Document:

EX-4.11

 Exhibit 4.11 

FIRST SUPPLEMENTAL INDENTURE, (this “Supplemental Indenture”) dated as of March 27, 2020, by and among
CHS/Community Health Systems, Inc., a Delaware corporation (“Issuer”), the party that is a signatory hereto as a Guarantor (the “Guaranteeing Subsidiary”), Credit Suisse AG, as Collateral Agent, and Regions Bank, as
Trustee under the Indenture referred to below. 
 W I T N E S S E T H:

 WHEREAS, each of the Issuer, the Guarantors, the Trustee and the Collateral Agent have heretofore executed and delivered an indenture
dated as of February 6, 2020 (as amended, supplemented, waived or otherwise modified, the “Indenture”), providing for the issuance on such date of an aggregate principal amount of $1,462,000,000 of 6.625% Senior Secured Notes
due 2025 (the “Notes”) of the Issuer; 
 WHEREAS, the Indenture provides that the Guaranteeing Subsidiary shall execute
and deliver to the Trustee and the Collateral Agent a supplemental indenture pursuant to which the Guaranteeing Subsidiary shall unconditionally guarantee all of the Issuer’s Obligations under the Notes and the Indenture on the terms and
conditions set forth herein and under the Indenture (the “Note Guarantee”), each on the terms and conditions set forth herein; and 

WHEREAS, pursuant to Section 9.1 of the Indenture, the Issuer, any Guarantor, the Collateral Agent and the Trustee
are authorized to execute and deliver this Supplemental Indenture to amend or supplement the Indenture, without the consent of any Holder; 

NOW, THEREFORE, in consideration of the foregoing and for other good and valuable consideration, the receipt of which is hereby acknowledged,
the Issuer, the Guaranteeing Subsidiary, the Collateral Agent and the Trustee mutually covenant and agree for the benefit of the Trustee, the Collateral Agent and the Holders of the Notes as follows: 

ARTICLE I 

DEFINITIONS 
 SECTION
1.1.   Defined Terms. As used in this Supplemental Indenture, terms defined in the Indenture or in the preamble or recitals hereto are used herein as therein defined. The words “herein,” “hereof” and
“hereby” and other words of similar import used in this Supplemental Indenture refer to this Supplemental Indenture as a whole and not to any particular section hereof. 

ARTICLE II 

AGREEMENT TO BE BOUND; GUARANTEE 

SECTION 2.1.   Agreement to be Bound. The Guaranteeing Subsidiary hereby becomes a party to the Indenture as a
“Guarantor” and as such will have all of the rights and be subject to all of the obligations and agreements of a “Guarantor” under the Indenture. 

SECTION 2.2.   Guarantee. The Guaranteeing Subsidiary agrees, on a joint and several basis with all the existing
Guarantors, to fully, unconditionally and irrevocably Guarantee 

 
to each Holder of the Notes, the Trustee and the Collateral Agent the Guaranteed Obligations pursuant to Article X of the Indenture as and to the extent provided for therein. 

ARTICLE III 

MISCELLANEOUS 
 SECTION
3.1.   Notices. All notices and other communications to the Guarantors shall be given as provided in the Indenture. 

SECTION 3.2.   Merger and Consolidation. The Guaranteeing Subsidiary shall not sell or otherwise dispose of all or
substantially all of its assets to, or consolidate with or merge with or into, another Person (other than the Issuer or any Restricted Subsidiary that is a Guarantor or becomes a Guarantor concurrently with the transaction) except in accordance with
Section 4.1(e) of the Indenture. 
 SECTION 3.3.   Release of Guarantee. The Note
Guarantees hereunder may be released in accordance with Section 10.2 of the Indenture. 
 SECTION
3.4.   Parties. Nothing expressed or mentioned herein is intended or shall be construed to give any Person, firm or corporation, other than the Holders and the Trustee, any legal or equitable right, remedy or claim under or in
respect of this Supplemental Indenture or the Indenture or any provision herein or therein contained. 
 SECTION
3.5.   Governing Law. This Supplemental Indenture shall be governed by, and construed in accordance with, the laws of the State of New York. 

SECTION 3.6.   Severability. In case any provision in this Supplemental Indenture shall be invalid, illegal or
unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby and such provision shall be ineffective only to the extent of such invalidity, illegality or unenforceability.

 SECTION 3.7.   Benefits Acknowledged. The Guaranteeing Subsidiary’s Note Guarantee is subject to the terms
and conditions set forth in the Indenture. The Guaranteeing Subsidiary acknowledges that it will receive direct and indirect benefits from the financing arrangements contemplated by the Indenture and this Supplemental Indenture and that the
guarantee and waivers made by it pursuant to its Note Guarantee are knowingly made in contemplation of such benefits. 
 SECTION
3.8.   Ratification of Indenture; Supplemental Indentures Part of Indenture. Except as expressly amended hereby, the Indenture is in all respects ratified and confirmed and all the terms, conditions and provisions thereof shall
remain in full force and effect. This Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of Notes heretofore or hereafter authenticated and delivered shall be bound hereby. 

SECTION 3.9.   The Trustee and the Collateral Agent. Neither the Trustee nor the Collateral Agent make any
representation or warranty as to the validity or sufficiency of this Supplemental Indenture or with respect to the recitals contained herein, all of which recitals are made solely by the other parties hereto. 

  
 2 

 SECTION 3.10.   Counterparts. The parties hereto may sign any number
of copies of this Supplemental Indenture. Each signed copy shall be an original, but all of them together represent the same agreement. The exchange of copies of this Supplemental Indenture and of signature pages by facsimile or other electronic
transmission shall constitute effective execution and delivery of this Supplemental Indenture as to the parties hereto and may be used in lieu of the original Supplemental Indenture for all purposes. Signatures of the parties hereto transmitted by
facsimile or other electronic transmission shall be deemed to be their original signatures for all purposes. 
 SECTION
3.11.   Execution and Delivery. The Guaranteeing Subsidiary agrees that its Note Guarantee shall remain in full force and effect notwithstanding any absence on each Note of a notation of any such Note Guarantee. 

SECTION 3.12.   Headings. The headings of the Articles and the Sections in this Supplemental Indenture are for
convenience of reference only and shall not be deemed to alter or affect the meaning or interpretation of any provisions hereof. 

[Signature on following pages] 

  
 3 

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

			
	 GREENBRIER VMC, LLC,
 as a
Guarantor

		
	By:	 	  /s/ R. Gabriel Ottinger                            

		 	R. Gabriel Ottinger
		 	Senior Vice President and Treasurer

  

			
	Acknowledged by:
	
	CHS/COMMUNITY HEALTH SYSTEMS, INC.
		
	By:	 	  /s/ R. Gabriel Ottinger                    
		 	R. Gabriel Ottinger
		 	Senior Vice President and Treasurer

  
 [Signature Page to
First Supplemental Indenture (2025 Notes)] 

 
			
	REGIONS BANK,
	as Trustee
		
	By:	 	  /s/ Kristine
Prall                                        

		 	  Name: Kristine Prall
		 	  Title:   Vice President

  
 [Signature Page to
First Supplemental Indenture (2025 Notes)] 

 
			
	 CREDIT SUISSE AG, CAYMAN ISLANDS

BRANCH, as Collateral Agent

		
	By:	 	  /s/ Lingzi
Hnang                                        

		 	  Name: Lingzi Hnang
		 	  Title: Authorized Signatory
		
	By:	 	  /s/ Komal
Shah                                        

		 	  Name: Komal Shah
		 	  Title: Authorized Signatory

  
 [Signature Page to
First Supplemental Indenture (2025 Notes)]EX-10.1

 Exhibit 10.1 

PERFORMANCE BASED RESTRICTED STOCK AWARD AGREEMENT 

(Senior Officers) 
 Community Health Systems,
Inc. 
 2009 Stock Option and Award Plan 

THIS AGREEMENT between you and Community Health Systems, Inc., a Delaware corporation (the “Company”) governs an Award
of the Company’s Restricted Stock in the amount and on the date specified in your Award notification (the “Date of Grant”). 

WHEREAS, the Company has adopted the Community Health Systems, Inc. 2009 Stock Option and Award Plan (the “Plan”) in
order to provide additional incentive to certain employees and directors of the Company and its Subsidiaries; 
 WHEREAS, the
Compensation Committee of the Company’s Board of Directors (the “Committee”) has determined to grant to you this Award of Restricted Stock as provided herein to encourage your efforts toward the continuing success of the Company; and

 WHEREAS, the Committee has determined to condition the Award on the attainment of certain performance-based criteria to better
align your economic interests with those of the other stockholders of the Company. 
 NOW, THEREFORE, the parties hereto agree as
follows: 
  

	1.	 Grant of Restricted Stock. 

1.1        The Company hereby grants to you this Award of Shares of Performance Based Restricted
Stock in the number set out in an electronic notification by the Company’s stock option plan administrator, as may be appointed from time to time (the “Plan Administrator”). The Shares of Performance Based Restricted Stock granted
pursuant to this Award shall be issued in the form of a book entry of Shares in your name as soon as reasonably practicable after the Date of Grant and shall be subject to your (or your estate’s, if applicable) acknowledgement and acceptance of
this Agreement by electronic means to the Plan Administrator as provided in Section 9 hereof, or as you have been otherwise instructed. 

1.2        This Agreement shall be construed in accordance and consistent with, and subject to,
the provisions of the Plan (the provisions of which are hereby incorporated by reference) and, except as otherwise expressly set forth herein, the capitalized terms used in this Agreement shall have the same definitions as set forth in the Plan.

  

	2.	 Restrictions on Transfer. 

The Shares of Performance Based Restricted Stock issued under this Agreement may not be sold, transferred or otherwise disposed of and
may not be pledged or otherwise hypothecated until the Restricted Period (as defined in Section 3) as expired and all restrictions on such Performance Based Restricted Stock shall have lapsed in the manner provided in Section 3, 4 or 5
hereof. 
  

	3.	 Performance Objectives; Lapse of Restrictions. 

Except as otherwise provided in Sections 4 and 5 hereof, the “Restricted Period” with respect to the Performance Based
Restricted Stock means the period beginning on the Date of Grant and expiring on the third anniversary of the Date of Grant, but only if (a) and to the extent the Company 

 CONFIDENTIAL 
  

 
has achieved the performance targets set forth on Exhibit A (and the other terms and conditions set forth herein have been met) as determined by the Committee, and (b) subject to
Sections 4 or 5 hereof, you have remained in service with the Company (or any of its Affiliates) continuously until that date; provided, that if later, the Restricted Period shall end on the date on which the Committee’s determination set forth
in (a) above is effective. Any Shares of Performance Based Restricted Stock with respect to which the Restricted Period does not expire as provided above shall be canceled not later than the date on which such determination is effective. 

 

	4.	 Effect of Certain Terminations of Employment. 

If your employment terminates as a result of your death or Disability, in each case if such termination occurs on or after the Date of
Grant, the target number of Shares of Performance Based Restricted Stock (as set forth in Exhibit A) which have not become vested in accordance with Section 3 or 5 hereof shall vest, and the restrictions thereon shall lapse as of the
date of such termination. If your employment is terminated by your employer for any reason other than for Cause, then the Restricted Period shall not end and your Award shall continue until such time as the Committee determines the extent to which
the Performance Objectives set forth in Exhibit A have been attained, and if attained, the Restricted Period as to the Award shall lapse as provided in Section 3(a) above, without regard to Section 3(b). If the minimum Performance
Objectives are not attained, the Award shall lapse in its entirety. 
  

	5.	 Effect of Change in Control. 

In the event of a Change in Control of the Company at any time on or after the Date of Grant, the terms of the Plan shall control the
vesting of any Shares of Performance Based Restricted Stock which have not become vested in accordance with Section 3 or 4 hereof. 
  

	6.	 Forfeiture of Performance Based Restricted Stock. 

Upon the termination of your employment by you, the Company or its Subsidiaries for any reason other than those set forth in
Section 4 hereof prior to such vesting upon the expiration of the Restricted Period, in addition to the circumstance described in Section 9(a) hereof, any and all Shares of Performance Based Restricted Stock which have not become vested in
accordance with Section 3, 4 or 5 hereof shall be forfeited and shall revert to the Company. 
  

	7.	 Delivery of Restricted Stock. 

7.1        Except as otherwise provided in Section 7.2 hereof, evidence of the book entry
of Shares or, if requested by you prior to such lapse of restrictions, a stock certificate with respect to the Shares of Performance Based Restricted Stock for which the restrictions have lapsed pursuant to Section 3, 4 or 5 hereof, shall be
delivered to you as soon as practicable following the date on which the restrictions on such Shares of Performance Based Restricted Stock have lapsed, free of all restrictions hereunder. 

7.2        Evidence of the book entry of Shares with respect to Shares of Performance Based
Restricted Stock in respect of which the restrictions have lapsed upon your death pursuant to Section 4 hereof or, if requested by the executors or administrators of your estate upon such lapse of restrictions, a stock certificate with respect
to such Shares of Performance Based Restricted Stock, shall be delivered to the executors or administrators of your estate as soon as practicable following the Company’s receipt of notification of your death, free of all restrictions hereunder.
In the event of your death, all references herein to “you” shall also include your executors, administrators, heirs or assigns. 

 CONFIDENTIAL 
  

	8.	 Dividends and Voting Rights. 

Subject to Section 9(a) hereof, upon issuance of the Shares of Performance Based Restricted Stock, you shall have all of the rights
of a stockholder with respect to such Shares, including the right to vote the Shares and to receive all dividends or other distributions paid or made with respect thereto; provided, however, that dividends or distributions declared or
paid on the Performance Based Restricted Stock by the Company shall be deferred and reinvested in Shares of Performance Based Restricted Stock based on the Fair Market Value of a Share of the Company’s common stock on the date such dividend or
distribution is paid or made (provided that no fractional Shares will be issued), and the additional Shares of Performance Based Restricted Stock thus acquired shall be subject to the same restrictions on transfer and forfeiture and the same
vesting schedule as the Performance Based Restricted Stock in respect of which such dividends or distributions were made. 
  

	9.	 Acknowledgement and Acceptance of Award Agreement. 

(a)        The Shares of Performance Based Restricted Stock granted to you pursuant to this
Award shall be subject to your acknowledgement and acceptance of the Award and the terms of this Agreement to the Company or its Plan Administrator (including by electronic means, if so provided) no later than the earlier of (i) 180 days from the
Date of Grant and (ii) the date that is immediately prior to the date that the Performance Based Restricted Stock vests pursuant to Section 4 or 5 hereof (the “Return Date”); provided that if you die before your Return
Date, this requirement shall be deemed to be satisfied if the executor or administrator of your estate acknowledges and accepts this Agreement through the Company or its Plan Administrator no later than ninety (90) days following your death
(the “Executor Return Date”). If this Agreement is not so acknowledged and accepted on or prior to your Return Date or the Executor Return Date, as applicable, the Award of Shares of Performance Based Restricted Stock evidenced by
this Agreement shall be forfeited, and neither you nor your heirs, executors, administrators or successors shall have any rights with respect thereto. 

(b)        If this Agreement is so acknowledged and accepted on or prior to your Return Date or
the Executor Return Date, as applicable, all dividends and other distributions paid or made with respect to the Shares of Performance Based Restricted Stock granted hereunder prior to your Return Date or the Executor Return Date shall be treated in
the manner provided in Section 8 hereof. 
  

	10.	 No Right to Continued Employment. 

Nothing in this Agreement or the Plan shall interfere with or limit in any way the right of the Company or its Subsidiaries to terminate
your employment, nor confer upon you any right to continuing employment by the Company or any of its Subsidiaries or continuing service as a Board member. 
  

	11.	 Withholding of Taxes. 

Prior to the delivery to you of a stock certificate or evidence of the book entry of Shares with respect to the Shares of Performance
Based Restricted Stock in respect of which all restrictions have lapsed, you shall pay to the Company or the Company’s Plan Administrator, the federal, state and local income taxes and other amounts as may be required by law to be withheld by
the Company (the “Withholding Taxes”) with respect to such Performance Based Restricted Stock. By acknowledging and accepting this Agreement in the manner provided in Section 9 hereof, you shall be deemed to elect to have the
Company or the Plan Administrator withhold a portion of such Performance Based Restricted Stock having an aggregate Fair Market Value equal to the Withholding Taxes in satisfaction thereof, such election to continue in effect until you notify the
Company or its Plan Administrator before such delivery that you shall satisfy such obligation in cash, in which event the 

 CONFIDENTIAL 
  

 
Company or the Plan Administrator shall not withhold a portion of such Performance Based Restricted Stock as otherwise provided in this Section 11. 

 

	12.	 Acknowledgement that You Are Bound by the Plan. 

By acknowledging and accepting this Award and the terms of this Agreement you hereby confirm the availability and your review of a copy
of the Plan and the Prospectus, and other documents provided to you in connection with this Award by the Company or its Plan Administrator, and you agree to be bound by all the terms and provisions thereof. 

 

	13.	 Modification of Agreement. 

This Agreement may be modified, amended, supplemented or terminated, and any terms or conditions may be waived, but only by a written instrument
executed by both parties hereto; provided that the Company may modify, amend, supplement or terminate this Agreement in a writing signed by the Company without any further action by you if such modification, amendment, supplement or termination does
not adversely affect your rights hereunder. 
  

	14.	 Severability. 

Should any provision of this Agreement be held by a court of competent jurisdiction to be unenforceable or invalid for any reason, the
remaining provisions of this Agreement shall not be affected by such holding and shall continue in full force in accordance with their terms. 
  

	15.	 Governing Law. 

The validity, interpretation, construction and performance of this Agreement shall be governed by the laws of the State of Delaware
without giving effect to the conflicts of laws principles thereof. 
  

	16.	 Successors in Interest. 

This Agreement shall inure to the benefit of and be binding upon any successor to the Company. This Agreement shall inure to the benefit
of your legal representatives. All obligations imposed upon the Company and all rights granted to you under this Agreement shall be binding upon the Company’s successors and upon your heirs, executors, administrators and successors. 

 

	17.	 Resolution of Disputes. 

Any dispute or disagreement which may arise under, or as a result of, or in any way relate to, the interpretation, construction or
application of this Agreement shall first be referred to the Chief Executive Officer for informal resolution, and if necessary, referred to the Committee for its determination. Any determination made hereunder shall be final, binding and conclusive
on you, your heirs, executors, administrators and successors, and the Company and its Subsidiaries for all purposes. 
  

	18.	 Entire Agreement. 

This Agreement and the terms and conditions of the Plan constitute the entire understanding between you and the Company and its
Subsidiaries, and supersede all other agreements, whether written or oral, with respect to the Award. 
  

	19.	 Headings. 

 CONFIDENTIAL 
  

 The headings of this Agreement are inserted for convenience only and do not constitute
a part of this Agreement. 
  

	20.	 Notice. 

All notifications and other communications hereunder shall be in writing and, unless otherwise provided herein, shall be deemed to have
been given when received by the party to whom such notice is to be given at its address set forth below, or such other address for the party as shall be specified by notice given pursuant hereto: 

(a)        If to the Company, by regular mail to: 

            Community Health Systems, Inc. 

            4000 Meridian Boulevard 

            Franklin, TN 37067 

            Attention: General Counsel 

(b)        If to you or your legal representative, to such person at the address as reflected in
the records of the Company. 
  

	21.	 Consent to Jurisdiction. 

Each party hereby irrevocably and unconditionally consents to submit to the exclusive jurisdiction of the courts of the State of Tennessee and of the
United States of America, in each case located in the County of Williamson, for any actions, suits or proceedings arising out of or relating to this Agreement, the Award or the Plan and the transactions contemplated hereby and thereby
(“Litigation”) (and agrees not to commence any Litigation except in any such court), and further agrees that service of process, summons, notice or document by U.S. certified mail to such party’s respective address set forth in
Section 20 hereof shall be effective service of process for any Litigation brought against such party in any such court. Each party hereby irrevocably and unconditionally waives any objection to the laying of venue of any litigation in the
courts of the State of Tennessee or of the United States of America, in each case located in the County of Williamson, and hereby further irrevocably and unconditionally waives and agrees not to plead or claim in any such court that any Litigation
brought in any such court has been brought in an inconvenient forum. 
 22.           Deemed
Execution. On the date of your electronic acceptance of the terms of the Award and this Agreement, this Agreement shall be deemed to have been executed and delivered by you and the Company. 

COMMUNITY HEALTH SYSTEMS, INC.

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