
(viii) Liens to secure

                                      -6-
<PAGE>

Permitted Refinancing Indebtedness incurred to refinance Indebtedness that was
secured by a Lien permitted hereunder and that was incurred in accordance with
the provisions hereof; PROVIDED that such Liens do not extend to or cover any
property or assets of the Company or any Subsidiary other than assets or
property securing the Indebtedness so refinanced.

       "PERMITTED REFINANCING INDEBTEDNESS" means any Indebtedness of the
Company or any of its Subsidiaries issued in exchange for, or the net proceeds
of which are used solely to extend, refinance, renew, replace, defease or
refund, other Indebtedness of the Company or any of its Subsidiaries; PROVIDED
that, except in the case of Indebtedness of the Company issued in exchange for,
or the net proceeds of which are used solely to extend, refinance, renew,
replace, defease or refund, Indebtedness of a Subsidiary of the Company: (i) the
principal amount of such Permitted Refinancing Indebtedness does not exceed the
principal amount of the Indebtedness so extended, refinanced, renewed, replaced,
defeased or refunded (plus the amount of any premiums paid and reasonable
expenses incurred in connection therewith); (ii) such Permitted Refinancing
Indebtedness has a final maturity date later than the final maturity date of,
and has a Weighted Average Life to Maturity equal to or greater than the
Weighted Average Life to Maturity of, the Indebtedness being extended,
refinanced, renewed, replaced, defeased or refunded; (iii) if the Indebtedness
being extended, refinanced, renewed, replaced, defeased or refunded is
subordinated in right of payment to the Securities, such Permitted Refinancing
Indebtedness has a final maturity date later than the final maturity date of,
and is subordinated in right of payment to, the Securities on subordination
terms at least as favorable to the Holders of Securities as those contained in
the documentation governing the Indebtedness being extended, refinanced,
renewed, replaced, defeased or refunded; (iv) such Indebtedness is incurred by
the Company if the Company is the obligor on the Indebtedness being extended,
refinanced, renewed, replaced, defeased or refunded; and (v) such Indebtedness
is incurred by the Company or a Subsidiary if a Subsidiary is the obligor on the
Indebtedness being extended, refinanced, renewed, replaced, defeased or
refunded.

       "PERSON" means any individual, corporation, partnership, joint venture,
association, joint-stock company, trust or unincorporated organization
(including any subdivision or ongoing business of any such entity or
substantially all of the assets of any such entity, subdivision or business).

       "PHYSICIAN JOINT VENTURE DISTRIBUTIONS" means distributions made by the
Company or any of its Subsidiaries to any physician, pharmacist or other allied
healthcare professional in connection with the unwinding, liquidation or other
termination of any joint venture or similar arrangement between any such Person
and the Company or any of its Subsidiaries.

       "PHYSICIAN SUPPORT OBLIGATIONS" means any obligation or Guarantee
incurred in the ordinary course of business by the Company or a Subsidiary of
the Company in connection with any advance, loan or payment to, or on behalf of
or for the benefit of any physician, pharmacist or other allied healthcare
professional for the purpose of recruiting, redirecting or retaining the
physician, pharmacist or other allied healthcare professional to provide service
to patients in the service area of any Hospital or Related Business owned or
operated by the Company or any of its Subsidiaries; EXCLUDING, HOWEVER,
compensation for services provided by physicians, pharmacists or other allied
healthcare professionals to any Hospital or Related Business owned or operated
by the Company or any of its Subsidiaries.

       "QUALIFIED EQUITY INTERESTS" shall mean all Equity Interests of the
Company other than Disqualified Stock of the Company.

       "RATING AGENCIES" means (i) S&P and (ii) Moody's or (iii) if S&P or
Moody's or both shall not make a rating of the Securities publicly available, a
nationally recognized securities rating

                                      -7-
<PAGE>

agency or agencies, as the case may be, selected by the Company, which shall be
substituted for S&P or Moody's or both, as the case may be.

       "RATING CATEGORY" means (i) with respect to S&P, any of the following
categories: BB, B, CCC, CC, C and D (or equivalent successor categories); (ii)
with respect to Moody's, any of the following categories: Ba, B, Caa, Ca, C and
D (or equivalent successor categories); and (iii) the equivalent of any such
category of S&P or Moody's used by another Rating Agency. In determining whether
the rating of the Securities has decreased by one or more gradations, gradations
within Rating Categories (+ and - for S&P; 1, 2 and 3 for Moody's; or the
equivalent gradations for another Rating Agency) shall be taken into account
(e.g., with respect to S&P, a decline in a rating from BB+ to BB, as well as
from BB- to B+, shall constitute a decrease of one gradation).

       "RATING DATE" means the date which is 90 days prior to the earlier of (i)
a Change of Control and (ii) the first public notice of the occurrence of a
Change of Control or of the intention by the Company to effect a Change of
Control.

       "RATING DECLINE" means the occurrence on or within 90 days after the date
of the first public notice of the occurrence of a Change of Control or of the
intention by the Company to effect a Change of Control (which period shall be
extended so long as the rating of the Securities is under publicly announced
consideration for possible downgrade by any of the Rating Agencies) of: (a) in
the event the Securities are rated by either Moody's or S&P on the Rating Date
as Investment Grade, a decrease in the rating of the Securities by both Rating
Agencies to a rating that is below Investment Grade, or (b) in the event the
Securities are rated below Investment Grade by both Rating Agencies on the
Rating Date, a decrease in the rating of the Securities by either Rating Agency
by one or more gradations (including gradations within Rating Categories as well
as between Rating Categories).

       "REFINANCING" has the meaning ascribed to it in the prospectus dated
January 27, 1997 relating to the Company's 7-7/8% Senior Notes due 2003, the
Securities and the Senior Subordinated Notes.

       "RELATED BUSINESS" means a healthcare business affiliated or associated
with a Hospital or any business related or ancillary to the provision of
healthcare services or information or the investment in, management, leasing or
operation of a Hospital.

       "RESPONSIBLE OFFICER" when used with respect to the Trustee, means any
officer within the corporate trust department of the Trustee (or any successor
group of the Trustee) or any other officer of the Trustee customarily performing
functions similar to those performed by any of the above designated officers and
also means, with respect to a particular corporate trust matter, any other
officer to whom such matter is referred because of his knowledge of and
familiarity with the particular subject.

       "SECURITIES" means the securities described above, issued under this
Indenture.

       "SECURITIES ACT" means the Securities Act of 1933, as amended.

       "SENIOR SUBORDINATED NOTES" means the 8-5/8% Senior Subordinated Notes
due 2007 of the Company in an aggregate principal amount of $700.0 million,
issued pursuant to the Senior Subordinated Note Indenture.

                                      -8-
<PAGE>

       "SENIOR SUBORDINATED NOTE INDENTURE" means the Indenture dated as of
January 15, 1997 between the Company and The Bank of New York, as trustee, as
amended or supplemented from time to time, under which the Senior Subordinated
Notes were issued.

       "SIGNIFICANT SUBSIDIARY" means any Subsidiary that would be a
"significant subsidiary" as defined in Article 1, Rule 1-02 of Regulation S-X,
promulgated pursuant to the Securities Act, as such Regulation is in effect on
the Closing Date.

       "S&P" means Standard & Poor's Corporation and its successors.

       "SPECIFIED EXCHANGE" means any retirement of Indebtedness upon the
exercise by a holder of such Indebtedness, pursuant to the terms thereof, of any
right to exchange such Indebtedness for shares of common stock of Vencor, Inc.
or any successor thereto or any other equity securities, other than Equity
Interests of a Subsidiary, owned by the Company as of October 11, 1995, or for
any securities or other property received with respect to such common stock or
equity securities or cash in lieu thereof, whether or not such right is subject
to the Company's ability to pay an amount in cash in lieu thereof.

       "STOCKHOLDERS' EQUITY" means, with respect to any Person as of any date,
the stockholders' equity of such Person determined in accordance with GAAP as of
the date of the most recent available internal financial statements of such
Person, and calculated on a PRO FORMA basis to give effect to any acquisition or
disposition by such Person consummated or to be consummated since the date of
such financial statements and on or prior to the date of such calculation.

       "SUBSIDIARY" means, with respect to any Person, (i) any corporation,
association or other business entity of which more than 50% of the total voting
power of shares of Capital Stock entitled (without regard to the occurrence of
any contingency), to vote in the election of directors, managers or trustees
thereof is at the time owned or controlled, directly or indirectly, by such
Person or one or more of the other Subsidiaries of that Person (or a combination
thereof) and (ii) any partnership (a) the sole general partner or the managing
general partner of which is such Person or a Subsidiary of such Person or (b)
the only general partners of which are such Person or of one or more
Subsidiaries of such Person (or any combination thereof).

       "TIA" means the Trust Indenture Act of 1939, as amended (15 U.S.C.
Section 77aaa-77bbbb) as in effect on the date on which this Indenture is
qualified under the TIA, except as provided in Section 8.03 hereof.

       "TRANSFER RESTRICTION" means, with respect to the Company's Subsidiaries,
any encumbrance or restriction on the ability of any Subsidiary to (i)(a) pay
dividends or make any other distributions to the Company or any of its
Subsidiaries (1) on its Capital Stock or (2) with respect to any other interest
or participation in, or measured by, its profits, or (b) pay any Indebtedness
owed to the Company or any of its Subsidiaries, (ii) make loans or advances to
the Company or any of its Subsidiaries, or (iii) transfer any of its properties
or assets to the Company or any of its Subsidiaries.

       "TRUSTEE" means the party named as such above until a successor replaces
it in accordance with the applicable provisions of this Indenture and thereafter
means the successor serving hereunder.

       "WEIGHTED AVERAGE LIFE TO MATURITY" means, when applied to any
Indebtedness at any date, the number of years obtained by dividing (i) the sum
of the products obtained by multiplying (a) the

                                      -9-
<PAGE>

amount of each then remaining installment, sinking fund, serial maturity or
other required payments of principal, including payment at final maturity, in
respect thereof, by (b) the number of years (calculated to the nearest
one-twelfth) that will elapse between such date and the making of such payment,
by (ii) the then outstanding principal amount of such Indebtedness.

       "WHOLLY OWNED SUBSIDIARY" of any Person means a Subsidiary of such Person
all of the outstanding Capital Stock or other ownership interests of which
(other than directors' qualifying shares) shall at the time be owned by such
Person or by one or more Wholly Owned Subsidiaries of such Person or by such
Person and one or more Wholly Owned Subsidiaries of such Person.

       "2005 EXCHANGEABLE SUBORDINATED NOTES" means the 6% Exchangeable
Subordinated Notes due 2005 of the Company in an aggregate principal amount of
$320.0 million, issued pursuant to the Indenture dated as of January 10, 1996,
between the Company and The Bank of New York, as trustee, as amended or
supplemented from time to time.

       "2005 SENIOR SUBORDINATED NOTES" means the 10-1/8% Senior Subordinated
Notes due 2005 of the Company in an aggregate principal amount of $900.0
million, issued pursuant to the Indenture dated as of March 1, 1995, between the
Company and The Bank of New York, as trustee, as amended or supplemented from
time to time.

SECTION 1.02. OTHER DEFINITIONS.
                                                             DEFINED IN
   TERM                                                        SECTION
   ----                                                        -------
   "Affiliate Transaction" ...................................   3.10
   "Bankruptcy Law" ..........................................   5.01
   "Change of Control Offer" .................................   3.12
   "Change of Control Payment" ...............................   3.12
   "Change of Control Payment Date" ..........................   3.12
   "Covenant Defeasance" .....................................   7.03
   "Custodian" ...............................................   5.01
   "Event of Default" ........................................   5.01
   "incur" ...................................................   3.09
   "Legal Defeasance" ........................................   7.02
   "Legal Holiday" ...........................................   9.07
   "Notice of Default" .......................................   5.01
   "Paying Agent" ............................................   2.03
   "Registrar" ...............................................   2.03
   "Restricted Payments" .....................................   3.07

SECTION 1.03. INCORPORATION BY REFERENCE OF TIA.

       Whenever this Indenture refers to a provision of the TIA, the provision
is incorporated by reference in and made a part of this Indenture.

       The following TIA terms used in this Indenture have the following
meanings:

       "INDENTURE SECURITIES" means the Securities;

       "INDENTURE SECURITY HOLDER" means a Holder;

                                      -10-
<PAGE>

       "INDENTURE TO BE QUALIFIED" means this Indenture;

       "INDENTURE TRUSTEE" or "INSTITUTIONAL TRUSTEE" means the Trustee;

       "OBLIGOR" on the Securities means the Company and any successor obligor
upon the Securities.

       All other terms used in this Indenture that are defined by the TIA,
defined by TIA reference to another statute or defined by the Commission rule
under the TIA have the meanings so assigned to them.

SECTION 1.04. RULES OF CONSTRUCTION.

       Unless the context otherwise requires:

              (1) a term has the meaning assigned to it;

              (2) an accounting term not otherwise defined has the meaning
       assigned to it in accordance with GAAP;

              (3) "or" is not exclusive;

              (4) words in the singular include the plural, and in the plural
       include the singular; and

              (5) provisions apply to successive events and transactions.

                                    ARTICLE 2
                                 THE SECURITIES

SECTION 2.01. FORM AND DATING.

       The Securities and the Trustee's certificate of authentication shall be
substantially in the form of Exhibit A hereto, the terms of which are
incorporated in and made a part of this Indenture. The Securities may have
notations, legends or endorsements approved as to form by the Company and
required by law, stock exchange rule, agreements to which the Company is subject
or usage. Each Security shall be dated the date of its authentication. The
Securities shall be issuable only in registered form, without coupons, in
denominations of $1,000 and integral multiples thereof. The Securities may be
Global Securities, as determined by the officers executing such Securities, as
evidenced by their execution of such Securities.

SECTION 2.02. FORM OF LEGEND FOR GLOBAL SECURITY.

       Every Global Security authenticated and delivered hereunder shall bear a
legend in substantially the following form:

              "This Security is a Global Security within the meaning of the
       Indenture hereinafter referred to and is registered in the name of a
       Depositary or a nominee thereof. This Security may not be exchanged in
       whole or in part for a Security registered, and no transfer of

                                      -11-
<PAGE>

       this Security in whole or in part may be registered, in the name of any
       person other than such Depositary or a nominee thereof, except in the
       limited circumstances described in the Indenture."

SECTION 2.03. EXECUTION AND AUTHENTICATION.

       An Officer of the Company shall sign the Securities for the Company by
manual or facsimile signature.

       If an Officer whose signature is on a Security no longer holds that
office at the time the Security is authenticated, the Security shall
nevertheless be valid.

       A Security shall not be valid until authenticated by the manual signature
of the Trustee. The signature of the Trustee shall be conclusive evidence that
the Security has been authenticated under this Indenture. The form of Trustee's
certificate of authentication to be borne by the Securities shall be
substantially as set forth in Exhibit A hereto.

       The Trustee shall, upon a written order of the Company signed by two
Officers of the Company, authenticate Securities for original issue up to the
aggregate principal amount stated in paragraph 4 of the Securities. The
aggregate principal amount of Securities outstanding at any time shall not
exceed the amount set forth herein except as provided in Section 2.09 hereof.

       The Trustee may appoint an authenticating agent acceptable to the Company
to authenticate Securities. Unless limited by the terms of such appointment, an
authenticating agent may authenticate Securities whenever the Trustee may do so.
Each reference in this Indenture to authentication by the Trustee includes
authentication by such agent. An authenticating agent has the same rights as an
Agent to deal with the Company or an Affiliate of the Company.

       Each Global Security authenticated under this Indenture shall be
registered in the name of the Depositary designated for such Global Security or
a nominee thereof and delivered to such Depositary or a nominee thereof or
custodian therefor, and each such Global Security shall constitute a single
Security for all purposes of this Indenture.

       The Company initially appoints The Depository Trust Company as the
Depositary.

SECTION 2.04. REGISTRAR AND PAYING AGENT.

       The Company shall maintain (i) an office or agency where Securities may
be presented for registration of transfer or for exchange (including any
co-registrar, the "REGISTRAR") and (ii) an office or agency where Securities may
be presented for payment (the "PAYING AGENT"). The Registrar shall keep a
register of the Securities and of their transfer and exchange. The Company may
appoint one or more co-registrars and one or more additional paying agents. The
term "Paying Agent" includes any additional paying agent. The Company may change
any Paying Agent, Registrar or co-registrar without prior notice to any Holder.
The Company shall notify the Trustee and the Trustee shall notify the Holders of
the name and address of any Agent not a party to this Indenture. If the Company
fails to appoint or maintain another entity as Registrar or Paying Agent, the
Trustee shall act as such. The Company or any of its Subsidiaries may act as
Paying Agent, Registrar or co-registrar. The Company shall enter into an
appropriate agency agreement with any Agent not a party to this Indenture, which
shall incorporate the provisions of the TIA. The agreement shall implement the
provisions of this Indenture that relate to such Agent. The Company shall notify
the Trustee of the name and address of any such

                                      -12-
<PAGE>

Agent. If the Company fails to maintain a Registrar or Paying Agent, or fails to
give the foregoing notice, the Trustee shall act as such, and shall be entitled
to appropriate compensation in accordance with Section 6.07 hereof.

       The Company initially appoints the Trustee as Registrar, Paying Agent and
agent for service of notices and demands in connection with the Securities.

SECTION 2.05. PAYING AGENT TO HOLD MONEY IN TRUST.

       On or prior to the due date of principal of, premium, if any, and
interest on any Securities, the Company shall deposit with the Trustee or the
Paying Agent money sufficient to pay such principal, premium, if any, and
interest becoming due. The Company shall require each Paying Agent other than
the Trustee to agree in writing that the Paying Agent shall hold in trust for
the benefit of the Holders or the Trustee all money held by the Paying Agent for
the payment of principal of, premium, if any, and interest on the Securities,
and shall notify the Trustee of any Default by the Company in making any such
payment. While any such Default continues, the Trustee may require a Paying
Agent to pay all money held by it to the Trustee. The Company at any time may
require a Paying Agent to pay all money held by it to the Trustee. Upon payment
over to the Trustee, the Paying Agent (if other than the Company) shall have no
further liability for the money delivered to the Trustee. If the Company acts as
Paying Agent, it shall segregate and hold in a separate trust fund for the
benefit of the Holders all money held by it as Paying Agent.

SECTION 2.06. HOLDER LISTS.

       The Trustee shall preserve in as current a form as is reasonably
practicable the most recent list available to it of the names and addresses of
Holders and shall otherwise comply with TIA Section 312(a). If the Trustee is
not the Registrar,. the Company shall furnish to the Trustee at least seven
Business Days before each interest payment date and at such other times as the
Trustee may request in writing a list in such form and as of such date as the
Trustee may reasonably require of the names and addresses of Holders, including
the aggregate principal amount of the Securities held by each thereof, and the
Company shall otherwise comply with TIA Section 312(a).

SECTION 2.07. TRANSFER AND EXCHANGE.

       When Securities are presented to the Registrar with a request to register
the transfer or to exchange them for an equal principal amount of Securities of
other denominations, the Registrar shall register the transfer or make the
exchange if its requirements for such transactions are met; PROVIDED, HOWEVER,
that any Security presented or surrendered for registration of transfer or
exchange shall be duly endorsed or accompanied by a written instruction of
transfer in form satisfactory to the Registrar and the Trustee duly executed by
the Holder thereof or by his attorney duly authorized in writing. To permit
registrations of transfer and exchanges, the Company shall issue and the Trustee
shall authenticate Securities at the Registrar's request, subject to such rules
as the Trustee may reasonably require.

       Neither the Company nor the Registrar shall be required to register the
transfer or exchange of a Security between the record date and the next
succeeding interest payment date.

       No service charge shall be made to any Holder for any registration of
transfer or exchange (except as otherwise expressly permitted herein), but the
Company may require payment of a sum sufficient to cover any transfer tax or
similar governmental charge payable in connection therewith

                                      -13-
<PAGE>

(other than such transfer tax or similar governmental charge payable upon
exchanges pursuant to Sections 2.12 or 8.05 hereof, which shall be paid by the
Company).

       Notwithstanding the foregoing, a Global Security may not be transferred
except as a whole by the Depositary to a nominee of the Depositary or any such
nominee to a successor of the Depositary or a nominee of such successor, unless:

              (i) the Depositary is at any time unwilling or unable to continue
       as depository or if at any time the Depositary ceases to be a clearing
       agency registered under the Exchange Act and a successor depository is
       not appointed by the Company within 90 days,

              (ii) an Event of Default under this Indenture with respect to the
       Securities has occurred and is continuing and the beneficial owners
       representing a majority in principal amount of the Securities advise the
       Depositary to cease acting as depositary or

              (iii) the Company, in its sole discretion, determines at any time
       that the Securities shall no longer be represented by a Global Security,
       the Company will issue individual Securities of the applicable amount and
       in certificated form in exchange for a Global Security. In any such
       instance, an owner of a beneficial interest in the Global Security will
       be entitled to physical delivery of individual securities in certificated
       form of like tenor, equal in principal amount to such beneficial interest
       and to have such Securities in certificated form registered in its name.

SECTION 2.08. PERSONS DEEMED OWNERS.

       Prior to due presentment for registration of transfer of any Security,
the Trustee, any Agent and the Company may deem and treat the Person in whose
name any Security is registered as the absolute owner of such Security for the
purpose of receiving payment of principal of, premium, if any, and interest on
such Security and for all other purposes whatsoever, whether or not such
Security is overdue, and neither the Trustee, any Agent nor the Company shall be
affected by notice to the contrary.

       So long as the Depositary or its nominee is the registered Holder of a
Global Security, the Depositary or its nominee, as the case may be, will be
treated as the sole owner of it for all purposes under the Indenture and the
beneficial owners of the Securities will be entitled only to those rights and
benefits afforded to them in accordance with the Depositary's regular operating
procedures. Except as provided in Section 2.07, owners of beneficial interests
in a Global Security will not be entitled to have Securities represented by a
Global Security registered in their names, will not receive or be entitled to
receive physical delivery of Securities in certificated form and will not be
considered the registered Holders thereof under the Indenture.

       None of the Company, the Trustee, any Paying Agent or the Registrar will
have any responsibility or liability for any aspect of the records relating to
or payments made on account of beneficial ownership interests of a Global
Security or for maintaining, supervising or reviewing any records relating to
such beneficial ownership interests.

SECTION 2.09. REPLACEMENT SECURITIES.

       If any mutilated Security is surrendered to the Trustee or the Company,
or the Trustee receives evidence to its satisfaction of the destruction, loss or
theft of any Security, the Company shall issue and the Trustee, upon the written
order of the Company signed by two Officers of the Company,

                                      -14-
<PAGE>

shall authenticate a replacement Security if the Trustee's requirements for
replacements of Securities are met. If required by the Trustee or the Company,
an indemnity bond must be supplied by the Holder that is sufficient in the
judgment of the Trustee and the Company to protect the Company, the Trustee, any
Agent and any authenticating agent from any loss which any of them may suffer if
a Security is re placed. Each of the Company and the Trustee may charge for its
expenses in replacing a Security.

       Every replacement Security is an additional obligation of the Company.

SECTION 2.10. OUTSTANDING SECURITIES.

       The Securities outstanding at any time are all the Securities
authenticated by the Trustee except for those cancelled by it, those delivered
to it for cancellation and those described in this Section as not outstanding.

       If a Security is replaced pursuant to Section 2.09 hereof, it ceases to
be outstanding unless the Trustee receives proof satisfactory to it that the
replaced Security is held by a bona fide purchaser.

       If the principal amount of any Security is considered paid under Section
3.01 hereof, it ceases to be outstanding and interest on it ceases to accrue.

       Subject to Section 2.11 hereof, a Security does not cease to be
outstanding because the Company or an Affiliate of the Company holds the
Security.

SECTION 2.11. TREASURY SECURITIES.

       In determining whether the Holders of the required principal amount of
Securities then outstanding have concurred in any demand, direction, waiver or
consent, Securities owned by the Company or any Affiliate of the Company shall
be considered as though not outstanding, except that for purposes of determining
whether the Trustee shall be protected in relying on any such demand, direction,
waiver or consent, only Securities that a Responsible Officer actually knows to
be so owned shall be so considered. Notwithstanding the foregoing, Securities
that are to be acquired by the Company or an Affiliate of the Company pursuant
to an exchange offer, tender offer or other agreement shall not be deemed to be
owned by the Company or an Affiliate of the Company until legal title to such
Securities passes to the Company or such Affiliate, as the case may be.

SECTION 2.12. TEMPORARY SECURITIES.

       Until definitive Securities are ready for delivery, the Company may
prepare and the Trustee, upon receipt of the written order of the Company signed
by two Officers of the Company, shall authenticate temporary Securities.
Temporary Securities shall be substantially in the form of definitive Securities
but may have variations that the Company and the Trustee consider appropriate
for temporary Securities. Without unreasonable delay, the Company shall prepare
and the Trustee, upon receipt of the written order of the Company signed by two
Officers of the Company, shall authenticate definitive Securities in exchange
for temporary Securities. Until such exchange, temporary Securities shall be
entitled to the same rights, benefits and privileges as definitive Securities.

                                      -15-
<PAGE>

SECTION 2.13. CANCELLATION.

       The Company at any time may deliver Securities to the Trustee for
cancellation. The Registrar and Paying Agent shall forward to the Trustee any
Securities surrendered to them for registration of transfer, exchange or
payment. The Trustee shall cancel all Securities surrendered for registration of
transfer, exchange, payment, replacement or cancellation and shall return such
cancelled Securities to the Company. The Company may not issue new Securities to
replace Securities that it has paid or that have been delivered to the Trustee
for cancellation.

SECTION 2.14. DEFAULTED INTEREST.

       If the Company defaults in a payment of interest on the Securities, it
shall pay the defaulted interest in any lawful manner plus, to the extent
lawful, interest payable on the defaulted interest, to the Persons who are
Holders on a subsequent special record date, which date shall be at the earliest
practicable date but in all events at least five Business Days prior to the
related payment date, in each case at the rate provided in the Securities and in
Section 3.01 hereof. The Company shall, with the consent of the Trustee, fix or
cause to be fixed each such special record date and payment date. At least 15
days before the special record date, the Company (or the Trustee, in the name of
and at the expense of the Company) shall mail to Holders a notice that states
the special record date, the related payment date and the amount of such
interest to be paid.

SECTION 2.15. RECORD DATE.

       The record date for purposes of determining the identity of Holders
entitled to vote or consent to any action by vote or consent authorized or
permitted under this Indenture shall be determined as provided for in TIA
Section 316(c).

SECTION 2.16. CUSIP NUMBER.

       The Company in issuing the Securities may use a "CUSIP" number, and if it
does so, the Trustee shall use the CUSIP number in notices to Holders; PROVIDED
that any such notice may state that no representation is made as to the
correctness or accuracy of the CUSIP number printed in the notice or on the
Securities and that reliance may be placed only on the other identification
numbers printed on the Securities. The Company shall promptly notify the Trustee
of any change in the CUSIP number.

                                    ARTICLE 3
                                    COVENANTS

SECTION 3.01. PAYMENT OF SECURITIES.

       The Company shall pay or cause to be paid the principal of, premium, if
any, and interest on the Securities on the dates and in the manner provided in
this Indenture and the Securities. Principal, premium, if any, and interest
shall be considered paid on the date due if the Paying Agent, if other than the
Company or a Subsidiary of the Company, holds as of 10:00 a.m. Eastern Time on
the due date money deposited by the Company in immediately available funds and
designated for and sufficient to pay all principal, premium, if any, and
interest then due. Such Paying Agent shall return to the Company, no later than
five days following the date of payment, any money (including accrued interest)
that exceeds such amount of principal, premium, if any, and interest to be paid
on the Securities.

                                      -16-
<PAGE>

       The Company shall pay interest (including post-petition interest in any
proceeding under any Bankruptcy Law) on overdue principal at the rate equal to
1% per annum in excess of the interest rate then applicable to the Securities
to the extent lawful. In addition, it shall pay interest (including
post-petition interest in any proceeding under any Bankruptcy Law) on overdue
installments of interest (without regard to any applicable grace period) at the
same rate to the extent lawful.

SECTION 3.02. MAINTENANCE OF OFFICE OR AGENCY.

       The Company shall maintain in the Borough of Manhattan, the City of New
York, an office or agency (which may be an office of the Trustee or an affiliate
of the Trustee, Registrar or co-registrar) where Securities may be surrendered
for registration of transfer or exchange and where notices and demands to or
upon the Company in respect of the Securities and this Indenture may be served.
The Company shall give prompt written notice to the Trustee of the location, and
any change in the location, of such office or agency. If at any time the Company
shall fail to maintain any such required office or agency or shall fail to
furnish the Trustee with the address thereof, such presentations, surrenders,
notices and demands may be made or served at the Corporate Trust Office of the
Trustee.

       The Company may also from time to time designate one or more other
offices or agencies where the Securities may be presented or surrendered for any
or all such purposes and may from time to time rescind such designations;
PROVIDED, HOWEVER, that no such designation or rescission shall in any manner
relieve the Company of its obligation to maintain an office or agency in
the Borough of Manhattan, the City of New York for such purposes. The Company
shall give prompt written notice to the Trustee of any such designation or
rescission and of any change in the location of any such other office or
agency.

       The Company hereby designates The Bank of New York, 101 Barclay Street,
21 West, New York, New York 10286 as one such office or agency of the Company in
accordance with Section 2.04 hereof.

SECTION 3.03. COMMISSION REPORTS.

              (i) So long as any of the Securities remain outstanding, the
       Company shall provide to the Trustee within 15 days after the filing
       thereof with the Commission copies of the annual reports and of the
       information, documents and other reports (or copies of such portions of
       any of the foregoing as the Commission may by rules and regulations
       prescribe) that the Company is required to file with the Commission
       pursuant to Section 13 or 15(d) of the Exchange Act. All obligors on the
       Securities shall comply with the provisions of TIA Section 314(a).
       Notwithstanding that the Company may not be subject to the reporting
       requirements of Section 13 or 15(d) of the Exchange Act or otherwise
       report on an annual and quarterly basis on forms provided for such annual
       and quarterly reporting pursuant to rules and regulations promulgated by
       the Commission, the Company shall file with the Commission and provide to
       the Trustee (a) within 90 days after the end of each fiscal year, annual
       reports on Form 10-K (or any successor or comparable form) containing the
       information required to be contained therein (or required in such
       successor or comparable form), including a "MANAGEMENT'S DISCUSSION AND
       ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS" and a report
       thereon by the Company's certified public accountants; (b) within 45 days
       after the end of each of the first three fiscal quarters of each fiscal
       year, reports on Form 10-Q (or any successor or comparable form)
       containing the information required to be contained therein (or required
       in any successor or comparable form), including a "MANAGEMENT'S
       DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF
       OPERATIONS"; and (c) promptly from time to time after the occurrence of
       an event required to be

                                      -17-
<PAGE>

       therein reported, such other reports on Form 8-K (or any successor or
       comparable form) containing the information required to be contained
       therein (or required in any successor or comparable form); PROVIDED,
       HOWEVER, that the Company shall not be in default of the provisions of
       this Section 3.03(i) for any failure to file reports with the Commission
       solely by the refusal of the Commission to accept the same for filing.
       Each of the financial statements contained in such reports shall be
       prepared in accordance with GAAP.

              (ii) The Trustee, at the Company's request and expense, shall
       promptly mail copies of all such annual reports, information, documents
       and other reports provided to the Trustee pursuant to Section 3.03(i)
       hereof to the Holders at their addresses appearing in the register of
       Securities maintained by the Registrar.

              (iii) Whether or not required by the rules and regulations of the
       Commission, the Company shall file a copy of all such information and
       reports with the Commission for public availability and make such
       information available to securities analysts and prospective investors
       upon request.

              (iv) The Company shall provide the Trustee with a sufficient
       number of copies of all reports and other documents and information that
       the Trustee may be required to deliver to the Holders under this Section
       3.03.

              (v) Delivery of such reports, information and documents to the
       Trustee is for informational purposes only and the Trustee's receipt of
       such shall not constitute constructive notice of any information
       contained therein or determinable from information contained therein,
       including the Company's compliance with any of its covenants hereunder
       (as to which the Trustee is entitled to rely exclusively on Officers'
       Certificates).

SECTION 3.04. COMPLIANCE CERTIFICATE.

              (i) The Company shall deliver to the Trustee, within 120 days
       after the end of each fiscal year, an Officers' Certificate stating that
       a review of the activities of the Company and its Subsidiaries during the
       preceding fiscal year has been made under the supervision of the signing
       Officers with a view to determining whether each has kept, observed,
       performed and fulfilled its obligations under this Indenture, and further
       stating, as to each such Officer signing such certificate, that to the
       best of his or her knowledge each entity has kept, observed, performed
       and fulfilled each and every covenant contained in this Indenture and is
       not in default in the performance or observance of any of the terms,
       provisions and conditions of this Indenture (or, if a Default or Event of
       Default shall have occurred, describing all such Defaults or Events of
       Default of which he or she may have knowledge and what action each is
       taking or proposes to take with respect thereto), all without regard to
       periods of grace or notice requirements, and that to the best of his or
       her knowledge no event has occurred and remains in existence by reason of
       which payments on account of the principal of or interest, if any, on the
       Securities is prohibited or if such event has occurred, a description of
       the event and what action each is taking or proposes to take with respect
       thereto.

              (ii) So long as not contrary to the then current recommendations
       of the American Institute of Certified Public Accountants, the year-end
       financial statements delivered pursuant to Section 3.03 above shall be
       accompanied by a written statement of the Company's certified independent
       public accountants (who shall be a firm of established national
       reputation) that in making the examination necessary for certification of
       such financial statements nothing has come

                                      -18-
<PAGE>

       to their attention which would lead them to believe that the Company or
       any Subsidiary of the Company has violated any provisions of Article 3 or
       of Article 4 of this Indenture or, if any such violation has occurred,
       specifying the nature and period of existence thereof, it being
       understood that such accountants shall not be liable directly or
       indirectly to any Person for any failure to obtain knowledge of any such
       violation.

              (iii) The Company shall, so long as any of the Securities are
       outstanding, deliver to the Trustee, forthwith upon any Officer becoming
       aware of (a) any Default or Event of Default or (b) any event of default
       under any other mortgage, indenture or instrument referred to in Section
       5.01(v) hereof, an Officers' Certificate specifying such Default, Event
       of Default or event of default and what action the Company is taking or
       proposes to take with respect thereto.

SECTION 3.05. TAXES.

       The Company shall pay, and shall cause each of its Subsidiaries to pay,
prior to delinquency, all material taxes, assessments, and governmental levies
except (i) as contested in good faith by appropriate proceedings and with
respect to which appropriate reserves have been taken in accordance with GAAP or
(ii) where the failure to effect such payment is not adverse in any material
respect to the Holders.

SECTION 3.06. STAY, EXTENSION AND USURY LAWS.

       The Company covenants (to the extent that it may lawfully do so) that it
shall not at any time insist upon, plead, or in any manner whatsoever claim or
take the benefit or advantage of, any stay, extension or usury law wherever
enacted, now or at any time hereafter in force, that may affect the covenants or
the performance of this Indenture; and the Company (to the extent that it may
lawfully do so) hereby expressly waives all benefit or advantage of any such
law, and covenants that it shall not, by resort to any such law, hinder, delay
or impede the execution of any power herein granted to the Trustee, but shall
suffer and permit the execution of every such power as though no such law has
been enacted.

SECTION 3.07. LIMITATIONS ON RESTRICTED PAYMENTS.

       The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly: (i) declare or pay any dividend or make any distribution
on account of the Company's or any of its Subsidiaries' Equity Interests (other
than (w) Physician Joint Venture Distributions, (x) dividends or distributions
payable in Qualified Equity Interests of the Company, (y) dividends or
distributions payable to the Company or any Subsidiary of the Company, and (z)
dividends or distributions by any Subsidiary of the Company payable to all
holders of a class of Equity Interests of such Subsidiary on a PRO RATA basis);
(ii) purchase, redeem or otherwise acquire or retire for value any Equity
Interests of the Company; or (iii) make any principal payment on, or purchase,
redeem, defease or otherwise acquire or retire for value any Indebtedness that
is subordinated to the Securities, except at the original final maturity date
thereof or pursuant to a Specified Exchange or the Refinancing (all such
payments and other actions set forth in clauses (i) through (iii) above being
collectively referred to as "RESTRICTED PAYMENTS"), unless, at the time of and
after giving effect to such Restricted Payment (the amount of any such
Restricted Payment, if other than cash, shall be the fair market value (as
conclusively evidenced by a resolution of the Board of Directors set forth in
an Officers' Certificate delivered to the Trustee within 60 days prior to the
date of such Restricted Payment) of the asset(s) proposed to be transferred by
the Company or such Subsidiary, as the case may be, pursuant to such Restricted
Payment):

                                      -19-
<PAGE>

              (a) no Default or Event of Default shall have occurred and be
       continuing or would occur as a consequence thereof; and

              (b) the Company would, at the time of such Restricted Payment and
       after giving PRO FORMA effect thereto as if such Restricted Payment had
       been made at the beginning of the most recently ended four full fiscal
       quarter period for which internal financial statements are available
       immediately preceding the date of such Restricted Payment, have been
       permitted to incur at least $1.00 of additional Indebtedness pursuant to
       the Fixed Charge Coverage Ratio test set forth in the first paragraph of
       Section 3.09 hereof; and

              (c) such Restricted Payment, together with the aggregate of all
       other Restricted Payments made by the Company and its Subsidiaries after
       March 1, 1995 (excluding Restricted Payments permitted by clauses (ii),
       (iii) and (iv) of the next succeeding paragraph), is less than the sum of
       (1) 50% of the Consolidated Net Income of the Company for the period
       (taken as one accounting period) from the beginning of the first fiscal
       quarter commencing after March 1, 1995 to the end of the Company's most
       recently ended fiscal quarter for which internal financial statements are
       available at the time of such Restricted Payment (or, if such
       Consolidated Net Income for such period is a deficit, less 100% of such
       deficit), PLUS (2) 100% of the aggregate net cash proceeds received by
       the Company from the issue or sale (other than to a Subsidiary of the
       Company) since March 1, 1995 of Qualified Equity Interests of the Company
       or of debt securities of the Company or any of its Subsidiaries that have
       been converted into or exchanged for such Qualified Equity Interests of
       the Company, PLUS (3) $20.0 million.

       If no Default or Event of Default has occurred and is continuing, or
would occur as a consequence thereof, the foregoing provisions shall not
prohibit the following Restricted Payments:

              (i) the payment of any dividend within 60 days after the date of
       declaration thereof, if at said date of declaration such payment would
       have complied with the provisions hereof;

              (ii) the payment of cash dividends on any series of Disqualified
       Stock issued after the Closing Date in an aggregate amount not to exceed
       the cash received by the Company since the Closing Date upon issuance of
       such Disqualified Stock;

              (iii) the redemption, repurchase, retirement or other acquisition
       of any Equity Interests of the Company or any Subsidiary in exchange for,
       or out of the net cash proceeds of, the substantially concurrent sale
       (other than to a Subsidiary of the Company) of Qualified Equity Interests
       of the Company; PROVIDED that the amount of any such net cash proceeds
       that are utilized for any such redemption, repurchase, retirement or
       other acquisition shall be excluded from clause (c)(2) of the preceding
       paragraph;

              (iv) the defeasance, redemption or repurchase of subordinated
       Indebtedness with the net cash proceeds from an incurrence of Permitted
       Refinancing Indebtedness or in exchange for or out of the net cash
       proceeds from the substantially concurrent sale (other than to a
       Subsidiary of the Company) of Qualified Equity Interests of the Company;
       PROVIDED that the amount of any such net cash proceeds that are utilized
       for any such redemption, repurchase, retirement or other acquisition
       shall be excluded from clause (c)(2) of the preceding paragraph;

              (v) the repurchase, redemption or other acquisition or retirement
       for value of any Equity Interests of the Company or any Subsidiary of the
       Company held by any member of the Company's (or any of its Subsidiaries')
       management pursuant to any management equity

                                      -20-
<PAGE>

       subscription agreement or stock option agreement; PROVIDED that the
       aggregate price paid for all such repurchased, redeemed, acquired or
       retired Equity Interests shall not exceed $15.0 million in any
       twelve-month period; and

              (vi) the making and consummation of (A) a senior subordinated
       asset sale offer in accordance with the provisions of the indenture
       relating to the 2005 Senior Subordinated Notes or (B) a Change of Control
       Offer with respect to the Senior Subordinated Notes in accordance with
       the provisions of the Senior Subordinated Note Indenture or change of
       control offer with respect to the 2005 Senior Subordinated Notes or the
       2005 Exchangeable Subordinated Notes in accordance with the provisions of
       the indentures relating thereto.

       Not later than the date of making any Restricted Payment, the Company
shall deliver to the Trustee an Officers' Certificate stating that such
Restricted Payment is permitted and setting forth the basis upon which the
calculations required by this covenant were computed.

SECTION 3.08. LIMITATIONS ON DIVIDEND AND OTHER PAYMENT RESTRICTIONS AFFECTING
              SUBSIDIARIES.

       The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly, create or otherwise cause or suffer to exist or become
effective any consensual Transfer Restriction, except for such Transfer
Restrictions existing under or by reason of:

              (a) Existing Indebtedness as in effect on the Closing Date,

              (b) this Indenture, the Senior Subordinated Note Indenture and the
       Indenture related to the Company's 7-7/8% Senior Notes due 2003,

              (c) applicable law,

              (d) any instrument governing Indebtedness or Capital Stock of a
       Person acquired by the Company or any of its Subsidiaries as in effect at
       the time of such acquisition (except to the extent such Indebtedness was
       incurred in connection with or in contemplation of such acquisition,
       unless such Indebtedness was incurred in connection with or in
       contemplation of such acquisition for the purpose of refinancing
       Indebtedness which was tax-exempt, or in violation of Section 3.09
       hereof), which encumbrance or restriction is not applicable to any
       Person, or the properties or assets of any Person, other than the Person,
       or the property or assets of the Person, so acquired, PROVIDED that the
       Consolidated Cash Flow of such Person shall not be taken into account in
       determining whether such acquisition was permitted by the terms hereof
       except to the extent that such Consolidated Cash Flow would be permitted
       to be dividends to the Company without the prior consent or approval of
       any third party,

              (e) customary non-assignment provisions in leases entered into in
       the ordinary course of business,

              (f) purchase money obligations for property acquired in the
       ordinary course of business that impose restrictions on the ability of
       any of the Company's Subsidiaries to transfer the property so acquired to
       the Company or any of its Subsidiaries,

                                      -21-
<PAGE>

              (g) Permitted Refinancing Indebtedness, PROVIDED that the
       restrictions contained in the agreements governing such Permitted
       Refinancing Indebtedness are no more restrictive than those contained in
       the agreements governing the Indebtedness being refinanced, or

              (h) the New Credit Facility and related documentation as the same
       is in effect on the Closing Date and as amended or replaced from time to
       time, PROVIDED that no such amendment or replacement is more restrictive
       as to Transfer Restrictions than the New Credit Facility and related
       documentation as in effect on the Closing Date.

SECTION 3.09. LIMITATIONS ON INCURRENCE OF INDEBTEDNESS AND ISSUANCE OF
              PREFERRED STOCK.

       The Company shall not, and shall not permit any of its Subsidiaries to,
directly or indirectly, create, incur, issue, assume, Guarantee or otherwise
become directly or indirectly liable contingently or otherwise, with respect to
(collectively, "INCUR") after the Closing Date any Indebtedness (including
Acquired Debt), and the Company shall not issue any Disqualified Stock and shall
not permit any of its Subsidiaries to issue any shares of preferred stock;
PROVIDED, HOWEVER, that the Company may incur Indebtedness (including Acquired
Debt) and the Company may issue shares of Disqualified Stock if the Fixed
Charge Coverage Ratio for the Company's most recently ended four full fiscal
quarters for which internal financial statements are available immediately
preceding the date on which such additional Indebtedness is incurred or such
Disqualified Stock is issued would have been at least 2.5 to 1, determined on a
PRO FORMA basis (including a PRO FORMA application of the net proceeds
therefrom), as if the additional Indebtedness had been incurred or the
Disqualified Stock had been issued, as the case may be, at the beginning of such
four-quarter period. Indebtedness consisting of reimbursement obligations in
respect of a letter of credit shall be deemed to be incurred when the letter of
credit is first issued.

       The foregoing provisions shall not apply to:

              (a) the incurrence by the Company of Indebtedness pursuant to the
       New Credit Facility in an aggregate principal amount at any time
       outstanding not to exceed an amount equal to $2.8 billion less the
       aggregate amount of all mandatory repayments applied to permanently
       reduce the commitments with respect to such Indebtedness;

              (b) the incurrence by the Company of Indebtedness represented by
       the Securities, the Senior 7-7/8% Notes due 2003 and the Senior
       Subordinated Notes;

              (c) the incurrence by the Company and its Subsidiaries of the
       Existing Indebtedness;

              (d) the incurrence by the Company or any of its Subsidiaries of
       Permitted Refinancing Indebtedness in exchange for, or the net proceeds
       of which are used to extend, refinance, renew, replace, defease or
       refund, Indebtedness that was permitted by this Indenture to be incurred
       (including, without limitation, Existing Indebtedness);

              (e) the incurrence by the Company of Hedging Obligations that are
       incurred for the purpose of fixing or hedging interest rate or currency
       risk with respect to any fixed or floating rate Indebtedness that is
       permitted by the terms hereof to be outstanding or any receivable or
       liability the payment of which is determined by reference to a foreign
       currency; PROVIDED that the notional principal amount of any such Hedging
       Obligation does not exceed the principal amount of the Indebtedness to
       which such Hedging Obligation relates;

                                      -22-
<PAGE>

              (f) the incurrence by the Company or any of its Subsidiaries of
       Physician Support Obligations;

              (g) the incurrence by the Company or any of its Subsidiaries of
       intercompany Indebtedness between or among the Company and any of its
       Subsidiaries;

              (h) the incurrence by the Company or any of its Subsidiaries of
       Indebtedness represented by tender, bid, performance, government
       contract, surety or appeal bonds, standby letters of credit or warranty
       or contractual service obligations of like nature, in each case to the
       extent incurred in the ordinary course of business of the Company or such
       Subsidiary;

              (i) the incurrence by any Subsidiary of the Company of
       Indebtedness, the aggregate principal amount of which, together with all
       other Indebtedness of the Company's Subsidiaries at the time outstanding
       (excluding the Existing Indebtedness until repaid or refinanced and
       excluding Physician Support Obligations), does not exceed the greater of
       (1) 10% of the Company's Stockholders' Equity as of the date of
       incurrence or (2) $10.0 million; PROVIDED that, in the case of clause (1)
       only, the Fixed Charge Coverage Ratio for the Company's most recently
       ended four full fiscal quarters for which internal financial statements
       are available immediately preceding the date on which such Indebtedness
       is incurred would have been at least 2.5 to 1, determined on a PRO FORMA
       basis (including a PRO FORMA application of the net proceeds therefrom),
       as if such Indebtedness had been incurred at the beginning of such
       four-quarter period; and

              (j) the incurrence by the Company of Indebtedness (in addition to
       Indebtedness permitted by any other clause of this covenant) in an
       aggregate principal amount at any time outstanding not to exceed $250.0
       million.

SECTION 3.10. LIMITATIONS ON TRANSACTIONS WITH AFFILIATES.

       The Company shall not, and shall not permit any of its Subsidiaries to,
sell, lease, transfer or otherwise dispose of any of its properties or assets
to, or purchase any property or assets from, or enter into or make any contract,
agreement, understanding, loan, advance or Guarantee with, or for the benefit
of, any Affiliate (each of the foregoing, an "AFFILIATE TRANSACTION"), unless
(i) such Affiliate Transaction, is on terms that are no less favorable to the
Company or the relevant Subsidiary than those that could have been obtained in a
comparable transaction by the Company or such Subsidiary with an unrelated
Person and (ii) the Company delivers to the Trustee (a) with respect to any
Affiliate Transaction involving aggregate consideration in excess of $5.0
million, a resolution of the Board of Directors set forth in an Officers'
Certificate certifying that such Affiliate Transaction complies with clause (i)
above and that such Affiliate Transaction was approved by a majority of the
disinterested members of the Board of Directors and (b) with respect to any
Affiliate Transaction involving aggregate consideration in excess of $15.0
million, an opinion as to the fairness to the Company or such Subsidiary of such
Affiliate Transaction from a financial point of view issued by an investment
banking firm of national standing; PROVIDED that (x) transactions or payments
pursuant to any employment arrangements or employee or director benefit plans
entered into by the Company or any of its Subsidiaries in the ordinary course of
business and consistent with the past practice of the Company or such
Subsidiary, (y) transactions between or among the Company and/or its
Subsidiaries and (z) transactions permitted under Section 3.07 hereof, in each
case, shall not be deemed to be Affiliate Transactions.

                                      -23-
<PAGE>

SECTION 3.11. LIMITATIONS ON LIENS.

       The Company shall not, and sha11 not permit any of its Subsidiaries to,
directly or indirectly, create, incur, assume or suffer to exist any Lien
(except Permitted Liens) on any asset now owned or hereafter acquired, or any
income or profits therefrom or assign or convey any right to receive income
therefrom unless all payments due hereunder and under the Securities are secured
on an equal and ratable basis with the Obligations so secured until such time as
such Obligations are no longer secured by a Lien.

SECTION 3.12. CHANGE OF CONTROL.

       Upon the occurrence of a Change of Control Triggering Event, each Holder
of Securities shall have the right to require the Company to repurchase all or
any part (equal to $1,000 or an integral multiple thereof) of such Holder's
Securities pursuant to the offer described below (the "CHANGE OF CONTROL OFFER")
at an offer price in cash equal to 101% of the aggregate principal amount
thereof plus accrued and unpaid interest, if any, thereon to the date of
purchase (the "CHANGE OF CONTROL PAYMENT") on a date that is not more than 90
days after the occurrence of such Change of Control Triggering Event (the
"CHANGE OF CONTROL PAYMENT DATE").

       Within 30 days following any Change of Control Triggering Event, the
Company shall mail, or at the Company's request the Trustee shall mail, a
notice of a Change of Control to each Holder (at its last registered address
with a copy to the Trustee and the Paying Agent) offering to repurchase the
Securities held by such Holder pursuant to the procedure specified in such
notice. The Change of Control Offer shall remain open from the time of mailing
until the close of business on the Business Day next preceding the Change of
Control Payment Date. The notice, which shall govern the terms of the Change of
Control Offer, shall contain all instructions and materials necessary to enable
the Holders to tender Securities pursuant to the Change of Control Offer and
shall state:

              (1) that the Change of Control Offer is being made pursuant to
       this Section 3.12 and that all Securities tendered will be accepted for
       payment;

              (2) the Change of Control Payment and the Change of Control
       Payment Date, which date shall be no earlier than 30 days nor later than
       60 days from the date such notice is mailed;

              (3) that any Security not tendered will continue to accrue
       interest in accordance with the terms of this Indenture;

              (4) that, unless the Company defaults in the payment of the Change
       of Control Payment, all Securities accepted for payment pursuant to the
       Change of Control Offer will cease to accrue interest after the Change of
       Control Payment Date;

              (5) that Holders electing to have a Security purchased pursuant
       to any Change of Control Offer will be required to surrender the
       Security, with the form entitled "Option of Holder to Elect Purchase" on
       the reverse of the Security completed, to the Company, a depositary, if
       appointed by the Company, or a Paying Agent at the address specified in
       the notice prior to the close of business on the Business Day next
       preceding the Change of Control Payment Date;

              (6) that Holders will be entitled to withdraw their election if
       the Company, depositary or Paying Agent, as the case may be, receives,
       not later than the close of business on the Business Day next preceding
       the Change of Control Payment Date, a facsimile transmission

                                      -24-
<PAGE>

       or letter setting forth the name of the Holder, the principal amount of
       the Security the Holder delivered for purchase, and a statement that such
       Holder is withdrawing his election to have such Security purchased;

              (7) that Holders whose Securities are being purchased only in part
       will be issued new Securities equal in principal amount to the
       unpurchased portion of the Securities surrendered, which unpurchased
       portion must be equal to $1,000 in principal amount or an integral
       multiple thereof; and

              (8) the circumstances and relevant facts regarding such Change of
       Control (including, but not limited to, information with respect to PRO
       FORMA historical financial information after giving effect to such Change
       of Control, information regarding the Person or Persons acquiring control
       and such Person's or Persons' business plans going forward) and any other
       information that would be material to a decision as to whether to tender
       a Security pursuant to the Change of Control Offer.

       On the Change of Control Payment Date, the Company shall, to the extent
lawful, (i) accept for payment all Securities or portions thereof properly
tendered and not withdrawn pursuant to the Change of Control Offer, (ii) deposit
with the Paying Agent an amount equal to the Change of Control Payment in
respect of all Securities or portions thereof so tendered and (iii) deliver or
cause to be delivered to the Trustee the Securities so accepted together with an
Officers' Certificate stating the aggregate principal amount of Securities or
portions thereof being purchased by the Company. The Paying Agent shall promptly
mail to each Holder of Securities so tendered the Change of Control Payment for
such Securities, and the Trustee shall promptly authenticate and mail (or cause
to be transferred by book entry) to each Holder a new Security equal in
principal amount to any unpurchased portion of the Securities surrendered, if
any; PROVIDED that each such new Security shall be in a principal amount of
$1,000 or an integral multiple thereof. The Company shall publicly announce the
results of the Change of Control Offer on or as soon as practicable after the
Change of Control Payment Date.

       The Company shall comply with the requirements of Rule 14e-1 under the
Exchange Act and any other securities laws and regulations thereunder to the
extent such laws and regulations are applicable in connection with the
repurchase of Securities as a result of a Change of Control Triggering Event.

SECTION 3.13. CORPORATE EXISTENCE.

       Subject to Section 3.12 and Article 4 hereof, the Company shall do or
cause to be done all things necessary to preserve and keep in full force and
effect (i) its corporate existence, and the corporate, partnership or other
existence of each of its Subsidiaries, in accordance with the respective
organizational documents (as the same may be amended from time to time) of each
Subsidiary and (ii) the rights (charter and statutory), licenses and franchises
of the Company and its Subsidiaries; PROVIDED, HOWEVER, that the Company shall
not be required to preserve any such right, license or franchise, or the
corporate, partnership or other existence of any of its Subsidiaries, if the
Board of Directors shall determine that the preservation thereof is no longer
desirable in the conduct of the business of the Company and its Subsidiaries,
taken as a whole, and that the loss thereof is not adverse in any material
respect to the Holders.

                                      -25-
<PAGE>

SECTION 3.14. LINE OF BUSINESS.

       The Company shall not, and shall not permit any of its Subsidiaries to,
engage in any material extent in any business other than the ownership,
operation and management of Hospitals and Related Businesses.

Subsidiary simultaneously executes and delivers a supplemental indenture to this
Indenture, in substantially the form attached hereto as Exhibit B, providing for
the Guarantee of the payment of the Securities by such Subsidiary, which
Guarantee shall be senior to or PARI PASSU with such Subsidiary's Guarantee of
or pledge to secure such other Indebtedness. Notwithstanding the foregoing, any
such Guarantee by a Subsidiary of the Securities shall provide by its terms that
it shall be automatically and unconditionally released and discharged upon the
sale or other disposition, by way of merger or otherwise, to any Person not an
Affiliate of the Company, of all of the Company's stock in, or all or
substantially all the assets of, such Subsidiary. The foregoing provisions shall
not be applicable to any one or more Guarantees that otherwise would be
prohibited of up to $25.0 million in aggregate principal amount of Indebtedness
of the Company or its Subsidiaries at any time outstanding.

SECTION 3.15. LIMITATIONS ON ISSUANCES OF GUARANTEES OF INDEBTEDNESS BY
              SUBSIDIARIES.

       The Company shall not permit any Subsidiary, directly or indirectly, to
Guarantee or secure the payment of any other Indebtedness of the Company or any
of its Subsidiaries (except Indebtedness of a Subsidiary of such Subsidiary or
Physician Support Obligations) unless such Subsidiary simultaneously executes
and delivers a supplemental indenture to this Indenture, in substantially the
form attached hereto as Exhibit B, providing for the Guarantee of the payment of
the Securities by such Subsidiary, which Guarantee shall be senior to or PARI
PASSU with such Subsidiary's Guarantee of or pledge to secure such other
Indebtedness. Notwithstanding the foregoing, any such Guarantee by a Subsidiary
of the Securities shall provide by its terms that it shall be automatically and
unconditionally released and discharged upon the sale or other disposition, by
way of merger or otherwise, to any Person not an Affiliate of the Company, of
all of the Company's stock in, or all or substantially all the assets of, such
Subsidiary. The foregoing provisions shall not be applicable to any one or more
Guarantees that otherwise would be prohibited of up to $25.0 million in
aggregate principal amount of Indebtedness of the Company or its Subsidiaries at
any time outstanding.

SECTION 3.16. NO AMENDMENT TO SUBORDINATION PROVISIONS OF SENIOR SUBORDINATED
              NOTE INDENTURE.

       The Company shall not amend, modify or alter the Senior Subordinated Note
Indenture or the indentures relating to the 2005 Senior Subordinated Notes or
the 2005 Exchangeable Subordinated Notes in any way that would (i) increase the
principal of, advance the final maturity date of or shorten the Weighted Average
Life to Maturity of (a) any 2005 Senior Subordinated Notes or 2005 Exchangeable
Subordinated Notes or (b) any Senior Subordinated Notes such that the final
maturity date of the Senior Subordinated Notes is earlier than the 91st day
following the final maturity date of the Senior Notes or (ii) amend the
provisions of Article 10 of the Senior Subordinated Note Indenture (which
relates to subordination) or the subordination provisions of the indentures
relating to the 2005 Senior Subordinated Notes or the 2005 Exchangeable
Subordinated Notes or any of the defined terms used therein in a manner that
would be adverse to the Holders of the Securities.

                                      -26-
<PAGE>

                                    ARTICLE 4

                                   SUCCESSORS

SECTION 4.01. LIMITATIONS ON MERGERS, CONSOLIDATIONS OR SALES OF ASSETS.

       The Company may not consolidate or merge with or into (whether or not the
Company is the surviving corporation), or sell, assign, transfer, lease, convey
or otherwise dispose of all or substantially all of its properties or assets in
one or more related transactions, to another corporation, Person or entity
unless:

              (i) the Company is the surviving corporation or the entity or the
       Person formed by or surviving any such consolidation or merger (if other
       than the Company) or to which such sale, assignment, transfer, lease,
       conveyance or other disposition shall have been made is a corporation
       organized or existing under the laws of the United States, any state
       thereof or the District of Columbia;

              (ii) the entity or Person formed by or surviving any such
       consolidation or merger (if other than the Company) or the entity or
       Person to which such sale, assignment, transfer, lease, conveyance or
       other disposition shall have been made assumes all the Obligations of the
       Company under this Indenture and the Securities pursuant to a
       supplemental indenture in a form reasonably satisfactory to the Trustee;

              (iii) immediately after such transaction no Default or Event of
       Default exists; and

              (iv) the Company or the entity or Person formed by or surviving
       any such consolidation or merger (if other than the Company), or to which
       such sale, assignment, transfer, lease, conveyance or other disposition
       shall have been made (A) shall have a Consolidated Net Worth immediately
       after the transaction equal to or greater than the Consolidated Net Worth
       of the Company immediately preceding the transaction and (B) shall, at
       the time of such transaction and after giving PRO FORMA effect thereto as
       if such transaction had occurred at the beginning of the applicable
       four-quarter period, be permitted to incur at least $1.00 of additional
       Indebtedness pursuant to the Fixed Charge Coverage Ratio test set forth
       in the first paragraph of Section 3.09 hereof.

       The Company shall deliver to the Trustee prior to the consummation of the
proposed transaction an Officers' Certificate to the foregoing effect and an
Opinion of Counsel, covering clauses (i) through (iv) above, stating that the
proposed transaction and such supplemental indenture comply with this Indenture.
The Trustee shall be entitled to conclusively rely upon such Officers'
Certificate and Opinion of Counsel.

SECTION 4.02. SUCCESSOR CORPORATION SUBSTITUTED.

       Upon any consolidation or merger, or any sale, assignment, transfer,
lease, conveyance or other disposition of all or substantially all of the assets
of the Company in accordance with Section 4.01 hereof, the successor corporation
formed by such consolidation or into or with which the Company is merged or to
which such sale, assignment, transfer, lease, conveyance or other disposition is
made shall succeed to, and be substituted for (so that from and after the date
of such consolidation, merger, sale, assignment, transfer, lease, conveyance or
other disposition, the provisions of this Indenture referring to the "Company"
shall refer instead to the successor corporation), and may exercise every right

                                      -27-
<PAGE>

and power of the Company under this Indenture with the same effect as if such
successor Person has been named as the Company, herein.

                                    ARTICLE 5
                              DEFAULTS AND REMEDIES

SECTION 5.01. EVENTS OF DEFAULT.

       Each of the following constitutes an "EVENT OF DEFAULT":

              (i) default for 30 days in the payment when due of interest on the
       Securities;

              (ii) default in payment when due of the principal of or premium,
       if any, on the Securities at maturity or otherwise;

              (iii) failure by the Company to comply with the provisions of
       Sections 3.07, 3.09 or 3.12 hereof;

              (iv) failure by the Company to comply with any other covenant or
       agreement in the Indenture or the Securities for the period and after the
       notice specified below;

              (v) any default that occurs under any mortgage, indenture or
       instrument under which there may be issued or by which there may be
       secured or evidenced any Indebtedness for money borrowed by the Company
       or any of its Significant Subsidiaries (or the payment of which is
       Guaranteed by the Company or any of its Significant Subsidiaries),
       whether such Indebtedness or Guarantee exists on the Closing Date or is
       created after the Closing Date, which default (a) constitutes a Payment
       Default or (b) results in the acceleration of such Indebtedness prior to
       its express maturity and, in each case, the principal amount of any such
       Indebtedness, together with the principal amount of any other such
       Indebtedness under which there has been a Payment Default or that has
       been so accelerated, aggregates $25.0 million or more;

              (vi) failure by the Company or any of its Significant Subsidiaries
       to pay a final judgment or final judgments aggregating in excess of $25.0
       million entered by a court or courts of competent jurisdiction against
       the Company or any of its Significant Subsidiaries if such final judgment
       or judgments remain unpaid or undischarged for a period (during which
       execution shall not be effectively stayed) of 60 days after their entry;

              (vii) the Company or any Significant Subsidiary thereof pursuant
       to or within the meaning of any Bankruptcy Law:

                     (a) commences a voluntary case,

                     (b) consents to the entry of an order for relief against it
              in an involuntary case in which it is the debtor,

                     (c) consents to the appointment of a Custodian of it or for
              all or substantially all of its property,

                     (d) makes a general assignment for the benefit of its
              creditors, or

                                      -28-
<PAGE>

                     (e) admits in writing its inability generally to pay its
              debts as the same become due; and

              (viii) a court of competent jurisdiction enters an order or decree
       under any Bankruptcy Law that:

                     (a) is for relief against the Company or any Significant
              Subsidiary thereof in an involuntary case in which it is the
              debtor,

                     (b) appoints a Custodian of the Company or any Significant
              Subsidiary thereof or for all or substantially all of the property
              of the Company or any Significant Subsidiary thereof, or

                     (c) orders the liquidation of the Company or any
              Significant Subsidiary thereof, and the order or decree remains
              unstayed and in effect for 60 days.

       The term "BANKRUPTCY LAW" means title 11, U.S. Code or any similar
federal or state law for the relief of debtors. The term "CUSTODIAN" means any
receiver, trustee, assignee, liquidator or similar official under any Bankruptcy
Law.

       A Default under clause (iv) is not an Event of Default until the Trustee
notifies the Company in writing, or the Holders of at least 25% in principal
amount of the then outstanding Securities notify the Company and the Trustee in
writing, of the Default and the Company does not cure the Default within 60 days
after receipt of such notice. The written notice must specify the Default,
demand that it be remedied and state that the notice is a "NOTICE OF DEFAULT."

SECTION 5.02. ACCELERATION.

       If any Event of Default (other than an Event of Default specified in
clause (vii) or (viii) of Section 5.01 hereof) occurs and is continuing, the
Trustee by notice to the Company, or the Holders of at least 25% in principal
amount of the then outstanding Securities by written notice to the Company and
the Trustee, may declare the unpaid principal of, premium, if any, and any
accrued and unpaid interest on all the Securities to be due and payable
immediately. Upon such declaration the principal, premium, if any, and interest
shall be due and payable immediately. If an Event of Default specified in clause
(vii) or (viii) of Section 5.01 hereof occurs with respect to the Company or any
Significant Subsidiary thereof such an amount shall IPSO FACTO become and be
immediately due and payable without further action or notice on the part of the
Trustee or any Holder.

       If an Event of Default occurs under this Indenture prior to the maturity
of the Securities by reason of any willful action (or inaction) taken (or not
taken) by or on behalf of the Company with the intention of avoiding the
prohibition on redemption of such Securities prior to the date of maturity, then
a premium with respect thereto (expressed as a percentage of the amount that
would otherwise be due but for the provisions of this sentence) shall also
become and be immediately due and payable to the extent permitted by law upon
the acceleration of such Securities if such Event of Default occurs during the
twelve-month period beginning on January 15 of the years set forth below:

                                      -29-
<PAGE>

          Year                                            Percentage
          ----                                            ----------
          1997 .........................................   108.000%
          1998 .........................................   106.857%
          1999 .........................................   105.714%
          2000 .........................................   104.571%
          2001 .........................................   103.428%
          2002 .........................................   102.285%
          2003 .........................................   101.142%
          2004 .........................................   100.000%

       Any determination regarding the primary purpose of any such action or
inaction, as the case may be, shall be made by and set forth in a resolution of
the Board of Directors (including the concurrence of a majority of the
independent directors of the Company then serving) delivered to the Trustee
after consideration of the business reasons for such action or inaction, other
than the avoidance of payment of such premium or prohibition on redemption. In
the absence of fraud, each such determination shall be final and binding upon
the Holders of Securities. Subject to Section 6.01 hereof, the Trustee shall be
entitled to rely on the determination set forth in any such resolutions
delivered to the Trustee.

SECTION 5.03. OTHER REMEDIES.

       If an Event of Default occurs and is continuing, the Trustee may pursue
any available remedy to collect the payment of principal or interest on the
Securities or to enforce the performance of any provision of the Securities or
this Indenture.

       The Trustee may maintain a proceeding even if it does not possess any of
the Securities or does not produce any of them in the proceeding. A delay or
omission by the Trustee or any Holder in exercising any right or remedy accruing
upon an Event of Default shall not impair the right or remedy or constitute a
waiver of or acquiescence in the Event of Default. All remedies are cumulative
to the extent permitted by law.

SECTION 5.04. WAIVER OF PAST DEFAULTS.

       The Holders of not less than a majority in aggregate principal amount of
the Securities then outstanding by written notice to the Trustee may on behalf
of the Holders of all of the Securities waive any existing Default or Event of
Default and its consequences under this Indenture except a continuing Default or
Event of Default in the payment of the principal of, premium, if any, or
interest on any Security. Upon any such waiver, such Default shall cease to
exist, and any Event of Default arising therefrom shall be deemed to have been
cured for every purpose of this Indenture; but no such waiver shall extend to
any subsequent or other Default or impair any right consequent thereon.

SECTION 5.05. CONTROL BY MAJORITY.

       Holders of a majority in principal amount of the then outstanding
Securities shall have the right to direct the time, method and place of
conducting any proceeding for exercising any remedy available to the Trustee or
exercising any trust or power conferred on it. However, the Trustee may refuse
to follow any direction that conflicts with law or this Indenture that the
Trustee determines may be unduly prejudicial to the rights of other Holders or
that may involve the Trustee in personal liability. The Trustee may take any
other action which it deems proper which is not inconsistent with any such
direction.

                                      -30-
<PAGE>

SECTION 5.06. LIMITATION ON SUITS

       A Holder may pursue a remedy with respect to this Indenture or the
Securities only if:

              (i) the Holder gives to the Trustee written notice of a continuing
       Event of Default;

              (ii) the Holders of at least 25% in principal amount of the then
       outstanding Securities make a written request to the Trustee to pursue
       the remedy;

              (iii) such Holder or Holders offer and, if requested, provide to
       the Trustee indemnity satisfactory to the Trustee against any loss,
       liability or expense;

              (iv) the Trustee does not comply with the request within 60 days
       after receipt of the request and the offer and, if requested, the
       provision of indemnity; and

              (v) during such 60-day period the Holders of a majority in
       principal amount of the then outstanding Securities do not give the
       Trustee a direction inconsistent with the request.

       A Holder may not use this Indenture to prejudice the rights of another
Holder or to obtain a preference or priority over another Holder.

SECTION 5.07. RIGHTS OF HOLDERS TO RECEIVE PAYMENT.

       Notwithstanding any other provision of this Indenture, the right of any
Holder to receive payment of principal, premium, if any, and interest on the
Security, on or after the respective due dates expressed in the Security, or to
bring suit for the enforcement of any such payment on or after such respective
dates, shall not be impaired or affected without the consent of the Holder.

SECTION 5.08. COLLECTION SUIT BY TRUSTEE.

       If an Event of Default specified in Section 5.01(i) or (ii) hereof occurs
and is continuing, the Trustee is authorized to recover judgment in its own name
and as trustee of an express trust against the Company or any other obligor for
the whole amount of principal, premium, if any, and interest remaining unpaid on
the Securities and interest on overdue principal and, to the extent lawful,
interest and such further amount as shall be sufficient to cover amounts due the
Trustee under Section 6.07 hereof, including the costs and expenses of
collection, including the reasonable compensation, expenses, disbursements and
advances of the Trustee, its agents and counsel.

SECTION 5.09. TRUSTEE MAY FILE PROOFS OF CLAIM.

       The Trustee is authorized to file such proofs of claim and other papers
or documents as may be necessary or advisable in order to have the claims of the
Trustee (including any claim for the reasonable compensation, expenses,
disbursements and advances of the Trustee, its agents and counsel) and the
Holders allowed in any judicial proceedings relative to the Company (or any
other obligor upon the Securities), its creditors or its property and shall be
entitled and empowered to collect, receive and distribute any money or other
property payable or deliverable on any such claims and any custodian in any such
judicial proceeding is hereby authorized by each Holder to make such payments to
the Trustee, and in the event that the Trustee shall consent to the making of
such payments directly to the Holders, to pay to the Trustee any amount due to
it for the reasonable compensation, expenses, disbursements and advances of the
Trustee, its agents and counsel, and any other amounts due the Trustee under
Section

                                      -31-
<PAGE>

6.07 hereof. To the extent that the payment of any such compensation, expenses,
disbursements and advances of the Trustee, its agents and counsel, and any other
amounts due the Trustee under Section 6.07 hereof out of the estate in any such
proceeding, shall be denied for any reason, payment of the same shall be secured
by a Lien on, and shall be paid out of, any and all distributions, dividends,
money, securities and other properties which the Holders may be entitled to
receive in such proceeding whether in liquidation or under any plan of
reorganization or arrangement or otherwise. Nothing herein contained shall be
deemed to authorize the Trustee to authorize or consent to or accept or adopt on
behalf of any Holder any plan of reorganization, arrangement, adjustment or
composition affecting the Securities or the rights of any Holder thereof, or to
authorize the Trustee to vote in respect of the claim of any Holder in any such
proceeding.

SECTION 5.10. PRIORITIES.

       If the Trustee collects any money pursuant to this Article, it shall pay
out the money in the following order:

       First: to the Trustee, its agents and attorneys for amounts due under
Section 6.07, including payment of all compensation, expense and liabilities
incurred, and all advances made, by the Trustee and the costs and expenses of
collection;

       Second: to Holders for amounts due and unpaid on the Securities for
principal, premium, if any, and interest, ratably, without preference or
priority of any kind, according to the amounts due and payable on the Securities
for principal, premium, if any and interest, respectively; and

       Third: to the Company or to such party as a court of competent
jurisdiction shall direct.

       The Trustee may fix a record date and payment date for any payment to
Holders pursuant to this Section 5.10 upon five Business Days prior notice to
the Company.

SECTION 5.11. UNDERTAKING FOR COSTS.

       In any suit for the enforcement of any right or remedy under this
Indenture or in any suit against the Trustee for any action taken or omitted by
it as a Trustee, a court in its discretion may require the filing by any party
litigant in the suit of an undertaking to pay the costs of the suit, and the
court in its discretion may assess reasonable costs, including reasonable
attorneys' fees and expenses, against any party litigant in the suit, having due
regard to the merits and good faith of the claims or defenses made by the party
litigant. This Section does not apply to a suit by the Trustee, a suit by a
Holder pursuant to Section 5.07 hereof, or a suit by Holders of more than 10% in
principal amount of the then outstanding Securities.

                                    ARTICLE 6
                                     TRUSTEE

SECTION 6.01. DUTIES OF TRUSTEE.

              (i) If an Event of Default has occurred and is continuing, the
       Trustee shall exercise such of the rights and powers vested in it by this
       Indenture, and use the same degree of care and skill in their exercise,
       as a prudent man would exercise or use under the circumstances in the
       conduct of his own affairs.

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              (ii) Except during the continuance of an Event of Default known to
       the Trustee:

                     (a) the duties of the Trustee shall be determined solely by
              the express provisions of this Indenture or the TIA and the
              Trustee need perform only those duties that are specifically set
              forth in this Indenture or the TIA and no others, and no implied
              covenants or obligations shall be read into this Indenture against
              the Trustee, and

                     (b) in the absence of bad faith on its part, the Trustee
              may conclusively rely, as to the truth of the statements and the
              correctness of the opinions expressed therein, upon certificates
              or opinions furnished to the Trustee and conforming to the
              requirements of this Indenture. However, in the case of any such
              certificates or opinions which by any provisions hereof are
              required to be furnished to the Trustee, the Trustee shall examine
              the certificates and opinions to determine whether or not they
              conform to the requirements of this Indenture.

              (iii) The Trustee may not be relieved from liabilities for its own
       negligent action, its own negligent failure to act, or its own willful
       misconduct, except that:

                     (a) this paragraph does not limit the effect of paragraph
              (ii) of this Section;

                     (b) the Trustee shall not be liable for any error of
              judgment made in good faith by a Responsible Officer, unless it is
              proved that the Trustee was negligent in ascertaining the
              pertinent facts; and

                     (c) the Trustee shall not be liable with respect to any
              action it takes or omits to take in good faith in accordance with
              a direction received by it pursuant to Section 5.05 hereof.

              (iv) Whether or not therein expressly so provided every provision
       of this Indenture that in any way relates to the Trustee is subject to
       paragraphs (i), (ii), and (iii) of this Section.

              (v) No provision of this Indenture shall require the Trustee to
       expend or risk its own funds or incur any liability. The Trustee may
       refuse to perform any duty or exercise any right or power unless it
       receives security and indemnity satisfactory to it against any loss,
       liability or expense.

              (vi) The Trustee shall not be liable for interest on any money
       received by it except as the Trustee may agree in writing with the
       Company. Absent written instruction from the Company, the Trustee shall
       not be required to invest any such money. Money held in trust by the
       Trustee need not be segregated from other funds except to the extent
       required by law.

              (vii) The Trustee shall not be deemed to have knowledge of any
       matter unless such matter is actually known to a Responsible Officer.

SECTION 6.02. RIGHTS OF TRUSTEE.

              (i) The Trustee may conclusively rely upon any document believed
       by it to be genuine and to have been signed or presented by the proper
       Person. The Trustee need not investigate any fact or matter stated in the
       document.

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              (ii) Before the Trustee acts or refrains from acting, it may
       require an Officers' Certificate or an Opinion of Counsel or both. The
       Trustee shall not be liable for any action it takes or omits to take in
       good faith in reliance on such Officers' Certificate or Opinion of
       Counsel. The Trustee may consult with counsel and the written advice of
       such counsel or any Opinion of Counsel shall be full and complete
       authorization and protection from liability in respect of any action
       taken, suffered or omitted by it hereunder in good faith and in reliance
       thereon.

              (iii) The Trustee may act through its attorneys and agents and
       shall not be responsible for the misconduct or negligence of any agent
       appointed with due care.

              (iv) The Trustee shall not be liable for any action it takes or
       omits to take in good faith which it believes to be authorized or within
       its rights or powers conferred upon it by this Indenture. A permissive
       right granted to the Trustee hereunder shall not be deemed an obligation
       to act.

              (v) Unless otherwise specifically provided in this Indenture, any
       demand, request, direction or notice from the Company shall be sufficient
       if signed by an Officer of the Company.

SECTION 6.03. INDIVIDUAL RIGHTS OF TRUSTEE.

       The Trustee in its individual or any other capacity may become the owner
or pledgee of Securities and may otherwise deal with the Company or any
Affiliate of the Company with the same rights it would have if it were not
Trustee. Any Agent may do the same with like rights. However, the Trustee is
subject to Sections 6.10 and 6.11 hereof.

SECTION 6.04. TRUSTEE'S DISCLAIMER.

       The Trustee shall not be responsible for and makes no representation as
to the validity or adequacy of this Indenture or the Securities, nor shall it be
accountable for the Company's use of the proceeds from the Securities or any
money paid to the Company or upon the Company's direction under any provision of
this Indenture, nor shall it be responsible for the use or application of any
money received by any Paying Agent other than the Trustee, nor shall it be
responsible for any statement or recital herein or any statement in the
Securities or any other document in connection with the sale of the Securities
or pursuant to this Indenture other than its certificate of authentication.

SECTION 6.05. NOTICE OF DEFAULTS.

       If a Default or Event of Default occurs and is continuing and if it is
known to the Trustee, the Trustee shall mail to Holders a notice of the Default
or Event of Default within 90 days after it occurs. Except in the case of a
Default or Event of Default in payment on any Security, the Trustee may withhold
the notice if and so long as a committee of its Responsible Officers in good
faith determines that withholding the notice is in the interests of the Holders.

SECTION 6.06. REPORTS BY TRUSTEE TO HOLDERS.

       Within 60 days after each December 31 beginning with the December 31
following the Closing Date, the Trustee shall mail to the Holders a brief report
dated as of such reporting date that complies with TIA Section 313(a) (but if no
event described in TIA Section 313(a) has occurred within the twelve months
preceding the reporting date, no report need be transmitted). The Trustee also
shall

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comply with TIA Section 313(b). The Trustee shall also transmit by mail all
reports as required by TIA Section 313(c).

       A copy of each report at the time of its mailing to the Holders shall be
mailed to the Company and filed with the Commission and each stock exchange on
which the Securities are listed. The Company shall promptly notify the Trustee
when the Securities are listed on any stock exchange.

SECTION 6.07. COMPENSATION AND INDEMNITY

       The Company shall pay to the Trustee from time to time such compensation
for its acceptance of this Indenture and services hereunder as the Company and
Trustee shall agree in writing. The Trustee's compensation shall not be limited
by any law on compensation of a trustee of an express trust. The Company shall
reimburse the Trustee promptly upon request for all reasonable disbursements,
advances and expenses incurred or made by it in addition to the compensation for
its services. Such expenses shall include the reasonable compensation,
disbursements and expenses of the Trustee's agents and counsel.

       The Company shall indemnify the Trustee against any and all losses,
liabilities, damages, claims or expenses incurred by it arising out of or in
connection with the acceptance of its duties and the administration of the
trusts under this Indenture, except as set forth below. The Trustee shall notify
the Company promptly of any claim for which it may seek indemnity. Failure by
the Trustee to so notify the Company shall not relieve the Company of its
obligations hereunder. The Company shall defend the claim and the Trustee shall
cooperate in the defense. The Trustee may have separate counsel and the Company
shall pay the reasonable fees and expenses of such counsel. The Company need not
pay for any settlement made without its consent, which consent shall not be
unreasonably withheld.

       The obligations of the Company under this Section 6.07 shall survive the
satisfaction and discharge of this Indenture.

       The Company need not reimburse any expense or indemnify against any loss
or liability incurred by the Trustee through its own negligence or bad faith.

       To secure the Company's payment obligations in this Section, the Trustee
shall have a Lien prior to the Securities on all money or property held or
collected by the Trustee, except that held in trust to pay principal and
interest on particular Securities. Such Lien shall survive the satisfaction and
discharge of this Indenture.

       When the Trustee incurs expenses or renders services after an Event of
Default specified in Section 5.01(vii) or (viii) hereof occurs, the expenses and
the compensation for the services (including the fees and expenses of its agents
and counsel) are intended to constitute expenses of administration under any
Bankruptcy Law.

SECTION 6.08. REPLACEMENT OF TRUSTEE.

       A resignation or removal of the Trustee and appointment of a successor
Trustee shall become effective only upon the successor Trustee's acceptance of
appointment as provided in this Section.

       The Trustee may resign in writing at any time and be discharged from the
trust hereby created by so notifying the Company. The Holders of a majority in
principal amount of the then

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outstanding Securities may remove the Trustee by so notifying the Trustee and
the Company in writing. The Company may remove the Trustee if:

              (1) the Trustee fails to comply with Section 6.10 hereof;

              (2) the Trustee is adjudged a bankrupt or an insolvent or an order
       for relief is entered with respect to the Trustee under any Bankruptcy
       Law;

              (3) a Custodian or public officer takes charge of the Trustee or
       its property; or

              (4) the Trustee becomes incapable of acting.

       If the Trustee resigns or is removed or if a vacancy exists in the office
of Trustee for any reason, the Company shall promptly appoint a successor
Trustee. Within one year after the successor Trustee takes office, the Holders
of a majority in principal amount of the then outstanding Securities may appoint
a successor Trustee to replace the successor Trustee appointed by the Company.

       If a successor Trustee does not take office within 60 days after the
retiring Trustee resigns or is removed, the retiring Trustee, the Company, or
the Holders of at least 10% in principal amount of the then outstanding
Securities may petition any court of competent jurisdiction for the appointment
of a successor Trustee.

       If the Trustee after written request by any Holder who has been a Holder
for at least six months fails to comply with Section 6.10 hereof, such Holder
may petition any court of competent jurisdiction for the removal of the Trustee
and the appointment of a successor Trustee.

       A successor Trustee shall deliver a written acceptance of its appointment
to the retiring Trustee and to the Company. Thereupon, the resignation or
removal of the retiring Trustee shall become effective, and the successor
Trustee shall have all the rights, powers and duties of the Trustee under this
Indenture. The successor Trustee shall mail a notice of its succession to
Holders. The retiring Trustee shall promptly transfer all property held by it as
Trustee to the successor Trustee, provided all sums owing to the Trustee
hereunder have been paid and subject to the Lien provided for in Section 6.07
hereof. Notwithstanding replacement of the Trustee pursuant to this Section
6.08, the Company's obligations under Section 6.07 hereof shall continue for the
benefit of the retiring Trustee.

SECTION 6.09. SUCCESSOR TRUSTEE OR AGENT BY MERGER, ETC.

       If the Trustee or any Agent consolidates, merges or converts into, or
transfers all or substantially all of its corporate trust business to, another
corporation, the successor corporation without any further act shall be the
successor Trustee or Agent.

SECTION 6.10. ELIGIBILITY; DISQUALIFICATION.

       There shall at all times be a Trustee hereunder which shall be a
corporation organized and doing business under the laws of the United States of
America or of any state thereof authorized under such laws to exercise corporate
trustee power, shall be subject to supervision or examination by federal or
state authority and shall have a combined capital and surplus of at least $100.0
million as set forth in its most recent published annual report of condition.

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       This Indenture shall always have a Trustee who satisfies the requirements
of TIA Section 310(a)(1), (2) and (5). The Trustee is subject to TIA Section
310(b).

SECTION 6.11. PREFERENTIAL COLLECTION OF CLAIMS AGAINST COMPANY.

       The Trustee is subject to TIA Section 311(a), excluding any creditor
relationship listed in TIA Section 311(b). A Trustee who has resigned or been
removed shall be subject to TIA Section 311(a) to the extent indicated
therein.

                                    ARTICLE 7
                             DISCHARGE OF INDENTURE

SECTION 7.01. DEFEASANCE AND DISCHARGE OF THIS INDENTURE AND THE SECURITIES.

       The Company may, at the option of its Board of Directors evidenced by a
resolution set forth in an Officers' Certificate, at any time, with respect to
the Securities, elect to have either Section 7.02 or 7.03 hereof be applied to
all outstanding Securities upon compliance with the conditions set forth below
in this Article 7.

SECTION 7.02. LEGAL DEFEASANCE AND DISCHARGE.

       Upon the Company's exercise under Section 7.01 hereof of the option
applicable to this Section 7.02, the Company shall be deemed to have been
discharged from its obligations with respect to all outstanding Securities on
the date the conditions set forth below are satisfied (hereinafter, "LEGAL
DEFEASANCE"). For this purpose, such Legal Defeasance means that the Company
shall be deemed to have paid and discharged the entire Indebtedness represented
by the outstanding Securities, which shall thereafter be deemed to be
"outstanding" only for the purposes of Section 7.05 hereof and the other
Sections of this Indenture referred to in clauses (i) and (ii) of this Section
7.02, and to have satisfied all its other obligations under such Securities and
this Indenture (and the Trustee, on demand of and at the expense of the Company,
shall execute proper instruments acknowledging the same), except for the
following provisions which shall survive until otherwise terminated or
discharged hereunder: (i) the rights of Holders of outstanding Securities to
receive solely from the trust fund described in Section 7.04 hereof, and as more
fully set forth in such Section, payments in respect of the principal of,
premium, if any, and interest on such Securities when such payments are due,
(ii) the Company's obligations with respect to such Securities under Sections
2.04, 2.06, 2.07 and 3.02 hereof, (iii) the rights, powers, trusts, duties and
immunities of the Trustee hereunder, including, without limitation, the
Trustee's rights under Section 6.07 hereof, and the Company's obligations in
connection therewith and (iv) this Article 7. Subject to compliance with this
Article 7, the Company may exercise its option under this Section 7.02
notwithstanding the prior exercise of its option under Section 7.03 hereof with
respect to the Securities.

SECTION 7.03. COVENANT DEFEASANCE.

       Upon the Company's exercise under Section 7.01 hereof of the option
applicable to this Section 7.03, the Company shall be released from its
obligations under the covenants contained in Sections 3.07, 3.08, 3.09, 3.10,
3.11, 3.12, 3.14, 3.15, and 3.16 and Article 4 hereof with respect to the
outstanding Securities on and after the date the conditions set forth below are
satisfied (hereinafter, "COVENANT DEFEASANCE"), and the Securities shall
thereafter be deemed not "outstanding" for the purposes of any direction,
waiver, consent or declaration or act of Holders (and the consequences of any

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thereof) in connection with such covenants, but shall continue to be deemed
"outstanding" for all other purposes hereunder (it being understood that such
Securities shall not be deemed outstanding for accounting purposes). For this
purpose, such Covenant Defeasance means that, with respect to the outstanding
Securities, the Company may omit to comply with and shall have no liability in
respect of any term, condition or limitation set forth in any such covenant,
whether directly or indirectly, by reason of any reference elsewhere herein to
any such covenant or by reason of any reference in any such covenant to any
other provision herein or in any other document and such omission to comply
shall not constitute a Default or an Event of Default under Section 5.01(iii)
hereof, but, except as specified above, the remainder of this Indenture and such
Securities shall be unaffected thereby. In addition, upon the Company's exercise
under Section 7.01 hereof of the option applicable to this Section 7.03,
Sections 5.01(iv) through 5.01(vi) hereof shall not constitute Events of
Default.

SECTION 7.04. CONDITIONS TO LEGAL OR COVENANT DEFEASANCE.

       The following shall be the conditions to application of either Section
7.02 or Section 7.03 hereof to the outstanding Securities:

              (i) The Company shall irrevocably have deposited or caused to be
       deposited with the Trustee (or another trustee satisfying the
       requirements of Section 6.10 who shall agree to comply with the
       provisions of this Article 7 applicable to it) as trust funds in trust
       for the purpose of making the following payments, specifically pledged as
       security for, and dedicated solely to, the benefit of the Holders of such
       Securities, (a) cash in U.S. Dollars in an amount, or (b) non-callable
       Government Securities that through the scheduled payment of principal and
       interest in respect thereof in accordance with their terms will provide,
       not later than one day before the due date of any payment, cash in U.S.
       Dollars in an amount, or (c) a combination thereof, in such amounts as
       will be sufficient, in the opinion of a nationally recognized firm of
       independent public accountants expressed in a written certification
       thereof delivered to the Trustee, to pay and discharge and which shall be
       applied by the Trustee (or other qualifying trustee) to pay and discharge
       the principal of, premium, if any, and interest on such outstanding
       Securities on the stated maturity date of such principal or installment
       of principal, premium, if any, or interest.

              (ii) In the case of an election under Section 7.02 hereof, the
       Company shall have delivered to the Trustee an Opinion of Counsel in the
       United States confirming that (a) the Company has received from, or there
       has been published by, the Internal Revenue Service a ruling or (b) since
       the Closing Date, there has been a change in the applicable federal
       income tax law, in either case to the effect that, and based thereon such
       Opinion of Counsel shall confirm that, the Holders of the outstanding
       Securities will not recognize income, gain or loss for federal income tax
       purposes as a result of such Legal Defeasance and will be subject to
       federal income tax on the same amounts, in the same manner and at the
       same times as would have been the case if such Legal Defeasance had not
       occurred.

              (iii) In the case of an election under Section 7.03 hereof before
       the date that is one year prior to the final maturity of the Securities,
       the Company shall have delivered to the Trustee an Opinion of Counsel in
       the United States confirming that the Holders of the outstanding
       Securities will not recognize income, gain or loss for federal income tax
       purposes as a result of such Covenant Defeasance and will be subject to
       federal income tax on the same amounts, in the same manner and at the
       same times as would have been the case if such Covenant Defeasance had
       not occurred.

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              (iv) No Default or Event of Default with respect to the Securities
       shall have occurred and be continuing on the date of such deposit (other
       than a Default or Event of Default resulting from the borrowing of funds
       to be applied to such deposit) or, insofar as Section 5.01(vii) or
       5.01(viii) hereof is concerned, at any time in the period ending on the
       91st day after the date of such deposit (it being understood that this
       condition shall not be deemed satisfied until the expiration of such
       period).

              (v) Such Legal Defeasance or Covenant Defeasance shall not result
       in a breach or violation of, or constitute a default under any material
       agreement or instrument (other than this Indenture) to which the Company
       or any of its Subsidiaries is a party or by which the Company or any of
       its Subsidiaries is bound (other than a breach, violation or default
       resulting from the borrowing of funds to be applied to such deposit).

              (vi) The Company shall have delivered to the Trustee an Opinion of
       Counsel to the effect that after the 91st day following the deposit, the
       trust funds will not be subject to the effect of any applicable
       bankruptcy, insolvency, reorganization or similar laws affecting
       creditors' rights generally.

              (vii) The Company shall have delivered to the Trustee an Officers'
       Certificate stating that the deposit made by the Company pursuant to its
       election under Section 7.02 or 7.03 hereof was not made by the Company
       with the intent of preferring the Holders of the Securities over the
       other creditors of the Company with the intent of defeating, hindering,
       delaying or defrauding creditors of the Company or others.

              (viii) The Company shall have delivered to the Trustee an
       Officers' Certificate stating that all conditions precedent provided for
       relating to either the Legal Defeasance under Section 7.02 hereof or the
       Covenant Defeasance under Section 7.03 hereof (as the case may be) have
       been complied with as contemplated by this Section 7.04.

SECTION 7.05. DEPOSITED MONEY AND GOVERNMENT SECURITIES TO BE HELD IN TRUST;
              OTHER MISCELLANEOUS PROVISIONS.

       Subject to Section 7.06 hereof, all money and non-callable Government
Securities (including the proceeds thereof) deposited with the Trustee (or other
qualifying trustee, collectively for purposes of this Section 7.05, the
"Trustee") pursuant to Section 7.04 hereof in respect of the outstanding
Securities shall be held in trust and applied by the Trustee, in accordance with
the provisions of such Securities and this Indenture, to the payment, either
directly or through any Paying Agent (including the Company acting as Paying
Agent) as the Trustee may determine, to the Holders of such Securities of all
sums due and to become due thereon in respect of principal, premium, if any, and
interest, but such money need not be segregated from other funds except to the
extent required by law.

       The Company shall pay and indemnify the Trustee against any tax, fee or
other charge imposed on or assessed against the cash or non-callable Government
Securities deposited pursuant to Section 7.04 hereof or the principal and
interest received in respect thereof other than any such tax, fee or other
charge which by law is for the account of the Holders of the outstanding
Securities.

       Anything in this Article 7 to the contrary notwithstanding, the Trustee
shall deliver or pay to the Company from time to time upon the Company's request
any money or non-callable Government Securities held by it as provided in
Section 7.04 hereof which, in the opinion of a nationally recognized firm of
independent public accountants expressed in a written certification thereof
delivered

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to the Trustee (which may be the opinion delivered under Section 7.04(i)
hereof), are in excess of the amount thereof which would then be required to be
deposited to effect an equivalent Legal Defeasance or Covenant Defeasance.

SECTION 7.06. REPAYMENT TO COMPANY.

       Any money deposited with the Trustee or any Paying Agent, or then held by
the Company, in trust for the payment of the principal of, premium, if any, or
interest on any Security and remaining unclaimed for two years after such
principal, and premium, if any, or interest has become due and payable shall be
paid to the Company on its written request or (if then held by the Company)
shall be discharged from such trust; and the Holder of such Security shall
thereafter, as an unsecured general creditor, look only to the Company for
payment thereof, and all liability of the Trustee or such Paying Agent with
respect to such trust money, and all liability of the Company as trustee
thereof, shall thereupon cease; PROVIDED, HOWEVER, that the Trustee or such
Paying Agent, before being required to make any such repayment, may at the
expense of the Company cause to be published once, in the NEW YORK TIMES and THE
WALL STREET JOURNAL National edition), notice that such money remains unclaimed
and that, after a date specified therein, which shall not be less than 30 days
from the date of such notification or publication, any unclaimed balance of such
money then remaining will be repaid to the Company.

SECTION 7.07. REINSTATEMENT.

       If the Trustee or Paying Agent is unable to apply any U.S. Dollars or
non-callable Government Securities in accordance with Section 7.02 or 7.03
hereof, as the case may be, by reason of any order or judgment of any court or
governmental authority enjoining, restraining or otherwise prohibiting such
application, then the Company's obligations under this Indenture and the
Securities shall be revived and reinstated as though no deposit had occurred
pursuant to Section 7.02 or 7.03 hereof until such time as the Trustee or Paying
Agent is permitted to apply all such money in accordance with Section 7.02 or
7.03 hereof, as the case may be; PROVIDED, HOWEVER, that, if the Company makes
any payment of principal of, premium, if any, or interest on any Security
following the reinstatement of its obligations, the Company shall be subrogated
to the rights of the Holders of such Security to receive such payment from the
money held by the Trustee or Paying Agent.

                                    ARTICLE 8
                        AMENDMENT, SUPPLEMENT AND WAIVER

SECTION 8.01. WITHOUT CONSENT OF HOLDERS.

       The Company and the Trustee may amend or supplement this Indenture or the
Securities without the consent of any Holder:

              (i) to cure any ambiguity, defect or inconsistency;

              (ii) to provide for uncertificated Securities in addition to or in
       place of certificated Securities;

              (iii) to provide for any supplemental indenture required pursuant
       to Section 3.15 hereof;

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              (iv) to provide for the assumption of the Company's obligations to
       Holders of Securities in the case of a merger, consolidation or sale of
       assets pursuant to Article 4 hereof;

              (v) to make any change that would provide any additional rights or
       benefits to the Holders of the Securities or that does not adversely
       affect the legal rights hereunder of any such Holder; or

              (vi) to comply with requirements of the Commission in order to
       effect or maintain the qualification of this Indenture under the TIA.

       Upon the request of the Company accompanied by a resolution of its Board
of Directors authorizing the execution of any such supplemental indenture, and
upon receipt by the Trustee of the documents described in Section 8.06 hereof,
the Trustee shall join with the Company in the execution of any supplemental
indenture authorized or permitted by the terms of this Indenture and to make any
further appropriate agreements and stipulations which may be therein contained,
but the Trustee shall not be obligated to enter into such supplemental indenture
which affects its own rights, duties or immunities under this Indenture or
otherwise.

SECTION 8.02. WITH CONSENT OF HOLDERS.

       Except as provided in Section 8.01 and the next succeeding paragraphs,
this Indenture or the Securities may be amended or supplemented with the consent
of the Holders of at least a majority in principal amount of the Securities then
outstanding (including consents obtained in connection with a tender offer or
exchange offer for such Securities), and any existing default or compliance with
any provision of this Indenture or the Securities may be waived with the consent
of the Holders of a majority in principal amount of the then outstanding
Securities (including consents obtained in connection with a tender offer or
exchange offer for such Securities).

       Upon the request of the Company accompanied by a resolution of its Board
of Directors authorizing the execution of any such supplemental indenture, and
upon the filing with the Trustee of evidence satisfactory to the Trustee of the
consent of the Holders as aforesaid, and upon receipt by the Trustee of the
documents described in Section 8.06 hereof, the Trustee shall join with the
Company in the execution of such supplemental indenture unless such supplemental
indenture affects the Trustee's own rights, duties or immunities under this
Indenture or otherwise, in which case the Trustee may in its discretion, but
shall not be obligated to, enter into such supplemental indenture.

       It shall not be necessary for the consent of the Holders under this
Section 8.02 to approve the particular form of any proposed amendment or waiver,
but it shall be sufficient if such consent approves the substance thereof.

       After an amendment, supplement or waiver under this Section becomes
effective, the Company shall mail to the Holders affected thereby a notice
briefly describing the amendment, supplement or waiver. Any failure of the
Company to mail such notice, or any defect therein, shall not, however, in any
way impair or affect the validity of any such supplemental indenture or waiver.
Subject to Sections 5.04 and 5.07 hereof, the Holders of a majority in aggregate
principal amount of the Securities then outstanding may waive compliance in a
particular instance by the Company with any provision of this Indenture or the
Securities. Without the consent of each Holder affected, however, an amendment
or waiver may not (with respect to any Security held by a non-consenting
Holder):

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              (i) reduce the principal amount of Securities whose Holders must
       consent to an amendment, supplement or waiver;

              (ii) reduce the principal of or change the fixed maturity of any
       Security;

              (iii) reduce the rate of or change the time for payment of
       interest on any Security;

              (iv) waive a Default or Event of Default in the payment of
       principal of or premium, if any, or interest on the Securities (except a
       rescission of acceleration of the Securities by the Holders of at least a
       majority in aggregate principal amount thereof and a waiver of the
       payment default that resulted from such acceleration);

              (v) make any Security payable in money other than that stated in
       the Securities;

              (vi) make any change in Section 5.04 or 5.07 hereof; or

              (vii) make any change in this sentence of this Section 8.02.

SECTION 8.03. COMPLIANCE WITH TIA.

       Every amendment to this Indenture or the Securities shall be set forth in
a supplemental indenture that complies with the TIA as then in effect.

SECTION 8.04. REVOCATION AND EFFECT OF CONSENTS.

       Until an amendment or waiver becomes effective, a consent to it by a
Holder is a continuing consent by the Holder and every subsequent Holder of a
Security or portion of a Security that evidences the same debt as the consenting
Holder's Security, even if notation of the consent is not made on any Security.
However, any such Holder or subsequent Holder may revoke the consent as to its
Security if the Trustee receives written notice of revocation before the date
the waiver or amendment becomes effective. An amendment or waiver becomes
effective in accordance with its terms and thereafter binds every Holder.

       The Company may, but shall not be obligated to, fix a record date for
determining which Holders must consent to such amendment or waiver. If the
Company fixes a record date, the record date shall be fixed at (i) the later of
30 days prior to the first solicitation of such consent or the date of the most
recent list of Holders furnished to the Trustee prior to such solicitation
pursuant to Section 2.06 hereof or (ii) such other date as the Company shall
designate.

SECTION 8.05. NOTATION ON OR EXCHANGE OF SECURITIES.

       The Trustee may place an appropriate notation about an amendment or
waiver on any Security thereafter authenticated. The Company in exchange for all
Securities may issue and the Trustee shall authenticate new Securities that
reflect the amendment or waiver.

       Failure to make the appropriate notation or issue a new Security shall
not affect the validity and effect of such amendment or waiver.

                                      -42-
<PAGE>

SECTION 8.06. TRUSTEE TO SIGN AMENDMENTS, ETC.

       The Trustee shall sign any amendment or supplemental indenture authorized
pursuant to this Article 8 if the amendment does not adversely affect the
rights, duties, liabilities or immunities of the Trustee. If it does, the
Trustee may, but need not, sign it. In signing or refusing to sign such
amendment or supplemental indenture, the Trustee shall be entitled to receive
and, subject to Section 6.01, shall be fully protected in relying upon, an
Officers' Certificate and an Opinion of Counsel as conclusive evidence that such
amendment or Supplemental Indenture is authorized or permitted by this
Indenture, that it is not inconsistent herewith, and that it shall be valid and
binding upon the Company in accordance with its terms. The Company may not sign
an amendment or supplemental indenture until the Board of Directors approves it.

                                    ARTICLE 9
                                  MISCELLANEOUS

SECTION 9.01. TIA CONTROLS.

       If any provision of this Indenture limits, qualifies or conflicts with
the duties imposed by TIA Section 318(c), the imposed duties shall control.

SECTION 9.02. NOTICES.

       Any notice or communication by the Company or the Trustee to the other is
duly given if in writing and delivered in person or mailed by first class mail
(registered or certified, return receipt requested), telex, telecopier or
overnight air courier guaranteeing next day delivery, to the other's address:

       If to the Company:

       Tenet Healthcare Corporation
       3820 State Street
       Santa Barbara, California 93105
       Telecopier No.: (805) 563-7070
       Attention: Treasurer

       With a copy to:

       Skadden, Arps, Slate, Meagher & Flom
       300 South Grand Avenue, Suite 3400
       Los Angeles, California 90071
       Telecopier No.: (213) 687-5600
       Attention: Brian J. McCarthy

       If to the Trustee:

       The Bank of New York
       101 Barclay Street, 21 West
       New York, New York 10286

                                      -43-
<PAGE>

       Telecopier No.: (212) 815-5915
       Attention: Corporate Trust Trustee Administration

       The Company or the Trustee, by notice to the others may designate
additional or different addresses for subsequent notices or communications.

       All notices and communications (other than those sent to Holders) shall
be deemed to have been duly given: at the time delivered by hand, if personally
delivered; five Business Days after being deposited in the mail, postage
prepaid, if mailed; when answered back, if telexed; when receipt acknowledged,
if telecopied; and the next Business Day after timely delivery to the courier,
if sent by overnight air courier guaranteeing next day delivery.

       Unless otherwise set forth above, any notice or communication to a Holder
shall be mailed by first class mail, or by overnight air courier guaranteeing
next day delivery to its address shown on the register kept by the Registrar.
Any notice or communication shall also be so mailed to any Person described in
TIA Section 313(c), to the extent required by the TIA. Failure to mail a notice
or communication to a Holder or any defect in it shall not affect its
sufficiency with respect to other Holders.

       If a notice or communication is mailed in the manner provided above
within the time prescribed, it is duly given, whether or not the addressee
receives it.

       If the Company mails a notice or communication to Holders, it shall mail
a copy to the Trustee and each Agent at the same time.

SECTION 9.03. COMMUNICATION BY HOLDERS WITH OTHER HOLDERS.

       Holders may communicate pursuant to TIA Section 312(b) with other Holders
with respect to their rights under this Indenture or the Securities. The
Company, the Trustee, the Registrar and anyone else shall have the protection of
TIA Section 312(c).

SECTION 9.04. CERTIFICATE AND OPINION AS TO CONDITIONS PRECEDENT.

       Upon any request or application by the Company to the Trustee to take any
action under this Indenture, the Company shall furnish to the Trustee:

              (1) an Officers' Certificate (which shall include the statements
       set forth in Section 9.05 hereof) stating that, in the opinion of the
       signers, all conditions precedent and covenants, if any, provided for in
       this Indenture relating to the proposed action have been satisfied; and

              (2) an Opinion of Counsel (which shall include the statements set
       forth in Section 9.05 hereof) stating that, in the opinion of such
       counsel, all such conditions precedent and covenants have been satisfied.

SECTION 9.05. STATEMENTS REQUIRED IN CERTIFICATE OR OPINION.

       Each certificate or opinion with respect to compliance with a condition
or covenant provided for in this Indenture (other than a certificate provided
pursuant to TIA Section 314(a)(4)) shall include:

                                      -44-
<PAGE>

              (1) a statement that the person making such certificate or opinion
       has read such covenant or condition;

              (2) a brief statement as to the nature and scope of the
       examination or investigation upon which the statements or opinions
       contained in such certificate or opinion are based;

              (3) a statement that, in the opinion of such person, he has made
       such examination or investigation as is necessary to enable him to
       express an informed opinion as to whether or not such covenant or
       condition has been satisfied; and

              (4) a statement as to whether or not, in the opinion of such
       person, such condition or covenant has been satisfied; PROVIDED, HOWEVER,
       that with respect to matters of fact, an Opinion of Counsel may rely on
       an Officers' Certificate or certificates of public officials.

SECTION 9.06. RULES BY TRUSTEE AND AGENTS.

       The Trustee may make reasonable rules for action by or at a meeting of
Holders. The Registrar or Paying Agent may make reasonable rules and set
reasonable requirements for its functions.

SECTION 9.07. LEGAL HOLIDAYS.

       A "LEGAL HOLIDAY" is a Saturday, a Sunday or a day on which banking
institutions in The City of New York or at a place of payment are authorized or
obligated by law, regulation or executive order to remain closed. If a payment
date is a Legal Holiday at a place of payment, payment may be made at that place
on the next succeeding day that is not a Legal Holiday, and no interest shall
accrue for the intervening period.

SECTION 9.08. NO PERSONAL LIABILITY OF DIRECTORS, OFFICERS, EMPLOYEES AND
              SHAREHOLDERS.

       No director, officer, employee, incorporator or shareholder of the
Company, as such, shall have any liability for any obligations of the Company
under the Securities, the Indenture or for any claim based on, in respect of, or
by reason of, such obligations or their creation. Each Holder of the Securities
by accepting a Security waives and releases all such liability. The waiver and
release are part of the consideration for the issuance of the Securities. Such
waiver may not be effective to waive liabilities under the federal securities
laws and it is the view of the Commission that such a waiver is against public
policy.

SECTION 9.09. DUPLICATE ORIGINALS.

       The parties may sign any number of copies of this Indenture. One signed
copy is enough to prove this Indenture.

SECTION 9.10. GOVERNING LAW.

       The internal law of the State of New York, shall govern and be used to
construe this Indenture and the Securities, without regard to the conflict of
laws provisions thereof.

                                      -45-
<PAGE>

SECTION 9.11. NO ADVERSE INTERPRETATI0N OF OTHER AGREEMENTS.

       This Indenture may not be used to interpret another indenture, loan or
debt agreement of the Company or its Subsidiaries. Any such indenture, loan or
debt agreement may not be used to interpret this Indenture.

SECTION 9.12. SUCCESSORS.

       All agreements of the Company in this Indenture and the Securities shall
bind its successors. All agreements of the Trustee in this Indenture shall bind
its successor.

SECTION 9.13. SEVERABILITY.

       In case any provision in this Indenture or in the Securities shall be
invalid, illegal or unenforceable, the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby,
it being intended that all of the provisions hereof shall be enforceable to the
full extent permitted by law.

SECTION 9.14. COUNTERPART ORIGINALS.

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

SECTION 9.15. TABLE OF CONTENTS, HEADINGS, ETC.

       The Table of Contents, Cross-Reference Table and Headings of the Articles
and Sections of this Indenture have been inserted for convenience of reference
only, are not to be considered a part of this Indenture and shall in no way
modify or restrict any of the terms or provisions hereof.

                                      -46-
<PAGE>

                            Intentionally Left Blank

                                      -47-
<PAGE>

                                   SIGNATURES

Dated as of January 15, 1997                  TENET HEALTHCARE CORPORATION

                                              By: /s/ Terence P. McMullen
                                                  -----------------------
                                              Name:  Terence P. McMullen
                                              Title: Vice President
Attest:

/s/ Richard B. Silver  (SEAL)
    -----------------
    Richard B. Silver

Dated as of January 15, 1997                  THE BANK OF NEW YORK,
                                              as Trustee

                                              By: /s/ Vivian George
                                                  -----------------------
                                              Name:  Vivian George
                                              Title: Assistant Vice President

Attest:

________________________________       (SEAL)

By: /s/
    ----------------------
    Authorized Signatory

                                      -48-
<PAGE>

                                                                       EXHIBIT A
                               (Face of Security)

                                 8% Senior Note
                              due January 15, 2005

CUSIP: 88033G AF 7
No.

                                                             $__________________

                          TENET HEALTHCARE CORPORATION

promises to pay to
_______________________________________________________

or its registered assigns, the principal sum of _______________ Dollars on
January 15, 2005.

Interest Payment Dates: January 15 and July 15, commencing July 15, 1997.

Record Dates: January 1 and July 1 (whether or not a Business Day).

[(If Security is a Global Security--) This Security is a Global Security within
the meaning of the Indenture hereinafter referred to and is registered in the
name of a Depositary or a nominee thereof. This Security may not be exchanged in
whole or in part for a Security registered, and no transfer of this Security in
whole or in part may be registered, in the name of any person other than such
Depositary or a nominee thereof, except in the limited circumstances described
in the Indenture.]

TENET HEALTHCARE CORPORATION

By: ______________________

(SEAL)

Dated: _____________, ____

Trustee's Certificate of Authentication:

This is one of the Securities referred
to in the within-mentioned Indenture:

The Bank of New York, as Trustee

By:____________________________
     Authorized Signatory

                                      A-1
<PAGE>

                               (Back of Security)

                                 8% SENIOR NOTE
                              due January 15, 2005

       Capitalized terms used herein have the meanings assigned to them in the
Indenture (as defined below) unless otherwise indicated.

       1. INTEREST. Tenet Healthcare Corporation, a Nevada corporation (the
"Company"), promises to pay interest on the principal amount of this Security at
the rate and in the manner specified below.

              The Company shall pay interest in cash on the principal amount of
this Security at the rate per annum of 8%. The Company shall pay interest
semiannually in arrears on January 15 and July 15 of each year, commencing July
15, 1997 to Holders of record on the immediately preceding January 1 and July 1,
respectively, or if any such date of payment is not a Business Day on the next
succeeding Business Day (each an "Interest Payment Date").

              Interest shall be computed on the basis of a 360-day year
comprised of twelve 30-day months. Interest shall accrue from the most recent
date to which interest has been paid or, if no interest has been paid, from the
date of the original issuance of the Securities. To the extent lawful, the
Company shall pay interest on overdue principal at the rate of 1% per annum in
excess of the interest rate then applicable to the Securities; it shall pay
interest on overdue installments of interest (without regard to any applicable
grace periods) at the same rate to the extent lawful.

       2. METHOD OF PAYMENT. The Company shall pay interest on the Securities
(except defaulted interest) to the Persons who are registered Holders of
Securities at the close of business on the record date next preceding the
Interest Payment Date, even if such Securities are canceled after such record
date and on or before such Interest Payment Date. The Holder hereof must
surrender this Security to a Paying Agent to collect principal payments. The
Company shall pay principal and interest in money of the United States that at
the time of payment is legal tender for payment of public and private debts.
Principal, premium, if any, and interest shall be payable at the office or
agency of the Company maintained for such purpose within the City and State of
New York or, at the option of the Company, payment of interest may be made by
check mailed to the Holder's registered address. Notwithstanding the foregoing,
all payments with respect to Securities, the Holders of which have given
appropriate written wire transfer instructions, on or before the relevant record
date, to the Paying Agent shall be made by wire transfer of immediately
available funds to the accounts specified by such Holders.

       3. PAYING AGENT AND REGISTRAR. Initially, the Trustee shall act as Paying
Agent and Registrar. The Company may change any Paying Agent or Registrar or
co-registrar without prior notice to any Holder. The Company and any of its
Subsidiaries may act in any such capacity.

       4. INDENTURE. The Company issued the Securities under an Indenture, dated
as of January 15, 1997 (the "Indenture"), between the Company and the Trustee.
The terms of the Securities include those stated in the Indenture and those made
part of the Indenture by reference to the Trust Indenture Act of 1939, as
amended (15 U.S. Code Sections 77aaa-77bbbb) (the "TIA") as in effect on the
date of the Indenture. The Securities are subject to all such terms, and Holders
are referred to the Indenture and such act for a statement of such terms. The
terms of the Indenture shall govern any inconsistencies between the Indenture
and the Securities. The Securities are unsecured general obligations of the
Company. The Securities are limited to $900,000,000 in aggregate principal
amount.

                                      A-2
<PAGE>

       5. MANDATORY REDEMPTION. Subject to the Company's obligation to make an
offer to repurchase Securities under certain circumstances pursuant to Section
3.12 of the Indenture (as described in paragraph 6 below), the Company shall not
be required to make any mandatory redemption or sinking fund payments with
respect to the Securities.

       6. REPURCHASE AT OPTION OF HOLDER. If there is a Change of Control
Triggering Event, the Company shall offer to repurchase on the Change of Control
Payment Date all outstanding Securities at 101% of the aggregate principal
amount thereof plus accrued and unpaid interest thereon to the Change of Control
Payment Date. Holders that are subject to an offer to purchase shall receive a
Change of Control Offer from the Company prior to any related Change of Control
Payment Date and may elect to have such Securities purchased by completing the
form entitled "Option of Holder to Elect Purchase" appearing below.

       7. DENOMINATIONS, TRANSFER, EXCHANGE. The Securities are in registered
form without coupons, and in denominations of $1,000 and integral multiples of
$1,000. The transfer of Securities may be registered and Securities may be
exchanged as provided in the Indenture. The Registrar and the Trustee may
require a Holder, among other things, to furnish appropriate endorsements and
transfer documents and to pay any taxes and fees required by law or permitted by
the Indenture. The Registrar need not exchange or register the transfer of any
Securities between a record date and the corresponding Interest Payment Date.

       8. PERSONS DEEMED OWNERS. Prior to due presentment to the Trustee for
registration of the transfer of this Security, the Trustee, any Agent and the
Company may deem and treat the Person in whose name this Security is registered
as its absolute owner for the purpose of receiving payment of principal of,
premium, if any, and interest on this Security and for all other purposes
whatsoever, whether or not this Security is overdue, and neither the Trustee,
any Agent nor the Company shall be affected by notice to the contrary. The
registered Holder of a Security shall be treated as its owner for all purposes.

       9. AMENDMENT, SUPPLEMENT AND WAIVERS. Except as provided in the next
succeeding paragraphs, the Indenture or the Securities may be amended or
supplemented with the consent of the Holders of at least a majority in principal
amount of the Securities then outstanding (including consents obtained in
connection with a tender offer or exchange offer for such Securities), and any
existing default or compliance with any provision of the Indenture or the
Securities may be waived with the consent of the Holders of a majority in
principal amount of the then outstanding Securities (including consents obtained
in connection with a tender offer or exchange offer for such Securities).

              Without the consent of each Holder affected, an amendment or
waiver may not (with respect to any Security held by a non-consenting Holder):
(i) reduce the principal amount of Securities whose Holders must consent to an
amendment, supplement or waiver; (ii) reduce the principal of or change the
fixed maturity of any Security; (iii) reduce the rate of or change the time for
payment of interest on any Security; (iv) waive a Default or Event of Default in
the payment of principal of or premium, if any, or interest on the Securities,
(except a rescission of acceleration of the Securities by the Holders of at
least a majority in aggregate principal amount thereof and a waiver of the
payment default that resulted from such acceleration); (v) make any Security
payable in money other than that stated in the Securities; (vi) make any change
in the provisions of the Indenture relating to waivers of past Defaults or the
rights of Holders of Securities to receive payments of principal of or premium,
if any, or interest on the Securities; or (vii) make any change in the foregoing
amendment and waiver provisions.

              Notwithstanding the foregoing, without the consent of any Holder
of Securities, the Company and the Trustee may amend or supplement the Indenture
or the Securities to cure any

                                      A-3
<PAGE>

ambiguity, defect or inconsistency, to provide for uncertificated Securities in
addition to or in place of certificated Securities, to provide for any
supplemental Indenture required pursuant to Section 3.15 of the Indenture, to
provide for the assumption of the Company's obligations to Holders of Securities
in the case of a merger, consolidation or sale of assets pursuant to Article 4
of the Indenture, to make any change that would provide any additional rights or
benefits to the Holders of the Securities or that does not adversely affect the
legal rights under the Indenture of any such Holder, or to comply with
requirements of the Commission in order to effect or maintain the qualification
of the Indenture under the TIA.

       10. DEFAULTS AND REMEDIES. Events of Default under the Indenture include:
(i) a default for 30 days in the payment when due of interest on the Securities;
(ii) a default in payment when due of the principal of or premium, if any, on
the Securities, at maturity or otherwise; (iii) a failure by the Company to
comply with the provisions of Sections 3.07, 3.09 or 3.12 of the Indenture; (iv)
a failure by the Company for 60 days after notice to comply with any of its
other agreements in the Indenture or the Securities; (v) any default occurs
under any mortgage, indenture or instrument under which there may be issued or
by which there may be secured or evidenced any Indebtedness for money borrowed
by the Company or any of its Significant Subsidiaries (or the payment of which
is Guaranteed by the Company or any of its Significant Subsidiaries), whether
such Indebtedness or Guarantee exists on the date of the Indenture or is created
after the date of the Indenture, which default (a) constitutes a Payment Default
or (b) results in the acceleration of such Indebtedness prior to its express
maturity and, in each case, the principal amount of any such Indebtedness,
together with the principal amount of any other such Indebtedness under which
there has been a Payment Default or that has been so accelerated, aggregates
$25.0 million or more; (vi) failure by the Company or any of its Significant
Subsidiaries to pay a final judgment or final judgments aggregating in excess of
$25.0 million, which judgment or judgments are not paid, discharged or stayed
for a period of 60 days; and (vii) certain events of bankruptcy or insolvency
with respect to the Company or any of its Significant Subsidiaries.

              If any Event of Default occurs and is continuing, the Trustee or
the Holders of at least 25% in principal amount of the then outstanding
Securities by written notice to the Company and the Trustee, may declare all the
Securities to be due and payable immediately. Notwithstanding the foregoing, in
the case of an Event of Default arising from certain events of bankruptcy or
insolvency with respect to the Company or any of its Significant Subsidiaries,
all outstanding Securities shall become due and payable without further action
or notice. Holders of the Securities may not enforce the Indenture or the
Securities except as provided in the Indenture. Subject to certain limitations,
Holders of a majority in principal amount of the then outstanding Securities may
direct the Trustee in its exercise of any trust or power. The Trustee may
withhold from Holders of the Securities notice of any continuing Default or
Event of Default (except a Default or Event of Default relating to the payment
of principal or interest) if it determines that withholding notice is in the
Holders' interest.

              If an Event of Default occurs under the Indenture prior to
maturity by reason of any willful action (or inaction) taken (or not taken) by
or on behalf of the Company with the intention of avoiding the prohibition on
redemption of such Securities prior to the date of maturity, then the premium
specified in Section 5.02 of the Indenture shall also become immediately due and
payable to the extent permitted by law upon the acceleration of such Securities.

              The Holders of not less than a majority in aggregate principal
amount of the Securities then outstanding by written notice to the Trustee may
on behalf of the Holders of all of the Securities waive any existing Default or
Event of Default and its consequences under the Indenture except a continuing
Default or Event of Default in the payment of the principal of, premium, if any,
or interest on the Securities.

                                      A-4
<PAGE>

              The Company is required to deliver to the Trustee annually a
statement regarding compliance with the Indenture, and the Company is required
upon becoming aware of any Default or Event of Default, to deliver to the
Trustee a statement specifying such Default or Event of Default.

              The above description of Events of Default and remedies is
qualified by reference, and subject in its entirety, to the more complete
description thereof contained in the Indenture.

       11. RESTRICTIVE COVENANTS. The Indenture imposes certain limitations on
the ability of the Company and its Subsidiaries to incur additional indebtedness
and issue preferred stock, pay dividends or make other distributions, repurchase
Equity Interests or subordinated indebtedness, create certain liens, enter into
certain transactions with affiliates, issue or sell Equity Interests of the
Company's Subsidiaries, issue Guarantees of Indebtedness by the Company's
Subsidiaries and enter into certain mergers and consolidations.

       12. TRUSTEE DEALINGS WITH COMPANY. The Trustee under the Indenture, in
its individual or any other capacity, may make loans to, accept deposits from,
and perform services for the Company or its Affiliates and may otherwise deal
with the Company or its Affiliates, as if it were not Trustee.

       13. NO PERSONAL LIABILITY OF DIRECTORS, OFFICERS, EMPLOYEES AND
SHAREHOLDERS. No director, officer, employee, incorporator or shareholder of the
Company, as such, shall have any liability for any obligations of the Company
under the Securities, the Indenture or for any claim based on, in respect of, or
by reason of, such obligations or their creation. Each Holder of Securities by
accepting a Security waives and releases all such liability. The waiver and
release are part of the consideration for the issuance of the Securities. Such
waiver may not be effective to waive liabilities under the federal securities
laws and it is the view of the Commission that such a waiver is against public
policy.

       14. AUTHENTICATION. This Security shall not be valid until authenticated
by the manual signature of the Trustee or an authenticating agent.

       15. ABBREVIATIONS. Customary abbreviations may be used in the name of a
Holder or an assignee, such as: TEN COM (= tenants in common), TEN ENT (=
tenants by the entireties), JT TEN = joint tenants with right of survivorship
and not as tenants in common), CUST (= Custodian), and U/G/M/A (= Uniform Gifts
to Minors Act).

       16. CUSIP NUMBERS. Pursuant to a recommendation promulgated by the
Committee on Uniform Security Identification Procedures, the Company has caused
CUSIP numbers to be printed on the Securities and has directed the Trustee to
use CUSIP numbers as a convenience to Holders. No representation is made as to
the accuracy of such numbers either as printed on the Securities and reliance
may be placed only on the other identification numbers placed thereon.

              The Company will furnish to any Holder upon written request and
without charge a copy of the Indenture. Request may be made to:

              Tenet Healthcare Corporation
              3820 State Street
              Santa Barbara, California 93105
              Attention: Treasurer

       17. GOVERNING LAW. The internal laws of the State of New York shall
govern and be used to construe the Indenture and the Securities, without regard
to conflict of laws provisions thereof.

                                      A-5
<PAGE>

                                 ASSIGNMENT FORM

       To assign this Security, fill in the form below: For value received (I)
or (we) hereby sell, assign and transfer this Security to

________________________________________________________________________________
                  (Insert assignee's soc. sec. or tax I.D. no.)

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________
              (Print or type assignee's name, address and zip code)

and do hereby irrevocably constitute and appoint _____________________________
Attorney to transfer this Security on the books of the Company with full power
of substitution in the premises.

--------------------------------------------------------------------------------

Date: ____________________

                 Your Signature: _______________________________________________
                (Sign exactly as your name appears on the face of this Security)

Signature Guarantee.*

---------------------

       * NOTICE: The Signature must be guaranteed by an Institution which is a
member of one of the following recognized Signature Guaranty Programs: (i) The
Securities Transfer Agent Medallion Program (Stamp); (ii) The New York Stock
Exchange Medallion Program (MSP); (iii) The Stock Exchange Medallion Program
(SEMP); or (iv) such other guarantee program acceptable to the Trustee.

                                      A-6
<PAGE>

                       OPTION OF HOLDER TO ELECT PURCHASE

              If you want to elect to have all or any part of this Security
purchased by the Company pursuant to Section 3.12 of the Indenture, check the
box below:

                       [ ]       Section 3.12
                                 (Change of Control)

              If you want to have only part of the Security purchased by the
Company pursuant to Section 3.12 of the Indenture, state the amount you elect to
have purchased:

$___________________

Date: ______________

                                  Your Signature: ______________________________
                                  (Sign exactly as your name appears on the face
                                  of this Security)

Signature Guarantee.*

---------------------

       * NOTICE: The Signature must be guaranteed by an Institution which is a
member of one of the following recognized Signature Guaranty Programs: (i) The
Securities Transfer Agent Medallion Program (Stamp); (ii) The New York Stock
Exchange Medallion Program (MSP); (iii) The Stock Exchange Medallion Program
(SEMP); or (iv) such other guarantee program acceptable to the Trustee.

                                      A-7
<PAGE>

                                                                       EXHIBIT B

                                   FORM OF SUPPLEMENTAL INDENTURE

              SUPPLEMENTAL INDENTURE (this "Supplemental Indenture"), dated as
of __________________, between ______________ (the "Guarantor"), a subsidiary of
Tenet Healthcare Corporation (or its successor), a Nevada corporation (the
"Company"), and The Bank of New York, as trustee under the indenture referred to
below (the "Trustee").

                               W I T N E S S E T H

              WHEREAS, the Company has heretofore executed and delivered to the
Trustee an indenture (the "Indenture"), dated as of January 15, 1997, providing
for the issuance of an aggregate principal amount of $900,000,000 of 8% Senior
Notes due 2005 (the "Securities");

              WHEREAS, Section 3.15 of the Indenture provides that under certain
circumstances the Company is required to cause the Guarantor to execute and
deliver to the Trustee a supplemental indenture pursuant to which the Guarantor
shall guarantee the payment of the Securities pursuant to a Guarantee on the
terms and conditions set forth herein; and

              WHEREAS, pursuant to Section 8.01 of the Indenture, the Trustee is
authorized to execute and deliver this Supplemental Indenture.

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

       1. CAPITALIZED TERMS. Capitalized terms used herein without definition
shall have the meanings assigned to them in the Indenture.

       2. AGREEMENT TO GUARANTEE. The Guarantor hereby unconditionally
guarantees to each Holder of a Security authenticated and delivered by the
Trustee and to the Trustee and its successors and assigns, irrespective of the
validity and enforceability of the Indenture, the Securities or the Obligations
of the Company hereunder and thereunder, that: (a) the principal of, premium, if
any, and interest on the Securities will be promptly paid in full when due,
whether at maturity, by acceleration, redemption or otherwise, and interest on
the overdue principal, premium, if any, and (to the extent permitted by law)
interest on any interest on the Securities and all other payment Obligations of
the Company to the Holders or the Trustee hereunder or thereunder will be
promptly paid in full, all in accordance with the terms hereof and thereof and
(b) in case of any extension of time of payment or renewal of any Securities or
any of such other payment Obligations, that same will be promptly paid in full
when due or performed in accordance with the terms of the extension or renewal,
whether at stated maturity, by acceleration, redemption or otherwise. Failing
payment when due of any amount so guaranteed for whatever reason the Guarantor
shall be obligated to pay the same immediately. An Event of Default under the
Indenture or the Securities shall constitute an event of default under this
Guarantee, and shall entitle the Holders of Securities to accelerate the
Obligations of the Guarantor hereunder in the same manner and to the same extent
as the Obligations of the Company. The Guarantor hereby agrees that its
Obligations hereunder shall be unconditional, irrespective of the validity,
regularity or enforceability of the Securities or the Indenture, the absence of
any action to enforce the same, any waiver or consent by any Holder of the
Securities with respect to any provisions hereof or thereof, the recovery of any

                                         B-1
<PAGE>

judgment against the Company, any action to enforce the same or any other
circumstance which might otherwise constitute a legal or equitable discharge or
defense of the Guarantor. The Guarantor hereby waives diligence, presentment,
demand of payment, filing of claims with a court in the event of insolvency or
bankruptcy of the Company, any right to require a proceeding first against the
Company, protest, notice and all demands whatsoever and covenant that this
Guarantee will not be discharged except by complete performance of the
Obligations contained in the Securities and the Indenture. If any Holder or the
Trustee is required by any court or otherwise to return to the Company, the
Guarantor, or any Custodian, Trustee, liquidator or other similar official
acting in relation to either the Company or the Guarantor, any amount paid by
either to the Trustee or such Holder, this Guarantee, to the extent theretofore
discharged, shall be reinstated in full force and effect. The Guarantor agrees
that it shall not be entitled to, and hereby waives, any right of subrogation in
relation to the Holders in respect of any Obligations guaranteed hereby. The
Guarantor further agrees that, as between the Guarantor, on one hand, and the
Holders and the Trustee, on the other hand, (x) the maturity of the Obligations
guaranteed hereby may be accelerated as provided in Article 5 of the Indenture
for the purposes of this Guarantee, notwithstanding any stay, injunction or
other prohibition preventing such acceleration in respect of the Obligations
guaranteed hereby, and (y) in the event of any declaration of acceleration of
such Obligations as provided in Article 5 of the Indenture, such Obligations
(whether or not due and payable) shall forthwith become due and payable by the
Guarantor for the purpose of this Guarantee.

       3. EXECUTION AND DELIVERY OF GUARANTEE. To evidence its Guarantee set
forth in Section 2, the Guarantor hereby agrees that a notation of such
Guarantee substantially in the form of EXHIBIT A shall be endorsed by an officer
of such Guarantor on each Security authenticated and delivered by the Trustee
and that this Supplemental Indenture shall be executed on behalf of such
Guarantor, by manual or facsimile signature, by its President or one of its Vice
Presidents.

              The Guarantor hereby agrees that its Guarantee set forth in
Section 2 shall remain in full force and effect notwithstanding any failure to
endorse on each Security a notation of such Guarantee.

              If an Officer whose signature is on this Supplemental Indenture or
on the Guarantee no longer holds that office at the time the Trustee
authenticates the Security on which a Guarantee is endorsed, the Guarantee shall
be valid nevertheless.

              The delivery of any Security by the Trustee, after the
authentication thereof hereunder, shall constitute due delivery of the Guarantee
set forth in this Indenture on behalf of the Guarantors.

       4. GUARANTORS MAY CONSOLIDATE, ETC. ON CERTAIN TERMS.

              (a) Except as set forth in Articles 3 and 4 of the Indenture,
nothing contained in this Supplemental Indenture or in the Securities shall
prevent any consolidation or merger of the Guarantor with or into the Company or
any Subsidiary of the Company that has executed and delivered a supplemental
indenture substantially in the form hereof or shall prevent any sale or
conveyance of the property of the Guarantor as an entirety or substantially as
an entirety, to the Company or any such Subsidiary of the Company.

              (b) Except as provided in Section 4(a) hereof or in a transaction
referred to in Section 5 hereof, the Guarantor shall not consolidate with or
merge with or into, or sell, assign, transfer, lease, convey or otherwise
dispose of all or substantially all of its assets to, another Person unless (1)
either (x) the Guarantor shall be the surviving Person of such merger or
consolidation or (y) the surviving Person or transferee is a corporation,
partnership or trust organized and existing under the laws of the United States,
any state thereof or the District of Columbia and such surviving Person or
transferee shall

                                       B-2
<PAGE>

expressly assume all the obligations of the Guarantor under this Guarantee and
the Indenture pursuant to a supplemental indenture substantially in the form
hereof; (2) immediately after giving effect to such transaction (including the
incurrence of any Indebtedness incurred or anticipated to be incurred in
connection with such transaction) no Default or Event of Default shall have
occurred and be continuing; and (3) the Company has delivered to the Trustee an
Officers' Certificate and Opinion of Counsel, each stating that such
consolidation, merger or transfer complies with the Indenture, that the
surviving Person agrees to be bound thereby, and that all conditions precedent
in the Indenture relating to such transaction have been satisfied. For purposes
of the foregoing, the transfer (by lease, assignment, sale or otherwise, in a
single transaction or series of related transactions) of all or substantially
all of the properties and assets of one or more Subsidiaries of the Guarantor,
the Capital Stock of which constitutes all or substantially all of the
properties and assets of the Guarantor, shall be deemed to be the transfer of
all or substantially all of the properties and assets of the Guarantor.

              Upon any consolidation or merger, or any sale, assignment,
transfer, lease, conveyance or other disposition of all or substantially all of
the assets of the Guarantor in accordance with this Section 4(b) hereof, the
successor corporation shall succeed to and be substituted for the Guarantor with
the same effect as if it had been named herein as a Guarantor. Such successor
corporation thereupon may cause to be signed any or all of the Guarantees to be
endorsed upon all of the Securities issuable hereunder which theretofore shall
not have been signed by the Company and delivered to the Trustee. All Guarantees
so issued shall in all respects have the same legal rank and benefit under the
Indenture as the Guarantees theretofore and thereafter issued in accordance with
the terms of the Indenture as though all of such Guarantees had been issued at
the date of the execution hereof.

       5. RELEASES FOLLOWING SALE OF ASSETS. Concurrently with any sale, lease,
conveyance or other disposition (by merger, consolidation or otherwise) of
assets of the Guarantor (including, if applicable, disposition of all of the
Capital Stock of the Guarantor), any Liens in favor of the Trustee in the assets
sold, leased, conveyed or otherwise disposed of shall be released. If the assets
sold, leased, conveyed or otherwise disposed of (by merger, consolidation or
otherwise) include all or substantially all of the assets of the Guarantor or
all of the Capital Stock of the Guarantor in each case, in compliance with the
terms of the Indenture, then the Guarantor shall be automatically and
unconditionally released from and relieved of its Obligations under its
Guarantee. Upon delivery by the Company to the Trustee of an Officers'
Certificate to the effect that such sale, lease, conveyance or other disposition
was made by the Company in accordance with the provisions of the Indenture, the
Trustee shall execute any documents reasonably required in order to evidence the
release of the Guarantor from its Obligations under its Guarantee.

       6. LIMITATION ON GUARANTOR LIABILITY. For purposes hereof, the
Guarantor's liability will be that amount from time to time equal to the
aggregate liability of the Guarantor hereunder, but shall be limited to the
lesser of (i) the aggregate amount of the Obligations of the Company under the
Securities and the Indenture and (ii) the amount, if any, which would not have
(A) rendered the Guarantor "insolvent" (as such term is defined in the federal
Bankruptcy Law and in the Debtor and Creditor Law of the State of New York) or
(B) left it with unreasonably small capital at the time its Guarantee of the
Securities was entered into, after giving effect to the incurrence of existing
Indebtedness immediately prior to such time; PROVIDED that it shall be a
presumption in any lawsuit or other proceeding in which the Guarantor is a party
that the amount guaranteed pursuant to its Guarantee is the amount set forth in
clause (i) above unless any creditor, or representative of creditors of the
Guarantor, or debtor in possession or trustee in bankruptcy of the Guarantor,
otherwise proves in such a lawsuit that the aggregate liability of the Guarantor
is limited to the amount set forth in clause (ii). In making any determination
as to the solvency or sufficiency of capital of the Guarantor in accordance with
the previous sentence, the right of the Guarantor to contribution from other
Subsidiaries of the Company that

                                       B-3
<PAGE>

have executed and delivered a supplemental indenture substantially in the form
hereof and any other rights the Guarantor may have, contractual or otherwise,
shall be taken into account.

       7. "TRUSTEE" TO INCLUDE PAYING AGENT. In case at any time any Paying
Agent other than the Trustee shall have been appointed by the Company and be
then acting under the Indenture, the term "Trustee" as used in this Supplemental
Indenture shall in each case (unless the context shall otherwise require) be
construed as extending to and including such Paying Agent within its meaning as
fully and for all intents and purposes as if such Paying Agent were named in
this Supplemental Indenture in place of the Trustee.

       8. NO RECOURSE AGAINST OTHERS. No director, officer, employee,
incorporator or stockholder of the Guarantor, as such, shall have any liability
for any obligations of the Company or the Guarantor under the Securities, any
Guarantees, the Indenture or this Supplemental Indenture or for any claim based
on, in respect of, or by reason of, such obligations or their creation. Each
Holder of the Securities by accepting a Security waives and releases all such
liability. The waiver and release are part of the consideration for issuance of
the Securities. Such waiver may not be effective to waive liabilities under the
federal securities laws and it is the view of the Commission that such a waiver
is against public policy.

       9. NEW YORK LAW TO GOVERN. The internal law of the State of New York
shall govern and be used to construe this Supplemental Indenture.

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

       11. EFFECT OF HEADINGS. The Section headings herein are for convenience
only and shall not affect the construction hereof.

                                         B-4
<PAGE>

              IN WITNESS WHEREOF, the parties hereto have caused this
Supplemental Indenture to be duly executed and attested, all as of the date
first above written.

Dated: ___________________ __, _____

[Guarantor]

By: ________________________________
Name:
Title:

The Bank of New York,
   as Trustee

By: ________________________________
Name:
Title:

                                       B-5
<PAGE>

                       EXHIBIT A TO SUPPLEMENTAL INDENTURE
                                    GUARANTEE

       The Guarantor hereby unconditionally guarantees to each Holder of a
Security authenticated and delivered by the Trustee and to the Trustee and its
successors and assigns, irrespective of the validity and enforceability of the
Indenture, the Securities or the Obligations of the Company to the Holders or
the Trustee under the Securities or under the Indenture, that: (a) the principal
of, and premium, if any, and interest on the Securities will be promptly paid in
full when due, whether at maturity, by acceleration, redemption or otherwise,
and interest on overdue principal, premium, if any, and (to the extent permitted
by law) interest on any interest on the Securities and all other payment
Obligations of the Company to the Holders or the Trustee under the Indenture or
under the Securities will be promptly paid in full, all in accordance with the
terms thereof; and (b) in case of any extension of time of payment or renewal of
any Securities or any of such other payment Obligations, the same will be
promptly paid in full when due in accordance with the terms of the extension or
renewal, whether at stated maturity, by acceleration, redemption or otherwise.
Failing payment when due of any amount so guaranteed, for whatever reason, the
Guarantor shall be obligated to pay the same immediately.

       The obligations of the Guarantor to the Holders of Securities and to the
Trustee pursuant to this Guarantee and the Indenture are expressly set forth in
a Supplemental Indenture, dated as of _____________ __, ______ to the Indenture,
and reference is hereby made to the Indenture, as supplemented, for the precise
terms of this Guarantee.

       This is a continuing Guarantee and shall remain in full force and effect
and shall be binding upon the Guarantor and its respective successors and
assigns to the extent set forth in the Indenture until full and final payment of
all of the Company's Obligations under the Securities and the Indenture and
shall inure to the benefit of the successors and assigns of the Trustee and the
Holders of Securities and, in the event of any transfer or assignment of rights
by any Holder of Securities or the Trustee, the rights and privileges herein
conferred upon that party shall automatically extend to and be vested in such
transferee or assignee, all subject to the terms and conditions hereof. This a
Guarantee of payment and not a guarantee of collection.

       This Guarantee shall not be valid or obligatory for any purpose until the
certificate of authentication on the Security upon which this Guarantee is noted
shall have been executed by the Trustee under the Indenture by the manual
signature of one of its authorized signatories.

         For purposes hereof, the Guarantor's liability will be that amount from
time to time equal to the aggregate liability of the Guarantor hereunder, but
shall be limited to the lesser of (i) the aggregate amount of the Obligations of
the Company under the Securities and the Indenture and (ii) the amount, if any,
which would not have (A) rendered the Guarantor "insolvent" (as such term is
defined in the federal Bankruptcy Law and in the Debtor and Creditor Law of the
State of New York) or (B) left it with unreasonably small capital at the time
its Guarantee of the Securities was entered into, after giving effect to the
incurrence of existing Indebtedness immediately prior to such time; PROVIDED
that it shall be a presumption in any lawsuit or other proceeding in which the
Guarantor is a party that the amount guaranteed pursuant to its Guarantee is the
amount set forth in clause (i) above unless any creditor, or representative of
creditors of the Guarantor, or debtor in possession or trustee in bankruptcy of
the Guarantor, otherwise proves in such a lawsuit that the aggregate liability
of the Guarantor is limited to the amount set forth in clause (ii). The
Indenture provides that, in making any determination as to the solvency or
sufficiency of capital of a Guarantor in accordance with the previous sentence,
the right of

                                       B-6
<PAGE>

the Guarantor to contribution from other Subsidiaries of the Company that have
become Guarantors and any other rights the Guarantor may have, contractual or
otherwise, shall be taken into account.

       Capitalized terms used herein have the same meanings given in the
Indenture unless otherwise indicated.

                                              [GUARANTOR]

                                              By: _____________________________
                                                  Name:
                                                  Title:

                                       B-7

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