Document:

Exhibit 4.1

 

 

THE BANK OF NEW YORK MELLON

NEW YORK’S FIRST BANK-FOUNDED 1784 BY ALEXANDER HAMILTON

 

 

2 HANSON PLACE, 12TH FLOOR, BROOKLYN,
N.Y. 11217

 

 

 

November 4, 2014

 

Hennion & Walsh, Inc.

2001 Route 46, Waterview Plaza

Parsippany, New Jersey 07054

 

Smart Trust, Closed-End Fund Advisors Select
BDC Trust, Series 1

Dear Sirs:

The Bank of New York
Mellon is acting as trustee for Smart Trust, Closed-End Fund Advisors Select BDC Trust, Series 1 set forth above (the “Trust”).
We enclosed a list of the Securities to be deposited in the Trust on the date hereof. The prices indicated therein reflect our
evaluation of such Securities as of close of business on November 3, 2014, in accordance with the valuation method set forth in
the Trust Indenture and Agreement. We consent to the reference to The Bank of New York Mellon as the party performing the evaluations
of the Trust Securities in the Registration Statement (No. 333-198684) filed with the Securities and Exchange Commission with respect
to the registration of the sale of the Trust Units and to the filing of this consent as an exhibit thereto.

 

 

Very truly yours,

 

/s/ GERARDO CIPRIANO_______________ 

Gerardo Cipriano

Vice PresidentExhibit 4.3

 

 

Consent of Independent Registered
Public Accounting Firm

We consent to the
reference made to our firm under the caption “Independent Registered Public Accounting Firm” in Part B of the Prospectus
and to the use of our report dated November 4, 2014, in this Registration Statement (Form S-6 No. 333-198684) of Smart Trust, Closed-End
Fund Advisors Select BDC Trust, Series 1.

 

/s/ Grant
Thornton LLP

Grant
Thornton LLP

Chicago, Illinois

November 4, 2014EX-10.1

 Exhibit 10.1 

FOURTH AMENDMENT TO RECEIVABLES LOAN AGREEMENT 

This FOURTH AMENDMENT TO RECEIVABLES LOAN AGREEMENT is made as of August 29, 2014 (this “Amendment”), among CHS
RECEIVABLES FUNDING, LLC, a Delaware limited liability company (“Receivables Funding”), as Borrower, THE BANK OF NOVA SCOTIA (“Scotia”), as a Committed Lender and as a Managing Agent, CRÉDIT AGRICOLE
CORPORATE AND INVESTMENT BANK (“CA-CIB”), as a Committed Lender, as a Managing Agent and as Administrative Agent, THE BANK OF TOKYO-MITSUBISHI UFJ, LTD. (“BTMU”), as a Committed
Lender and as a Managing Agent, ATLANTIC ASSET SECURITIZATION LLC (“Atlantic”), as a Conduit Lender, LIBERTY STREET FUNDING LLC (“Liberty Street”), as a Conduit Lender, VICTORY RECEIVABLES CORPORATION
(“Victory”), as a Conduit Lender, and COMMUNITY HEALTH SYSTEMS PROFESSIONAL SERVICES CORPORATION (“Professional Services”), a Delaware corporation, as Collection Agent under the Receivables Loan Agreement,
and is acknowledged and agreed by Receivables Funding, as the Company, Professional Services, as Collection Agent under each of the Contribution Agreement and the Sale Agreement, and as Authorized Representative (as defined in the Sale Agreement,
the “Authorized Representative”), CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation (“CHS”), as Transferor, as Buyer and individually (as the provider of a performance undertaking), and EACH OF THE OTHER
PERSONS IDENTIFIED AS ORIGINATORS ON THE SIGNATURE PAGES HERETO AFFILIATED WITH CHS/COMMUNITY HEALTH SYSTEMS, INC., as Originators. All capitalized terms used herein without reference shall have the meanings assigned to such terms in the Receivables
Loan Agreement (as defined below) after giving effect to this Amendment. 
 WHEREAS, Receivables Funding, as Borrower, Scotia, as a
Committed Lender and as a Managing Agent, CA-CIB, as a Committed Lender, as a Managing Agent and as Administrative Agent, BTMU, as a Committed Lender and as a Managing Agent, the other Lenders party thereto and Professional Services, as Collection
Agent, have entered into the Receivables Loan Agreement, dated as of March 21, 2012 (as amended, restated, supplemented or otherwise modified prior to the date hereof, the “Receivables Loan Agreement”); 

WHEREAS, CHS, as Transferor, Receivables Funding, as the Company, and Professional Services, as Collection Agent thereunder, have entered into
the Receivables Purchase and Contribution Agreement, dated as of March 21, 2012 (as amended, restated, supplemented or otherwise modified prior to the date hereof, the “Contribution Agreement”); 

WHEREAS, the Originators, Professional Services, as Collection Agent and Authorized Representative thereunder, and CHS, as Buyer, have entered
into the Receivables Sale Agreement, dated as of March 21, 2012 (as amended, restated, supplemented or otherwise modified prior to the date hereof, the “Sale Agreement”); 

WHEREAS, the parties hereto desire to amend certain provisions of the Receivables Loan Agreement pursuant to Section 10.01 of the
Receivables Loan Agreement and take the other actions set forth herein, and have agreed to do so subject to the terms and conditions of this Amendment. 

NOW, THEREFORE, in consideration of the agreements hereinafter set forth, 

  

 
and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the parties hereto agree as follows: 

SECTION 1. Amendments to Receivables Loan Agreement. Subject to all of the terms and conditions set forth in this Amendment: 

(a) Section 1.01 of the Receivables Loan Agreement is amended as by inserting the following definitions in the appropriate alphabetical
order: 
 “Specified Defaulted Receivables” means a Receivable: 

(a) as to which, as of the date that is 150 days after the Last Service Date, the amount paid thereon is less than the Expected
Net Value of such Receivable (other than as a result of a miscalculation by the Collection Agent of Contractual Allowances) and which is between 151 days and 180 days from the Last Service Date, 

(b) as to which the Obligor thereof is currently the subject of an Insolvency Proceeding, or 

(c) which, consistent with the Credit and Collection Policy, has been or should be written off the Borrower’s or an
Originator’s books as uncollectible. 
 “Trigger Temporary Relief Period” means the period comprised
of the six consecutive Collection Periods from August 2014 through and including January 2015. 
 (b) The definition of “Default
Ratio” in Section 1.01 of the Receivables Loan Agreement is hereby amended and restated in its entirety to read as follows: 

“Default Ratio” means, in respect of any Collection Period, the ratio (expressed as a percentage) computed as
of the Determination Date, by dividing 
 (a) the aggregate Expected Net Value of all Receivables that were Specified
Defaulted Receivables as of the last day of such Collection Period by 
 (b) the aggregate Expected Net Value of all
Receivables as of the last day of such Collection Period. 
 (c) The definition of “Temporary Relief Period” in Section 1.01
of the Receivables Loan Agreement is hereby amended and restated in its entirety to read as follows: 
 “HHS
Temporary Relief Period” means, solely to the extent that the HHS Compliance Date occurs on or before October 1, 2014, the following periods: (i) with respect to the Default Ratio for a single Collection Period, the period
comprised of the five consecutive Collection Periods from February 2015 through and including June 2015, (ii) with respect to the Delinquency Ratio for a single Collection Period, the period comprised of the five consecutive Collection Periods

  
 2 

 
from February 2015 through and including June 2015, (iii) with respect to the Payment Denial Rate for a single Collection Period, the period comprised of the four consecutive Collection
Periods from April 2015 through and including July 2015, (iv) with respect to the average of the Default Ratio for a Collection Period and the two prior Collection Periods, the period comprised of the five consecutive Collection Periods from
March 2015 through and including July 2015, (v) with respect to the average of the Delinquency Ratio for a Collection Period and the two prior Collection Periods, the period comprised of the five consecutive Collection Periods from March 2015
through and including July 2015, and (vi) with respect to the DSO for a single Collection Period, the period comprised of the three consecutive Collection Periods from February 2015 through and including April 2015; provided, that if the
HHS Compliance Date occurs after October 1, 2014, the “HHS Temporary Relief Period” hereunder shall consist of such periods, if any, and pursuant to such terms as the Administrative Agent and the Managing Agents each agrees in writing
in its respective sole discretion. 
 (d) Clause (h) of Section 7.01 of the Receivables Loan Agreement is hereby amended and
restated in its entirety to read as follows: 
 (h) As of the last day of any Collection Period, (i) the Default Ratio
(x) for any Collection Period occurring during the Trigger Temporary Relief Period shall exceed 2.25%, (y) for any Collection Period occurring during the HHS Temporary Relief Period shall exceed 2.50% and (z) for all other Collection
Periods shall exceed 2.00%, (ii) the Delinquency Ratio (x) for any Collection Period occurring during the Trigger Temporary Relief Period shall exceed 4.00%, (y) for any Collection Period occurring during the HHS Temporary Relief
Period shall exceed 5.75% and (z) for all other Collection Periods, shall exceed 3.50%, (iii) the Payment Denial Rate (x) for any Collection Period occurring during the HHS Temporary Relief Period shall exceed 1.50% and (y) for
all other Collection Periods shall exceed 1.25%, (iv) the average of the Default Ratio for each of such Collection Period and the two prior Collection Periods (x) for any Collection Period occurring during the Trigger Temporary Relief
Period shall exceed 2.15%, (y) for any Collection Period occurring during the HHS Temporary Relief Period shall exceed 2.65% and (z) for all other Collection Periods shall exceed 1.90%, or (v) the average of the Delinquency Ratio for
each of such Collection Period and the two prior Collection Periods (x) for any Collection Period occurring during the Trigger Temporary Relief Period shall exceed 3.75%, (y) for any Collection Period occurring during the HHS Temporary
Relief Period shall exceed 5.25% and (z) for all other Collection Periods shall exceed 3.25%; or 
 (e) Clause (i) of
Section 7.01 of the Receivables Loan Agreement is hereby amended and restated in its entirety to read as follows: 
 (i)
The DSO reported on any Monthly Report shall exceed, (x) if with respect to a Collection Period occurring during the HHS Temporary Relief Period, 60 days and (y) if with respect to a Collection Period occurring at any other time, 55 days;
or 

  
 3 

 SECTION 2. Conditions to Effectiveness. This Amendment shall become effective upon the
date (the “Amendment Effective Date”) on which the following conditions have been satisfied (in form and substance reasonably acceptable to the Administrative Agent): 

(a) The Administrative Agent shall have received counterparts of this Amendment duly executed by each of the Borrower, the Collection Agent,
the Managing Agents, the Committed Lenders, the Conduit Lenders and the Administrative Agent and counterparts evidencing acknowledgment and agreement duly executed by each of the Company, the Collection Agent (as Collection Agent under each of the
Contribution Agreement and the Sale Agreement), the Authorized Representative, the Transferor, the Buyer, CHS individually and the Originators. 

(b) All fees and expenses required to be paid prior to an Advance under the Receivables Loan Agreement (as amended by this Amendment) pursuant
to (i) the Receivables Loan Agreement (as amended by this Amendment) and (ii) the Fee Letter shall have been paid. 
 (c) Each
Managing Agent and the Administrative Agent shall have completed satisfactory due diligence and obtained the requisite credit approvals. 

SECTION 3. Representations and Warranties. 

(a) Each of the Borrower and the Collection Agent represents and warrants as of the date hereof that (i) it has taken all necessary
action to authorize the execution, delivery and performance of this Amendment and the performance of the Receivables Loan Agreement and the other Facility Documents, each as amended hereby, as applicable, and (ii) no consent, approval,
authorization or order of, or filing, registration or qualification with, any court or governmental authority or third party is required in connection with the execution, delivery or performance by such Person of this Amendment other than such as
has been met or obtained and are in full force and effect. 
 (b) Each of the Borrower and the Collection Agent represents and warrants as
of the date hereof that each of this Amendment and each Facility Document (as amended by this Amendment or otherwise as of the date hereof, as applicable) constitutes such Person’s legal, valid and binding obligation, enforceable against such
person in accordance with its terms, except as such enforceability may be subject to (A) bankruptcy, insolvency, reorganization, fraudulent conveyance or transfer, moratorium or similar laws affecting creditors’ rights generally and
(B) general principles of equity (regardless of whether such enforceability is considered in a proceeding at law or in equity). 
 (c)
The Borrower hereby makes each of the representations and warranties contained in Sections 4.01 and 4.03 of the Receivables Loan Agreement as of the date hereof, in each case after giving effect to this Amendment, except for those representations
and warranties that refer to specific dates, which are made as of the dates indicated therein. 
 (d) The Collection Agent hereby makes each
of the representations and warranties contained in Section 4.02 of the Receivables Loan Agreement as of the date hereof, in each case after giving effect to this Amendment, except for those representations and warranties that refer to specific
dates, which are made as of the dates indicated therein. 

  
 4 

 (e) Each of the Borrower and the Collection Agent further represents and warrants that, both
before and after giving effect to this Amendment, no event has occurred and is continuing which constitutes an Event of Default, or would, with the passage of time or the giving of notice, constitute an Event of Default. 

SECTION 4. Facility Document. This Amendment shall constitute a Facility Document under the terms of the Receivables Loan Agreement as
amended hereby. 
 SECTION 5. Further Assurances. The Borrower and the Collection Agent agree to promptly take such action, upon the
reasonable request of the Administrative Agent, as is necessary to carry out the intent of this Amendment. 
 SECTION 6. Confirmation of
Agreement. On and after the date hereof, all references to the Receivables Loan Agreement in the Facility Documents and the other documents and instruments delivered pursuant to or in connection with such Facility Documents shall mean the
Receivables Loan Agreement as amended by this Amendment, and as hereafter modified, amended or restated in accordance with its terms. Except as herein expressly amended, the Receivables Loan Agreement is ratified and confirmed in all respects and
shall remain in full force and effect in accordance with its terms. 
 SECTION 7. Confirmation of Undertaking. CHS, as undertaking
party under the Collection Agent Performance Undertaking, dated as of March 21, 2012 (as amended, restated, supplemented or otherwise modified prior to the date hereof, the “Performance Undertaking”), in favor of CA-CIB as
administrative agent on behalf of the Lenders, hereby consents to the amendments to the Receivables Loan Agreement set forth in Section 3 of this Amendment, and hereby confirms and agrees that, notwithstanding the effectiveness of this
Amendment, the Performance Undertaking heretofore executed and delivered by it is, and shall continue to be, in full force and effect in accordance with its terms and shall apply to the Receivables Loan Agreement (as amended by this Amendment),
Contribution Agreement and Sale Agreement and the Performance Undertaking is hereby so ratified and confirmed. 
 SECTION 8. GOVERNING
LAW. THIS AMENDMENT SHALL, IN ACCORDANCE WITH SECTION 5-1401 OF THE GENERAL OBLIGATIONS LAW OF THE STATE OF NEW YORK, BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK. EACH OF THE PARTIES HERETO HEREBY SUBMITS
TO THE EXCLUSIVE JURISDICTION OF THE STATE AND FEDERAL COURTS OF THE UNITED STATES AND THE NON-EXCLUSIVE JURISDICTION OF THE STATE AND FEDERAL COURTS SITTING IN NEW YORK COUNTY, NEW YORK IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS
AMENDMENT, ANY OTHER FACILITY DOCUMENT, ANY OTHER DOCUMENT DELIVERED PURSUANT HERETO OR THERETO, OR THE TRANSACTIONS CONTEMPLATED HEREBY OR THEREBY. EACH OF THE PARTIES HERETO HEREBY WAIVES ANY OBJECTION BASED ON FORUM NON CONVENIENS THE MAINTENANCE
OF ANY SUCH ACTION OR PROCEEDING AND CONSENTS TO THE GRANTING OF SUCH LEGAL OR EQUITABLE RELIEF AS IS DEEMED APPROPRIATE BY SUCH COURT. 

  
 5 

 SECTION 9. Execution in Counterparts. This Amendment may be executed in any number of
counterparts and by different parties hereto in separate counterparts, each of which when so executed shall be deemed to be an original and all of which when taken together shall constitute one and the same agreement. Delivery of an executed
counterpart of a signature page to this Amendment by facsimile or by electronic mail in portable document format (pdf) shall be effective as delivery of a manually executed counterpart of this Amendment. 

SECTION 10. Severability of Provisions. Any provision of this Amendment which is prohibited or unenforceable in any jurisdiction shall,
as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof or affecting the validity or enforceability of such provision in any other jurisdiction. 

SECTION 11. Headings. Section headings used herein are for convenience of reference only, are not part of this Amendment and shall not
affect the construction of, or be taken into consideration in interpreting, this Amendment. 
 [Signature Pages Follow] 

  
 6 

 IN WITNESS WHEREOF, this Amendment has been duly executed as of the date first written above.

  

			
	 CHS RECEIVABLES FUNDING, LLC,
 as
Borrower

		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title: Senior Vice President and Treasurer
	
	 CHS Receivables Funding, LLC
 4000
Meridian Boulevard
 Franklin, Tennessee 37067
 Attention:
Rachel A. Seifert
 Telephone No: (615) 465-7000
 Facsimile
No: (615) 373-9704
 Email: rachel_seifert@chs.net

	
	 COMMUNITY HEALTH SYSTEMS PROFESSIONAL SERVICES CORPORATION,

as Collection Agent under the Receivables Loan Agreement

		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title: Senior Vice President and Treasurer
	
	 Community Health Systems Professional Services Corporation

4000 Meridian Boulevard
 Franklin, Tennessee 37067

Attention: Rachel A. Seifert
 Telephone No:
(615) 465-7000
 Facsimile No: (615) 373-9704
 Email:
rachel_seifert@chs.net

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

  

 
			
	 CRÉDIT AGRICOLE CORPORATE AND

INVESTMENT BANK, as Administrative Agent,

as a Managing Agent and as a Committed Lender

		
	By:	 	/s/ Sam Pilcer
		 	Name: Sam Pilcer
		 	Title:   Managing Director
		
	By:	 	/s/ Michael Regan
		 	Name: Michael Regan
		 	Title:   Managing Director
	
	 Crédit Agricole CIB
 1301
Avenue of the Americas
 New York, NY 10019
 Attention: Sunny
Gulrajani
 Telephone No: (212) 261-7845
 Facsimile No:
(917) 849-5584
 Email: sunny.gulrajani@ca-cib.com

	
	 ATLANTIC ASSET SECURITIZATION LLC,

as a Conduit Lender

	
	 By: CRÉDIT AGRICOLE CORPORATE AND

INVESTMENT BANK, as attorney-in-fact

		
	By:	 	/s/ Sam Pilcer
		 	Name: Sam Pilcer
		 	Title:   Managing Director
		
	By:	 	/s/ Michael Regan
		 	Name: Michael Regan
		 	Title:   Managing Director
	
	 Atlantic Asset Securitization
 c/o
Crédit Agricole CIB
 1301 Avenue of the Americas
 New
York, NY 10019
 Attention: Sunny Gulrajani
 Telephone No:
(212) 261-7845
 Facsimile No: (917) 849-5584
 Email:
sunny.gulrajani@ca-cib.com

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	 THE BANK OF NOVA SCOTIA, as a Managing

Agent and as a Committed Lender

		
	By:	 	/s/ John Frazell
		 	Name: John Frazell
		 	Title:   Director
	
	 LIBERTY STREET FUNDING LLC,
 as a
Conduit Lender

		
	By:	 	/s/ Frank B. Bilotta
		 	Name: Frank B. Bilotta
		 	Title:   Vice President

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	 THE BANK OF TOKYO-MITSUBISHI UFJ, LTD.,

as a Managing Agent

		
	By:	 	/s/ Christopher Pohl
		 	Name: Christopher Pohl
		 	Title:   Managing Director
	
	 THE BANK OF TOKYO-MITSUBISHI UFJ, LTD.,

as a Committed Lender

		
	By:	 	/s/ Jaime Sussman
		 	Name: Jaime Sussman
		 	Title:   Vice President
	
	 VICTORY RECEIVABLES CORPORATION,

as a Conduit Lender

		
	By:	 	/s/ David V. DeAngelis
		 	Name: David V. DeAngelis
		 	Title:   Vice President

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 ACKNOWLEDGED AND AGREED: 

 

			
	 CHS RECEIVABLES FUNDING, LLC,
 as
Company

		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	 CHS Receivables Funding, LLC
 4000
Meridian Boulevard
 Franklin, Tennessee 37067
 Attention:
Rachel A. Seifert
 Telephone No: (615) 465-7000
 Facsimile No:
(615) 373-9704
 Email: rachel_seifert@chs.net

	
	 COMMUNITY HEALTH SYSTEMS PROFESSIONAL SERVICES CORPORATION,

as Collection Agent under each of the Contribution Agreement and the Sale Agreement and as
Authorized Representative

		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	 Community Health Systems Professional Services Corporation

4000 Meridian Boulevard
 Franklin, Tennessee 37067

Attention: Rachel A. Seifert
 Telephone No:
(615) 465-7000
 Facsimile No: (615) 373-9704
 Email:
rachel_seifert@chs.net

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 ACKNOWLEDGED AND AGREED: 

 

			
	 CHS/COMMUNITY HEALTH SYSTEMS, INC.,

as Transferor, as Buyer and individually

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

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 ACKNOWLEDGED AND AGREED: 

			
	ORIGINATORS:
	
	AFFINITY HOSPITAL, LLC
	BERWICK HOSPITAL COMPANY, LLC
	BLUEFIELD HOSPITAL COMPANY, LLC
	BLUFFTON HEALTH SYSTEM LLC
	BULLHEAD CITY HOSPITAL CORPORATION
	CARLSBAD MEDICAL CENTER, LLC
	CLEVELAND TENNESSEE HOSPITAL COMPANY, LLC
	COATESVILLE HOSPITAL CORPORATION
	CRESTVIEW HOSPITAL CORPORATION
	DEACONESS HEALTH SYSTEM, LLC
	DHSC, LLC
	DUKES HEALTH SYSTEM, LLC
	DYERSBURG HOSPITAL CORPORATION
	EMPORIA HOSPITAL CORPORATION
	 FOLEY HOSPITAL CORPORATION

FRANKLIN HOSPITAL CORPORATION

	GADSDEN REGIONAL MEDICAL CENTER, LLC
	GALESBURG HOSPITAL CORPORATION
	GRANBURY HOSPITAL CORPORATION
	GRANITE CITY ILLINOIS HOSPITAL COMPANY, LLC
	GREENBRIER VMC, LLC
	HOSPITAL OF MORRISTOWN, INC.
	JACKSON, TENNESSEE HOSPITAL COMPANY, LLC
	JOURDANTON HOSPITAL CORPORATION
	KAY COUNTY OKLAHOMA HOSPITAL COMPANY, LLC
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	LAKE WALES HOSPITAL CORPORATION
	LANCASTER HOSPITAL CORPORATION
	LAS CRUCES MEDICAL CENTER, LLC
	LEA REGIONAL HOSPITAL, LLC
	MARTIN HOSPITAL CORPORATION
	MARY BLACK HEALTH SYSTEM LLC
	MCKENZIE-WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES, LLC
	 MCNAIRY HOSPITAL CORPORATION
 MCSA,
L.L.C.

	MOBERLY HOSPITAL COMPANY, LLC
	NATIONAL HEALTHCARE OF LEESVILLE, INC.
	NATIONAL HEALTHCARE OF MT. VERNON, INC.
	NORTHAMPTON HOSPITAL COMPANY, LLC
	NORTHWEST HOSPITAL, LLC
	 ORO VALLEY HOSPITAL, LLC
 PAYSON
HOSPITAL CORPORATION

	PETERSBURG HOSPITAL COMPANY, LLC
	PHOENIXVILLE HOSPITAL COMPANY, LLC
	POTTSTOWN HOSPITAL COMPANY, LLC
	PORTER HOSPITAL, LLC
	QHG OF ENTERPRISE, INC.
	QHG OF SOUTH CAROLINA, INC.
	ROSWELL HOSPITAL CORPORATION
	RUSTON LOUISIANA HOSPITAL COMPANY, LLC
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	SAN MIGUEL HOSPITAL CORPORATION
	 SCRANTON HOSPITAL COMPANY, LLC

SHELBYVILLE HOSPITAL CORPORATION

	SILOAM SPRINGS ARKANSAS HOSPITAL COMPANY, LLC
	SPOKANE VALLEY WASHINGTON HOSPITAL COMPANY, LLC
	SPOKANE WASHINGTON HOSPITAL COMPANY, LLC
	ST. JOSEPH HEALTH SYSTEM LLC
	TOMBALL TEXAS HOSPITAL COMPANY, LLC
	TOOELE HOSPITAL CORPORATION
	WARREN OHIO HOSPITAL COMPANY, LLC
	WARREN OHIO REHAB HOSPITAL COMPANY, LLC
	WARSAW HEALTH SYSTEM LLC
	WAUKEGAN ILLINOIS HOSPITAL COMPANY, LLC
	WEATHERFORD TEXAS HOSPITAL COMPANY, LLC
	WESLEY HEALTH SYSTEM, LLC
	WEST GROVE HOSPITAL COMPANY, LLC
	WILKES-BARRE HOSPITAL COMPANY, LLC
	WOMEN & CHILDREN’S HOSPITAL, LLC
	YOUNGSTOWN OHIO HOSPITAL COMPANY, LLC
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	ANNA HOSPITAL CORPORATION
	AUGUSTA HOSPITAL, LLC
	BIG BEND HOSPITAL CORPORATION
	BIG SPRING HOSPITAL CORPORATION
	BLUE RIDGE GEORGIA HOSPITAL COMPANY, LLC
	CENTRE HOSPITAL CORPORATION
	CLINTON HOSPITAL CORPORATION
	DEMING HOSPITAL CORPORATION
	EVANSTON HOSPITAL CORPORATION
	FALLBROOK HOSPITAL CORPORATION
	FORREST CITY ARKANSAS HOSPITAL COMPANY, LLC
	FORT PAYNE HOSPITAL CORPORATION
	GREENVILLE HOSPITAL CORPORATION
	HOSPITAL OF BARSTOW, INC.
	HOSPITAL OF FULTON, INC.
	HOSPITAL OF LOUISA, INC.
	KIRKSVILLE MISSOURI HOSPITAL COMPANY, LLC
	LEXINGTON HOSPITAL CORPORATION
	LUTHERAN MUSCULOSKELETAL CENTER, LLC
	MARION HOSPITAL CORPORATION
	 MCKENZIE TENNESSEE HOSPITAL COMPANY, LLC

MMC OF NEVADA, LLC

	 NATIONAL HEALTHCARE OF NEWPORT, INC.

OAK HILL HOSPITAL CORPORATION
 PHILLIPS HOSPITAL
CORPORATION

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

  

 
			
	ORIGINATORS (CONT.):
	
	RED BUD ILLINOIS HOSPITAL COMPANY, LLC
	SALEM HOSPITAL CORPORATION
	SCRANTON QUINCY HOSPITAL COMPANY, LLC
	SUNBURY HOSPITAL COMPANY, LLC
	WATSONVILLE HOSPITAL CORPORATION
	WILLIAMSTON HOSPITAL CORPORATION
	WOODWARD HEALTH SYSTEM, LLC
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	BROWNWOOD HOSPITAL, L.P.
	By: Brownwood Medical Center, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	COLLEGE STATION HOSPITAL, L.P.
	By: College Station Medical Center, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	IOM HEALTH SYSTEM, L.P.
	By: Lutheran Health Network Investors, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	LAREDO TEXAS HOSPITAL COMPANY, L.P.
	By: Webb Hospital Corporation
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	LONGVIEW MEDICAL CENTER, L.P.
	By: Regional Hospital of Longview, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	NAVARRO HOSPITAL, L.P.
	By: Navarro Regional, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	PINEY WOODS HEALTHCARE SYSTEM, L.P.
	By: Woodland Heights Medical Center, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	REHAB HOSPITAL OF FORT WAYNE GENERAL PARTNERSHIP
	By: Lutheran Health Network Investors, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	SAN ANGELO HOSPITAL, L.P.
	By: San Angelo Community Medical Center, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	VICTORIA OF TEXAS, L.P.
	By: Detar Hospital, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title: Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement 

 
			
	ORIGINATORS (CONT.):
	
	ARMC, L.P.
	By: Triad-ARMC, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer
	
	CRESTWOOD HEALTHCARE, L.P.
	By: Crestwood Hospital, LLC
	Its: General Partner
		
	By:	 	/s/ James W. Doucette
		 	Name: James W. Doucette
		 	Title:   Senior Vice President and Treasurer

 Signature Page to Fourth Amendment to Receivables Loan Agreement

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