Document:

MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT

Drumright Regional Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company
4, LLC D/B/A Drumright Regional Hospital (“DRH”), a Delaware Limited Liability Company, and iHealthcare Management
II Company II, a Florida Corporation (“Manager”). DRH and Manager are sometimes referred to herein individually as
a “Party” or collectively as the “Parties.”

WITNESSETH:

WHEREAS, DRH owns and operates an acute general medical
and surgical hospital (the “DRH Facilities”) located on the medical campus with a principal address of 610 West Truck
Bypass Drumright, Oklahoma 74030;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, DRH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the DRH Facilities
on behalf of DRH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with DRH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, DRH hereby retains and appoints
Manager to manage the DRH Facilities on behalf of DRH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.Strategic
Plan and Budget. Manager and DRH, shall develop and agree on an annual plan setting forth details regarding the strategic,
operational and capital activities that Manager shall undertake and  

1

oversee on behalf of DRH and the budgets regarding
such activities (as amended from time to time, the “Strategic Plan and Budget”), which shall include, among other matters:

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the DRH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the DRH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, DRH will be solely responsible for its cost of operation. If requested by DRH, Manager will use commercially reasonable
efforts to assist DRH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By DRH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of DRH shall be the Governing Body
of the DRH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over DRH. DRH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, DRH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by DRH’s governing documents. DRH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with DRH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the DRH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

2

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the DRH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the DRH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of DRH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of DRH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

3

 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all DRH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise DRH regarding the operations
and business of the DRH Facilities in order to ensure effective management of the DRH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of DRH,
in Manager’s reasonable discretion and/or at DRH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the DRH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of DRH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the DRH Facilities. Manager
shall execute on behalf of DRH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the DRH Facilities periodically. 

(c)All
personnel required to be employed directly by DRH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of DRH (“DRH Personnel”) and not Manager, and shall be subject to DRH’s personnel
policies. All wages, benefits and other payroll expenses related to DRH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term DRH Personnel does not include any Senior Executives or any personnel of Manager, unless DRH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with DRH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging DRH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  DRH or the DRH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized agent of DRH, shall (i) determine the staffing plans on behalf of DRH with respect
to  

4

the number and qualifications of DRH Personnel
required for the efficient and effective operation of DRH Facilities operations, and, (ii) in accordance with the Strategic Plan
and Budget, implement wage scales, employee benefit packages and programs, in-service training programs, staffing schedules, and
job descriptions for DRH Personnel, all in order to accomplish the policies established by DRH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with DRH, shall assist in educational training programs for DRH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the DRH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the DRH
Facilities in the name of DRH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in DRH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the DRH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the DRH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the DRH Facilities building, and grounds), janitorial,
security and food services. 

5

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the DRH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the DRH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement DRH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the DRH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the DRH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the DRH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12DRH
Missions. Manager shall assist DRH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the DRH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by DRH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the DRH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the DRH Facilities’ image and reputation and to secure and maintain patients at the DRH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on DRH’s behalf and at DRH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the DRH Facilities
as are designated by DRH and consistent with the Strategic Plan and Budget or, in the absence of such a specification, as Manager
considers reasonable and prudent based on criteria generally used by Manager with respect to the hospitals owned or managed by
Manager. DRH, Manager and the Senior Executives shall be covered under all such applicable policies (or programs). Additionally,
Manager and the Senior Executives shall be  

6

named as additional insured's under DRH’s Directors’
and Officers’ liability, Errors and Omissions liability, professional liability and other insurance policies and the Senior
Executives shall be insured under any such policies to the same extent as DRH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the DRH Facilities in accordance with DRH’s mission,
the Strategic Plan and Budget and applicable law. Manager and DRH shall ensure that charity care at DRH Facilities is provided
in a manner consistent with DRH’s policies in effect from time to time. Manager shall implement and administer on behalf
of DRH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the DRH Facilities and the collection of all accounts due to the DRH Facilities
in accordance with lawful Charge-master and collection policies developed by DRH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. DRH shall approve the Charge-master. Manager shall update DRH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, DRH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)DRH
shall maintain bank accounts (“DRH Accounts”) necessary for operations of the DRH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the DRH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of DRH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from DRH Accounts on behalf
of DRH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided DRH has sufficient funds, Manager shall timely and accurately pay on behalf of DRH, from funds generated
by the DRH Facilities in the DRH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the DRH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the DRH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the DRH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing Body or the Management Committee) on behalf of DRH, any claims for
payment asserted with respect to the DRH Facilities that Manager, in good faith, considers erroneous or improper. 

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist DRH as the agent and attorney-in-fact of DRH in the procuring of licenses, permits and other
approvals, the payment and  

7

collection of accounts, and in all other activities
necessary, appropriate, or useful to Manager in the carrying out of its duties. In performing such services, Manager shall comply
with all applicable laws, regulations and requirements of governmental bodies.

4.19Elective
Corporate-Based Consulting Services. If requested by DRH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to DRH. For the purpose of keeping informed with respect to the operation of the DRH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the DRH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the DRH Facilities, audited financial statements of the
DRH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the DRH Facilities (selected by the Governing Body). The timing of audit submissions
assumes DRH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each DRH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of DRH and delivery of such reports
is conditioned upon the capability, availability, cooperation and access to, such DRH systems and personnel for Manager. Manager
shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports required by this
Agreement. 

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the DRH Facilities. 

8

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the DRH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the DRH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding DRH’s existing Quality Assurance Program and QIIP
and shall assist DRH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with DRH’s Quality Assurance Program, Manager shall assist DRH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of DRH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the DRH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the DRH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the DRH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the DRH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
 

9

taxation, environmental compliance, antitrust, or
physical facility compliance. Manager shall assist DRH to operate the DRH Facilities so that it maintains all necessary licenses,
permits, consents, and approvals from all governmental agencies that have jurisdiction over the operation of the DRH Facilities.
Manager shall not be obligated to DRH for failure of the DRH Facilities to comply with any such laws, rules, and regulations or
for failure of the DRH Facilities to maintain any such licenses, permits, consents, and approvals, to the extent that the failure
is due to financial limitations of the DRH Facilities or to the design or construction of the DRH Facilities, or is attributable
to acts, errors or omissions of DRH or its agents (other than Manager or Manager’s employees or contractors).

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the DRH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the DRH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither DRH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the DRH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the DRH Facilities; (iii) cause a termination of, or adversely
affect, DRH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause DRH to violate or default under any of its legal obligations under debt financings. DRH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by DRH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on DRH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by DRH. 

(2)Incur
debt on behalf of DRH; 

(3)Encumber
DRH property, or sell or dispose of any material assets having a value in excess of $25,000; 

10

(4)Approve
or undertake any other matters required by law to be approved by DRH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the DRH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, DRH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, DRH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1DRH. 

(a)DRH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
DRH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and its affiliates (together,
the “SE Employer”), and direct or indirect equity holder of Manager, and any person who controls Manager (any or all
of the foregoing hereinafter a “Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies,
claims, actions, suits, proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including
reasonable attorneys’ fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”)
that may be incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified
Person is party  

11

to such Claims) to the extent they result from,
arise out of, or are in any way related to, the following, in each case as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by DRH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of DRH set forth in this Agreement; 

(2)any
actions or omissions of DRH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of DRH or its Representatives  related
to this Agreement; 

(3)any
failure by DRH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the DRH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or DRH’s ownership or operation of the DRH Facilities, including without limitation the use of any real or tangible property
in connection with the DRH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of DRH or any of its
Representatives. 

(b)Furthermore,
DRH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a party to any Claims out of which any such expenses arise and whether or not such Claims are brought
by DRH, its Representatives or any other person or entity. 

(c)However,
DRH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the  

12

Agreement; or (c) arising from (i) felony criminal
activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts indemnifiable by Manager,
in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator.

(d)The
reimbursement and indemnity obligations of DRH under this Agreement shall be in addition to any liability DRH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of DRH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless DRH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“DRH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of DRH or a DRH Indemnified
Person (b) by one DRH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any DRH Indemnified Person directly participated in or (ii) other acts
indemnifiable by DRH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee based thereon, and shall
have the right to contest and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided,
however, that if the Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of
any such action within ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to
take any such action as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment
and claim indemnification as provided herein; provided, however, that no Party shall settle any such action without the consent
of the  

13

other applicable Party (which consent shall
not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides the Indemnitee
a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification is claimed,
the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided, however,
that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement of such
counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the defense
in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists a conflict
or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor to represent
both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding effected
without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, DRH shall indemnify the Senior
Executives who will be acting as officers of DRH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under DRH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to DRH and DRH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to DRH or DRH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and DRH and DRH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such Claims result primarily and directly from such Senior Executive’s felony criminal acts, willful
misconduct, gross negligence or fraud in each such case (other than with respect to felony criminal acts which shall require final
judgment by a court of competent jurisdiction (not subject to further appeal)), as finally determined by an arbitrator. 

14

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, DRH’s auditors and accountants, DRH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, DRH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will be deferred as owed but carried as a deferred expense due Manager. When, in
Manager’s best business judgement, sufficient funds become available to pay off all or part of fees incurred and still owing,
Manager will pay down all or part of the balance of fees owed using prudent business judgement and discretion. In no case shall
Manager forgive fees due for management services rendered.  

15

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to DRH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term.  

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in good faith for thirty (30) days following written notice of the Dispute served on a Party,
either Party may refer such Dispute to DRH and the CEO of Manager for resolution.  

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive  

16

covenants, mishandling of Confidential Information,
or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction, in Miami, Florida, of either
the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator shall agree: (a) that the
arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention (or demand) to arbitrate  (but
it may be extended by written agreement of the parties); (b) to base any decision or award on governing law; (c) to not award punitive
or other damages that are not measured by the prevailing party’s actual damages, except as may be required by statute; and
(d) to issue an award in writing within ten (10) days of concluding the presentation of evidence and briefs.  Judgment may
be entered in any court having jurisdiction thereof.  The prevailing party shall be entitled to recover from the other party
its costs and expenses, including reasonable attorney’s fees.

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after DRH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by DRH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

17

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to DRH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by DRH to perform, fund or meet any of DRH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to DRH in the event DRH (or DRH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and DRH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, DRH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of DRH, upon request of DRH, Manager shall be obligated to continue to provide DRH with the Management Services described herein
for a period of up to one hundred twenty (120) days after such termination or expiration of this Agreement (the “Transition
Period”), and during such Transition Period: (a) Provided  DRH shall continue to compensate Manager in accordance with
this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly and efficient transfer of its functions hereunder
to DRH and/or another service provider; (c) Manager shall fully cooperate in order to ensure no disruption to patient care functions;
and (d) the Parties shall  

18

cooperate in order to resolve any outstanding operational,
financial, legal or other matters arising (including audits) from the period in which this Agreement was in effect.

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to DRH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

 

19.2DRH.
As of the Effective Date, DRH represents and warrants to Manager as follows: 

(a)DRH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)DRH
has full authority to enter into and perform this Agreement, and the signature of DRH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against DRH in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

19

(c)The
execution, delivery and performance of this Agreement by DRH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to DRH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
DRH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which DRH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to DRH’s
knowledge threatened against DRH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason DRH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to DRH or Manager relating to DRH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about DRH, services provided and its relationship hereunder. 

20.3Use
of DRH Name. Manager may use the DRH or DRH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to DRH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to DRH of invoices. Any such expenses, subject to this section, shall
require prior approval by DRH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title) designated
below (or to such other address, facsimile number, email address or person as a Party may designate by notice delivered to the
other Party in accordance with this Section: 

20

Manager:Executive
Vice President  

iHealthcare Management II Company
II

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

DRH:
               Drumright
Regional Hospital 

                              610
W Truck Bypass

                              Drumright,
OK 74030

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in electronic (“pdf” or “tif”) format shall be effective
as delivery of a manually executed counterpart of this Agreement. 

21

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by DRH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of DRH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to DRH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, DRH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19
  Amendment and First Right of Refusal. This Agreement sets forth the entire understanding and agreement among the parties
hereto with reference to the subject matter hereof and may not be modified, amended, discharged or terminated except by a written
instrument signed by the parties hereto. First Right of Refusal:
 Landlord/Owner hereby grants to iHealthcare (iHCC) a first right of refusal to purchase the hospital property and
real estate during the term and any extensions of this Management and 

22

Administrative
Services Agreement.  If Landlord/Owner shall desire to sell the hospital property and real estate, and receives a bona fide
offer to purchase, Landlord/Owner shall give iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest
in the hospital property and real estate as contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall
state the terms and conditions under which Landlord/Owner intends to sell its interest. For Sixty (60) business days following
the giving of such notice, iHealthcare shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. DRH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

Drumright Regional Hospital: 

 

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT

Fairfax Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 12, LLC
D/B/A Fairfax Community Hospital (“FCH”), a Delaware Limited Liability Company, and iHealthcare Management II Company,
a Florida Corporation (“Manager”). FCH and Manager are sometimes referred to herein individually as a “Party”
or collectively as the “Parties.”

WITNESSETH:

WHEREAS, FCH owns and operates an acute general medical
and surgical hospital (the “FCH Facilities”) located on the medical campus with a principal address of 40 Hospital
Road Fairfax, Oklahoma 74637;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, FCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the FCH Facilities
on behalf of FCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with FCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, FCH hereby retains and appoints
Manager to manage the FCH Facilities on behalf of FCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.Strategic
Plan and Budget. Manager and FCH, shall develop and agree on an annual plan setting forth details regarding the strategic,
operational and capital activities that Manager shall undertake and  

1

oversee on behalf of FCH and the budgets regarding
such activities (as amended from time to time, the “Strategic Plan and Budget”), which shall include, among other matters:

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the FCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the FCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, FCH will be solely responsible for its cost of operation. If requested by FCH, Manager will use commercially reasonable
efforts to assist FCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By FCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of FCH shall be the Governing Body
of the FCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over FCH. FCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, FCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by FCH’s governing documents. FCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with FCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the FCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

2

 

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the FCH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the FCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of FCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of FCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

3

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services 

 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all FCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise FCH regarding the operations
and business of the FCH Facilities in order to ensure effective management of the FCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of FCH,
in Manager’s reasonable discretion and/or at FCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the FCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of FCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the FCH Facilities. Manager
shall execute on behalf of FCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the FCH Facilities periodically. 

(c)All
personnel required to be employed directly by FCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of FCH (“FCH Personnel”) and not Manager, and shall be subject to FCH’s personnel
policies. All wages, benefits and other payroll expenses related to FCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term FCH Personnel does not include any Senior Executives or any personnel of Manager, unless FCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with FCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging FCH Personnel. 

4

(e)Subject
to the terms of any applicable labor agreements binding  FCH or the FCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized agent of FCH, shall (i) determine the staffing plans on behalf of FCH with respect
to the number and qualifications of FCH Personnel required for the efficient and effective operation of FCH Facilities operations,
and, (ii) in accordance with the Strategic Plan and Budget, implement wage scales, employee benefit packages and programs, in-service
training programs, staffing schedules, and job descriptions for FCH Personnel, all in order to accomplish the policies established
by FCH. 

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with FCH, shall assist in educational training programs for FCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the FCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the FCH
Facilities in the name of FCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in FCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the FCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the FCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

5

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the FCH Facilities building, and grounds), janitorial,
security and food services. 

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the FCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the FCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement FCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the FCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the FCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the FCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12FCH
Missions. Manager shall assist FCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the FCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by FCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the FCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the FCH Facilities’ image and reputation and to secure and maintain patients at the FCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on FCH’s behalf and at FCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the FCH Facilities
as are designated  

6

by FCH and consistent with the Strategic Plan and
Budget or, in the absence of such a specification, as Manager considers reasonable and prudent based on criteria generally used
by Manager with respect to the hospitals owned or managed by Manager. FCH, Manager and the Senior Executives shall be covered under
all such applicable policies (or programs). Additionally, Manager and the Senior Executives shall be named as additional insured's
under FCH’s Directors’ and Officers’ liability, Errors and Omissions liability, professional liability and other
insurance policies and the Senior Executives shall be insured under any such policies to the same extent as FCH’s other officers
and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the FCH Facilities in accordance with FCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and FCH shall ensure that charity care at FCH Facilities is provided
in a manner consistent with FCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of FCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the FCH Facilities and the collection of all accounts due to the FCH Facilities
in accordance with lawful Charge-master and collection policies developed by FCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. FCH shall approve the Charge-master. Manager shall update FCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, FCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)FCH
shall maintain bank accounts (“FCH Accounts”) necessary for operations of the FCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the FCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of FCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from FCH Accounts on behalf
of FCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided FCH has sufficient funds, Manager shall timely and accurately pay on behalf of FCH, from funds generated
by the FCH Facilities in the FCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the FCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the FCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the FCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing  

7

Body or the Management Committee) on behalf of FCH,
any claims for payment asserted with respect to the FCH Facilities that Manager, in good faith, considers erroneous or improper.

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist FCH as the agent and attorney-in-fact of FCH in the procuring of licenses, permits and other
approvals, the payment and collection of accounts, and in all other activities necessary, appropriate, or useful to Manager in
the carrying out of its duties. In performing such services, Manager shall comply with all applicable laws, regulations and requirements
of governmental bodies. 

4.19Elective
Corporate-Based Consulting Services. If requested by FCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to FCH. For the purpose of keeping informed with respect to the operation of the FCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the FCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the FCH Facilities, audited financial statements of the
FCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the FCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes FCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each FCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of FCH and delivery of such reports
is conditioned upon the capability, availability, cooperation  

8

and access to, such FCH systems and personnel for
Manager. Manager shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports
required by this Agreement.

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the FCH Facilities. 

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the FCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the FCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding FCH’s existing Quality Assurance Program and QIIP
and shall assist FCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with FCH’s Quality Assurance Program, Manager shall assist FCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of FCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the FCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the FCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the FCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

9

 

 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the FCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
taxation, environmental compliance, antitrust, or physical facility compliance. Manager shall assist FCH to operate the FCH Facilities
so that it maintains all necessary licenses, permits, consents, and approvals from all governmental agencies that have jurisdiction
over the operation of the FCH Facilities. Manager shall not be obligated to FCH for failure of the FCH Facilities to comply with
any such laws, rules, and regulations or for failure of the FCH Facilities to maintain any such licenses, permits, consents, and
approvals, to the extent that the failure is due to financial limitations of the FCH Facilities or to the design or construction
of the FCH Facilities, or is attributable to acts, errors or omissions of FCH or its agents (other than Manager or Manager’s
employees or contractors). 

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the FCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the FCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither FCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the FCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the FCH Facilities; (iii) cause a termination of, or adversely
affect, FCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause FCH to violate or default under any of its legal obligations under debt financings. FCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by FCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on FCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

10

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by FCH. 

(2)Incur
debt on behalf of FCH; 

(3)Encumber
FCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

(4)Approve
or undertake any other matters required by law to be approved by FCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the FCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, FCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, FCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1FCH. 

(a)FCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
FCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and  

11

its affiliates (together, the “SE Employer”),
and direct or indirect equity holder of Manager, and any person who controls Manager (any or all of the foregoing hereinafter a
“Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies, claims, actions, suits,
proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including reasonable attorneys’
fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”) that may be
incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified Person
is party to such Claims) to the extent they result from, arise out of, or are in any way related to, the following, in each case
as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by FCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of FCH set forth in this Agreement; 

(2)any
actions or omissions of FCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of FCH or its Representatives  related
to this Agreement; 

(3)any
failure by FCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the FCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or FCH’s ownership or operation of the FCH Facilities, including without limitation the use of any real or tangible property
in connection with the FCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of FCH or any of its
Representatives. 

(b)Furthermore,
FCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a  

12

party to any Claims out of which any such expenses
arise and whether or not such Claims are brought by FCH, its Representatives or any other person or entity.

(c)However,
FCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the Agreement; or (c) arising from
(i) felony criminal activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts
indemnifiable by Manager, in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator. 

(d)The
reimbursement and indemnity obligations of FCH under this Agreement shall be in addition to any liability FCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of FCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless FCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“FCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of FCH or a FCH Indemnified
Person (b) by one FCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any FCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by FCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee  

13

based thereon, and shall have the right to contest
and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided, however, that if the
Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of any such action within
ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to take any such action
as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment and claim indemnification
as provided herein; provided, however, that no Party shall settle any such action without the consent of the other applicable Party
(which consent shall not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides
the Indemnitee a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification
is claimed, the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided,
however, that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement
of such counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the
defense in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists
a conflict or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor
to represent both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding
effected without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, FCH shall indemnify the Senior
Executives who will be acting as officers of FCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under FCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to FCH and FCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to FCH or FCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and FCH and FCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such  

14

Claims result primarily and directly from such Senior
Executive’s felony criminal acts, willful misconduct, gross negligence or fraud in each such case (other than with respect
to felony criminal acts which shall require final judgment by a court of competent jurisdiction (not subject to further appeal)),
as finally determined by an arbitrator.

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, FCH’s auditors and accountants, FCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, FCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will  

15

be deferred as owed but carried as a deferred
expense due Manager. When, in Manager’s best business judgement, sufficient funds become available to pay off all or part
of fees incurred and still owing, Manager will pay down all or part of the balance of fees owed using prudent business judgement
and discretion. In no case shall Manager forgive fees due for management services rendered.

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to FCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term.  

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in  

16

good faith for thirty (30) days following written
notice of the Dispute served on a Party, either Party may refer such Dispute to FCH and the CEO of Manager for resolution.

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base any decision or award
on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s actual damages,
except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the presentation
of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing party shall
be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.  

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after FCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by FCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

17

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to FCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by FCH to perform, fund or meet any of FCH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to FCH in the event FCH (or FCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and FCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, FCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of FCH, upon request of FCH, Manager shall be obligated to continue to provide FCH with the Management Services described herein
for a period of up to one  

18

hundred twenty (120) days after such termination or
expiration of this Agreement (the “Transition Period”), and during such Transition Period: (a) Provided  FCH shall
continue to compensate Manager in accordance with this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly
and efficient transfer of its functions hereunder to FCH and/or another service provider; (c) Manager shall fully cooperate in
order to ensure no disruption to patient care functions; and (d) the Parties shall cooperate in order to resolve any outstanding
operational, financial, legal or other matters arising (including audits) from the period in which this Agreement was in effect.

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to FCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2FCH.
As of the Effective Date, FCH represents and warrants to Manager as follows: 

(a)FCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)FCH
has full authority to enter into and perform this Agreement, and the signature of FCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against  

19

FCH in accordance with its terms (subject only
to customary limitations on the enforceability and availability of remedies in accordance with principles of law and equity).

(c)The
execution, delivery and performance of this Agreement by FCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to FCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
FCH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which FCH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to FCH’s
knowledge threatened against FCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason FCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to FCH or Manager relating to FCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about FCH, services provided and its relationship hereunder. 

20.3Use
of FCH Name. Manager may use the FCH or FCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to FCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to FCH of invoices. Any such expenses, subject to this section, shall
require prior approval by FCH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title)  

20

designated below (or to such other address, facsimile
number, email address or person as a Party may designate by notice delivered to the other Party in accordance with this Section:

Manager:Executive
Vice President  

iHealthcare Management II Company
II

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

FCH:
              Fairfax
Community Hospital 

                            40
Hospital Road

                            Fairfax,
Oklahoma 74637

                              

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in  

21

electronic (“pdf” or “tif”)
format shall be effective as delivery of a manually executed counterpart of this Agreement.

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by FCH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of FCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to FCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, FCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19   Amendment and First Right of Refusal.
This Agreement sets forth the entire understanding and agreement among the parties hereto with reference to the subject matter
hereof and may not be

22

modified,
amended, discharged or terminated except by a written instrument signed by the parties hereto. First
Right of Refusal:  Landlord/Owner hereby grants to iHealthcare (iHCC) a first right
of refusal to purchase the hospital property and real estate during the term and any extensions of this Management and Administrative
Services Agreement.  If Landlord/Owner shall desire to sell the hospital property and real estate, and receives a bona fide
offer to purchase, Landlord/Owner shall give iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest
in the hospital property and real estate as contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall
state the terms and conditions under which Landlord/Owner intends to sell its interest. For Sixty (60) business days following
the giving of such notice, iHealthcare shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. FCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 12, LLC D/B/A Fairfax Community
Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Haskell County Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 16, LLC
D/B/A Haskell County Community Hospital (“HCCH”), a Delaware Limited Liability Company, and iHealthcare Management
II Company, a Florida Corporation (“Manager”). HCCH and Manager are sometimes referred to herein individually as a
“Party” or collectively as the “Parties.”

WITNESSETH:

WHEREAS, HCCH owns and operates an acute general medical
and surgical hospital (the “HCCH Facilities”) located on the medical campus with a principal address of 401 Northwest
H Street, Stigler, Oklahoma 74462;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, HCCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the HCCH Facilities
on behalf of HCCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with HCCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, HCCH hereby retains and appoints
Manager to manage the HCCH Facilities on behalf of HCCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

1

2.
   Strategic Plan and Budget. Manager and HCCH,
shall develop and agree on an annual plan setting forth details regarding the strategic, operational and capital activities that
Manager shall undertake and oversee on behalf of HCCH and the budgets regarding such activities (as amended from time to time,
the “Strategic Plan and Budget”), which shall include, among other matters: 

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the HCCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the HCCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, HCCH will be solely responsible for its cost of operation. If requested by HCCH, Manager will use commercially reasonable
efforts to assist HCCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By HCCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of HCCH shall be the Governing Body
of the HCCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over HCCH. HCCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, HCCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by HCCH’s governing documents. HCCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with HCCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

2

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the HCCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the HCCH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the HCCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of HCCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of HCCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

3

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all HCCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise HCCH regarding the operations
and business of the HCCH Facilities in order to ensure effective management of the HCCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of HCCH,
in Manager’s reasonable discretion and/or at HCCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the HCCH Facilities, and
Manager shall oversee and administer the recruitment and hiring in the name of and on behalf of HCCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the HCCH Facilities. Manager
shall execute on behalf of HCCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the HCCH Facilities periodically. 

(c)All
personnel required to be employed directly by HCCH under applicable licensure and reimbursement laws, regulations, and related
requirements shall be employees or contractors of HCCH (“HCCH Personnel”) and not Manager, and shall be subject to
HCCH’s personnel policies. All wages, benefits and other payroll expenses related to HCCH Personnel shall be included as
part of Hospital Expenses. For the avoidance of doubt, the term HCCH Personnel does not include any Senior Executives or any personnel
of Manager, unless HCCH first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with HCCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging HCCH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  HCCH or the HCCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the  

4

authorized agent of HCCH, shall (i) determine
the staffing plans on behalf of HCCH with respect to the number and qualifications of HCCH Personnel required for the efficient
and effective operation of HCCH Facilities operations, and, (ii) in accordance with the Strategic Plan and Budget, implement wage
scales, employee benefit packages and programs, in-service training programs, staffing schedules, and job descriptions for HCCH
Personnel, all in order to accomplish the policies established by HCCH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with HCCH, shall assist in educational training programs for HCCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the HCCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the HCCH
Facilities in the name of HCCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in HCCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the HCCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the HCCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

5

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the HCCH Facilities building, and grounds), janitorial,
security and food services. 

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the HCCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the HCCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement HCCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the HCCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the HCCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the HCCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its
obligations hereunder. 

4.12HCCH
Missions. Manager shall assist HCCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the HCCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve
the quality of life and overall health outcomes of the patient populations served by HCCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the HCCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the HCCH Facilities’ image and reputation and to secure and maintain patients at the HCCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on HCCH’s behalf and at HCCH’s sole expense, throughout
the term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability
and hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the HCCH
 

6

Facilities as are designated by HCCH and consistent
with the Strategic Plan and Budget or, in the absence of such a specification, as Manager considers reasonable and prudent based
on criteria generally used by Manager with respect to the hospitals owned or managed by Manager. HCCH, Manager and the Senior Executives
shall be covered under all such applicable policies (or programs). Additionally, Manager and the Senior Executives shall be named
as additional insured's under HCCH’s Directors’ and Officers’ liability, Errors and Omissions liability, professional
liability and other insurance policies and the Senior Executives shall be insured under any such policies to the same extent as
HCCH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the HCCH Facilities in accordance with HCCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and HCCH shall ensure that charity care at HCCH Facilities is provided
in a manner consistent with HCCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of HCCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the HCCH Facilities and the collection of all accounts due to the HCCH Facilities
in accordance with lawful Charge-master and collection policies developed by HCCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. HCCH shall approve the Charge-master. Manager shall update HCCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, HCCH, the assistance of one or more collection agencies who shall be required to act in accordance with law
and generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)HCCH
shall maintain bank accounts (“HCCH Accounts”) necessary for operations of the HCCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the HCCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of HCCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from HCCH Accounts on
behalf of HCCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided HCCH has sufficient funds, Manager shall timely and accurately pay on behalf of HCCH, from funds generated
by the HCCH Facilities in the HCCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the HCCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the HCCH Facilities and all personal property,
supplies, inventory and all other items necessary for operation of the HCCH Facilities and to provide the Management Services described
herein. Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines
and policies as are established from time to  

7

time by the Governing Body or the Management Committee)
on behalf of HCCH, any claims for payment asserted with respect to the HCCH Facilities that Manager, in good faith, considers erroneous
or improper.

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist HCCH as the agent and attorney-in-fact of HCCH in the procuring of licenses, permits and other
approvals, the payment and collection of accounts, and in all other activities necessary, appropriate, or useful to Manager in
the carrying out of its duties. In performing such services, Manager shall comply with all applicable laws, regulations and requirements
of governmental bodies. 

4.19Elective
Corporate-Based Consulting Services. If requested by HCCH and agreed by Manager, Manager or its designees may provide as added
elective consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements),
corporate-based consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting
Services”). Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to
by the Parties, which rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to HCCH. For the purpose of keeping informed with respect to the operation of the HCCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the HCCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the HCCH Facilities, audited financial statements of
the HCCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement
of changes in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles
and accompanied by a report of the independent auditor of the HCCH Facilities (selected by the Governing Body). The timing of audit
submissions assumes HCCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each HCCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of HCCH and delivery of such reports
is conditioned upon the capability, availability, cooperation  

8

and access to, such HCCH systems and personnel for
Manager. Manager shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports
required by this Agreement.

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the HCCH Facilities. 

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the HCCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the HCCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding HCCH’s existing Quality Assurance Program and
QIIP and shall assist HCCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with HCCH’s Quality Assurance Program, Manager shall assist HCCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of HCCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the HCCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the HCCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the HCCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

9

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the HCCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
taxation, environmental compliance, antitrust, or physical facility compliance. Manager shall assist HCCH to operate the HCCH Facilities
so that it maintains all necessary licenses, permits, consents, and approvals from all governmental agencies that have jurisdiction
over the operation of the HCCH Facilities. Manager shall not be obligated to HCCH for failure of the HCCH Facilities to comply
with any such laws, rules, and regulations or for failure of the HCCH Facilities to maintain any such licenses, permits, consents,
and approvals, to the extent that the failure is due to financial limitations of the HCCH Facilities or to the design or construction
of the HCCH Facilities, or is attributable to acts, errors or omissions of HCCH or its agents (other than Manager or Manager’s
employees or contractors). 

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the HCCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the HCCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither HCCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority
having jurisdiction over the operation of the HCCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the HCCH Facilities; (iii) cause a termination of, or adversely
affect, HCCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause HCCH to violate or default under any of its legal obligations under debt financings. HCCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by HCCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on HCCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

10

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by HCCH. 

(2)Incur
debt on behalf of HCCH; 

(3)Encumber
HCCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

(4)Approve
or undertake any other matters required by law to be approved by HCCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the HCCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, HCCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, HCCH agrees to consult and cooperate
with Manager in good faith concerning any decisions related to the above listed items. The following list includes general items
that require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1HCCH. 

(a)HCCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
HCCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and  

11

its affiliates (together, the “SE Employer”),
and direct or indirect equity holder of Manager, and any person who controls Manager (any or all of the foregoing hereinafter a
“Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies, claims, actions, suits,
proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including reasonable attorneys’
fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”) that may be
incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified Person
is party to such Claims) to the extent they result from, arise out of, or are in any way related to, the following, in each case
as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by HCCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of HCCH set forth in this Agreement; 

(2)any
actions or omissions of HCCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of HCCH or its Representatives  related
to this Agreement; 

(3)any
failure by HCCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes
in the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the HCCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or HCCH’s ownership or operation of the HCCH Facilities, including without limitation the use of any real or tangible property
in connection with the HCCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of HCCH or any of its
Representatives. 

(b)Furthermore,
HCCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a  

12

party to any Claims out of which any such expenses
arise and whether or not such Claims are brought by HCCH, its Representatives or any other person or entity.

(c)However,
HCCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the Agreement; or (c) arising from
(i) felony criminal activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts
indemnifiable by Manager, in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator. 

(d)The
reimbursement and indemnity obligations of HCCH under this Agreement shall be in addition to any liability HCCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of HCCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless HCCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“HCCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of HCCH or a HCCH Indemnified
Person (b) by one HCCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any HCCH Indemnified Person directly participated in or (ii) other
acts indemnifiable by HCCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee  

13

based thereon, and shall have the right to contest
and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided, however, that if the
Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of any such action within
ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to take any such action
as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment and claim indemnification
as provided herein; provided, however, that no Party shall settle any such action without the consent of the other applicable Party
(which consent shall not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides
the Indemnitee a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification
is claimed, the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided,
however, that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement
of such counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the
defense in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists
a conflict or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor
to represent both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding
effected without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, HCCH shall indemnify the Senior
Executives who will be acting as officers of HCCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under HCCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to HCCH and HCCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to HCCH or HCCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and HCCH and HCCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent  

14

that any such Claims result primarily and directly
from such Senior Executive’s felony criminal acts, willful misconduct, gross negligence or fraud in each such case (other
than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction (not subject
to further appeal)), as finally determined by an arbitrator.

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, HCCH’s auditors and accountants, HCCH’s fiscal intermediaries, and accountants
and agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority,
access to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, HCCH shall pay Manager as follows
(collectively, the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will  

15

be deferred as owed but carried as a deferred
expense due Manager. When, in Manager’s best business judgement, sufficient funds become available to pay off all or part
of fees incurred and still owing, Manager will pay down all or part of the balance of fees owed using prudent business judgement
and discretion. In no case shall Manager forgive fees due for management services rendered.

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to HCCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term. 

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in  

16

good faith for thirty (30) days following written
notice of the Dispute served on a Party, either Party may refer such Dispute to HCCH and the CEO of Manager for resolution.

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base any decision or award
on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s actual damages,
except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the presentation
of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing party shall
be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.  

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after HCCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by HCCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

17

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to HCCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by HCCH to perform, fund or meet any of HCCH’s obligations hereunder; and provided
that Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to HCCH in the event HCCH (or HCCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and HCCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, HCCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of HCCH, upon request of HCCH, Manager shall be obligated to continue to provide HCCH with the Management Services described herein
for a period of up to one  

18

hundred twenty (120) days after such termination or
expiration of this Agreement (the “Transition Period”), and during such Transition Period: (a) Provided  HCCH
shall continue to compensate Manager in accordance with this Agreement, (b) Manager shall fully cooperate in order to ensure the
orderly and efficient transfer of its functions hereunder to HCCH and/or another service provider; (c) Manager shall fully cooperate
in order to ensure no disruption to patient care functions; and (d) the Parties shall cooperate in order to resolve any outstanding
operational, financial, legal or other matters arising (including audits) from the period in which this Agreement was in effect.

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to HCCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2HCCH.
As of the Effective Date, HCCH represents and warrants to Manager as follows: 

(a)HCCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)HCCH
has full authority to enter into and perform this Agreement, and the signature of HCCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against  

19

HCCH in accordance with its terms (subject only
to customary limitations on the enforceability and availability of remedies in accordance with principles of law and equity).

(c)The
execution, delivery and performance of this Agreement by HCCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to HCCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets
of HCCH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which HCCH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to HCCH’s
knowledge threatened against HCCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason HCCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to HCCH or Manager relating to HCCH
while employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about HCCH, services provided and its relationship hereunder. 

20.3Use
of HCCH Name. Manager may use the HCCH or HCCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to HCCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to HCCH of invoices. Any such expenses, subject to this section, shall
require prior approval by HCCH to be eligible for reimbursement. 

 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title)  

20

designated below (or to such other address, facsimile
number, email address or person as a Party may designate by notice delivered to the other Party in accordance with this Section:

Manager:Executive
Vice President 

iHealthcare
Management II Company II 

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

HCCH:
              Haskell
County Community Hospital 

                            401
Northwest H Street

                            Stigler,
Oklahoma 74462

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in  

21

electronic (“pdf” or “tif”)
format shall be effective as delivery of a manually executed counterpart of this Agreement.

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by HCCH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of HCCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to HCCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of
various aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their
obligations hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any
such assignee and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, HCCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19   Amendment and First Right of Refusal.
This Agreement sets forth the entire understanding and agreement among the parties hereto with reference to the subject matter
hereof and may not be

22

modified,
amended, discharged or terminated except by a written instrument signed by the parties hereto. First
Right of Refusal:  Landlord/Owner hereby grants to iHealthcare (iHCC) a first right
of refusal to purchase the hospital property and real estate during the term and any extensions of this Management and Administrative
Services Agreement.  If Landlord/Owner shall desire to sell the hospital property and real estate, and receives a bona fide
offer to purchase, Landlord/Owner shall give iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest
in the hospital property and real estate as contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall
state the terms and conditions under which Landlord/Owner intends to sell its interest. For Sixty (60) business days following
the giving of such notice, iHealthcare shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. HCCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 16, LLC D/B/A Haskell County
Community Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Hillsboro Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 5, LLC D/B/A
Hillsboro Community Hospital (“HCH”), a Delaware Limited Liability Company, and iHealthcare Management II Company,
a Florida Corporation (“Manager”). HCH and Manager are sometimes referred to herein individually as a “Party”
or collectively as the “Parties.”

WITNESSETH:

WHEREAS, HCH owns and operates an acute general medical
and surgical hospital (the “HCH Facilities”) located on the medical campus with a principal address of 701 South Main
Hillsboro, Kansas, 67063;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, HCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the HCH Facilities
on behalf of HCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with HCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, HCH hereby retains and appoints
Manager to manage the HCH Facilities on behalf of HCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.Strategic
Plan and Budget. Manager and HCH, shall develop and agree on an annual plan setting forth details regarding the strategic,
operational and capital activities that Manager shall undertake and oversee on behalf of HCH and the budgets regarding such activities
(as amended from time to time, the “Strategic Plan and Budget”), which shall include, among other matters: 

1

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the HCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the HCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, HCH will be solely responsible for its cost of operation. If requested by HCH, Manager will use commercially reasonable
efforts to assist HCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By HCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of HCH shall be the Governing Body
of the HCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over HCH. HCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, HCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by HCH’s governing documents. HCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with HCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the HCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

2

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the HCH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the HCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of HCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of HCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

3

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all HCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise HCH regarding the operations
and business of the HCH Facilities in order to ensure effective management of the HCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of HCH,
in Manager’s reasonable discretion and/or at HCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the HCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of HCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the HCH Facilities. Manager
shall execute on behalf of HCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the HCH Facilities periodically. 

(c)All
personnel required to be employed directly by HCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of HCH (“HCH Personnel”) and not Manager, and shall be subject to HCH’s personnel
policies. All wages, benefits and other payroll expenses related to HCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term HCH Personnel does not include any Senior Executives or any personnel of Manager, unless HCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with HCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging HCH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  HCH or the HCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized agent of HCH, shall (i) determine the staffing plans on behalf of HCH with respect
to the number and qualifications of HCH Personnel required for the efficient and effective operation  

4

of HCH Facilities operations, and, (ii) in accordance
with the Strategic Plan and Budget, implement wage scales, employee benefit packages and programs, in-service training programs,
staffing schedules, and job descriptions for HCH Personnel, all in order to accomplish the policies established by HCH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with HCH, shall assist in educational training programs for HCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the HCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the HCH
Facilities in the name of HCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in HCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the HCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the HCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the HCH Facilities building, and grounds), janitorial,
security and food services. 

5

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the HCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the HCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement HCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the HCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the HCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the HCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12HCH
Missions. Manager shall assist HCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the HCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by HCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the HCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the HCH Facilities’ image and reputation and to secure and maintain patients at the HCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on HCH’s behalf and at HCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the HCH Facilities
as are designated by HCH and consistent with the Strategic Plan and Budget or, in the absence of such a specification, as Manager
considers reasonable and prudent based on criteria generally used by Manager with respect to the hospitals owned or managed by
Manager. HCH, Manager and the Senior Executives shall be covered under all such applicable policies (or programs). Additionally,
Manager and the Senior Executives shall be  

6

named as additional insured's under HCH’s Directors’
and Officers’ liability, Errors and Omissions liability, professional liability and other insurance policies and the Senior
Executives shall be insured under any such policies to the same extent as HCH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the HCH Facilities in accordance with HCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and HCH shall ensure that charity care at HCH Facilities is provided
in a manner consistent with HCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of HCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the HCH Facilities and the collection of all accounts due to the HCH Facilities
in accordance with lawful Charge-master and collection policies developed by HCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. HCH shall approve the Charge-master. Manager shall update HCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, HCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)HCH
shall maintain bank accounts (“HCH Accounts”) necessary for operations of the HCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the HCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of HCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from HCH Accounts on behalf
of HCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided HCH has sufficient funds, Manager shall timely and accurately pay on behalf of HCH, from funds generated
by the HCH Facilities in the HCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the HCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the HCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the HCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing Body or the Management Committee) on behalf of HCH, any claims for
payment asserted with respect to the HCH Facilities that Manager, in good faith, considers erroneous or improper. 

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist HCH as the agent and attorney-in-fact of HCH in the procuring of licenses, permits and other
approvals, the payment and  

7

collection of accounts, and in all other activities
necessary, appropriate, or useful to Manager in the carrying out of its duties. In performing such services, Manager shall comply
with all applicable laws, regulations and requirements of governmental bodies.

4.19Elective
Corporate-Based Consulting Services. If requested by HCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to HCH. For the purpose of keeping informed with respect to the operation of the HCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the HCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the HCH Facilities, audited financial statements of the
HCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the HCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes HCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each HCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of HCH and delivery of such reports
is conditioned upon the capability, availability, cooperation and access to, such HCH systems and personnel for Manager. Manager
shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports required by this
Agreement. 

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the HCH Facilities. 

8

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the HCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the HCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding HCH’s existing Quality Assurance Program and QIIP
and shall assist HCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with HCH’s Quality Assurance Program, Manager shall assist HCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of HCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the HCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the HCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the HCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the HCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
 

9

taxation, environmental compliance, antitrust, or
physical facility compliance. Manager shall assist HCH to operate the HCH Facilities so that it maintains all necessary licenses,
permits, consents, and approvals from all governmental agencies that have jurisdiction over the operation of the HCH Facilities.
Manager shall not be obligated to HCH for failure of the HCH Facilities to comply with any such laws, rules, and regulations or
for failure of the HCH Facilities to maintain any such licenses, permits, consents, and approvals, to the extent that the failure
is due to financial limitations of the HCH Facilities or to the design or construction of the HCH Facilities, or is attributable
to acts, errors or omissions of HCH or its agents (other than Manager or Manager’s employees or contractors).

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the HCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the HCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither HCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the HCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the HCH Facilities; (iii) cause a termination of, or adversely
affect, HCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause HCH to violate or default under any of its legal obligations under debt financings. HCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by HCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on HCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by HCH. 

(2)Incur
debt on behalf of HCH; 

(3)Encumber
HCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

10

(4)Approve
or undertake any other matters required by law to be approved by HCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the HCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, HCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, HCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1HCH. 

(a)HCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
HCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and its affiliates (together,
the “SE Employer”), and direct or indirect equity holder of Manager, and any person who controls Manager (any or all
of the foregoing hereinafter a “Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies,
claims, actions, suits, proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including
reasonable attorneys’ fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”)
that may be incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified
Person is party  

11

to such Claims) to the extent they result from,
arise out of, or are in any way related to, the following, in each case as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by HCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of HCH set forth in this Agreement; 

(2)any
actions or omissions of HCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of HCH or its Representatives  related
to this Agreement; 

(3)any
failure by HCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the HCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or HCH’s ownership or operation of the HCH Facilities, including without limitation the use of any real or tangible property
in connection with the HCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of HCH or any of its
Representatives. 

(b)Furthermore,
HCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a party to any Claims out of which any such expenses arise and whether or not such Claims are brought
by HCH, its Representatives or any other person or entity. 

(c)However,
HCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the  

12

Agreement; or (c) arising from (i) felony criminal
activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts indemnifiable by Manager,
in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator.

(d)The
reimbursement and indemnity obligations of HCH under this Agreement shall be in addition to any liability HCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of HCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless HCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“HCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of HCH or a HCH Indemnified
Person (b) by one HCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any HCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by HCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee based thereon, and shall
have the right to contest and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided,
however, that if the Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of
any such action within ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to
take any such action as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment
and claim indemnification as provided herein; provided, however, that no Party shall settle any such action without the consent
of the  

13

other applicable Party (which consent shall
not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides the Indemnitee
a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification is claimed,
the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided, however,
that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement of such
counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the defense
in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists a conflict
or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor to represent
both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding effected
without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, HCH shall indemnify the Senior
Executives who will be acting as officers of HCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under HCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to HCH and HCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to HCH or HCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and HCH and HCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such Claims result primarily and directly from such Senior Executive’s felony criminal acts, willful
misconduct, gross negligence or fraud in each such case (other than with respect to felony criminal acts which shall require final
judgment by a court of competent jurisdiction (not subject to further appeal)), as finally determined by an arbitrator. 

14

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, HCH’s auditors and accountants, HCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, HCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will be deferred as owed but carried as a deferred expense due Manager. When, in
Manager’s best business judgement, sufficient funds become available to pay off all or part of fees incurred and still owing,
Manager will pay down all or part of the balance of fees owed using prudent business judgement and discretion. In no case shall
Manager forgive fees due for management services rendered.  

15

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to HCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term. 

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in good faith for thirty (30) days following written notice of the Dispute served on a Party,
either Party may refer such Dispute to HCH and the CEO of Manager for resolution.  

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive  

16

covenants, mishandling of Confidential Information,
or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction, in Miami, Florida, of either
the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator shall agree: (a) that the
arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention (or demand) to arbitrate  (but
it may be extended by written agreement of the parties); (b) to base any decision or award on governing law; (c) to not award punitive
or other damages that are not measured by the prevailing party’s actual damages, except as may be required by statute; and
(d) to issue an award in writing within ten (10) days of concluding the presentation of evidence and briefs.  Judgment may
be entered in any court having jurisdiction thereof.  The prevailing party shall be entitled to recover from the other party
its costs and expenses, including reasonable attorney’s fees.

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after HCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by HCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

17

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to HCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by HCH to perform, fund or meet any of HCH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to HCH in the event HCH (or HCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and HCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, HCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of HCH, upon request of HCH, Manager shall be obligated to continue to provide HCH with the Management Services described herein
for a period of up to one hundred twenty (120) days after such termination or expiration of this Agreement (the “Transition
Period”), and during such Transition Period: (a) Provided  HCH shall continue to compensate Manager in accordance with
this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly and efficient transfer of its functions hereunder
to HCH and/or another service provider; (c) Manager shall fully cooperate in order to ensure no disruption to patient care functions;
and (d) the Parties shall cooperate in order to resolve any outstanding operational, financial, legal or other matters arising
(including audits) from the period in which this Agreement was in effect. 

18

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to HCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2HCH.
As of the Effective Date, HCH represents and warrants to Manager as follows: 

(a)HCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)HCH
has full authority to enter into and perform this Agreement, and the signature of HCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against HCH in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by HCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to HCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
HCH under, any agreement or instrument; or (iv) violate any judicial or administrative  

19

decree, contract, or other legal obligation
to which HCH is subject or by which any of its assets are bound.

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to HCH’s
knowledge threatened against HCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason HCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to HCH or Manager relating to HCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about HCH, services provided and its relationship hereunder. 

20.3Use
of HCH Name. Manager may use the HCH or HCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to HCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to HCH of invoices. Any such expenses, subject to this section, shall
require prior approval by HCH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title) designated
below (or to such other address, facsimile number, email address or person as a Party may designate by notice delivered to the
other Party in accordance with this Section: 

Manager:Executive
Vice President  

iHealthcare Management II Company

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

20

 

HCH:
              Hillsboro
Community Hospital 

                            701
South Main

                            Hillsboro,
Kansas 67063

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in electronic (“pdf” or “tif”) format shall be effective
as delivery of a manually executed counterpart of this Agreement. 

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War  

21

(including Terrorist activities), civil disorders,
vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive governmental
laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity or incomplete
or inaccurate data input as supplied by HCH.  

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of HCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to HCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, HCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19
  Amendment and First Right of Refusal. This Agreement sets forth the entire understanding and agreement among the parties
hereto with reference to the subject matter hereof and may not be modified, amended, discharged or terminated except by a written
instrument signed by the parties hereto. First Right of Refusal:
 Landlord/Owner hereby grants to iHealthcare (iHCC) a first right of refusal to purchase the hospital property and
real estate during the term and any extensions of this Management and Administrative Services Agreement.  If Landlord/Owner
shall desire to sell the hospital property and real estate, and receives a bona fide offer to purchase, Landlord/Owner shall give
iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest in the hospital property and real estate as
contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall state the terms and conditions under which Landlord/Owner
intends to sell its interest. For Sixty (60) business days following the giving of such 

22

notice, iHealthcare
shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner Notice.  A written notice in
substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within the period for exercising the Option,
shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. HCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 5, LLC D/B/A Hillsboro
Community Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Horton Community Hospital

 

THIS MANAGEMENT AND ADMINISTARTIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 3, LLC D/B/A
Horton Community Hospital (“HCH”), a Delaware Limited Liability Company, and iHealthcare Management II Company, a Florida
Corporation (“Manager”). HCH and Manager are sometimes referred to herein individually as a “Party” or
collectively as the “Parties.”

WITNESSETH:

WHEREAS, HCH owns and operates an acute general medical
and surgical hospital (the “HCH Facilities”) located on the medical campus with a principal address of 240 West 18th
Street Horton, Kansas 66439;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, HCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the HCH Facilities
on behalf of HCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with HCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, HCH hereby retains and appoints
Manager to manage the HCH Facilities on behalf of HCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.
 Strategic Plan and Budget. Manager and HCH, shall develop
and agree on an annual plan setting forth details regarding the strategic, operational and capital activities that Manager shall
undertake and oversee on behalf of HCH and the budgets regarding such activities (as amended from time to time, the “Strategic
Plan and Budget”), which shall include, among other matters: 

1

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the HCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the HCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, HCH will be solely responsible for its cost of operation. If requested by HCH, Manager will use commercially reasonable
efforts to assist HCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By HCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of HCH shall be the Governing Body
of the HCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over HCH. HCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, HCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by HCH’s governing documents. HCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with HCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the HCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise  

2

to oversee the implementation of processes and systems
at the HCH Facilities consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that
are in material violation of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing
the Management Services shall include the following:

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the HCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of HCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of HCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

3

 

 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all HCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise HCH regarding the operations
and business of the HCH Facilities in order to ensure effective management of the HCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of HCH,
in Manager’s reasonable discretion and/or at HCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the HCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of HCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the HCH Facilities. Manager
shall execute on behalf of HCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the HCH Facilities periodically. 

(c)All
personnel required to be employed directly by HCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of HCH (“HCH Personnel”) and not Manager, and shall be subject to HCH’s personnel
policies. All wages, benefits and other payroll expenses related to HCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term HCH Personnel does not include any Senior Executives or any personnel of Manager, unless HCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with HCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging HCH Personnel. 

4

(e)Subject
to the terms of any applicable labor agreements binding  HCH or the HCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized agent of HCH, shall (i) determine the staffing plans on behalf of HCH with respect
to the number and qualifications of HCH Personnel required for the efficient and effective operation of HCH Facilities operations,
and, (ii) in accordance with the Strategic Plan and Budget, implement wage scales, employee benefit packages and programs, in-service
training programs, staffing schedules, and job descriptions for HCH Personnel, all in order to accomplish the policies established
by HCH. 

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with HCH, shall assist in educational training programs for HCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the HCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the HCH
Facilities in the name of HCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in HCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the HCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the HCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

5

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the HCH Facilities building, and grounds), janitorial,
security and food services. 

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the HCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the HCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement HCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the HCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the HCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the HCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12HCH
Missions. Manager shall assist HCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the HCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by HCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the HCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the HCH Facilities’ image and reputation and to secure and maintain patients at the HCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on HCH’s behalf and at HCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the HCH Facilities
as are designated  

6

by HCH and consistent with the Strategic Plan and
Budget or, in the absence of such a specification, as Manager considers reasonable and prudent based on criteria generally used
by Manager with respect to the hospitals owned or managed by Manager. HCH, Manager and the Senior Executives shall be covered under
all such applicable policies (or programs). Additionally, Manager and the Senior Executives shall be named as additional insured's
under HCH’s Directors’ and Officers’ liability, Errors and Omissions liability, professional liability and other
insurance policies and the Senior Executives shall be insured under any such policies to the same extent as HCH’s other officers
and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the HCH Facilities in accordance with HCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and HCH shall ensure that charity care at HCH Facilities is provided
in a manner consistent with HCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of HCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the HCH Facilities and the collection of all accounts due to the HCH Facilities
in accordance with lawful Charge-master and collection policies developed by HCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. HCH shall approve the Charge-master. Manager shall update HCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, HCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)HCH
shall maintain bank accounts (“HCH Accounts”) necessary for operations of the HCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the HCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of HCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from HCH Accounts on behalf
of HCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided HCH has sufficient funds, Manager shall timely and accurately pay on behalf of HCH, from funds generated
by the HCH Facilities in the HCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the HCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the HCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the HCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing  

7

Body or the Management Committee) on behalf of HCH,
any claims for payment asserted with respect to the HCH Facilities that Manager, in good faith, considers erroneous or improper.

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist HCH as the agent and attorney-in-fact of HCH in the procuring of licenses, permits and other
approvals, the payment and collection of accounts, and in all other activities necessary, appropriate, or useful to Manager in
the carrying out of its duties. In performing such services, Manager shall comply with all applicable laws, regulations and requirements
of governmental bodies. 

4.19Elective
Corporate-Based Consulting Services. If requested by HCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to HCH. For the purpose of keeping informed with respect to the operation of the HCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the HCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the HCH Facilities, audited financial statements of the
HCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the HCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes HCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each HCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of HCH and delivery of such reports
is conditioned upon the capability, availability, cooperation  

8

and access to, such HCH systems and personnel for
Manager. Manager shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports
required by this Agreement.

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the HCH Facilities. 

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the HCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the HCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding HCH’s existing Quality Assurance Program and QIIP
and shall assist HCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with HCH’s Quality Assurance Program, Manager shall assist HCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of HCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the HCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the HCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the HCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

9

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the HCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
taxation, environmental compliance, antitrust, or physical facility compliance. Manager shall assist HCH to operate the HCH Facilities
so that it maintains all necessary licenses, permits, consents, and approvals from all governmental agencies that have jurisdiction
over the operation of the HCH Facilities. Manager shall not be obligated to HCH for failure of the HCH Facilities to comply with
any such laws, rules, and regulations or for failure of the HCH Facilities to maintain any such licenses, permits, consents, and
approvals, to the extent that the failure is due to financial limitations of the HCH Facilities or to the design or construction
of the HCH Facilities, or is attributable to acts, errors or omissions of HCH or its agents (other than Manager or Manager’s
employees or contractors). 

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the HCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the HCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither HCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the HCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the HCH Facilities; (iii) cause a termination of, or adversely
affect, HCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause HCH to violate or default under any of its legal obligations under debt financings. HCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by HCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on HCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

10

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by HCH. 

(2)Incur
debt on behalf of HCH; 

(3)Encumber
HCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

(4)Approve
or undertake any other matters required by law to be approved by HCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the HCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, HCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, HCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1HCH. 

(a)HCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
HCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and  

11

its affiliates (together, the “SE Employer”),
and direct or indirect equity holder of Manager, and any person who controls Manager (any or all of the foregoing hereinafter a
“Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies, claims, actions, suits,
proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including reasonable attorneys’
fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”) that may be
incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified Person
is party to such Claims) to the extent they result from, arise out of, or are in any way related to, the following, in each case
as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by HCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of HCH set forth in this Agreement; 

(2)any
actions or omissions of HCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of HCH or its Representatives  related
to this Agreement; 

(3)any
failure by HCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the HCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or HCH’s ownership or operation of the HCH Facilities, including without limitation the use of any real or tangible property
in connection with the HCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of HCH or any of its
Representatives. 

(b)Furthermore,
HCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a  

12

party to any Claims out of which any such expenses
arise and whether or not such Claims are brought by HCH, its Representatives or any other person or entity.

(c)However,
HCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the Agreement; or (c) arising from
(i) felony criminal activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts
indemnifiable by Manager, in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator. 

(d)The
reimbursement and indemnity obligations of HCH under this Agreement shall be in addition to any liability HCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of HCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless HCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“HCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of HCH or a HCH Indemnified
Person (b) by one HCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any HCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by HCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee  

13

based thereon, and shall have the right to contest
and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided, however, that if the
Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of any such action within
ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to take any such action
as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment and claim indemnification
as provided herein; provided, however, that no Party shall settle any such action without the consent of the other applicable Party
(which consent shall not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides
the Indemnitee a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification
is claimed, the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided,
however, that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement
of such counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the
defense in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists
a conflict or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor
to represent both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding
effected without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, HCH shall indemnify the Senior
Executives who will be acting as officers of HCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under HCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to HCH and HCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to HCH or HCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and HCH and HCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such  

14

Claims result primarily and directly from such Senior
Executive’s felony criminal acts, willful misconduct, gross negligence or fraud in each such case (other than with respect
to felony criminal acts which shall require final judgment by a court of competent jurisdiction (not subject to further appeal)),
as finally determined by an arbitrator.

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, HCH’s auditors and accountants, HCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, HCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will  

15

be deferred as owed but carried as a deferred
expense due Manager. When, in Manager’s best business judgement, sufficient funds become available to pay off all or part
of fees incurred and still owing, Manager will pay down all or part of the balance of fees owed using prudent business judgement
and discretion. In no case shall Manager forgive fees due for management services rendered.

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to HCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term. 

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in  

16

good faith for thirty (30) days following written
notice of the Dispute served on a Party, either Party may refer such Dispute to HCH and the CEO of Manager for resolution.

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base any decision or award
on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s actual damages,
except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the presentation
of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing party shall
be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.  

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after HCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by HCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

17

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to HCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by HCH to perform, fund or meet any of HCH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to HCH in the event HCH (or HCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and HCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, HCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of HCH, upon request of HCH, Manager shall be obligated to continue to provide HCH with the Management Services described herein
for a period of up to one  

18

hundred twenty (120) days after such termination or
expiration of this Agreement (the “Transition Period”), and during such Transition Period: (a) Provided  HCH shall
continue to compensate Manager in accordance with this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly
and efficient transfer of its functions hereunder to HCH and/or another service provider; (c) Manager shall fully cooperate in
order to ensure no disruption to patient care functions; and (d) the Parties shall cooperate in order to resolve any outstanding
operational, financial, legal or other matters arising (including audits) from the period in which this Agreement was in effect.

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to HCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2HCH.
As of the Effective Date, HCH represents and warrants to Manager as follows: 

(a)HCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)HCH
has full authority to enter into and perform this Agreement, and the signature of HCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against  

19

HCH in accordance with its terms (subject only
to customary limitations on the enforceability and availability of remedies in accordance with principles of law and equity).

(c)The
execution, delivery and performance of this Agreement by HCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to HCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
HCH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which HCH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to HCH’s
knowledge threatened against HCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason HCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to HCH or Manager relating to HCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about HCH, services provided and its relationship hereunder. 

20.3Use
of HCH Name. Manager may use the HCH or HCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to HCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to HCH of invoices. Any such expenses, subject to this section, shall
require prior approval by HCH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title)  

20

designated below (or to such other address, facsimile
number, email address or person as a Party may designate by notice delivered to the other Party in accordance with this Section:

 

Manager:Executive
Vice President  

iHealthcare Management II Company

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

HCH:
              Horton
Community Hospital 

                            240
West 18th Street

                            Horton,
Kansas 66439

           

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in  

21

electronic (“pdf” or “tif”)
format shall be effective as delivery of a manually executed counterpart of this Agreement.

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by HCH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of HCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to HCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, HCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19   Amendment and First Right of Refusal.
This Agreement sets forth the entire understanding and agreement among the parties hereto with reference to the subject matter
hereof and may not be

22

modified,
amended, discharged or terminated except by a written instrument signed by the parties hereto. First
Right of Refusal:  Landlord/Owner hereby grants to iHealthcare (iHCC) a first right
of refusal to purchase the hospital property and real estate during the term and any extensions of this Management and Administrative
Services Agreement.  If Landlord/Owner shall desire to sell the hospital property and real estate, and receives a bona fide
offer to purchase, Landlord/Owner shall give iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest
in the hospital property and real estate as contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall
state the terms and conditions under which Landlord/Owner intends to sell its interest. For Sixty (60) business days following
the giving of such notice, iHealthcare shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. HCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                   
[Signature Page Follows]

23

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 3, LLC D/B/A Horton Community
Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

 

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

I-70 Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 6, LLC D/B/A
I-70 Community Hospital (“I-70CH”), a Delaware Limited Liability Company, and iHealthcare Management II Company, a
Florida Corporation (“Manager”). I-70CH and Manager are sometimes referred to herein individually as a “Party”
or collectively as the “Parties.”

WITNESSETH:

WHEREAS, I-70CH owns and operates an acute general
medical and surgical hospital (the “I-70CH Facilities”) located on the medical campus with a principal address of 105
Hospital Drive Sweet Springs, Missouri 65351;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, I-70CH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the I-70CH Facilities
on behalf of I-70CH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with I-70CH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, I-70CH hereby retains and appoints
Manager to manage the I-70CH Facilities on behalf of I-70CH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.Strategic
Plan and Budget. Manager and I-70CH, shall develop and agree on an annual plan setting forth details regarding the strategic,
operational and capital activities that Manager shall  

1

undertake and oversee on behalf of I-70CH and the
budgets regarding such activities (as amended from time to time, the “Strategic Plan and Budget”), which shall include,
among other matters:

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the I-70CH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the I-70CH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, I-70CH will be solely responsible for its cost of operation. If requested by I-70CH, Manager will use commercially
reasonable efforts to assist I-70CH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable
efforts to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By I-70CH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of I-70CH shall be the Governing
Body of the I-70CH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over I-70CH.
I-70CH authorizes general operating policies developed by and to be carried out by Manager under this Agreement. The Governing
Body shall delegate authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this
Agreement, I-70CH does not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested
in the Governing Body by law or by I-70CH’s governing documents. I-70CH is solely obligated to and shall pay, make funds
available to Manager for the payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance
with the terms of this Agreement. On a monthly basis, Manager shall meet or confer with I-70CH and provide financial reports, statistical
reports, updates and review requests for approvals by the Governing Body.  

2

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the I-70CH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the I-70CH
Facilities consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material
violation of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management
Services shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the I-70CH Facilities, and compliance with government programs and
private payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of I-70CH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of I-70CH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

3

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all I-70CH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise I-70CH regarding the operations
and business of the I-70CH Facilities in order to ensure effective management of the I-70CH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of I-70CH,
in Manager’s reasonable discretion and/or at I-70CH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the I-70CH Facilities, and
Manager shall oversee and administer the recruitment and hiring in the name of and on behalf of I-70CH such physicians, nurses,
technicians, administrative, and other staff as are determined to be necessary or appropriate for the operation of the I-70CH Facilities.
Manager shall execute on behalf of I-70CH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor
and review all payroll functions for the I-70CH Facilities periodically. 

(c)All
personnel required to be employed directly by I-70CH under applicable licensure and reimbursement laws, regulations, and related
requirements shall be employees or contractors of I-70CH (“I-70CH Personnel”) and not Manager, and shall be subject
to I-70CH’s personnel policies. All wages, benefits and other payroll expenses related to I-70CH Personnel shall be included
as part of Hospital Expenses. For the avoidance of doubt, the term I-70CH Personnel does not include any Senior Executives or any
personnel of Manager, unless I-70CH first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with I-70CH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging I-70CH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  I-70CH or the I-70CH Facilities, including, without limitation, any
collective bargaining agreements, Manager, as the  

4

authorized agent of I-70CH, shall (i) determine
the staffing plans on behalf of I-70CH with respect to the number and qualifications of I-70CH Personnel required for the efficient
and effective operation of I-70CH Facilities operations, and, (ii) in accordance with the Strategic Plan and Budget, implement
wage scales, employee benefit packages and programs, in-service training programs, staffing schedules, and job descriptions for
I-70CH Personnel, all in order to accomplish the policies established by I-70CH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with I-70CH, shall assist in educational training programs for I-70CH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the I-70CH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the I-70CH
Facilities in the name of I-70CH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in I-70CH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the I-70CH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the I-70CH Facilities, of all medical records, charts, and files,
all in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems,
and other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

5

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the I-70CH Facilities building, and grounds), janitorial,
security and food services. 

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the I-70CH
Facilities’ affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee
the preparation and maintenance of all books and records regarding operations and financial transactions pertaining to the I-70CH
Facilities and shall ensure copies of such books and records are made available to the Governing Body or its designee upon request.
 

4.10Establishment
of Operational Policies. Manager shall develop and implement I-70CH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the I-70CH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the I-70CH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget,
(iii) applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the
Joint Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the I-70CH Facilities as Manager reasonably deems necessary and appropriate to fulfill its
obligations hereunder. 

4.12I-70CH
Missions. Manager shall assist I-70CH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the I-70CH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve
the quality of life and overall health outcomes of the patient populations served by I-70CH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the I-70CH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the I-70CH Facilities’ image and reputation and to secure and maintain patients at the I-70CH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on I-70CH’s behalf and at I-70CH’s sole expense, throughout
the term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability
and hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the I-70CH
 

6

Facilities as are designated by I-70CH and consistent
with the Strategic Plan and Budget or, in the absence of such a specification, as Manager considers reasonable and prudent based
on criteria generally used by Manager with respect to the hospitals owned or managed by Manager. I-70CH, Manager and the Senior
Executives shall be covered under all such applicable policies (or programs). Additionally, Manager and the Senior Executives shall
be named as additional insured's under I-70CH’s Directors’ and Officers’ liability, Errors and Omissions liability,
professional liability and other insurance policies and the Senior Executives shall be insured under any such policies to the same
extent as I-70CH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the I-70CH Facilities in accordance with I-70CH’s
mission, the Strategic Plan and Budget and applicable law. Manager and I-70CH shall ensure that charity care at I-70CH Facilities
is provided in a manner consistent with I-70CH’s policies in effect from time to time. Manager shall implement and administer
on behalf of I-70CH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent
and uninsured persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the I-70CH Facilities and the collection of all accounts due to the I-70CH Facilities
in accordance with lawful Charge-master and collection policies developed by I-70CH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. I-70CH shall approve the Charge-master. Manager shall update I-70CH on all
changes to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf
of, and at the expense of, I-70CH, the assistance of one or more collection agencies who shall be required to act in accordance
with law and generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)I-70CH
shall maintain bank accounts (“I-70CH Accounts”) necessary for operations of the I-70CH Facilities and Manager shall
cause to be deposited therein all receipts and money arising from operations of the I-70CH Facilities. It is anticipated that the
Senior Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of I-70CH, and such other
individuals as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from I-70CH
Accounts on behalf of I-70CH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided I-70CH has sufficient funds, Manager shall timely and accurately pay on behalf of I-70CH, from funds generated
by the I-70CH Facilities in the I-70CH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the I-70CH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the I-70CH Facilities and all personal property,
supplies, inventory and all other items necessary for operation of the I-70CH Facilities and to provide the Management Services
described herein. Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such
guidelines and policies as are established from time to  

7

time by the Governing Body or the Management Committee)
on behalf of I-70CH, any claims for payment asserted with respect to the I-70CH Facilities that Manager, in good faith, considers
erroneous or improper.

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist I-70CH as the agent and attorney-in-fact of I-70CH in the procuring of licenses, permits and
other approvals, the payment and collection of accounts, and in all other activities necessary, appropriate, or useful to Manager
in the carrying out of its duties. In performing such services, Manager shall comply with all applicable laws, regulations and
requirements of governmental bodies. 

4.19Elective
Corporate-Based Consulting Services. If requested by I-70CH and agreed by Manager, Manager or its designees may provide as added
elective consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements),
corporate-based consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting
Services”). Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to
by the Parties, which rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to I-70CH. For the purpose of keeping informed with respect to the operation of the I-70CH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the I-70CH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the I-70CH Facilities, audited financial statements of
the I-70CH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement
of changes in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles
and accompanied by a report of the independent auditor of the I-70CH Facilities (selected by the Governing Body). The timing of
audit submissions assumes I-70CH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each I-70CH Fiscal Year during the Term of this Agreement. 

8

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of I-70CH and delivery of such
reports is conditioned upon the capability, availability, cooperation and access to, such I-70CH systems and personnel for Manager.
Manager shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports required
by this Agreement. 

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the I-70CH Facilities. 

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the I-70CH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the I-70CH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding I-70CH’s existing Quality Assurance Program and
QIIP and shall assist I-70CH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with I-70CH’s Quality Assurance Program, Manager shall assist I-70CH in the implementation and administration of a Medical
Affairs Committee that shall consist of a designated senior officer of I-70CH, physicians appointed by the Medical Staff, persons
designated by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee,
if and when implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the I-70CH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the I-70CH Facilities
may be measured objectively; 

(c)to
ensure that all patients admitted to the I-70CH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

9

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the I-70CH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
taxation, environmental compliance, antitrust, or physical facility compliance. Manager shall assist I-70CH to operate the I-70CH
Facilities so that it maintains all necessary licenses, permits, consents, and approvals from all governmental agencies that have
jurisdiction over the operation of the I-70CH Facilities. Manager shall not be obligated to I-70CH for failure of the I-70CH Facilities
to comply with any such laws, rules, and regulations or for failure of the I-70CH Facilities to maintain any such licenses, permits,
consents, and approvals, to the extent that the failure is due to financial limitations of the I-70CH Facilities or to the design
or construction of the I-70CH Facilities, or is attributable to acts, errors or omissions of I-70CH or its agents (other than Manager
or Manager’s employees or contractors). 

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the I-70CH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the I-70CH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither I-70CH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority
having jurisdiction over the operation of the I-70CH Facilities to institute any proceeding for the rescission, suspension, or
revocation of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation
organization to institute any proceeding or action to revoke its accreditation of the I-70CH Facilities; (iii) cause a termination
of, or adversely affect, I-70CH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical
payment program; or (iv) cause I-70CH to violate or default under any of its legal obligations under debt financings. I-70CH, and
not Manager, shall bear sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds
or acts, errors or omissions by I-70CH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the  

10

authority to undertake the following, on I-70CH’s
behalf, without the advance written consent of the Governing Body (or its designee authorized in writing):

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by I-70CH. 

(2)Incur
debt on behalf of I-70CH; 

(3)Encumber
I-70CH property, or sell or dispose of any material assets having a value in excess of $25,000; 

(4)Approve
or undertake any other matters required by law to be approved by I-70CH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the I-70CH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, I-70CH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, I-70CH agrees to consult and cooperate
with Manager in good faith concerning any decisions related to the above listed items. The following list includes general items
that require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1I-70CH. 

(a)I-70CH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
I-70CH), affiliates, subsidiaries, successors and assigns, and  

11

any employee, agent, officer, director, shareholders,
manager, representative, attorney, or independent contractors, including but not limited to Senior Executives and their employer
and its affiliates (together, the “SE Employer”), and direct or indirect equity holder of Manager, and any person who
controls Manager (any or all of the foregoing hereinafter a “Manager Indemnified Person”), from and against any losses,
damages, liabilities, deficiencies, claims, actions, suits, proceedings, judgments, settlements, interest, awards, penalties, fines,
costs, or expenses (including reasonable attorneys’ fees and costs of defense), joint or several, of any kind or nature whatsoever
(collectively, “Claims”) that may be incurred by or asserted against Manager or a Manager Indemnified Person (whether
or not Manager or a Manager Indemnified Person is party to such Claims) to the extent they result from, arise out of, or are in
any way related to, the following, in each case as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by I-70CH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of I-70CH set forth in this Agreement; 

(2)any
actions or omissions of I-70CH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of I-70CH or its Representatives
 related to this Agreement; 

(3)any
failure by I-70CH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes
in the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the I-70CH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or I-70CH’s ownership or operation of the I-70CH Facilities, including without limitation the use of any real or tangible
property in connection with the I-70CH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of I-70CH or any of its
Representatives. 

(b)Furthermore,
I-70CH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by
Manager or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims  

12

(including without limitation in connection
with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any Manager Indemnified Person
is a party to any Claims out of which any such expenses arise and whether or not such Claims are brought by I-70CH, its Representatives
or any other person or entity.

(c)However,
I-70CH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the Agreement; or (c) arising from
(i) felony criminal activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts
indemnifiable by Manager, in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator. 

(d)The
reimbursement and indemnity obligations of I-70CH under this Agreement shall be in addition to any liability I-70CH may otherwise
have; shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to
the benefit of any successors, assigns, heirs, and personal representatives of I-70CH, or of Manager or any Manager Indemnified
Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless I-70CH including its affiliates, subcontractors, successors and assigns and
any employee, agent, officer, director, manager, representative, attorney or independent contractor (“I-70CH Indemnified
Persons”) against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result
from the felony criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or
fraud of Manager, in each such case (other than with respect to felony criminal acts which shall require final judgment by a court
of competent jurisdiction (not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person
shall not be liable for any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees
and subcontractors. In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims
(a) to the extent such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of
I-70CH or a I-70CH Indemnified Person (b) by one I-70CH Indemnified Person against another relating to activities of such  parties
pursuant to the Agreement; or (c) arising from (i) felony criminal activity that  any I-70CH Indemnified Person directly participated
in or (ii) other acts indemnifiable by I-70CH, in each such case (other than with respect to felony criminal acts) as finally determined
by an arbitrator. The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific
direction or with the express approval of the Governing Body to take action or the failure of the Governing Body to take action.
 

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this  

13

Agreement (“Indemnitor”) written
notice of such loss, liability, claim, damage, or expense and the Indemnitor shall have the right to contest and defend any action
brought against the Indemnitee based thereon, and shall have the right to contest and defend any such action in the name of the
Indemnitee at the Indemnitor’s own expense; provided, however, that if the Indemnitor shall fail to assume the defense and
notify the Indemnitee of the assumption of the defense of any such action within ten (10) days of the giving of such notice by
the Indemnitee, then the Indemnitee shall have the right to take any such action as it reasonably deems appropriate to defend,
contest, settle, or compromise any such action or assessment and claim indemnification as provided herein; provided, however, that
no Party shall settle any such action without the consent of the other applicable Party (which consent shall not be unreasonably
withheld) unless such settlement involves only the payment of money and the claimant provides the Indemnitee a release from all
liability in respect of such claim. If the Indemnitor defends any action for which indemnification is claimed, the Indemnitee shall
be entitled to participate at its own expense in the defense of such action; and further, provided, however, that the Indemnitor
shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement of such counsel is specifically
authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the defense in good faith, or (iii)
the named parties to such action include both the Indemnitor and the Indemnitee and there exists a conflict or divergence of interest
between such parties which renders it inappropriate for counsel selected by the Indemnitor to represent both of  such parties.
The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding effected without its written consent.
No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, I-70CH shall indemnify the Senior
Executives who will be acting as officers of I-70CH to the same extent and subject to the same conditions as the most favorable
indemnification it extends to its officers or directors, whether under I-70CH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to I-70CH and I-70CH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to I-70CH or I-70CH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and I-70CH and I-70CH expressly waive  

14

and agree not to assert any claim of respondent superior
or similar legal theory which might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the
Senior Executives), except to the extent that any such Claims result primarily and directly from such Senior Executive’s
felony criminal acts, willful misconduct, gross negligence or fraud in each such case (other than with respect to felony criminal
acts which shall require final judgment by a court of competent jurisdiction (not subject to further appeal)), as finally determined
by an arbitrator.

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, I-70CH’s auditors and accountants, I-70CH’s fiscal intermediaries, and accountants
and agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority,
access to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, I-70CH shall pay Manager as follows
(collectively, the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager  

15

must first ensure Hospital payroll is met as
its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all or part
of Manger’s fees, the balance due will be deferred as owed but carried as a deferred expense due Manager. When, in Manager’s
best business judgement, sufficient funds become available to pay off all or part of fees incurred and still owing, Manager will
pay down all or part of the balance of fees owed using prudent business judgement and discretion. In no case shall Manager forgive
fees due for management services rendered.

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to I-70CH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term. 

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this  

16

Agreement (a “Dispute”). In the event
the Parties are unable to resolve the Dispute after negotiating in good faith for thirty (30) days following written notice of
the Dispute served on a Party, either Party may refer such Dispute to I-70CH and the CEO of Manager for resolution.

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base any decision or award
on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s actual damages,
except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the presentation
of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing party shall
be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.  

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after I-70CH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by I-70CH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with  

17

the terms hereof, and/or (g) any other lawful and
appropriate remedy, including termination of this Agreement.

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to I-70CH and shall not be deemed to be in breach of this
Agreement for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the
extent such failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement
rules or policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by I-70CH to perform, fund or meet any of I-70CH’s obligations hereunder; and provided
that Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to I-70CH in the event I-70CH (or I-70CH’s sponsoring entity)  becomes insolvent or fails to pay,
or admits in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed
for such other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days
of appointment;  or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency
law or any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and I-70CH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, I-70CH shall pay to Manager all unpaid fees then due.  

18

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of I-70CH, upon request of I-70CH, Manager shall be obligated to continue to provide I-70CH with the Management Services described
herein for a period of up to one hundred twenty (120) days after such termination or expiration of this Agreement (the “Transition
Period”), and during such Transition Period: (a) Provided  I-70CH shall continue to compensate Manager in accordance
with this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly and efficient transfer of its functions hereunder
to I-70CH and/or another service provider; (c) Manager shall fully cooperate in order to ensure no disruption to patient care functions;
and (d) the Parties shall cooperate in order to resolve any outstanding operational, financial, legal or other matters arising
(including audits) from the period in which this Agreement was in effect. 

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to I-70CH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2I-70CH.
As of the Effective Date, I-70CH represents and warrants to Manager as follows: 

(a)I-70CH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

19

(b)I-70CH
has full authority to enter into and perform this Agreement, and the signature of I-70CH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against I-70CH in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by I-70CH does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision
of law applicable to I-70CH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or
assets of I-70CH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other
legal obligation to which I-70CH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to I-70CH’s
knowledge threatened against I-70CH that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason I-70CH,
on behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets
agrees that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise
engage any Senior Executive or other employee of the Manager or SE Employer that provided services to I-70CH or Manager relating
to I-70CH while employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about I-70CH, services provided and its relationship hereunder. 

20.3Use
of I-70CH Name. Manager may use the I-70CH or I-70CH Hospital names in a manner reasonably necessary or conducive to performing
its services hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to I-70CH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to I-70CH of invoices. Any such expenses, subject to this section, shall
require prior approval by I-70CH to be eligible for reimbursement. 

20

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title) designated
below (or to such other address, facsimile number, email address or person as a Party may designate by notice delivered to the
other Party in accordance with this Section: 

Manager:Executive
Vice President  

iHealthcare Management II Company

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

I-70CH:
               I-70
Community Hospital 

                             105
Hospital Drive

                             Sweet
Springs, Missouri 65351

                     

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

21

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in electronic (“pdf” or “tif”) format shall be effective
as delivery of a manually executed counterpart of this Agreement. 

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by I-70CH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of I-70CH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to I-70CH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of
various aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their
obligations hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any
such assignee and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, I-70CH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and

22

agreements, whether oral or written, concerning the
subject matter hereof, all of which are merged in this Agreement.

20.19
  Amendment and First Right of Refusal. This Agreement sets forth the entire understanding and agreement among the parties
hereto with reference to the subject matter hereof and may not be modified, amended, discharged or terminated except by a written
instrument signed by the parties hereto. First Right of Refusal:
 Landlord/Owner hereby grants to iHealthcare (iHCC) a first right of refusal to purchase the hospital property and
real estate during the term and any extensions of this Management and Administrative Services Agreement.  If Landlord/Owner
shall desire to sell the hospital property and real estate, and receives a bona fide offer to purchase, Landlord/Owner shall give
iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest in the hospital property and real estate as
contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall state the terms and conditions under which Landlord/Owner
intends to sell its interest. For Sixty (60) business days following the giving of such notice, iHealthcare shall have the option
to purchase the Landlord/Owner interest as stated in the Landlord/Owner Notice.  A written notice in substantially the following
form, addressed to Landlord/Owner and signed by iHealthcare, within the period for exercising the Option, shall be an effective
exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. I-70CH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

 

 

 

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 6, LLC D/B/A I-70 Community
Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Lauderdale Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 11, LLC
D/B/A Lauderdale Community Hospital (“LCH”), a Delaware Limited Liability Company, and iHealthcare Management II Company,
a Florida Corporation (“Manager”). LCH and Manager are sometimes referred to herein individually as a “Party”
or collectively as the “Parties.”

WITNESSETH:

WHEREAS, LCH owns and operates an acute general medical
and surgical hospital (the “LCH Facilities”) located on the medical campus with a principal address of 326 Asbury Avenue,
Ripley, Tennessee 38063;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, LCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the LCH Facilities
on behalf of LCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with LCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, LCH hereby retains and appoints
Manager to manage the LCH Facilities on behalf of LCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.Strategic
Plan and Budget. Manager and LCH, shall develop and agree on an annual plan setting forth details regarding the strategic,
operational and capital activities that Manager shall undertake and oversee on behalf of LCH and the budgets regarding such activities
(as amended from time to time, the “Strategic Plan and Budget”), which shall include, among other matters: 

1

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the LCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the LCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, LCH will be solely responsible for its cost of operation. If requested by LCH, Manager will use commercially reasonable
efforts to assist LCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By LCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of LCH shall be the Governing Body
of the LCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over LCH. LCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, LCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by LCH’s governing documents. LCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with LCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the LCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

2

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the LCH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the LCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of LCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of LCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

3

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all LCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise LCH regarding the operations
and business of the LCH Facilities in order to ensure effective management of the LCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of LCH,
in Manager’s reasonable discretion and/or at LCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the LCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of LCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the LCH Facilities. Manager
shall execute on behalf of LCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the LCH Facilities periodically. 

(c)All
personnel required to be employed directly by LCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of LCH (“LCH Personnel”) and not Manager, and shall be subject to LCH’s personnel
policies. All wages, benefits and other payroll expenses related to LCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term LCH Personnel does not include any Senior Executives or any personnel of Manager, unless LCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with LCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging LCH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  LCH or the LCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized agent of LCH, shall (i) determine the staffing plans on behalf of LCH with respect
to the number and qualifications of LCH Personnel required for the efficient and effective operation of LCH  

4

Facilities operations, and, (ii) in accordance
with the Strategic Plan and Budget, implement wage scales, employee benefit packages and programs, in-service training programs,
staffing schedules, and job descriptions for LCH Personnel, all in order to accomplish the policies established by LCH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with LCH, shall assist in educational training programs for LCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the LCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the LCH
Facilities in the name of LCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in LCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the LCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the LCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the LCH Facilities building, and grounds), janitorial,
security and food services. 

5

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the LCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the LCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement LCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the LCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the LCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the LCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12LCH
Missions. Manager shall assist LCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the LCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by LCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the LCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the LCH Facilities’ image and reputation and to secure and maintain patients at the LCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on LCH’s behalf and at LCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the LCH Facilities
as are designated by LCH and consistent with the Strategic Plan and Budget or, in the absence of such a specification, as Manager
considers reasonable and prudent based on criteria generally used by Manager with respect to the hospitals owned or managed by
Manager. LCH, Manager and the Senior Executives shall be covered under all such applicable policies (or programs). Additionally,
Manager and the Senior Executives shall be  

6

named as additional insured's under LCH’s Directors’
and Officers’ liability, Errors and Omissions liability, professional liability and other insurance policies and the Senior
Executives shall be insured under any such policies to the same extent as LCH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the LCH Facilities in accordance with LCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and LCH shall ensure that charity care at LCH Facilities is provided
in a manner consistent with LCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of LCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the LCH Facilities and the collection of all accounts due to the LCH Facilities
in accordance with lawful Charge-master and collection policies developed by LCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. LCH shall approve the Charge-master. Manager shall update LCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, LCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)LCH
shall maintain bank accounts (“LCH Accounts”) necessary for operations of the LCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the LCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of LCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from LCH Accounts on behalf
of LCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided LCH has sufficient funds, Manager shall timely and accurately pay on behalf of LCH, from funds generated
by the LCH Facilities in the LCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the LCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the LCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the LCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing Body or the Management Committee) on behalf of LCH, any claims for
payment asserted with respect to the LCH Facilities that Manager, in good faith, considers erroneous or improper. 

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist LCH as the agent and attorney-in-fact of LCH in the procuring of licenses, permits and other
approvals, the payment and  

7

collection of accounts, and in all other activities
necessary, appropriate, or useful to Manager in the carrying out of its duties. In performing such services, Manager shall comply
with all applicable laws, regulations and requirements of governmental bodies.

4.19Elective
Corporate-Based Consulting Services. If requested by LCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to LCH. For the purpose of keeping informed with respect to the operation of the LCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the LCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the LCH Facilities, audited financial statements of the
LCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the LCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes LCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each LCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of LCH and delivery of such reports
is conditioned upon the capability, availability, cooperation and access to, such LCH systems and personnel for Manager. Manager
shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports required by this
Agreement. 

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the LCH Facilities. 

8

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the LCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the LCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding LCH’s existing Quality Assurance Program and QIIP
and shall assist LCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with LCH’s Quality Assurance Program, Manager shall assist LCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of LCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the LCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the LCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the LCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the LCH Facilities or Manager’s
Management Services, including  

9

without limitation all agencies having jurisdiction
over health care services, billing, labor/employment, taxation, environmental compliance, antitrust, or physical facility compliance.
Manager shall assist LCH to operate the LCH Facilities so that it maintains all necessary licenses, permits, consents, and approvals
from all governmental agencies that have jurisdiction over the operation of the LCH Facilities. Manager shall not be obligated
to LCH for failure of the LCH Facilities to comply with any such laws, rules, and regulations or for failure of the LCH Facilities
to maintain any such licenses, permits, consents, and approvals, to the extent that the failure is due to financial limitations
of the LCH Facilities or to the design or construction of the LCH Facilities, or is attributable to acts, errors or omissions of
LCH or its agents (other than Manager or Manager’s employees or contractors).

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the LCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the LCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither LCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the LCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the LCH Facilities; (iii) cause a termination of, or adversely
affect, LCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause LCH to violate or default under any of its legal obligations under debt financings. LCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by LCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on LCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by LCH. 

(2)Incur
debt on behalf of LCH; 

(3)Encumber
LCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

10

(4)Approve
or undertake any other matters required by law to be approved by LCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the LCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, LCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, LCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1LCH. 

(a)LCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
LCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and its affiliates (together,
the “SE Employer”), and direct or indirect equity holder of Manager, and any person who controls Manager (any or all
of the foregoing hereinafter a “Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies,
claims, actions, suits, proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including
reasonable attorneys’ fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”)
that may be incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified
Person is party  

11

to such Claims) to the extent they result from,
arise out of, or are in any way related to, the following, in each case as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by LCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of LCH set forth in this Agreement; 

(2)any
actions or omissions of LCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of LCH or its Representatives  related
to this Agreement; 

(3)any
failure by LCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the LCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or LCH’s ownership or operation of the LCH Facilities, including without limitation the use of any real or tangible property
in connection with the LCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of LCH or any of its
Representatives. 

(b)Furthermore,
LCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a party to any Claims out of which any such expenses arise and whether or not such Claims are brought
by LCH, its Representatives or any other person or entity. 

(c)However,
LCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the  

12

Agreement; or (c) arising from (i) felony criminal
activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts indemnifiable by Manager,
in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator.

(d)The
reimbursement and indemnity obligations of LCH under this Agreement shall be in addition to any liability LCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of LCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless LCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“LCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of LCH or a LCH Indemnified
Person (b) by one LCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any LCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by LCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee based thereon, and shall
have the right to contest and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided,
however, that if the Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of
any such action within ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to
take any such action as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment
and claim indemnification as provided herein; provided, however, that no Party shall settle any such action without the consent
of the  

13

other applicable Party (which consent shall
not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides the Indemnitee
a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification is claimed,
the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided, however,
that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement of such
counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the defense
in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists a conflict
or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor to represent
both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding effected
without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, LCH shall indemnify the Senior
Executives who will be acting as officers of LCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under LCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to LCH and LCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to LCH or LCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and LCH and LCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such Claims result primarily and directly from such Senior Executive’s felony criminal acts, willful
misconduct, gross negligence or fraud in each such case (other than with respect to felony criminal acts which shall require final
judgment by a court of competent jurisdiction (not subject to further appeal)), as finally determined by an arbitrator. 

11.Access
to Records. 

14

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, LCH’s auditors and accountants, LCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, LCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will be deferred as owed but carried as a deferred expense due Manager. When, in
Manager’s best business judgement, sufficient funds become available to pay off all or part of fees incurred and still owing,
Manager will pay down all or part of the balance of fees owed using prudent business judgement and discretion. In no case shall
Manager forgive fees due for management services rendered.  

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

15

(c)IT
support and EMR services are not included in the management fee and will be offered to LCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term.  

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence. 

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in good faith for thirty (30) days following written notice of the Dispute served on a Party,
either Party may refer such Dispute to LCH and the CEO of Manager for resolution.  

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award  

16

shall be made within nine (9) months of the filing
of a notice of intention (or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base
any decision or award on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s
actual damages, except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the
presentation of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing
party shall be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after LCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by LCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to LCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or  

17

all obligations to be performed by Manager pursuant
to this Agreement, to the extent such failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations,
rules or reimbursement rules or policies that actually prevent such performance, (iv) any other action or force majeure or event
which is beyond the reasonable control of Manager, or (v) any failure by LCH to perform, fund or meet any of LCH’s obligations
hereunder; and provided that Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains
feasible.

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to LCH in the event LCH (or LCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and LCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Companyand this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, LCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of LCH, upon request of LCH, Manager shall be obligated to continue to provide LCH with the Management Services described herein
for a period of up to one hundred twenty (120) days after such termination or expiration of this Agreement (the “Transition
Period”), and during such Transition Period: (a) Provided  LCH shall continue to compensate Manager in accordance with
this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly and efficient transfer of its functions hereunder
to LCH and/or another service provider; (c) Manager shall fully cooperate in order to ensure no disruption to patient care functions;
and (d) the Parties shall cooperate in order to resolve any outstanding operational, financial, legal or other matters arising
(including audits) from the period in which this Agreement was in effect. 

19.Representations
and Warranties. 

18

19.1Manager.
As of the Effective Date, Manager represents and warrants to LCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2LCH.
As of the Effective Date, LCH represents and warrants to Manager as follows: 

(a)LCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)LCH
has full authority to enter into and perform this Agreement, and the signature of LCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against LCH in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by LCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to LCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
LCH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which LCH is subject or by which any of its assets are bound. 

19

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to LCH’s
knowledge threatened against LCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason LCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to LCH or Manager relating to LCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about LCH, services provided and its relationship hereunder. 

20.3Use
of LCH Name. Manager may use the LCH or LCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to LCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to LCH of invoices. Any such expenses, subject to this section, shall
require prior approval by LCH to be eligible for reimbursement. 

 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title) designated
below (or to such other address, facsimile number, email address or person as a Party may designate by notice delivered to the
other Party in accordance with this Section: 

Manager:Executive
Vice President  

iHealthcare Management II Company

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

LCH:
              Lauderdale
Community Hospital 

                            326
Asbury Avenue

                            Ripley,
Tennessee 38063

20

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in electronic (“pdf” or “tif”) format shall be effective
as delivery of a manually executed counterpart of this Agreement. 

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions  

21

or shortages, criminal activity of third parties,
 loss of internet connectivity or incomplete or inaccurate data input as supplied by LCH.  

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of LCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to LCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, LCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19
  Amendment and First Right of Refusal. This Agreement sets forth the entire understanding and agreement among the parties
hereto with reference to the subject matter hereof and may not be modified, amended, discharged or terminated except by a written
instrument signed by the parties hereto. First Right of Refusal:
 Landlord/Owner hereby grants to iHealthcare (iHCC) a first right of refusal to purchase the hospital property and
real estate during the term and any extensions of this Management and Administrative Services Agreement.  If Landlord/Owner
shall desire to sell the hospital property and real estate, and receives a bona fide offer to purchase, Landlord/Owner shall give
iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest in the hospital property and real estate as
contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall state the terms and conditions under which Landlord/Owner
intends to sell its interest. For Sixty (60) business days following the giving of such notice, iHealthcare shall have the option
to purchase the Landlord/Owner interest as stated in the Landlord/Owner Notice.  A written notice in substantially the following
form, addressed to Landlord/Owner 

22

and signed
by iHealthcare, within the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. LCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 11, LLC D/B/A Lauderdale
Community Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Oswego Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company
2, LLC D/B/A Oswego Community Hospital (“OCH”), a Delaware Limited Liability Company, and iHealthcare Management II
Company II, a Florida Corporation (“Manager”). OCH and Manager are sometimes referred to herein individually as a “Party”
or collectively as the “Parties.”

WITNESSETH:

WHEREAS, OCH owns and operates an acute general medical
and surgical hospital (the “OCH Facilities”) located on the medical campus with a principal address of 800 Barker Drive
Oswego, Kansas 67356;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, OCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the OCH Facilities
on behalf of OCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with OCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, OCH hereby retains and appoints
Manager to manage the OCH Facilities on behalf of OCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.
 Strategic Plan and Budget. Manager and OCH, shall develop
and agree on an annual plan setting forth details regarding the strategic, operational and capital activities that Manager shall
undertake and oversee on behalf of OCH and the budgets regarding such activities (as amended from time to time, the “Strategic
Plan and Budget”), which shall include, among other matters: 

1

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the OCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the OCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, OCH will be solely responsible for its cost of operation. If requested by OCH, Manager will use commercially reasonable
efforts to assist OCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By OCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of OCH shall be the Governing Body
of the OCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over OCH. OCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, OCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by OCH’s governing documents. OCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with OCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the OCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise  

2

to oversee the implementation of processes and systems
at the OCH Facilities consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that
are in material violation of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing
the Management Services shall include the following:

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the OCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of OCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of OCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

3

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all OCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise OCH regarding the operations
and business of the OCH Facilities in order to ensure effective management of the OCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of OCH,
in Manager’s reasonable discretion and/or at OCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the OCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of OCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the OCH Facilities. Manager
shall execute on behalf of OCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the OCH Facilities periodically. 

(c)All
personnel required to be employed directly by OCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of OCH (“OCH Personnel”) and not Manager, and shall be subject to OCH’s personnel
policies. All wages, benefits and other payroll expenses related to OCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term OCH Personnel does not include any Senior Executives or any personnel of Manager, unless OCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with OCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging OCH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  OCH or the OCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized agent of OCH, shall (i) determine the staffing plans on behalf of OCH with respect
to the number and qualifications of OCH Personnel required for the efficient and effective operation  

4

of OCH Facilities operations, and, (ii) in accordance
with the Strategic Plan and Budget, implement wage scales, employee benefit packages and programs, in-service training programs,
staffing schedules, and job descriptions for OCH Personnel, all in order to accomplish the policies established by OCH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with OCH, shall assist in educational training programs for OCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the OCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the OCH
Facilities in the name of OCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in OCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the OCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the OCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the OCH Facilities building, and grounds), janitorial,
security and food services. 

5

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the OCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the OCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement OCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the OCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the OCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the OCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12OCH
Missions. Manager shall assist OCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the OCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by OCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the OCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the OCH Facilities’ image and reputation and to secure and maintain patients at the OCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on OCH’s behalf and at OCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the OCH Facilities
as are designated by OCH and consistent with the Strategic Plan and Budget or, in the absence of such a specification, as Manager
considers reasonable and prudent based on criteria generally used by Manager with respect to the hospitals owned or managed by
Manager. OCH, Manager and the Senior Executives shall be covered under all such applicable policies (or programs). Additionally,
Manager and the Senior Executives shall be  

6

named as additional insured's under OCH’s Directors’
and Officers’ liability, Errors and Omissions liability, professional liability and other insurance policies and the Senior
Executives shall be insured under any such policies to the same extent as OCH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the OCH Facilities in accordance with OCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and OCH shall ensure that charity care at OCH Facilities is provided
in a manner consistent with OCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of OCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the OCH Facilities and the collection of all accounts due to the OCH Facilities
in accordance with lawful Charge-master and collection policies developed by OCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. OCH shall approve the Charge-master. Manager shall update OCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, OCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)OCH
shall maintain bank accounts (“OCH Accounts”) necessary for operations of the OCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the OCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of OCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from OCH Accounts on behalf
of OCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided OCH has sufficient funds, Manager shall timely and accurately pay on behalf of OCH, from funds generated
by the OCH Facilities in the OCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the OCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the OCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the OCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing Body or the Management Committee) on behalf of OCH, any claims for
payment asserted with respect to the OCH Facilities that Manager, in good faith, considers erroneous or improper. 

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist OCH as the agent and attorney-in-fact of OCH in the procuring of licenses, permits and other
approvals, the payment and  

7

collection of accounts, and in all other activities
necessary, appropriate, or useful to Manager in the carrying out of its duties. In performing such services, Manager shall comply
with all applicable laws, regulations and requirements of governmental bodies.

4.19Elective
Corporate-Based Consulting Services. If requested by OCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to OCH. For the purpose of keeping informed with respect to the operation of the OCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the OCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the OCH Facilities, audited financial statements of the
OCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the OCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes OCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each OCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of OCH and delivery of such reports
is conditioned upon the capability, availability, cooperation and access to, such OCH systems and personnel for Manager. Manager
shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports required by this
Agreement. 

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the OCH Facilities. 

8

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the OCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the OCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding OCH’s existing Quality Assurance Program and QIIP
and shall assist OCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with OCH’s Quality Assurance Program, Manager shall assist OCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of OCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the OCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the OCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the OCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the OCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
 

9

taxation, environmental compliance, antitrust, or
physical facility compliance. Manager shall assist OCH to operate the OCH Facilities so that it maintains all necessary licenses,
permits, consents, and approvals from all governmental agencies that have jurisdiction over the operation of the OCH Facilities.
Manager shall not be obligated to OCH for failure of the OCH Facilities to comply with any such laws, rules, and regulations or
for failure of the OCH Facilities to maintain any such licenses, permits, consents, and approvals, to the extent that the failure
is due to financial limitations of the OCH Facilities or to the design or construction of the OCH Facilities, or is attributable
to acts, errors or omissions of OCH or its agents (other than Manager or Manager’s employees or contractors).

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the OCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the OCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither OCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the OCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the OCH Facilities; (iii) cause a termination of, or adversely
affect, OCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause OCH to violate or default under any of its legal obligations under debt financings. OCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by OCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on OCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by OCH. 

(2)Incur
debt on behalf of OCH; 

(3)Encumber
OCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

10

(4)Approve
or undertake any other matters required by law to be approved by OCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the OCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, OCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, OCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1OCH. 

(a)OCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
OCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and its affiliates (together,
the “SE Employer”), and direct or indirect equity holder of Manager, and any person who controls Manager (any or all
of the foregoing hereinafter a “Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies,
claims, actions, suits, proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including
reasonable attorneys’ fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”)
that may be incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified
Person is party  

11

to such Claims) to the extent they result from,
arise out of, or are in any way related to, the following, in each case as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by OCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of OCH set forth in this Agreement; 

(2)any
actions or omissions of OCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of OCH or its Representatives  related
to this Agreement; 

(3)any
failure by OCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the OCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or OCH’s ownership or operation of the OCH Facilities, including without limitation the use of any real or tangible property
in connection with the OCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of OCH or any of its
Representatives. 

(b)Furthermore,
OCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a party to any Claims out of which any such expenses arise and whether or not such Claims are brought
by OCH, its Representatives or any other person or entity. 

(c)However,
OCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the  

12

Agreement; or (c) arising from (i) felony criminal
activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts indemnifiable by Manager,
in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator.

(d)The
reimbursement and indemnity obligations of OCH under this Agreement shall be in addition to any liability OCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of OCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless OCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“OCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of OCH or a OCH Indemnified
Person (b) by one OCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any OCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by OCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee based thereon, and shall
have the right to contest and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided,
however, that if the Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of
any such action within ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to
take any such action as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment
and claim indemnification as provided herein; provided, however, that no Party shall settle any such action without the consent
of the  

13

other applicable Party (which consent shall
not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides the Indemnitee
a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification is claimed,
the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided, however,
that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement of such
counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the defense
in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists a conflict
or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor to represent
both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding effected
without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, OCH shall indemnify the Senior
Executives who will be acting as officers of OCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under OCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to OCH and OCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to OCH or OCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and OCH and OCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such Claims result primarily and directly from such Senior Executive’s felony criminal acts, willful
misconduct, gross negligence or fraud in each such case (other than with respect to felony criminal acts which shall require final
judgment by a court of competent jurisdiction (not subject to further appeal)), as finally determined by an arbitrator. 

11.Access
to Records. 

14

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, OCH’s auditors and accountants, OCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, OCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will be deferred as owed but carried as a deferred expense due Manager. When, in
Manager’s best business judgement, sufficient funds become available to pay off all or part of fees incurred and still owing,
Manager will pay down all or part of the balance of fees owed using prudent business judgement and discretion. In no case shall
Manager forgive fees due for management services rendered.  

15

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to OCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term.  

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in good faith for thirty (30) days following written notice of the Dispute served on a Party,
either Party may refer such Dispute to OCH and the CEO of Manager for resolution.  

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive  

16

covenants, mishandling of Confidential Information,
or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction, in Miami, Florida, of either
the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator shall agree: (a) that the
arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention (or demand) to arbitrate  (but
it may be extended by written agreement of the parties); (b) to base any decision or award on governing law; (c) to not award punitive
or other damages that are not measured by the prevailing party’s actual damages, except as may be required by statute; and
(d) to issue an award in writing within ten (10) days of concluding the presentation of evidence and briefs.  Judgment may
be entered in any court having jurisdiction thereof.  The prevailing party shall be entitled to recover from the other party
its costs and expenses, including reasonable attorney’s fees.

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after OCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by OCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

17

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to OCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by OCH to perform, fund or meet any of OCH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to OCH in the event OCH (or OCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and OCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, OCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of OCH, upon request of OCH, Manager shall be obligated to continue to provide OCH with the Management Services described herein
for a period of up to one hundred twenty (120) days after such termination or expiration of this Agreement (the “Transition
Period”), and during such Transition Period: (a) Provided  OCH shall continue to compensate Manager in accordance with
this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly and efficient transfer of its functions hereunder
to OCH and/or another service provider; (c) Manager shall fully cooperate in order to ensure no disruption to patient care functions;
and (d) the Parties shall cooperate in order to resolve any outstanding operational, financial, legal or other matters arising
(including audits) from the period in which this Agreement was in effect. 

18

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to OCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2OCH.
As of the Effective Date, OCH represents and warrants to Manager as follows: 

(a)OCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)OCH
has full authority to enter into and perform this Agreement, and the signature of OCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against OCH in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by OCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to OCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
OCH under, any agreement or instrument; or (iv) violate any judicial or administrative  

19

decree, contract, or other legal obligation
to which OCH is subject or by which any of its assets are bound.

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to OCH’s
knowledge threatened against OCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason OCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to OCH or Manager relating to OCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about OCH, services provided and its relationship hereunder. 

20.3Use
of OCH Name. Manager may use the OCH or OCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to OCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to OCH of invoices. Any such expenses, subject to this section, shall
require prior approval by OCH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title) designated
below (or to such other address, facsimile number, email address or person as a Party may designate by notice delivered to the
other Party in accordance with this Section: 

Manager:Executive
Vice President  

iHealthcare Management II Company
II

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

20

OCH:
              Oswego
Community Hospital 

                             800
Barker Drive

                             Oswego,
Kansas 67356

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in electronic (“pdf” or “tif”) format shall be effective
as delivery of a manually executed counterpart of this Agreement. 

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal  

21

delays, inability to procure materials, sabotage,
restrictive governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet
connectivity or incomplete or inaccurate data input as supplied by OCH.  

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of OCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to OCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, OCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19
  Amendment and First Right of Refusal. This Agreement sets forth the entire understanding and agreement among the parties
hereto with reference to the subject matter hereof and may not be modified, amended, discharged or terminated except by a written
instrument signed by the parties hereto. First Right of Refusal:
 Landlord/Owner hereby grants to iHealthcare (iHCC) a first right of refusal to purchase the hospital property and
real estate during the term and any extensions of this Management and Administrative Services Agreement.  If Landlord/Owner
shall desire to sell the hospital property and real estate, and receives a bona fide offer to purchase, Landlord/Owner shall give
iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest in the hospital property and real estate as
contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall state the terms and conditions under which Landlord/Owner
intends to sell its interest. For Sixty (60) business days following the giving of such notice, iHealthcare shall have the option
to purchase the Landlord/Owner interest as stated in the 

22

Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. OCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

 

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 2, LLC D/B/A Oswego Community
Hospital:

 By:
/s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Prague Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company
7, LLC D/B/A Prague Community Hospital (“PCH”), a Delaware Limited Liability Company, and iHealthcare Management II
Company II, a Florida Corporation (“Manager”). PCH and Manager are sometimes referred to herein individually as a “Party”
or collectively as the “Parties.”

WITNESSETH:

WHEREAS, PCH owns and operates an acute general medical
and surgical hospital (the “PCH Facilities”) located on the medical campus with a principal address of 1322 Klabzuba
Avenue, Prague, Oklahoma 74864;

WHEREAS, Manager is a Hospital Management Company;

WHEREAS, Manager has demonstrated expertise and a
track record of successfully managing and improving the performance of hospitals serving rural communities;

WHEREAS, PCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the PCH Facilities
on behalf of PCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with PCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, PCH hereby retains and appoints
Manager to manage the PCH Facilities on behalf of PCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

1

2.
   Strategic Plan and Budget. Manager and PCH, shall
develop and agree on an annual plan setting forth details regarding the strategic, operational and capital activities that Manager
shall undertake and oversee on behalf of PCH and the budgets regarding such activities (as amended from time to time, the “Strategic
Plan and Budget”), which shall include, among other matters: 

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the PCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the PCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, PCH will be solely responsible for its cost of operation. If requested by PCH, Manager will use commercially reasonable
efforts to assist PCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By PCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of PCH shall be the Governing Body
of the PCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over PCH. PCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, PCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by PCH’s governing documents. PCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with PCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

2

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the PCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the PCH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the PCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of PCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of PCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

3

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to a Chief Executive
Officer and necessary and adequate corporate administration, shared services and business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all PCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise PCH regarding the operations
and business of the PCH Facilities in order to ensure effective management of the PCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of PCH,
in Manager’s reasonable discretion and/or at PCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the PCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of PCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the PCH Facilities. Manager
shall execute on behalf of PCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the PCH Facilities periodically. 

(c)All
personnel required to be employed directly by PCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of PCH (“PCH Personnel”) and not Manager, and shall be subject to PCH’s personnel
policies. All wages, benefits and other payroll expenses related to PCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term PCH Personnel does not include any Senior Executives or any personnel of Manager, unless PCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with PCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging PCH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  PCH or the PCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the authorized  

4

agent of PCH, shall (i) determine the staffing
plans on behalf of PCH with respect to the number and qualifications of PCH Personnel required for the efficient and effective
operation of PCH Facilities operations, and, (ii) in accordance with the Strategic Plan and Budget, implement wage scales, employee
benefit packages and programs, in-service training programs, staffing schedules, and job descriptions for PCH Personnel, all in
order to accomplish the policies established by PCH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with PCH, shall assist in educational training programs for PCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the PCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the PCH
Facilities in the name of PCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall provide assistance in obtaining and maintaining, in PCH’s name, all licenses, permits,
approvals and certificates of accreditation required for the operation of the PCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the PCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the PCH Facilities building, and grounds), janitorial,
security and food services. 

5

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the PCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the PCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement PCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the PCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the PCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the PCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12PCH
Missions. Manager shall assist PCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the PCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by PCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the PCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the PCH Facilities’ image and reputation and to secure and maintain patients at the PCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on PCH’s behalf and at PCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the PCH Facilities
as are designated by PCH and consistent with the Strategic Plan and Budget or, in the absence of such a specification, as Manager
considers reasonable and prudent based on criteria generally used by Manager with respect to the hospitals owned or managed by
Manager. PCH, Manager and the Senior Executives shall be covered under all such applicable policies (or programs). Additionally,
Manager and the Senior Executives shall be  

6

named as additional insured's under PCH’s Directors’
and Officers’ liability, Errors and Omissions liability, professional liability and other insurance policies and the Senior
Executives shall be insured under any such policies to the same extent as PCH’s other officers and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the PCH Facilities in accordance with PCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and PCH shall ensure that charity care at PCH Facilities is provided
in a manner consistent with PCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of PCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the PCH Facilities and the collection of all accounts due to the PCH Facilities
in accordance with lawful Charge-master and collection policies developed by PCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. PCH shall approve the Charge-master. Manager shall update PCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, PCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)PCH
shall maintain bank accounts (“PCH Accounts”) necessary for operations of the PCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the PCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of PCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from PCH Accounts on behalf
of PCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided PCH has sufficient funds, Manager shall timely and accurately pay on behalf of PCH, from funds generated
by the PCH Facilities in the PCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the PCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the PCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the PCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing Body or the Management Committee) on behalf of PCH, any claims for
payment asserted with respect to the PCH Facilities that Manager, in good faith, considers erroneous or improper. 

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist PCH as the agent and attorney-in-fact of PCH in the procuring of licenses, permits and other
approvals, the payment and  

7

collection of accounts, and in all other activities
necessary, appropriate, or useful to Manager in the carrying out of its duties. In performing such services, Manager shall comply
with all applicable laws, regulations and requirements of governmental bodies.

4.19Elective
Corporate-Based Consulting Services. If requested by PCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to PCH. For the purpose of keeping informed with respect to the operation of the PCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the PCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the PCH Facilities, audited financial statements of the
PCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the PCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes PCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each PCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of PCH and delivery of such reports
is conditioned upon the capability, availability, cooperation and access to, such PCH systems and personnel for Manager. Manager
shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports required by this
Agreement. 

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the PCH Facilities. 

8

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the PCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the PCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding PCH’s existing Quality Assurance Program and QIIP
and shall assist PCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with PCH’s Quality Assurance Program, Manager shall assist PCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of PCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the PCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the PCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the PCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

 

 

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

9

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the PCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
taxation, environmental compliance, antitrust, or physical facility compliance. Manager shall assist PCH to operate the PCH Facilities
so that it maintains all necessary licenses, permits, consents, and approvals from all governmental agencies that have jurisdiction
over the operation of the PCH Facilities. Manager shall not be obligated to PCH for failure of the PCH Facilities to comply with
any such laws, rules, and regulations or for failure of the PCH Facilities to maintain any such licenses, permits, consents, and
approvals, to the extent that the failure is due to financial limitations of the PCH Facilities or to the design or construction
of the PCH Facilities, or is attributable to acts, errors or omissions of PCH or its agents (other than Manager or Manager’s
employees or contractors). 

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the PCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the PCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither PCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the PCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the PCH Facilities; (iii) cause a termination of, or adversely
affect, PCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause PCH to violate or default under any of its legal obligations under debt financings. PCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by PCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on PCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by PCH. 

10

(2)Incur
debt on behalf of PCH; 

(3)Encumber
PCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

(4)Approve
or undertake any other matters required by law to be approved by PCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the PCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, PCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, PCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars). 

10.Defense
of Claims; Exculpation. 

10.1PCH. 

(a)PCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
PCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and its affiliates (together,
the “SE Employer”), and direct or indirect equity holder of Manager, and any person who controls Manager (any or all
of the foregoing hereinafter a “Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies,
claims, actions, suits, proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses  

11

(including reasonable attorneys’ fees
and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”) that may be incurred
by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified Person is party
to such Claims) to the extent they result from, arise out of, or are in any way related to, the following, in each case as finally
determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by PCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of PCH set forth in this Agreement; 

(2)any
actions or omissions of PCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of PCH or its Representatives  related
to this Agreement; 

(3)any
failure by PCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the PCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or PCH’s ownership or operation of the PCH Facilities, including without limitation the use of any real or tangible property
in connection with the PCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of PCH or any of its
Representatives. 

(b)Furthermore,
PCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a party to any Claims out of which any such expenses arise and whether or not such Claims are brought
by PCH, its Representatives or any other person or entity. 

12

(c)However,
PCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the Agreement; or (c) arising from
(i) felony criminal activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts
indemnifiable by Manager, in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator. 

(d)The
reimbursement and indemnity obligations of PCH under this Agreement shall be in addition to any liability PCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of PCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless PCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“PCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of PCH or a PCH Indemnified
Person (b) by one PCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any PCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by PCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee based thereon, and shall
have the right to contest and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided,
however, that if the Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of
any such  

13

action within ten (10) days of the giving of
such notice by the Indemnitee, then the Indemnitee shall have the right to take any such action as it reasonably deems appropriate
to defend, contest, settle, or compromise any such action or assessment and claim indemnification as provided herein; provided,
however, that no Party shall settle any such action without the consent of the other applicable Party (which consent shall not
be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides the Indemnitee a
release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification is claimed,
the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided, however,
that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement of such
counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the defense
in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists a conflict
or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor to represent
both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding effected
without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, PCH shall indemnify the Senior
Executives who will be acting as officers of PCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under PCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to PCH and PCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to PCH or PCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and PCH and PCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent that any such Claims result primarily and directly from such Senior Executive’s felony criminal acts, willful
misconduct, gross negligence or fraud in each such case (other than with respect to felony criminal acts which shall  

14

require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator.

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, PCH’s auditors and accountants, PCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, PCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will be deferred as owed but carried as a deferred expense due Manager. When, in
Manager’s best business judgement, sufficient funds become available to pay off all or part of fees incurred and  

15

still owing, Manager will pay down all or part
of the balance of fees owed using prudent business judgement and discretion. In no case shall Manager forgive fees due for management
services rendered.

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to PCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term. 

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in good faith for thirty (30) days following written notice of the Dispute served on a Party,
either Party may refer such Dispute to PCH and the CEO of Manager for resolution.  

16

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base any decision or award
on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s actual damages,
except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the presentation
of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing party shall
be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.  

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after PCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by PCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

17

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to PCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by PCH to perform, fund or meet any of PCH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to PCH in the event PCH (or PCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and PCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, PCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of PCH, upon request of PCH, Manager shall be obligated to continue to provide PCH with the Management Services described herein
for a period of up to one hundred twenty (120) days after such termination or expiration of this Agreement (the “Transition
Period”), and during such Transition Period: (a) Provided  PCH shall continue to compensate Manager in  

18

accordance with this Agreement, (b) Manager shall
fully cooperate in order to ensure the orderly and efficient transfer of its functions hereunder to PCH and/or another service
provider; (c) Manager shall fully cooperate in order to ensure no disruption to patient care functions; and (d) the Parties shall
cooperate in order to resolve any outstanding operational, financial, legal or other matters arising (including audits) from the
period in which this Agreement was in effect.

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to PCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2PCH.
As of the Effective Date, PCH represents and warrants to Manager as follows: 

(a)PCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)PCH
has full authority to enter into and perform this Agreement, and the signature of PCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against PCH in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

19

(c)The
execution, delivery and performance of this Agreement by PCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to PCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
PCH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which PCH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to PCH’s
knowledge threatened against PCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason PCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to PCH or Manager relating to PCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about PCH, services provided and its relationship hereunder. 

20.3Use
of PCH Name. Manager may use the PCH or PCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to PCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to PCH of invoices. Any such expenses, subject to this section, shall
require prior approval by PCH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title) designated
below (or to such other address, facsimile number, email address or person as a Party may designate by notice delivered to the
other Party in accordance with this Section: 

20

 

Manager:Executive
Vice President 

iHealthcare Management II Company
II

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

PCH:
              Prague
Community Hospital 

                            1322
Klabzuba Avenue

                            Prague,
Oklahoma 74864

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in electronic (“pdf” or “tif”) format shall be effective
as delivery of a manually executed counterpart of this Agreement. 

21

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by PCH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of PCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to PCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, PCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19
  Amendment and First Right of Refusal. This Agreement sets forth the entire understanding and agreement among the parties
hereto with reference to the subject matter hereof and may not be modified, amended, discharged or terminated except by a written
instrument signed by the parties hereto. First Right of Refusal:
 Landlord/Owner hereby grants to iHealthcare (iHCC) a first right of refusal to purchase the hospital property and
real estate during the term and any extensions of this Management and 

22

Administrative
Services Agreement.  If Landlord/Owner shall desire to sell the hospital property and real estate, and receives a bona fide
offer to purchase, Landlord/Owner shall give iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest
in the hospital property and real estate as contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall
state the terms and conditions under which Landlord/Owner intends to sell its interest. For Sixty (60) business days following
the giving of such notice, iHealthcare shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. PCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows]

23

 

 

 

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 7, LLC D/B/A Prague Community
Hospital:

 By:
/s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24

 

 

MANAGEMENT AND ADMINISTRATIVE SERVICES
AGREEMENT

Washington County Community Hospital

 

THIS MANAGEMENT AND ADMINISTRATIVE SERVICES AGREEMENT
(this “Agreement”) is entered into as of the 7th day of January 2019, by and among CAH Acquisition Company 1, LLC D/B/A
Washington County Hospital AKA Washington County Community Hospital (“WCH”), a Delaware Limited Liability Company,
and iHealthcare Management II Company, a Florida Corporation (“Manager”). WCH and Manager are sometimes referred to
herein individually as a “Party” or collectively as the “Parties.”

WITNESSETH:

WHEREAS, WCH owns and operates an acute general medical
and surgical hospital (the “WCH Facilities”) located on the medical campus with a principal address of 958 US Highway
64 East, Plymouth, NC 27962;

WHEREAS, Manager is a Hospital Management Company;
WHEREAS, Manager has demonstrated expertise and a track record of successfully managing and improving the performance of hospitals
serving rural communities;

WHEREAS, WCH desires that Manager provide services
to administer, supervise, and manage, and Manager desires to administer, supervise, and manage, the operations of the WCH Facilities
on behalf of WCH commencing on January 7, 2019 (the “Effective Date”) on the terms and conditions set forth hereinafter,
in furtherance of and consistent with WCH’s mission:

NOW, THEREFORE, in consideration of the foregoing
and the mutual agreements, covenants and promises hereinafter set forth and for other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, and intending to be legally bound, the Parties hereto agree as follows:

1.Retention
of Manager. Subject to the terms and conditions of this Agreement, as of the Effective Date, WCH hereby retains and appoints
Manager to manage the WCH Facilities on behalf of WCH. Manager shall provide, at Manager’s sole expense and determination,
all necessary corporate administration, shared services, legal services, compliance, hospital employee benefits program sponsorship,
general business infrastructure and support necessary for Manager’s performance under this agreement. During the Term hereof,
Manager shall be the exclusive provider of such services as are described herein as Management Services. 

2.Strategic
Plan and Budget. Manager and WCH, shall develop and agree on an annual plan setting forth details regarding the strategic,
operational and capital activities that Manager shall undertake and  

1

oversee on behalf of WCH and the budgets regarding
such activities (as amended from time to time, the “Strategic Plan and Budget”), which shall include, among other matters:

(a)strategic,
programmatic and service line initiatives (including their operating and capital requirements) for the WCH Facilities; 

(b)performance
improvement initiatives, business development objectives, cost reduction plans, synergistic opportunities and efficiency improvements; 

(c)an
annual operating budget setting forth an estimate of operating revenues and expenses for the next year, which operating budget
shall be in reasonable detail and shall contain an explanation of anticipated changes in utilization, patient charges, payroll,
and other factors; 

(d)an
annual capital expenditures budget outlining a program of capital expenditures for the next fiscal year, which budget shall designate
expenditure items as either “routine capital” or “enhancement capital” and estimate where possible their
return on investment and other impact on operations, market position, etc.; and 

(e)an
annual projection of cash receipts and disbursements based upon the proposed capital expenditures and operating budgets, which
projection shall contain recommendations concerning use of excess cash flow, if any. 

2.2Revenues.
To the extent cash revenues of the WCH Facilities are not sufficient to support expenditures contemplated by the Strategic Plan
and Budget, WCH will be solely responsible for its cost of operation. If requested by WCH, Manager will use commercially reasonable
efforts to assist WCH in obtaining financing to fund such cost of operation. Manager shall use commercially reasonable efforts
to achieve the revenue targets and other goals consistent with the Strategic Plan and Budget and Performance Targets. 

3.Control
By WCH. Notwithstanding anything contained anywhere to the contrary, the Governing Body of WCH shall be the Governing Body
of the WCH Facilities (the “Governing Body”) and, shall possess ultimate authority and control over WCH. WCH authorizes
general operating policies developed by and to be carried out by Manager under this Agreement. The Governing Body shall delegate
authority to Manager to enable Manager effectively to perform its functions hereunder. By entering into this Agreement, WCH does
not, and shall not in the future, delegate to Manager any of the powers, duties, and responsibilities vested in the Governing Body
by law or by WCH’s governing documents. WCH is solely obligated to and shall pay, make funds available to Manager for the
payment of, or otherwise cause to be satisfied or discharged, all Hospital Expenses in accordance with the terms of this Agreement.
On a monthly basis, Manager shall meet or confer with WCH and provide financial reports, statistical reports, updates and review
requests for approvals by the Governing Body.  

4.Operational
Services. Manager shall use commercially reasonable efforts to oversee the efficient and orderly operation of the WCH Facilities
and shall provide the following services in accordance to the terms hereof, or if not herein specified then at least at the level
of prevailing industry practices:  

2

 

4.1Key
Hospital Services. Manager shall (a) use commercially reasonable efforts to perform all services consistent with the specific standards
herein, (b) use commercially reasonable efforts otherwise to oversee the implementation of processes and systems at the WCH Facilities
consistent with the Strategic Plan and Budget, and (c) refrain from intentionally taking any actions that are in material violation
of applicable laws in its activities pursuant to this Agreement. Manager’s objectives in performing the Management Services
shall include the following: 

(a)Improving
Emergency Department responsiveness to patients, reducing wait times and left-without-being-seen metrics; 

(b)Improving
clinical service quality and documentation through sophisticated hospitalist and case management programs and quality of services
[which may be provided by telehealth services]; 

(c)Decreasing
supply chain costs and quality of services by standardizing purchasing activities and establishing cost-effective purchasing and
usage protocols; 

(d)Managing
labor costs through disciplined staffing policies, while strengthening employee retention and recruitment activities; 

(e)Improving
the clinical documentation, coding and billing procedures of the WCH Facilities, and compliance with government programs and private
payor requirements, so as to increase proper fee realization in accordance with applicable contracts and law; 

(f)Assisting
with the improvement of other revenue cycle functions; 

(g)Developing
new recurring revenue streams and increasing inpatient volumes by expanding and refining managed care activities; 

(h)Realigning
administrative infrastructure to better capitalize on system scale and to standardize best practices; 

(i)Improving
marketing, advertising and positioning of WCH within the local market; 

(j)Improving
care protocols and management of patient care flow, bed availability and turnover, and length of stay; 

(k)Augmenting
initiatives in payer relations and contracting; 

(l)Enhancing
the effective linkage of the clinical enterprise with support of WCH’s teaching and research activities; and 

(m)Implementing
the services described in the remainder of this Agreement. 

3

(n)Advising
the Governing Body of any material actions that Manager recommends be taken to avoid material non-compliance with law or deficiencies
in services. 

4.2Staffing. 

(a)During
the Term, Manager shall contract with and provide, and at its sole expense pay all compensation and benefits due to support necessary
and adequate corporate administration, corporate shared services and corporate business infrastructure. Each such Senior Executive,
and any future replacement thereof, shall be subject to reasonable advance approval by the Governing Body, which shall not be unreasonably
withheld or delayed. When so approved by the Governing Body and in the performance of their duties hereunder, such Senior Executives
shall be subject to and shall comply with all WCH policies and requirements applicable to their respective positions and duties,
subject to the Senior Executives being advised thereof in writing in advance.  In addition, at Hospital Expense and not included
in the Management Fee, Manager may make available certain advisors and other personnel (the “Senior Advisors”) from
time to time to consult with, visit and perform on site periodic reviews and evaluations, and advise WCH regarding the operations
and business of the WCH Facilities in order to ensure effective management of the WCH Facilities.  The Parties acknowledge
and agree that the composition of such advisory services at any given time may vary depending on the needs of the business of WCH,
in Manager’s reasonable discretion and/or at WCH’s reasonable request and Manager’s agreement thereto. 

(b)Subject
to the Strategic Plan and Budget, Manager will determine necessary and appropriate staffing levels of the WCH Facilities, and Manager
shall oversee and administer the recruitment and hiring in the name of and on behalf of WCH such physicians, nurses, technicians,
administrative, and other staff as are determined to be necessary or appropriate for the operation of the WCH Facilities. Manager
shall execute on behalf of WCH, as appropriate, any employee hiring, terminations, or other actions. Manager shall monitor and
review all payroll functions for the WCH Facilities periodically. 

(c)All
personnel required to be employed directly by WCH under applicable licensure and reimbursement laws, regulations, and related requirements
shall be employees or contractors of WCH (“WCH Personnel”) and not Manager, and shall be subject to WCH’s personnel
policies. All wages, benefits and other payroll expenses related to WCH Personnel shall be included as part of Hospital Expenses.
For the avoidance of doubt, the term WCH Personnel does not include any Senior Executives or any personnel of Manager, unless WCH
first approves their addition at Hospital Expense.  

(d)Manager
shall administer and oversee the enforcement of personnel policies established in accordance with WCH’s contractual obligations,
employment policies and the Strategic Plan and Budget in connection with hiring, managing, and discharging WCH Personnel. 

(e)Subject
to the terms of any applicable labor agreements binding  WCH or the WCH Facilities, including, without limitation, any collective
bargaining agreements, Manager, as the  

4

authorized agent of WCH, shall (i) determine
the staffing plans on behalf of WCH with respect to the number and qualifications of WCH Personnel required for the efficient and
effective operation of WCH Facilities operations, and, (ii) in accordance with the Strategic Plan and Budget, implement wage scales,
employee benefit packages and programs, in-service training programs, staffing schedules, and job descriptions for WCH Personnel,
all in order to accomplish the policies established by WCH.

(f)           Manager
is authorized to provide or arrange for cost effective employer self-insured employee benefits programs either through third parties
or through an affiliate of Manager on behalf of the Hospital at Hospital Expense. Manager is authorized to sponsor such programs
as necessary for their implementation.  

4.3Training.
Manager, in collaboration with WCH, shall assist in educational training programs for WCH Personnel designed to improve inpatient
and case management, clinical documentation, departmental operations and such other matters as Manager may determine to be beneficial
to the efficient operation of the WCH Facilities. 

4.4Contracts.
Manager shall assist the Senior Executives in negotiating and consummating agreements and contracts for and on behalf of the WCH
Facilities in the name of WCH in the usual course of business, all in accordance with the Strategic Plan and Budget. 

4.5Laws
and Accreditations. Manager shall aid in obtaining and maintaining, in WCH’s name, all licenses, permits, approvals and certificates
of accreditation required for the operation of the WCH Facilities. 

4.6Medical
Records. Manager shall administer and oversee systems for the timely, accurate and efficient creation, filing, security, sharing
among care givers and other lawful persons, and retrieval at the WCH Facilities, of all medical records, charts, and files, all
in accordance with applicable law, the requirements of payors, the needs of effective risk management and compliance systems, and
other best practices. 

4.7HIPAA
and Business Associate Agreement. The Parties hereby acknowledge and agree to enter into and comply with the Business Associate
Addendum attached hereto, to evidence their compliance with privacy standards adopted by   the U.S. Department of Health
and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160 and 164, subparts A, D and E, the security standards
adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. Parts 160, 162
and 164, subpart C , and the requirements of Title XIII, Subtitle D of the Health Information Technology for Economic and Clinical
Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009, 42 U.S.C. §§ 17921-17954,
and all its implementing regulations, when and as each is effective and compliance is required, as well as any applicable state
confidentiality laws. 

5

4.8Support
Services. Manager shall administer and oversee customary hospital support services, including, but not limited to, housekeeping,
maintenance (including repair and maintenance of the interior and exterior of the WCH Facilities building, and grounds), janitorial,
security and food services. 

4.9Information
Technology Systems and Records. Manager shall administer and oversee the maintenance and operation of accounting, auditing, budgeting,
reimbursement, revenue cycle, payor reporting and reconciliation, electronic health record, computerized physician order entry,
and other clinical service records and other information technology systems required for the efficient management of the WCH Facilities’
affairs and compliance with payor program requirements and/or contracts. Manager shall administer and oversee the preparation and
maintenance of all books and records regarding operations and financial transactions pertaining to the WCH Facilities and shall
ensure copies of such books and records are made available to the Governing Body or its designee upon request.  

4.10Establishment
of Operational Policies. Manager shall develop and implement WCH policies, procedures, and standards of operation, maintenance,
pricing, and other matters affecting the WCH Facilities and the operation thereof, consistent with the Strategic Plan and Budget. 

4.11Acquisition
of Property. Manager shall be responsible for the oversight of acquisition of all personal property, equipment, supplies, and inventory
as may be necessary to operate the WCH Facilities in accordance with (i) this Agreement, (ii) the Strategic Plan and Budget, (iii)
applicable laws, rules, and regulations, and (iv) applicable standards and guidelines on accreditation promulgated by the Joint
Commission or any other applicable accreditation organization. Manager shall have the right to utilize such personal property,
equipment, supplies, and inventory at the WCH Facilities as Manager reasonably deems necessary and appropriate to fulfill its obligations
hereunder. 

4.12WCH
Missions. Manager shall assist WCH in: 

(a)Managing
the linkage between the clinical programs and student and resident academic training programs; and 

(b)Enhancing
the WCH Facilities’ community service mission and engagement in community activities that educate, inspire, and improve the
quality of life and overall health outcomes of the patient populations served by WCH. 

4.13Public
Relations. Manager shall implement such advertising, marketing and other activities as may be conducive to the efficient operation
of the WCH Facilities, subject to the prior approval of the Management Committee for all new materials. Subject to the foregoing,
from time to time, Manager shall engage in reasonable and lawful marketing and public relations activities designed to enhance
the WCH Facilities’ image and reputation and to secure and maintain patients at the WCH Facilities. 

4.14Liability
Insurance. Manager shall obtain and/or maintain in effect, on WCH’s behalf and at WCH’s sole expense, throughout the
term of this Agreement, such policies (or programs) of property/casualty coverage, public liability, professional liability and
hazard insurance and other customary insurance coverage's in commercially reasonable amounts for and on behalf of the WCH Facilities
as are designated  

6

by WCH and consistent with the Strategic Plan and
Budget or, in the absence of such a specification, as Manager considers reasonable and prudent based on criteria generally used
by Manager with respect to the hospitals owned or managed by Manager. WCH, Manager and the Senior Executives shall be covered under
all such applicable policies (or programs). Additionally, Manager and the Senior Executives shall be named as additional insured's
under WCH’s Directors’ and Officers’ liability, Errors and Omissions liability, professional liability and other
insurance policies and the Senior Executives shall be insured under any such policies to the same extent as WCH’s other officers
and directors.

4.15Indigent
Care. Manager shall assure access to medical care for indigent persons at the WCH Facilities in accordance with WCH’s mission,
the Strategic Plan and Budget and applicable law. Manager and WCH shall ensure that charity care at WCH Facilities is provided
in a manner consistent with WCH’s policies in effect from time to time. Manager shall implement and administer on behalf
of WCH appropriate agreements with governmental authorities concerning reimbursement for services provided to indigent and uninsured
persons. 

4.16Charges. 

(a)Manager
shall oversee the billing for services rendered by the WCH Facilities and the collection of all accounts due to the WCH Facilities
in accordance with lawful Charge-master and collection policies developed by WCH pursuant to the Strategic Plan and Budget and
each applicable third-party payor program or contract. WCH shall approve the Charge-master. Manager shall update WCH on all changes
to the Charge-master as they may occur in the normal course of business. Manager shall be entitled to obtain, on behalf of, and
at the expense of, WCH, the assistance of one or more collection agencies who shall be required to act in accordance with law and
generally recognized practices for hospitals (such as the AHA Guidelines.)  

(b)WCH
shall maintain bank accounts (“WCH Accounts”) necessary for operations of the WCH Facilities and Manager shall cause
to be deposited therein all receipts and money arising from operations of the WCH Facilities. It is anticipated that the Senior
Executives appointed as Chief Executive Officer and designated Chief Financial Officer or designee of WCH, and such other individuals
as are approved by the Governing Body from time to time, shall have the right to authorize disbursements from WCH Accounts on behalf
of WCH in such amounts and at such times as the same are required, as addressed further below. 

4.17Payment
of Expenses. Provided WCH has sufficient funds, Manager shall timely and accurately pay on behalf of WCH, from funds generated
by the WCH Facilities in the WCH Accounts, where and as due, and without delinquency or default, all proper debts, liabilities,
costs, and expenses (“Expenses”) related to the ownership, management and operation of the WCH Facilities, including
any taxes  and all  bills for goods delivered or services rendered to the WCH Facilities and all personal property, supplies,
inventory and all other items necessary for operation of the WCH Facilities and to provide the Management Services described herein.
Manager shall contest by appropriate and legal means, (but may not bring any lawsuit without complying with such guidelines and
policies as are established from time to time by the Governing  

7

Body or the Management Committee) on behalf of WCH,
any claims for payment asserted with respect to the WCH Facilities that Manager, in good faith, considers erroneous or improper.

4.18Agency.
Within the scope of functions delegated to Manager hereunder and subject to other conditions set forth herein, Manager shall have
the right to act and shall assist WCH as the agent and attorney-in-fact of WCH in the procuring of licenses, permits and other
approvals, the payment and collection of accounts, and in all other activities necessary, appropriate, or useful to Manager in
the carrying out of its duties. In performing such services, Manager shall comply with all applicable laws, regulations and requirements
of governmental bodies. 

4.19Elective
Corporate-Based Consulting Services. If requested by WCH and agreed by Manager, Manager or its designees may provide as added elective
consulting services (not included with Management Fees but paid instead under mutually agreed separate written agreements), corporate-based
consulting services that are outside of the scope of the Management Services provided under this Agreement (“Consulting Services”).
Manager will provide any such Consulting Services at market rates or such rates as may be mutually agreed to by the Parties, which
rates shall be determined at the time such Consulting Services are requested. 

4.20Compliance
with Law and Professional Standards. In performing its services hereunder, and in all conduct related to this Agreement, Manager
will comply with all applicable laws and with generally recognized professional standards for similar services within the hospital
management industry. 

5.Reports
to WCH. For the purpose of keeping informed with respect to the operation of the WCH Facilities and Manager’s performance
hereunder, Manager shall arrange for the preparation and delivery to the Governing Body or its designee the following: 

5.1Financial
Statements. 

(a)Submit
to the Governing Body quarterly unaudited financial statements of the WCH Facilities, containing a balance sheet and a statement
of income, prepared in reasonable detail and in accordance with generally accepted accounting principles; and 

(b)Annually,
within one hundred twenty (120) days after the end of each fiscal year of the WCH Facilities, audited financial statements of the
WCH Facilities (“Audited Financial Statements”), including a balance sheet, statement of income, and statement of changes
in financial position, prepared in reasonable detail and in accordance with generally accepted accounting principles and accompanied
by a report of the independent auditor of the WCH Facilities (selected by the Governing Body). The timing of audit submissions
assumes WCH has paid audit fees in a timely manner.  

5.2Strategic
Plan and Budget. An annual updated Strategic Plan and Budget, to be delivered at least thirty (30) days prior to the beginning
of each WCH Fiscal Year during the Term of this Agreement. 

5.3Reports.
All reports deliverable hereunder shall be generated by Manager using the then-existing systems of WCH and delivery of such reports
is conditioned upon the capability, availability, cooperation  

8

and access to, such WCH systems and personnel for
Manager. Manager shall hold annual meetings with the Governing Body or its designee specified in writing to discuss the reports
required by this Agreement.

6.Access
to Reports and Communications. Each Party agrees to provide the other, promptly when received, with access to all material
reports, other filings, and communications from governmental authorities or agencies having jurisdiction over the WCH Facilities. 

7.Medical
Staff, Quality of Care. 

7.1Cooperation
with Medical Staff. Manager shall reasonably cooperate and maintain liaisons with the medical staff of the WCH Facilities (collectively,
the “Medical Staff”) and shall advise and assist the Medical Staff concerning procedural matters and standards and
guidelines on accreditation promulgated by The Joint Commission or any other applicable accreditation organization. However, all
medical, ethical, and professional matters, including control of and questions relating to the composition, qualifications, and
responsibilities of the Medical Staff, shall be the responsibility of the Governing Body, the Credentialing Committee, and the
Medical Staff of the WCH Facilities. 

7.2Quality
Assurance Program. Manager shall review and make recommendations regarding WCH’s existing Quality Assurance Program and QIIP
and shall assist WCH with the implementation and administration of its Quality Assurance Program in accordance with applicable
law. 

7.3Medical
Affairs Committee. In order to provide a forum for communication among representatives of the Medical Staff and to ensure compliance
with WCH’s Quality Assurance Program, Manager shall assist WCH in the implementation and administration of a Medical Affairs
Committee that shall consist of a designated senior officer of WCH, physicians appointed by the Medical Staff, persons designated
by the Governing Body or its designee, and one additional person designated by Manager. The Medical Affairs Committee, if and when
implemented, would meet quarterly, or as needed, keep minutes of its meetings, and have the following suggested duties: 

(a)to
ensure that acceptable medical, ethical, and professional standards are attained within the WCH Facilities; 

(b)to
assist in implementation of the Quality Assurance Program so that the quality of health care provided at the WCH Facilities may
be measured objectively; 

(c)to
ensure that all patients admitted to the WCH Facilities or treated as outpatients receive quality patient care; 

(d)to
provide a forum for discussion of problems of a medical- administrative nature; 

(e)to
assist the Governing Body and Manager in ensuring compliance with federal, state, and local requirements; and 

(f)to
act in an advisory capacity in the implementation of quality of care policies adopted by the Governing Body or the Medical Staff. 

9

8.Laws;
Licenses; Reimbursement Programs; Accreditation. 

8.1Compliance
with Law. In performing services hereunder and in all other actions related to this Agreement, Manager and all personnel of Manager
shall comply with applicable federal, state, and local laws, rules, and regulations relating to the WCH Facilities or Manager’s
Management Services, including without limitation all agencies having jurisdiction over health care services, billing, labor/employment,
taxation, environmental compliance, antitrust, or physical facility compliance. Manager shall assist WCH to operate the WCH Facilities
so that it maintains all necessary licenses, permits, consents, and approvals from all governmental agencies that have jurisdiction
over the operation of the WCH Facilities. Manager shall not be obligated to WCH for failure of the WCH Facilities to comply with
any such laws, rules, and regulations or for failure of the WCH Facilities to maintain any such licenses, permits, consents, and
approvals, to the extent that the failure is due to financial limitations of the WCH Facilities or to the design or construction
of the WCH Facilities, or is attributable to acts, errors or omissions of WCH or its agents (other than Manager or Manager’s
employees or contractors). 

8.2Compliance
for Charges for Services. Manager shall oversee compliance with all laws, regulations and payer contract or program requirements
concerning coding, billing, charging, collecting and reporting on fees received for services of or provided in the WCH Facilities. 

8.3Accreditation.
Manager shall use its commercially reasonable efforts to manage the WCH Facilities in the manner necessary to maintain accreditation
by The Joint Commission or any other similar applicable accreditation organization. 

8.4No
Violation. Neither WCH nor Manager shall knowingly cause or permit any action that shall (i) cause any governmental authority having
jurisdiction over the operation of the WCH Facilities to institute any proceeding for the rescission, suspension, or revocation
of any license, permit, consent, or approval; (ii) cause the Joint Commission or any other similar applicable accreditation organization
to institute any proceeding or action to revoke its accreditation of the WCH Facilities; (iii) cause a termination of, or adversely
affect, WCH’s participation in Medicare, Medicaid, Blue Cross, or any other public or private medical payment program; or
(iv) cause WCH to violate or default under any of its legal obligations under debt financings. WCH, and not Manager, shall bear
sole responsibility for non-compliance with this section if non-compliance was due to insufficient funds or acts, errors or omissions
by WCH Personnel.  

9.Limitations
on Manager’s Exercise of Duties. 

9.1Limitations
on Manager’s Exercise of Duties. 

(a)Except
as contemplated by the Strategic Plan and Budget or as the Governing Body or its designee may specifically authorize in writing
from time to time, Manager shall not have the authority to undertake the following, on WCH’s behalf, without the advance
written consent of the Governing Body (or its designee authorized in writing): 

10

(1)Purchase
capital assets or incur expenses (other than consistent with the Strategic Plan and Budget) in excess of $50,000 or such higher
amount as may be authorized by WCH. 

(2)Incur
debt on behalf of WCH; 

(3)Encumber
WCH property, or sell or dispose of any material assets having a value in excess of $25,000; 

(4)Approve
or undertake any other matters required by law to be approved by WCH’s Governing Body; 

(5)File
or settle litigation; 

(6)Grant
any person any rights with respect to ownership of, or limiting the activities of, the WCH Facilities; or 

(b)Except
as set forth in the Strategic Plan and Budget, WCH shall have the ultimate authority to decide, in its sole and absolute discretion,
whether to approve, disapprove or undertake any of the above listed items.  However, WCH agrees to consult and cooperate with
Manager in good faith concerning any decisions related to the above listed items. The following list includes general items that
require Board approval: 

1.Adopting
or amending employee equity and benefit plans 

2.Hiring
or firing senior officers or key employees 

3.Entering
into employment agreements, or amending the terms of employment, for senior officers 

4.Borrowing
or lending money 

5.Adopting
an annual budget 

6.Entering
into agreements of material importance to the corporation (e.g., financing agreements, material license agreements and leases) 

7.Any
expenses of greater than $50,000.00 (Fifty Thousand Dollars) 

10.Defense
of Claims; Exculpation. 

10.1WCH. 

(a)WCH
agrees to indemnify, defend and hold harmless Manager, including its “advisors” (selected by Manager and accepted by
WCH), affiliates, subsidiaries, successors and assigns, and any employee, agent, officer, director, shareholders, manager, representative,
attorney, or independent contractors, including but not limited to Senior Executives and their employer and  

11

its affiliates (together, the “SE Employer”),
and direct or indirect equity holder of Manager, and any person who controls Manager (any or all of the foregoing hereinafter a
“Manager Indemnified Person”), from and against any losses, damages, liabilities, deficiencies, claims, actions, suits,
proceedings, judgments, settlements, interest, awards, penalties, fines, costs, or expenses (including reasonable attorneys’
fees and costs of defense), joint or several, of any kind or nature whatsoever (collectively, “Claims”) that may be
incurred by or asserted against Manager or a Manager Indemnified Person (whether or not Manager or a Manager Indemnified Person
is party to such Claims) to the extent they result from, arise out of, or are in any way related to, the following, in each case
as finally determined by an arbitrator:

(1)the
breach or non-fulfillment or violation by WCH or any of its Representatives of any of the covenants, duties, obligations, representations
or warranties of WCH set forth in this Agreement; 

(2)any
actions or omissions of WCH or its affiliates, subsidiaries, successors, assigns, employees, agents, officers, directors, managers,
advisors, representatives, attorneys, independent contractors (respectively, “Representatives,” but for the avoidance
of doubt specifically excluding Manager, SE Employer and Manager Indemnified Persons), including without limitation actions or
omissions arising out of the negligence, gross negligence, recklessness, or willful misconduct of WCH or its Representatives  related
to this Agreement; 

(3)any
failure by WCH or any of its Representatives to comply with any applicable federal, state or local laws, regulations or codes in
the performance of its obligations under this Agreement; 

(4)Manager’s
or any Manager Indemnified Person’s involvement in, in any manner including without limitation the management of, oversight
of or operation of, the WCH Facilities or any other errors, actions or omissions of Manager or any Manager Indemnified Person; 

(5)any
claim which is brought or asserted by third parties against Manager or any Manager Indemnified Person relating to this Agreement
or WCH’s ownership or operation of the WCH Facilities, including without limitation the use of any real or tangible property
in connection with the WCH Facilities; or 

(6)any
bodily injury, death of any person or damage to real or tangible property caused by the acts or omissions of WCH or any of its
Representatives. 

(b)Furthermore,
WCH agrees to reimburse Manager, as incurred and upon demand by Manager, for legal or other expenses reasonably incurred by Manager
or a Manager Indemnified Person in connection with investigating, defending or preparing to defend any such Claims (including without
limitation in connection with the enforcement of the indemnification obligations set forth herein), whether or not Manager or any
Manager Indemnified Person is a  

12

party to any Claims out of which any such expenses
arise and whether or not such Claims are brought by WCH, its Representatives or any other person or entity.

(c)However,
WCH shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent such Claims resulted
in whole or in part from the gross negligence, willful misconduct or fraud of Manager or a Manager Indemnified Person; (b) by one
Manager Indemnified Person against another relating to activities of such parties pursuant to the Agreement; or (c) arising from
(i) felony criminal activity that any Senior Executive or Manager Indemnified Person directly participated in or (ii) other acts
indemnifiable by Manager, in each such case (other than with respect to felony criminal acts), as finally determined by an arbitrator. 

(d)The
reimbursement and indemnity obligations of WCH under this Agreement shall be in addition to any liability WCH may otherwise have;
shall extend upon the same terms and conditions to the Manager Indemnified Persons, and shall be binding upon and inure to the
benefit of any successors, assigns, heirs, and personal representatives of WCH, or of Manager or any Manager Indemnified Persons. 

10.2Manager.
Manager shall indemnify, defend, and hold harmless WCH including its affiliates, subcontractors, successors and assigns and any
employee, agent, officer, director, manager, representative, attorney or independent contractor (“WCH Indemnified Persons”)
against any Claims (including reasonable attorneys’ fees and costs of defense) to the extent that they result from the felony
criminal acts that Manager Indemnified Persons directly participated in, willful misconduct, gross negligence or fraud of Manager,
in each such case (other than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction
(not subject to further appeal)), as finally determined by an arbitrator. A Manager Indemnified Person shall not be liable for
any act or omission of any other Manager Indemnified Person other than its own officers, directors, employees and subcontractors.
In addition, Manager shall not be obligated under the foregoing indemnity agreement in respect to any Claims (a) to the extent
such Claims resulted in whole or in part   from the gross negligence, willful misconduct or fraud of WCH or a WCH Indemnified
Person (b) by one WCH Indemnified Person against another relating to activities of such  parties pursuant to the Agreement;
or (c) arising from (i) felony criminal activity that  any WCH Indemnified Person directly participated in or (ii) other acts
indemnifiable by WCH, in each such case (other than with respect to felony criminal acts) as finally determined by an arbitrator.
The Manager Indemnified Persons shall not be liable for any act, error, omission or delay taken at the specific direction or with
the express approval of the Governing Body to take action or the failure of the Governing Body to take action.  

10.3Procedure. 

(a)In
the event that any Party hereunder shall receive any notice of any claim or proceeding against said Party in respect to which indemnity
may be sought under this Agreement, the said Party (“Indemnitee”) shall give the Party upon whom   a claim
could be made under this Agreement (“Indemnitor”) written notice of such loss, liability, claim, damage, or expense
and the Indemnitor shall have the right to contest and defend any action brought against the Indemnitee  

13

based thereon, and shall have the right to contest
and defend any such action in the name of the Indemnitee at the Indemnitor’s own expense; provided, however, that if the
Indemnitor shall fail to assume the defense and notify the Indemnitee of the assumption of the defense of any such action within
ten (10) days of the giving of such notice by the Indemnitee, then the Indemnitee shall have the right to take any such action
as it reasonably deems appropriate to defend, contest, settle, or compromise any such action or assessment and claim indemnification
as provided herein; provided, however, that no Party shall settle any such action without the consent of the other applicable Party
(which consent shall not be unreasonably withheld) unless such settlement involves only the payment of money and the claimant provides
the Indemnitee a release from all liability in respect of such claim. If the Indemnitor defends any action for which indemnification
is claimed, the Indemnitee shall be entitled to participate at its own expense in the defense of such action; and further, provided,
however, that the Indemnitor shall bear the fees  and expense of the Indemnitee’s counsel only if (i) the engagement
of such counsel is specifically authorized in writing by the Indemnitor, (ii) the Indemnitor is not adequately prosecuting the
defense in good faith, or (iii) the named parties to such action include both the Indemnitor and the Indemnitee and there exists
a conflict or divergence of interest between such parties which renders it inappropriate for counsel selected by the Indemnitor
to represent both of  such parties. The Indemnitor shall not be liable for any settlement of any claim, action, or proceeding
effected without its written consent. No Party shall recover an amount in excess of the actual damages incurred.

(b)Notice
of all claims as required by this Agreement shall be promptly provided as to (i) the nature of any claim; or (ii) the commencement
of any suitor proceeding brought to enforce any claim. In the event of failure to provide such notice or in the event that Indemnitee
shall fail to cooperate fully with the Indemnitor in the Indemnitor’s defense of any suit or proceeding, the Indemnitor shall
be released from some or all of its obligations with respect to that suit or proceeding to the extent that the failure of notice
or cooperation actually and materially adversely affected the Indemnitor’s defense of such claims. 

10.4Indemnification
of Senior Executives. In addition to, and without limiting the indemnification described above, WCH shall indemnify the Senior
Executives who will be acting as officers of WCH to the same extent and subject to the same conditions as the most favorable indemnification
it extends to its officers or directors, whether under WCH's charter, bylaws, by contract or otherwise. 

10.5Exculpation
of Senior Executives and SE Employer. Though the Senior Executives may continue to be employed by and associated with the Manager
or SE Employer and its affiliates while providing services described hereunder, with respect to WCH and WCH, the Senior Executives
shall serve at the pleasure and direction of the Manager and/or Governing Body and neither the SE Employer, any Senior Executive
nor any of their respective affiliates shall have any liability to WCH or WCH for any acts or omissions of the Senior Executives,
notwithstanding that SE Employer may receive compensation from Manager for making the Senior Executives available to serve in such
capacity (and WCH and WCH expressly waive and agree not to assert any claim of respondent superior or similar legal theory which
might otherwise hold SE Employer or its affiliates liable for the acts or omissions  of the Senior Executives), except to
the extent  

14

that any such Claims result primarily and directly
from such Senior Executive’s felony criminal acts, willful misconduct, gross negligence or fraud in each such case (other
than with respect to felony criminal acts which shall require final judgment by a court of competent jurisdiction (not subject
to further appeal)), as finally determined by an arbitrator.

11.Access
to Records. 

11.1Access
to Records. 

(a)Manager
shall provide to the Governing Body, WCH’s auditors and accountants, WCH’s fiscal intermediaries, and accountants and
agents for the Medicare and Medicaid programs or any other governmental authority exercising legal and appropriate authority, access
to all lawfully required records for a period of seven (7) years after the furnishing of services under this Agreement. 

(b)Until
the expiration of four (4) years after the furnishing of Management Services pursuant to this Agreement, the Parties shall, upon
written request, make available to the Secretary of Health and Human Services (the “Secretary”) or the Comptroller
General, or their duly authorized representative(s), contract, books, documents, and records related to this Agreement and necessary
to verify the nature and extent of the cost of such Management Services. If any Party carries out any of its obligations under
this Agreement by means of a subcontract with a value of $100,000 or more, that Party agrees to include this requirement in any
such subcontract. The availability of books, documents, and records shall be subject at all times to all applicable legal requirements,
including without limitation such criteria and procedures for seeking and obtaining access that may be promulgated by the Secretary
by regulation. Neither Party shall be construed to have waived any applicable attorney-client privilege by virtue of this Section. 

11.2Exercise
of Right of Access. The foregoing rights of access shall be exercisable through a written request, upon which Manager and its subcontractors
shall give access to the above contracts, books, documents, and records from time to time during reasonable business hours. 

12.Management
Fee. 

12.1Management
Fees. In consideration for the Management Services provided by Manager under this Agreement, WCH shall pay Manager as follows (collectively,
the “Management Fees”): 

(a)A
total annual base fee (the “Base Fee”) equal to Twelve Percent (12%) of all collected cash revenues for each fiscal
year of this agreement.  Manager will be paid the Management Fee on a weekly basis for the preceding week’s total cash
and settlements collected from all sources. Manager is authorized to withdraw this fee on a weekly basis and will present an invoice
concurrently, based on the preceding week's collected settlement reports. However, Manager must first ensure Hospital payroll is
met as its’ highest priority before cash is withdrawn to pay Manager’s fees. If funds are insufficient to cover all
or part of Manger’s fees, the balance due will  

15

be deferred as owed but carried as a deferred
expense due Manager. When, in Manager’s best business judgement, sufficient funds become available to pay off all or part
of fees incurred and still owing, Manager will pay down all or part of the balance of fees owed using prudent business judgement
and discretion. In no case shall Manager forgive fees due for management services rendered.

(b)An
incentive or success fee (the “Incentive Fee”) to be negotiated based on the achievement of certain mutually agreed
milestones.  

(c)IT
support and EMR services are not included in the management fee and will be offered to WCH by separate agreement.  

12.2Arm’s
Length Transaction. The Parties have negotiated the Management Fees at arm’s length, assisted by professional financial advisers.
They believe that the management fees are consistent with fair market value and comply with law. 

13.Breach.
In the event of a breach of any obligation or covenant under this Agreement, other than the obligation to pay money (which shall
have a thirty (30) day cure period), the non-breaching Party may give the breaching Party written notice of the specifics of the
breach, and the breaching Party shall have sixty (60) days (the “Cure Period”) in which to cure the breach; provided,
that for any non-monetary defaults reasonably requiring greater than ninety (90) days to cure, the breaching Party shall not be
in default so long as the breaching Party commences to cure such default within the required sixty (60) days and diligently prosecutes
 such cure to completion thereafter. Only if the breach is not cured within said Cure Period shall the non-breaching Party
be entitled to pursue any remedies it may have by reason of the breach.  A waiver of any breach of this Agreement shall not
constitute a waiver of any future breaches of this Agreement, whether of a similar or dissimilar nature. 

14.Term.
The term of this Agreement (“Term”) shall commence and be deemed effective as of the Effective Date, and continue for
an initial ten (10) year period, and shall automatically renew for one (1) additional five (5) year period unless a Party provides
at least one hundred eighty (180) days prior written notice of nonrenewal to the other party. Thereafter, this Agreement may be
renewed upon prior written agreement of the Parties. Any renewal periods shall be deemed a part of the Term.  

In the event of and regardless of a Change
of Control or merger or sale of the Hospital, this Management and Administrative Service Agreement will be assigned and
assumed by the new owner or controlling entity as part of the transaction or event and continue in full force and effect through
the end of the term and renewals.  iHealthcare Inc reserves all rights to this agreement in the event of such an occurrence.  

15.Dispute
Resolution and Remedies. 

15.1Resolution
by Management. The Parties’ respective management teams shall attempt, in good faith, to privately and confidentially resolve
any dispute, controversy or claim arising under this Agreement (a “Dispute”). In the event the Parties are unable to
resolve the Dispute after negotiating in  

16

good faith for thirty (30) days following written
notice of the Dispute served on a Party, either Party may refer such Dispute to WCH and the CEO of Manager for resolution.

15.2Arbitration.
IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD IN MIAMI-DADE COUNTY, FLORIDA BEFORE
A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. (“JAMS”); AND (b) WAIVE ANY RIGHT TO CIVIL
TRIAL BY JUDGE OR JURY.  Notwithstanding the foregoing, all claims alleging violation of this agreement, restrictive covenants,
mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive jurisdiction,
in Miami, Florida, of either the Florida state courts or the US District Court.  Before accepting appointment, the arbitrator
shall agree: (a) that the arbitrator’s award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate  (but it may be extended by written agreement of the parties); (b) to base any decision or award
on governing law; (c) to not award punitive or other damages that are not measured by the prevailing party’s actual damages,
except as may be required by statute; and (d) to issue an award in writing within ten (10) days of concluding the presentation
of evidence and briefs.  Judgment may be entered in any court having jurisdiction thereof.  The prevailing party shall
be entitled to recover from the other party its costs and expenses, including reasonable attorney’s fees.  

15.3LIMITATION
OF LIABILITY.  NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY SPECIAL, CONSEQUENTIAL, INCIDENTAL, PUNITIVE, OR INDIRECT
DAMAGES, NOR THE COST OF PROCURING SUBSTITUTE ITEMS OR SERVICES, ARISING FROM OR RELATING TO ANY BREACH OF THIS AGREEMENT, REGARDLESS
OF ANY NOTICE OF THE POSSIBILITY OF SUCH DAMAGES.  IN NO EVENT WILL MANAGER BE LIABLE TO CLIENT FOR SPECIAL OR CONSEQUENTIAL
DAMAGES ARISING FROM THE PROVISIONS AND THE PERFORMANCE OF SERVICES BY MANAGER UNDER THIS AGREEMENT, EVEN IF MANAGER HAS BEEN ADVISED
OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE TOTAL LIABILITY OF MANAGER UNDER THIS AGREEMENT, FOR ANY AND ALL CAUSES, WILL
BE LIMITED, AND MANAGER’S TOTAL LIABILITY WILL NEVER EXCEED THE SUM OF TWENTY PERCENT [20%] OF ONE (1) MONTH AVERAGE MANAGEMENT
FEES.  

EXCEPT AS PROVIDED HEREIN, MANAGER DISCLAIMS ALL REPRESENTATIONS
AND WARRANTIES OF ANY KIND OR NATURE, EXPRESS OR IMPLIED [EITHER IN FACT OR BY OPERATION OF LAW], WITH RESPECT TO ANY ITEM OR SERVICE
PROVIDED HEREUNDER, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY, TITLE, NON-INFRIGEMENT, OR FITNESS FOR A PARTICULAR
PURPOSE OR ANY WARRANTY ARISING FROM CONDUCT, COURSE OF DEALING, CUSTOM, OR USAGE IN TRADE. No claim against MANAGER of any kind
under any circumstances will be filed more than one year after WCH knows of, or in the exercise of reasonable care, could know
of, such claim or an act or omission of MANAGER that would give rise to such a claim.

15.4Remedies.
The arbitrator may grant as remedies in connection with an outstanding Dispute: (a) a required Corrective Action Plan for Manager’s
performance of the Management Services, (b) specific performance of this Agreement, (c) full payment by WCH to Manager in accordance
with the terms hereof, (d) a modification to the Performance Targets; (e) monetary indemnification in accordance with the terms
hereof, and/or (g) any other lawful and appropriate remedy, including termination of this Agreement. 

17

15.5Exclusive
Process. Except as otherwise set forth herein, the procedure set forth in this Section 15 shall be the Parties’ exclusive
process for resolution of all Disputes. 

16.Termination.
This Agreement may be terminated prior to the expiration of the Term only as follows, and any such termination shall not affect
any rights or obligations arising prior to the effective date of termination: 

16.1Termination
for Material Breach. 

(a)Notwithstanding
any provision contained herein, however, Manager shall not be liable to WCH and shall not be deemed to be in breach of this Agreement
for  the failure to perform any or all obligations to be performed by Manager pursuant to this Agreement, to the extent such
failure results from (i) governmental intervention, (ii) labor dispute, (iii) law, regulations, rules or reimbursement rules or
policies that actually prevent such performance, (iv) any other action or force majeure or event which is beyond the reasonable
control of Manager, or (v) any failure by WCH to perform, fund or meet any of WCH’s obligations hereunder; and provided that
Manager shall nevertheless be obligated duly to perform hereunder to the extent such performance remains feasible. 

16.2Bankruptcy
Insolvency. Manager shall be entitled to file a UCC for unpaid Management Fees. Manager may terminate this Agreement upon ten (10)
days written notice to WCH in the event WCH (or WCH’s sponsoring entity)  becomes insolvent or fails to pay, or admits
in writing its inability to pay, its debts as they  mature; or a trustee, receiver or other custodian is appointed for such
other party for all or a substantial part of such person’s property and is not discharged within sixty (60) days of appointment;
 or any bankruptcy reorganization, debt, arrangement, or other proceeding under  any bankruptcy or insolvency law or
any dissolution or liquidation proceeding is instituted by or against such person and if instituted against such person’s
is consented to or acquiesced in by such person or remains un-dismissed for sixty (60) days following the original filing; or any
warrant or attachment is issued against any substantial portion of the property of such person which is not released within sixty
(60) days of service; and WCH may likewise terminate if   any of the foregoing occurs with regard to Manager or iHealthcare
Management II Company and this substantially impairs Manager’s ability to perform its obligations under this Agreement. 

17.Effects
of Termination. The termination of this Agreement for any reason shall be without prejudice to any payments or obligations
which may have been earned and accrued or become due to any Party hereunder prior to the date of termination. Notwithstanding anything
to the contrary herein, the following provisions shall survive any termination hereof: Sections 10 (Defense of Claims), 11 (Access
to Records), 12 (Management Fee), 15 (Disputes), 19 (Representation and Warranties) and 21 (Miscellaneous). In the event this Agreement
is terminated for any reason, WCH shall pay to Manager all unpaid fees then due.  

18.Transition
Services. In the event of termination of this Agreement prior to expiration for any reason other than insolvency or bankruptcy
of WCH, upon request of WCH, Manager shall be obligated to continue to provide WCH with the Management Services described herein
for a period of up to one  

18

hundred twenty (120) days after such termination or
expiration of this Agreement (the “Transition Period”), and during such Transition Period: (a) Provided  WCH shall
continue to compensate Manager in accordance with this Agreement, (b) Manager shall fully cooperate in order to ensure the orderly
and efficient transfer of its functions hereunder to WCH and/or another service provider; (c) Manager shall fully cooperate in
order to ensure no disruption to patient care functions; and (d) the Parties shall cooperate in order to resolve any outstanding
operational, financial, legal or other matters arising (including audits) from the period in which this Agreement was in effect.

19.Representations
and Warranties. 

19.1Manager.
As of the Effective Date, Manager represents and warrants to WCH as follows: 

(a)Manager
is a Florida company duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)Manager
has full authority to enter into and perform this Agreement, and the signature of Manager’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represents a legal, valid and binding agreement
enforceable against Manager in accordance with its terms (subject only to customary limitations on the enforceability and availability
of remedies in accordance with principles of law and equity). 

(c)The
execution, delivery and performance of this Agreement by Manager does not (i) require any consent, waiver, approval, license or
authorization of any person or public authority which has not been obtained and is not presently in effect; (ii) to the knowledge
of Manager, violate any provision of law applicable to Manager; or (iii) conflict with or result in a default under, or create
any lien upon any of the property or assets of Manager under, any agreement or instrument; or (iv) violate any judicial or administrative
decree, contract, or other legal obligation to which Manager is subject or by which any of its assets are bound. 

(e)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to Manager’s
knowledge threatened against Manager that may materially delay or interfere with its entering into and fully and duly performing
this Agreement. 

(f)Neither
Manager nor, to the knowledge of Manager, any Manager personnel (including any Senior Executive) is a person excluded or barred
from the Medicare or Medicaid programs. 

19.2WCH.
As of the Effective Date, WCH represents and warrants to Manager as follows: 

(a)WCH
is a for-profit corporation duly organized, validly existing, and in good standing under the laws of the State of Florida. 

(b)WCH
has full authority to enter into and perform this Agreement, and the signature of WCH’s representative at the end hereof
signifies that this Agreement has been duly authorized, executed and delivered and represses a legal, valid and binding agreement
enforceable against  

19

WCH in accordance with its terms (subject only
to customary limitations on the enforceability and availability of remedies in accordance with principles of law and equity).

(c)The
execution, delivery and performance of this Agreement by WCH does not (i) require any consent, waiver, approval, license or authorization
of any person or public authority which has not been obtained and is not presently in effect; (ii) violate any provision of law
applicable to WCH; or (iii) conflict with or result in a default under, or create any lien upon any of the property or assets of
WCH under, any agreement or instrument; or (iv) violate any judicial or administrative decree, contract, or other legal obligation
to which WCH is subject or by which any of its assets are bound. 

(d)There
is no civil, criminal or administrative action, suit, demand, claim, hearing, proceeding or investigation pending or, to WCH’s
knowledge threatened against WCH that may materially delay or interfere with its entering into and fully and duly performing this
Agreement. 

20.Miscellaneous. 

20.1Non-Solicitation.
During the Term hereof and for a period of two  (2)  years after its expiration or termination for any reason WCH, on
behalf of itself and its subsidiaries and affiliates and any person which may acquire all or substantially all of its assets agrees
that, until two (2) years subsequent to the termination of this Agreement, it will not solicit, recruit, hire or otherwise engage
any Senior Executive or other employee of the Manager or SE Employer that provided services to WCH or Manager relating to WCH while
employed by SE Employer or its affiliates (“SE Employer Solicited Person”).  

20.2Public
Statements. Manager shall be authorized to make public statements about WCH, services provided and its relationship hereunder. 

20.3Use
of WCH Name. Manager may use the WCH or WCH Hospital names in a manner reasonably necessary or conducive to performing its services
hereunder.  

20.4Reimbursable
Expenses. During the Term, Manager shall be promptly reimbursed for all reasonable expenses (to the extent of and pursuant to WCH’s
expense reimbursement policy for other personnel and contractors) incurred by Manager or third parties Manager contracts with in
connection with the provision of the Management Services hereunder (e.g., Senior Executives), including, but not limited to transportation,
lodging, meals, travel and office expenses upon submission to WCH of invoices. Any such expenses, subject to this section, shall
require prior approval by WCH to be eligible for reimbursement. 

20.5Notices.
All notices, requests, demands and other communications  required or permitted to be given pursuant to this Agreement must
be in writing and shall be (i) delivered to the appropriate address by hand, by nationally recognized overnight service (costs
prepaid); (ii) sent by facsimile or email, or (iii) sent by registered or certified mail, return receipt requested, in each case
to the following addresses, facsimile numbers or email addresses and marked to the attention of the person (by name or title)  

20

designated below (or to such other address, facsimile
number, email address or person as a Party may designate by notice delivered to the other Party in accordance with this Section:

Manager:Vice
President of Operations  

iHealthcare Management II Company

                            3901
SW 28th Street 2nd Floor

                            Miami,
FL, 33142

 

WCH:
             Washington
County Hospital

                            958
US Highway 64 East

                            Plymouth,
NC 27962

 

All notices, requests, demands and other communications
shall be deemed have been duly given (as applicable): (A) if delivered by hand, when delivered by hand; (B) if delivered by UPS,
Federal Express, DHL or other nationally-recognized overnight delivery service, when delivered by such service; (C) if sent via
registered or certified mail, three (3) Business Days after being deposited in the mail, postage prepaid; or (D) if delivered by
email or facsimile, when transmitted if transmitted with confirmed delivery.

20.6Severability.
If any clause or provision of this Agreement  is  determined by a governmental body or a court having jurisdiction thereof
to be illegal, invalid, or unenforceable under any present or future law, then the Parties agree that the remaining provisions
of this Agreement that reasonably can be given effect apart from the illegal or unenforceable provision shall continue in effect
and there shall be substituted for such invalid or unenforceable provision a provision as similar as is feasible and yet would
be lawful. 

20.7Expenses.
Except as otherwise expressly provided herein, each Party will bear its own legal, accounting, and other fees and expenses relating
to the negotiation and preparation of this Agreement and the transactions contemplated hereby. 

20.8Public
Announcements. The time and content of any announcements, press releases, or other public statements concerning this Agreement
and the transactions described herein will be determined by a process agreed to by the Parties. 

20.9Waiver.
No failure on the part of any party hereto to exercise, and no delay in exercising, any right, power or remedy hereunder shall
operate as a waiver thereof, nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other
or further exercise thereof or the exercise of any other rights, power or remedy. 

20.10Captions.
The captions or titles of the sections herein have been included for convenience only and shall not be considered as part of this
Agreement. 

20.11Counterparts.
This Agreement may be signed in counterparts, each of which shall be deemed an original. Delivery of an executed counterpart of
a signature page to this Agreement by facsimile or in  

21

electronic (“pdf” or “tiff”)
format shall be effective as delivery of a manually executed counterpart of this Agreement.

20.12Force
Majeure. Manager shall not be deemed to be in violation hereunder for failure to perform any obligation contained in this Agreement
or for any incomplete performance hereunder for the time of and to the extent that such failure or incomplete performance is occasioned
by any cause or causes beyond the control of Manager, including, but not limited to, delays or failure in performance or non-performance
or interruption of services resulting directly or indirectly from acts of God, Acts of War (including Terrorist activities), civil
disorders, vandalism, fires, floods, weather, electrical failures, postal delays, inability to procure materials, sabotage, restrictive
governmental laws or regulations, labor actions or shortages, criminal activity of third parties,  loss of internet connectivity
or incomplete or inaccurate data input as supplied by WCH.    

20.13Consents.
Whenever under this Agreement provision is made for either Party’s securing the consent or approval of the other, such consent
or approval shall be in writing and (except as otherwise provided herein) shall not be unreasonably withheld, delayed, or conditioned. 

20.14Binding
Effect; Assignment. This Agreement is binding on, and is for the benefit of WCH and Manager and their successors, assigns, and
legal representatives (and Manager; iHealthcare Management II Company). A Party shall not assign its rights or delegate its obligations
under this Agreement without the prior,  written consent of the other Party; provided, that, Manager may (upon written notice
to WCH) assign this Agreement to an affiliate of Manager, and/or to subcontract with any other parties for the performance of various
aspects of its obligations hereunder, provided  that Manager shall (a) adequately inform such subcontractors of their obligations
hereunder, (b) ensure that they fully comply herewith, and (c) remain fully responsible for the performance of any such assignee
and/or subcontractor. 

20.15Governing
Law. This Agreement shall be governed and construed according to the laws of the State of Florida, without giving effect to any
choice or conflict of law provision or rule thereof. 

20.16Further
Assurance. Each Party agrees to execute and deliver to the other such additional instruments, certificates, and documents as the
requesting Party may reasonably request in order to assist the requesting Party in obtaining the rights and benefits to which such
Party is entitled hereunder. 

20.17Third
Party Beneficiaries. The Manager Indemnified Persons, WCH Indemnified Persons, the Senior Executives and SE Employer are express
third party beneficiaries of the provisions of this Agreement that relate to them. 

20.18    Entire Agreement. This Agreement
(including exhibits and schedules) contain the entire agreement of the Parties with respect to the matters set forth herein and
supersede all prior negotiations and agreements, whether oral or written, concerning the subject matter hereof, all of which are
merged in this Agreement.

20.19   Amendment and First Right of Refusal.
This Agreement sets forth the entire understanding and agreement among the parties hereto with reference to the subject matter
hereof and may not be

22

modified,
amended, discharged or terminated except by a written instrument signed by the parties hereto. First
Right of Refusal:  Landlord/Owner hereby grants to iHealthcare (iHCC) a first right
of refusal to purchase the hospital property and real estate during the term and any extensions of this Management and Administrative
Services Agreement.  If Landlord/Owner shall desire to sell the hospital property and real estate, and receives a bona fide
offer to purchase, Landlord/Owner shall give iHealthcare written notice of Landlord/Owner intention to sell Landlord/Owner interest
in the hospital property and real estate as contained in said offer to purchase. Such notice (Landlord/Owner Notice) shall
state the terms and conditions under which Landlord/Owner intends to sell its interest. For Sixty (60) business days following
the giving of such notice, iHealthcare shall have the option to purchase the Landlord/Owner interest as stated in the Landlord/Owner
Notice.  A written notice in substantially the following form, addressed to Landlord/Owner and signed by iHealthcare, within
the period for exercising the Option, shall be an effective exercise of iHealthcare Option to Purchase.

20.20Manager;
iHealthcare Management II Company. In consideration for the potential benefits to iHealthcare Management II Company, as sole member
or ultimate parent of Manager to be derived from the management fees and other benefits secured by Manager hereunder, iHealthcare
Management II Company hereby agrees fully to ensure that Manager duly and timely fulfills its performance obligations, financial
obligations, indemnification obligations, and other obligations, under this Agreement. WCH retains Manager as the sole and exclusive
executive group and management agent during the term of this Agreement.  

 

                                                                    [Signature
Page Follows] 

 

                                                                               

23

 

IN WITNESS WHEREOF, the Parties have caused
this Agreement to be executed as of January 7, 2019.

 

CAH Acquisition Company 1, LLC D/B/A Washington
County Hospital, AKA Washington County Community Hospital:

By: /s/ Jorge Perez

Name: Jorge Perez    

Title: Chairman, Hospital Governing Body 

 

Manager - iHealthcare Management Company

 

By: /s/ Noel Mijares 

Name: Noel Mijares 

Title:     Chief Executive Officer

24PROMISSORY NOTE

De Queen Healthcare Hospital

 

 

Note: $800,000.00Effective Date: January 7, 2019 

 

For value received, under the Business Development Agreement
[related to the delivery of an executed Management and Administrative Services Agreement for De Queen Healthcare Hospital LLC (DQH)]
that has been duly executed between iHealthcare Management Company and the Managing Partner of DQH, the undersigned iHealthcare
Management Company, a Florida Corporation (the "Borrower"), at 3901 NW 28th Street, 2nd Floor, Miami, Florida 33142,
promises to pay Empower Capital Group, LLLP at the direction of Jorge A. Perez and Ricardo J. Perez (the "Lender"), at
201 Alhambra Circle, Suite 702, Coral Gables, FL 33134(or at such other place as the Lender may designate in writing), the sum
of Eight Hundred Thousand Dollars $800,000.00 with interest from January 7, 2019, on the unpaid principal at the rate of
4% per annum.

 

 

I. TERMS OF REPAYMENT

 

A. Payments

 

The unpaid principal and accrued interest shall be payable
in annual installments of $80,000.00 plus 4% interest on the unpaid balance beginning on January 7, 2020, and continuing
annually until January 6, 2030, (the "Due Date"), at which time the remaining unpaid principal and interest shall be
due in full.

 

B. Application of Payments

 

All payments on this Note shall be applied first in payment
of accrued interest and any remainder in payment of principal.

 

C. Offsets: 

 

Offsets: This Agreement is based on the premise that the
Hospital Management and Administrative Services Agreements will be in effect for 10 full years which enables iHealthcare to fund
the payments for the Promissory Note during this term. Therefore, there may be a pro rata offset to the balance of the Promissory
Note if one or more of the following occur during the ten-year term:

 

a) Any early cancellation or termination of the
contract that is not as a result of breach of contract by iHealthcare. 

pg. 1  iHealthcare
Promissory Note / Empower Capital Group, LLLP

b) Failure to enforce the tagalong provision of
the contract. 

c)A Hospital ownership action to close the hospital. 

d)Loss or suspension of Hospital License or Medicare
Provider status relating to events occurring prior to closing. 

e)In the event that the hospital closes or is
placed in receivership, files for bankruptcy, becomes insolvent or is assigned to creditors, the portion of the Success Fee listed
in the Business Development Agreement shall be adjusted accordingly and the remaining portion of this Promissory Note shall be
adjusted to reflect the change in event and the balance due shall be reduced to reflect that portion for the remaining term of
the note. 

f)Any Offset is subject to arbitration and other
remedies as specified in the Hospital Management and Administrative Services Agreement.   

g)Liabilities incurred prior to closing.  

 

Lender Participation: Any claims sought under this provision
shall be vigorously contested with the full involvement and participation of the Lender, including access to documents, participation
in meetings and conference calls and final settlement discussions. Lender will pay their own expenses, if any, incurred by the
Seller in this process.

 

 

II. PREPAYMENT

 

The Borrower reserves the right to prepay this Note (in whole
or in part) prior to the Due Date with no prepayment penalty. And such prepayment shall be applied against the installments of
principal due under this note in the inverse order of their maturity and shall be accompanied by payment of accrued interest on
the amount prepaid to the date of prepayment.

 

This Promissory Note and/or interest may further be prepaid
without penalty, in full or in part, in cash or common stock of iHealthcare, Inc. at the option of iHealthcare.

 

 

III. COLLECTION COSTS

 

If any payment obligation under this Note is not paid when
due, the Borrower promises to pay all costs of collection, including reasonable attorney fees, whether or not a lawsuit is commenced
as part of the collection process.

 

 

 IV. DEFAULT  

 

If any of the following events of default occur, this Note
and any other obligations of the Borrower to the Lender shall become due immediately, without demand or notice:

 

1) the failure of the Borrower to pay the principal
and any accrued interest when due;

 

2) the liquidation, dissolution, incompetency
or death of the Borrower;

 

pg. 2  iHealthcare
Promissory Note / Empower Capital Group, LLLP

3) the filing of bankruptcy proceedings involving
the Borrower as a debtor;

 

4) the application or the appointment of a receiver
for the Borrower;

 

5) the making of a general assignment for the
benefit of the Borrower's creditors;

 

6) the insolvency of the Borrower;

 

7) a misrepresentation by the Borrower to the
Lender for the purpose of obtaining or extending credit; or

 

8) the sale of a material portion of the business
or assets of the Borrower.

 

In the event of a default, iHealthcare shall be granted 45
days to cure, as stipulated in the Management and Administrative Services Agreement.

 

In the event of failure to cure the default after the 45-day
period and remedies specified in the Management and Administrative Services Agreement, the management agreement shall be surrendered
to the Lender as security.

 

 V. SEWERABILITY OF PROVISIONS

 

If any one or more of the provisions of this Note are determined
to be unenforceable, in whole or in part, for any reason, the remaining provisions shall remain fully operative.

 

VI. MISCELLANEOUS

 

All payments of principal and interest on this Note shall
be paid in the legal currency of the United States.

 

This note may not be amended without the written approval
of the holder.

 

VII. GOVERNING LAW AND DISPUTE RESOLTUION

 

This Note shall me governed by and interpreted in accordance
with the laws of the State of Florida. IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE AKL DISPUTES BY BINDING ARBITRATION HELD
IN MIAMI-DADE COUNTY, FLORIDA BEFORE A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INS. ("JAMS");
AND (b) WAIVE ANY RIGHT TO CIVIL TRIAL BY JUDGE OR JURY. Notwithstanding the foregoing, all claims alleging violation of restrictive
covenants, mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive
jurisdiction, in Miami, Florida, of either the Florida state courts or the US District Court. Before accepting appointment, the
arbitrator shall agree: (a) that the arbitrator's award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate (but it may be extended by written agreement of the parties); (b) to base any decision or award on governing
law; (c) to not award punitive or other damages that are  not measured by the prevailing party's actual damages, except as
may be required by statute; and (d) to issue an award in writing

pg. 3  iHealthcare
Promissory Note / Empower Capital Group, LLLP

within ten (10) days of concluding the presentation of evidence
and briefs. Judgment may be entered in any cvurt having jurisdiction thereof. The prevailing party shall be entitled to recover
from the other party its costs and expenses, including reasonable attorney's fees.

 

 

VIII. SIGNATURES

 

This Note shall be signed by Noel Mijares, on behalf of iHealthcare
Management Company and Jorge A. Perez, on behalf of Empower Capital Group, LLLP.

 

 

 

[SIGNATURE PAGE FOLLOWS]

pg. 4  iHealthcare
Promissory Note / Empower Capital Group, LLLP

IN WITNESS WHEREOF, this Agreement has been executed
and delivered in the manner prescribed by law as of the date first written above.

 

Signed this 7th day of January 2019, at Miami, Florida.

 

 

Borrower:

iHealthcare Management Company

 

         

By:/s/Noel Mijares

Noel Mijares, CEO

 

 

Lender:

Empower Capital Group, LLLP on behalf of Jorge A. Perez and
Ricardo J. Perez.

 

         

By:/s/ Jorge A. Perez

Jorge A. Perez, Managing Partner, Empower Capital Group,
LLLP

 

 

 

pg. 5  iHealthcare
Promissory Note / Empower Capital Group, LLLP

 

PROMISSORY NOTE

Fulton Medical Center

 

 

Note: $950,000.00Effective Date: January 7, 2019 

 

For value received, under the Business Development Agreement
[related to the delivery of an executed Management and Administrative Services Agreement for Fulton Medical Center LLC (FMC)] that
has been duly executed between iHealthcare Management Company and the Managing Partner of FMC, the undersigned iHealthcare Management
Company, a Florida Corporation (the "Borrower"), at 3901 NW 28th Street, 2nd Floor, Miami, Florida 33142, promises to
pay Empower Capital Group, LLLP at the direction of Jorge A. Perez and Ricardo J. Perez (the "Lender"), at 201 Alhambra
Circle, Suite 702, Coral Gables, FL 33134(or at such other place as the Lender may designate in writing), the sum of Nine Hundred
Fifty Thousand Dollars $950,000.00 with interest from January 7, 2019, on the unpaid principal at the rate of 4% per annum.

 

 

I. TERMS OF REPAYMENT

 

A. Payments

 

The unpaid principal and accrued interest shall be payable
in annual installments of $95,000.00 plus 4% interest on the unpaid balance beginning on January 7, 2020, and continuing
annually until January 6, 2030, (the "Due Date"), at which time the remaining unpaid principal and interest shall be
due in full.

 

B. Application of Payments

 

All payments on this Note shall be applied first in payment
of accrued interest and any remainder in payment of principal.

 

C. Offsets: 

 

Offsets: This Agreement is based on the premise that the
Hospital Management and Administrative Services Agreements will be in effect for 10 full years which enables iHealthcare to fund
the payments for the Promissory Note during this term. Therefore, there may be a pro rata offset to the balance of the Promissory
Note if one or more of the following occur during the ten-year term:

pg. 1  iHealthcare
Promissory Note / Empower Capital Group, LLLP

a) Any early cancellation or termination of the
contract that is not as a result of breach of contract by iHealthcare. 

b)Failure to enforce the tagalong provision of
the contract. 

c)A Hospital ownership action to close the hospital. 

d)Loss or suspension of Hospital License or Medicare
Provider status relating to events occurring prior to closing. 

e)In the event that the hospital closes or is
placed in receivership, files for bankruptcy, becomes insolvent or is assigned to creditors, the portion of the Success Fee listed
in the Business Development Agreement shall be adjusted accordingly and the remaining portion of this Promissory Note shall be
adjusted to reflect the change in event and the balance due shall be reduced to reflect that portion for the remaining term of
the note. 

f)Any Offset is subject to arbitration and other
remedies as specified in the Hospital Management and Administrative Services Agreement.   

g)Liabilities incurred prior to closing.  

 

Lender Participation: Any claims sought under this provision
shall be vigorously contested with the full involvement and participation of the Lender, including access to documents, participation
in meetings and conference calls and final settlement discussions. Lender will pay their own expenses, if any, incurred by the
Seller in this process.

 

 

II. PREPAYMENT

 

The Borrower reserves the right to prepay this Note (in whole
or in part) prior to the Due Date with no prepayment penalty. Any such prepayment shall be applied against the installments of
principal due under this note in the inverse order of their maturity and shall be accompanied by payment of accrued interest on
the amount prepaid to the date of prepayment.

 

This Promissory Note and/or interest may further be prepaid
without penalty, in full or in part, in cash or common stock of iHealthcare, Inc. at the option of iHealthcare.

 

 

III. COLLECTION COSTS

 

If any payment obligation under this Note is not paid when
due, the Borrower promises to pay all costs of collection, including reasonable attorney fees, whether or not a lawsuit is commenced
as part of the collection process.

 

 

 IV. DEFAULT  

 

If any of the following events of default occur, this Note
and any other obligations of the Borrower to the Lender shall become due immediately, without demand or notice:

 

1) the failure of the Borrower to pay the principal
and any accrued interest when due;

 

pg. 2  iHealthcare
Promissory Note / Empower Capital Group, LLLP

2) the liquidation, dissolution, incompetency
or death of the Borrower;

 

3) the filing of bankruptcy proceedings involving
the Borrower as a debtor;

 

4) the application for the appointment of a receiver
for the Borrower;

 

5) the making of a general assignment for the
benefit of the Borrower's creditors;

 

6) the insolvency of the Borrower;

 

7) a misrepresentation by the Borrower to the
Lender for the purpose of obtaining or extending credit; or

 

8) the sale of a material portion of the business
or assets of the Borrower.

 

In the event of a default, iHealthcare shall be granted 45
days to cure, as stipulated in the Management and Administrative Services Agreement.

 

In the event of failure to cure the default after the 45-day
period and remedies specified in the Management and Administrative Services Agreement, the management agreement shall be surrendered
to the Lender as security.

 

 V. SEVERABILITY OF PROVISIONS

 

If any one or more of the provisions of this Note are determined
to be unenforceable, in whole or in part, for any reason, the remaining provisions shall remain fully operative.

 

VI. MISCELLANEOUS

 

All payments of principal and interest on this Note shall
be paid in the legal currency of the United States.

 

This note may not be amended without the written approval
of the holder.

 

VII. GOVERNING LAW AND DISPUTE RESOLTUION

 

This Note shall be governed by and interpreted in accordance
with the laws of the State of Florida. IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD
IN MIAMI-DADE COUNTY, FLORIDA BEFORE A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. ("JAMS");
AND (b) WAIVE ANY RIGHT TO CIVIL TRIAL BY JUDGE OR JURY. Notwithstanding the foregoing, all claims alleging violation of restrictive
covenants, mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive
jurisdiction, in Miami, Florida, of either the Florida state courts or the US District Court. Before accepting appointment, the
arbitrator shall agree: (a) that the arbitrator's award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate (but it may be extended by written agreement of the parties); (b) to base any decision or award on

pg. 3  iHealthcare
Promissory Note / Empower Capital Group, LLLP

governing law; (c) to not award punitive or other damages
that are  not measured by the prevailing party's actual damages, except as may be required by statute; and (d) to issue an
award in writing within ten (10) days of concluding the presentation of evidence and briefs. Judgment may be entered in any court
having jurisdiction thereof. The prevailing party shall be entitled to recover from the other party its costs and expenses, including
reasonable attorney's fees.

 

 

VIII. SIGNATURES

 

This Note shall be signed by Noel Mijares, on behalf of iHealthcare
Management Company and Jorge A. Perez, on behalf of Empower Capital Group, LLLP.

 

 

 

 

[SIGNATURE PAGE FOLLOWS]

pg. 4  iHealthcare
Promissory Note / Empower Capital Group, LLLP

IN WITNESS WHEREOF, this Agreement has been executed
and delivered in the manner prescribed by law as of the date first written above.

 

Signed this 7th day of Janaury, 2019, at Miami, Florida.

 

Borrower:

iHealthcare Management Company

 

         

By:/s/Noel Mijares

Noel Mijares, CEO

 

 

Lender:

Empower Capital Group, LLLP on behalf of Jorge A. Perez and
Ricardo J. Perez.

 

         

By:/s/ Jorge A. Perez

Jorge A. Perez, Managing Partner, Empower Capital Group,
LLLP

 

pg. 5  iHealthcare
Promissory Note / Empower Capital Group, LLLP

 

PROMISSORY NOTE

Regional General Hospital

 

 

Note: $780,000.00Effective Date: January 7, 2019 

 

For value received, under the Business Development Agreement
[related to the delivery of an executed Management and Administrative Services Agreement for Regional Health Partners, LLC D/B/A
Regional General Hospital (RGH)] that has been duly executed between iHealthcare Management Company and the Managing Partner of
RGH, the undersigned iHealthcare Management Company, a Florida Corporation (the "Borrower"), at 3901 NW 28th Street,
2nd Floor, Miami, Florida 33142, promises to pay Empower Capital Group, LLLP at the direction of Jorge A. Perez and Ricardo J.
Perez (the "Lender"), at 201 Alhambra Circle, Suite 702, Coral Gables, FL 33134(or at such other place as the Lender
may designate in writing), the sum of Seven Hundred  Eighty Thousand Dollars $780,000.00 with interest from January
7, 2019, on the unpaid principal at the rate of 4% per annum.

 

 

I. TERMS OF REPAYMENT

 

A. Payments

 

The unpaid principal and accrued interest shall be payable
in annual installments of $78,000.00 plus 4% interest on the unpaid balance beginning on January 7, 2020, and continuing
annually until Janaury 6, 2030, (the "Due Date"), at which time the remaining unpaid principal and interest shall be
due in full.

 

B. Application of Payments

 

All payments on this Note shall be applied first in payment
of accrued interest and any remainder in payment of principal.

 

C. Offsets: 

 

Offsets: This Agreement is based on the premise that the
Hospital Management and Administrative Services Agreements will be in effect for 10 full years which enables iHealthcare to fund
the payments for the Promissory Note during this term. Therefore, there may be a pro rata offset to the balance of the Promissory
Note if one or more of the following occur during the ten-year term:

pg. 1  iHealthcare
Promissory Note / Empower Capital Group, LLLP

a)Any early cancellation or termination of the
contract that is not as a result of breach of contract by iHealthcare. 

b)Failure to enforce the tagalong provision of
the contract. 

c)A Hospital ownership action to close the hospital. 

d)Loss or suspension of Hospital License or Medicare
Provider status relating to events occurring prior to closing. 

e)In the event that the hospital closes or is
placed in receivership, files for bankruptcy, becomes insolvent or is assigned to creditors, the portion of the Success Fee listed
in the Business Development Agreement shall be adjusted accordingly and the remaining portion of this Promissory Note shall be
adjusted to reflect the change in event and the balance due shall be reduced to reflect that portion for the remaining term of
the note. 

f)Any Offset is subject to arbitration and other
remedies as specified in the Hospital Management and Administrative Services Agreement.   

g)Liabilities incurred prior to closing.  

 

Lender Participation: Any claims sought under this provision
shall be vigorously contested with the full involvement and participation of the Lender, including access to documents, participation
in meetings and conference calls and final settlement discussions. Lender will pay their own expenses, if any, incurred by the
Seller in this process.

 

 

II. PREPAYMENT

 

The Borrower reserves the right to prepay this Note (in whole
or in part) prior to the Due Date with no prepayment penalty. Any such prepayment shall be applied against the installments of
principal due under this note in the inverse order of their maturity and shall be accompanied by payment of accrued interest on
the amount prepaid to the date of prepayment.

 

This Promissory Note and/or interest may further be prepaid
without penalty, in full or in part, in cash or common stock of iHealthcare, Inc. at the option of iHealthcare.

 

 

III. COLLECTION COSTS

 

If any payment obligation under this Note is not paid when
due, the Borrower promises to pay all costs of collection, including reasonable attorney fees, whether or not a lawsuit is commenced
as part of the collection process.

 

 

 IV. DEFAULT  

 

If any of the following events of default occur, this Note
and any other obligations of the Borrower to the Lender shall become due immediately, without demand or notice:

 

1) the failure of the Borrower to pay the principal
and any accrued interest when due;

 

pg. 2  iHealthcare
Promissory Note / Empower Capital Group, LLLP

2) the liquidation, dissolution, incompetency
or death of the Borrower;

 

3) the filing of bankruptcy proceedings involving
the Borrower as a debtor;

 

4) the application for the appointment of a receiver
for the Borrower;

 

5) the making of a general assignment for the
benefit of the Borrower's creditors;

 

6) the insolvency of the Borrower;

 

7) a misrepresentation by the Borrower to the
Lender for the purpose of obtaining or extending credit; or

 

8) the sale of a material portion of the business
or assets of the Borrower.

 

In the event of a default, iHealthcare shall be granted 45
days to cure, as stipulated in the Management and Administrative Services Agreement.

 

In the event of failure to cure the default after the 45-day
period and remedies specified in the Management and Administrative Services Agreement, the management agreement shall be surrendered
to the Lender as security.

 

 V. SEVERABILITY OF PROVISIONS

 

If any one or more of the provisions of this Note are determined
to be unenforceable, in whole or in part, for any reason, the remaining provisions shall remain fully operative.

 

VI. MISCELLANEOUS

 

All payments of principal and interest on this Note shall
be paid in the legal currency of the United States.

 

This note may not be amended without the written approval
of the holder.

 

VII. GOVERNING LAW AND DISPUTE RESOLTUION

 

This Note shall be governed by and interpreted in accordance
with the laws of the State of Florida. IF A DISPUTE ARISES, THE PARTIES WILL: (a) RESOLVE ALL DISPUTES BY BINDING ARBITRATION HELD
IN MIAMI-DADE COUNTY, FLORIDA BEFORE A SINGLE ARBITRATOR FROM JUDICIAL ARBITRATION AND MEDIATION SERVICES, INC. ("JAMS");
AND (b) WAIVE ANY RIGHT TO CIVIL TRIAL BY JUDGE OR JURY. Notwithstanding the foregoing, all claims alleging violation of restrictive
covenants, mishandling of Confidential Information, or transgression of intellectual property rights, shall be subject to the exclusive
jurisdiction, in Miami, Florida, of either the Florida state courts or the US District Court. Before accepting appointment, the
arbitrator shall agree: (a) that the arbitrator's award shall be made within nine (9) months of the filing of a notice of intention
(or demand) to arbitrate (but it may be extended by written agreement of the parties); (b) to base any decision or award on

pg. 3  iHealthcare
Promissory Note / Empower Capital Group, LLLP

governing law; (c) to not award punitive or other damages
that are  not measured by the prevailing party's actual damages, except as may be required by statute; and (d) to issue an
award in writing within ten (10) days of concluding the presentation of evidence and briefs. Judgment may be entered in any court
having jurisdiction thereof. The prevailing party shall be entitled to recover from the other party its costs and expenses, including
reasonable attorney's fees.

 

 

 

 

VIII. SIGNATURES

 

This Note shall be signed by Noel Mijares, on behalf of iHealthcare
Management Company and Jorge A. Perez, on behalf of Empower Capital Group, LLLP.

 

 

 

[SIGNATURE PAGE FOLLOWS]

pg. 4  iHealthcare
Promissory Note / Empower Capital Group, LLLP

IN WITNESS WHEREOF, this Agreement has been executed
and delivered in the manner prescribed by law as of the date first written above.

 

Signed this 7th day of January 2019, at Miami, Florida.

 

 

Borrower:

iHealthcare Management Company

 

         

By:/s/Noel Mijares

Noel Mijares, CEO

 

 

Lender:

Empower Capital Group, LLLP on behalf of Jorge A. Perez and
Ricardo J. Perez.

 

         

By:/s/ Jorge A. Perez

Jorge A. Perez, Managing Partner, Empower Capital Group,
LLLP

 

pg. 5  iHealthcare
Promissory Note / Empower Capital Group, LLLP

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00291-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00291-of-00352.parquet"}]]