Document:

<PAGE>

                                                                  EXHIBIT 10.2

                      SECOND AMENDMENT TO CREDIT AGREEMENT

      THIS SECOND AMENDMENT TO CREDIT AGREEMENT dated as of July 12, 2004 (the
"Amendment") is entered into among Ardent Health Services, Inc., a Delaware
corporation (the "Borrower"), each of the parties identified as "Guarantors" on
the signature pages hereto (the "Guarantors"), the Lenders party hereto and Bank
One, NA, as Administrative Agent, Swing Line Lender and L/C Issuer. All
capitalized terms used herein and not otherwise defined herein shall have the
meanings given to such terms in the Credit Agreement (as defined below).

                                    RECITALS

      WHEREAS, the Borrower, the Guarantors, the Lenders and the Administrative
Agent entered into that certain Credit Agreement dated as of August 19, 2003, as
amended by that certain First Amendment to Credit Agreement dated as of December
31, 2003 (as further amended and modified from time to time, the "Credit
Agreement");

      WHEREAS, the Borrower has advised the Lenders that Ardent Medical
Services, Inc. ("Ardent Medical") intends to reduce the amount of Lovelace
Intercompany Loan from $70 million to $43 million;

      WHEREAS, the Borrower has advised the Lenders that Ardent Medical intends
to make an additional intercompany loan (the "Lovelace Intercompany Loan #2") to
Lovelace and (i) to secure the Lovelace Intercompany Loan #2 with the assets of
Lovelace pursuant to the Intercompany Security Documents and (ii) to pledge
Ardent Medical's rights in the Lovelace Intercompany Loan #2 to the Collateral
Agent, in each case on or before the earlier of (a) the purchase by the Borrower
of substantially all of the assets of the Hillcrest HealthCare System in Tulsa,
Oklahoma and in certain other Oklahoma communities pursuant to and in accordance
with the terms of the that certain Asset Purchase Agreement dated as of May 11,
2004 between the Borrower and Hillcrest HealthCare System and such other
agreements, instruments and documents relating thereto (the "Hillcrest
Acquisition") and (b) September 13, 2004;

      WHEREAS, the Borrower has requested that the Lenders (i) amend the Credit
Agreement as set forth herein to permit the reduction of the Lovelace
Intercompany Loan from $70 million to $43 million, (ii) consent to Ardent
Medical waiting until the earlier of (a) the date of the closing of the
Hillcrest Acquisition and (b) September 13, 2004 to make certain modifications
to the Intercompany Security Documents securing the Lovelace Intercompany Loan
in order to reflect the reduction of the Lovelace Intercompany Loan from $70
million to $43 million, and (iii) consent to Ardent Medical waiting until the
earlier of (x) the date of the closing of the Hillcrest Acquisition and (y)
September 13, 2004 to cause the Lovelace Intercompany Loan #2 to be secured by
the assets of Lovelace and to make the related pledge of such assets to the
Collateral Agent, notwithstanding the terms of Sections 7.14 and 8.02(g) of the
Credit Agreement; and

      WHEREAS, the Lenders have agreed to amend the Credit Agreement and to
grant such consents on the terms and conditions set forth herein.

      NOW, THEREFORE, IN CONSIDERATION of the premises and other good and
valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereto agree as follows:

      1.    Amendments. The Credit Agreement is amended in the following
respects:

<PAGE>

            (a)   The definition of "Lovelace" in Section 1.01 is hereby amended
      to read as follows:

                  "Lovelace" means Lovelace Sandia Health System, Inc., a New
            Mexico corporation.

            (b)   The following definitions are hereby added to Section 1.01 in
      the appropriate alphabetical order and shall read as follows:

                  "Second Amendment Effective Date" means July 12, 2004.

            (c)   The following sentence is hereby added at the end of Section
      7.12(a)(iii) to read as follows:

                  Notwithstanding the foregoing, it is understood and agreed
            that as of the Second Amendment Effective Date, the $43,000,000
            promissory note representing the Lovelace Intercompany Loan
            satisfies the requirements of this Section 7.12(a)(iii).

            (d)   Subclause (q) of Section 8.01 is hereby amended to read as
      follows:

                  (q)   Liens in favor of the Borrower or any Loan Party on the
            assets of each HMO Subsidiary or Non-Guarantor Subsidiary in
            accordance with the terms hereof to secure the applicable
            Intercompany Note of such HMO Subsidiary or Non-Guarantor
            Subsidiary;

            (e)   Section 8.02(g) is hereby amended by replacing both references
      to "$70,000,000" in clause (i) thereof with references to "$43,000,000."

            (f)   Subclause (e) of Section 8.04 is hereby amended to read as
      follows and a new subclause (f) is hereby added thereafter to read as
      follows:

                  (e)   the Sandia Parties may merge or consolidate with
            Lovelace pursuant to the Lovelace/Sandia Merger; provided that (i)
            Lovelace shall have delivered an Intercompany Note in the amount of
            $70 million to the Borrower (it being acknowledged that the amount
            of such note as of the Second Amendment Effective Date has been
            lowered to $43 million as set out in Section 7.12(a)(iii)) and
            pledged its assets to the Borrower to secure such Intercompany Note
            pursuant to the Intercompany Security Documents and (ii) the
            Borrower shall have delivered such Intercompany Note to the
            Collateral Agent, executed Collateral Assignment Documents and
            delivered such other documentation to the Collateral Agent in
            accordance with Section 7.14 and (f) nothing in this Section 8.04
            shall prohibit any Disposition otherwise permitted under Section
            8.05.

            (g)   Subclause (i) of Section 10.11(b) is hereby amended by adding
      the following language immediately after the words "$70 million" and
      before the word "to":

            (it being acknowledged that the amount of such note as of the Second
            Amendment Effective Date has been lowered to $43 million as set out
            in Section 7.12(a)(iii))

<PAGE>

      2.    Consents. Subject to the satisfaction of the conditions precedent
set forth in Section 3 of this Amendment, the Administrative Agent and the
Lenders hereby (a) consent to the reduction of the Lovelace Intercompany Loan
from $70 million to $43 million, (b) consent to permitting Ardent Medical to
wait until the earlier of (i) the date of the closing of the Hillcrest
Acquisition and (ii) September 13, 2004 to make certain modifications to the
Intercompany Security Documents securing the Lovelace Intercompany Loan in order
to reflect the reduction of the Lovelace Intercompany Loan from $70 million to
$43 million, and (c) consent to permitting Ardent Medical to wait until the
earlier (i) the date of the closing of the Hillcrest Acquisition and (ii)
September 13, 2004 to cause the Lovelace Intercompany Loan #2 to be secured by
the assets of Lovelace and to make the related pledge of such assets to the
Collateral Agent, notwithstanding the terms of Sections 7.14 and 8.02(g) of the
Credit Agreement. This consent is limited solely to the consents specifically
identified in the preceding sentence, and nothing contained in this Amendment
shall be deemed to constitute a waiver of any other rights or remedies the
Administrative Agent or any Lender may have under the Credit Agreement, any
other Loan Documents, applicable law or any of the obligations of any Loan Party
thereunder.

      3.    Conditions Precedent. This Amendment shall be effective upon
satisfaction of the following conditions precedent:

            (a)   receipt by the Administrative Agent of this Amendment executed
      by the Borrower, the Guarantors, the Required Lenders and the
      Administrative Agent; and

            (b)   receipt by the Collateral Agent of a replacement promissory
      note evidencing the Lovelace Intercompany Loan in the amount of
      $43,000,000 in form and substance satisfactory to the Collateral Agent.

      4.    Miscellaneous.

            (a)   The Credit Agreement, and the obligations of the Loan Parties
      thereunder and under the other Loan Documents, are hereby ratified and
      confirmed and shall remain in full force and effect according to their
      terms.

            (b)   Each Guarantor (i) acknowledges and consents to all of the
      terms and conditions of this Amendment, (ii) affirms all of its
      obligations under the Loan Documents, (iii) agrees that this Amendment and
      all documents executed in connection herewith do not operate to reduce or
      discharge its obligations under the Credit Agreement or the other Loan
      Documents and (iv) hereby confirms and agrees that its Guaranty shall
      continue and remain in full force and effect after giving effect to this
      Amendment and that, notwithstanding any contrary terms in such Guaranty,
      such Guaranty now applies to the Credit Agreement as amended by this
      Amendment.

            (c)   The Borrower and the Guarantors hereby represent and warrant
      as follows:

                  (i)   Each Loan Party has taken all necessary action to
            authorize the execution, delivery and performance of this Amendment.

                  (ii)  This Amendment has been duly executed and delivered by
            the Loan Parties and constitutes each of the Loan Parties' legal,
            valid and binding obligations, enforceable 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

<PAGE>

            principles of equity (regardless of whether such enforceability is
            considered in a proceeding at law or in equity).

                  (iii) 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 any Loan Party of this
            Amendment, other than those that have already been obtained and are
            in full force and effect as of the date hereof.

            (d)   The Loan Parties represent and warrant to the Lenders that (i)
      the representations and warranties of the Loan Parties set forth in
      Article VI of the Credit Agreement and in each other Loan Document are
      true and correct in all material respects as of the date hereof with the
      same effect as if made on and as of the date hereof, except to the extent
      such representations and warranties expressly relate solely to an earlier
      date and (ii) no event has occurred and is continuing which constitutes a
      Default or an Event of Default.

            (e)   The Borrower agrees to pay all reasonable costs and expenses
      of the Administrative Agent in connection with the preparation, execution
      and delivery of this Amendment, including without limitation the
      reasonable fees and expenses of Moore & Van Allen, PLLC.

            (f)   This Amendment may be executed in any number of counterparts,
      each of which when so executed and delivered shall be an original, but all
      of which shall constitute one and the same instrument. Delivery of an
      executed counterpart of this Amendment by telecopy shall be effective as
      an original and shall constitute a representation that an executed
      original shall be delivered.

            (g)   THIS AMENDMENT AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES
      HEREUNDER SHALL BE GOVERNED BY AND CONSTRUED AND INTERPRETED IN ACCORDANCE
      WITH THE LAWS OF THE STATE OF NEW YORK.

                            [Signature pages follow]

<PAGE>

      Each of the parties hereto has caused a counterpart of this Amendment to
be duly executed and delivered as of the date first above written.

BORROWER:       ARDENT HEALTH SERVICES, INC.,
                a Delaware corporation

                By: /s/ R. Dirk Allison
                    ------------------------------
                Name: R. Dirk Allison
                Title: Executive Vice President and Chief Financial Officer

GUARANTORS:     ARDENT HEALTH SERVICES LLC,
                a Delaware limited liability company

                By: /s/ R. Dirk Allison
                    ------------------------------
                Name:  R. Dirk Allison
                Title:  Executive Vice President and Chief Financial Officer

                AHS ALBUQUERQUE HOLDINGS, LLC,
                a New Mexico limited liability company
                AHS CUMBERLAND HOSPITAL, LLC,
                a Virginia limited liability company
                AHS KENTUCKY HOLDINGS, INC.,
                a Delaware corporation
                AHS KENTUCKY HOSPITALS, INC.,
                a Delaware corporation
                AHS LOUISIANA HOLDINGS, INC.,
                a Delaware corporation
                AHS LOUISIANA HOSPITALS, INC.,
                a Delaware corporation
                AHS MANAGEMENT COMPANY, INC.,
                a Tennessee corporation
                AHS NEW MEXICO HOLDINGS, INC.,
                a New Mexico corporation
                AHS SAMARITAN HOSPITAL, LLC,
                a Kentucky limited liability company
                AHS S.E.D. MEDICAL LABORATORIES, INC.,
                a New Mexico corporation
                AHS SUMMIT HOSPITAL, LLC,
                a Delaware limited liability company
                ARDENT MEDICAL SERVICES, INC.,
                a Delaware corporation
                BEHAVIORAL HEALTHCARE CORPORATION,
                a Delaware corporation

                By: ______________________________
                Name: R. Dirk Allison
                Title: Senior Vice President of each of the foregoing Guarantors

<PAGE>

      Each of the parties hereto has caused a counterpart of this Amendment to
be duly executed and delivered as of the date first above written.

BORROWER:       ARDENT HEALTH SERVICES, INC.,
                a Delaware corporation

                By: _________________________________
                Name:
                Title:

GUARANTORS:     ARDENT HEALTH SERVICES LLC,
                a Delaware limited liability company

                By: _________________________________
                Name: R. Dirk Allison
                Title: Executive Vice President and Chief Financial Officer

                AHS ALBUQUERQUE HOLDINGS, LLC,
                a New Mexico limited liability company
                AHS CUMBERLAND HOSPITAL, LLC,
                a Virginia limited liability company
                AHS KENTUCKY HOLDINGS, INC.,
                a Delaware corporation
                AHS KENTUCKY HOSPITALS, INC.,
                a Delaware corporation
                AHS LOUISIANA HOLDINGS, INC.,
                a Delaware corporation
                AHS LOUISIANA HOSPITALS, INC.,
                a Delaware corporation
                AHS MANAGEMENT COMPANY, INC.,
                a Tennessee corporation
                AHS NEW MEXICO HOLDINGS, INC.,
                a New Mexico corporation
                AHS SAMARITAN HOSPITAL, LLC,
                a Kentucky limited liability company
                AHS S.E.D. MEDICAL LABORATORIES, INC.,
                a New Mexico corporation
                AHS SUMMIT HOSPITAL, LLC,
                a Delaware limited liability company
                ARDENT MEDICAL SERVICES, INC.,
                a Delaware corporation
                BEHAVIORAL HEALTHCARE CORPORATION,
                a Delaware corporation

                By: /s/ R. Dirk Allison
                    -----------------------------
                Name:  R. Dirk Allison
                Title: Senior Vice President of each of the foregoing Guarantors

<PAGE>

                BHC MANAGEMENT SERVICES OF NEW MEXICO, LLC,
                a Delaware limited liability company
                BHC MANAGEMENT SERVICES OF STREAMWOOD, LLC,
                a Delaware limited liability company
                BHC MEADOWS PARTNER, INC.,
                a Delaware corporation
                BHC MONTEVISTA HOSPITAL, INC.,
                a Nevada corporation
                BHC OF INDIANA, GENERAL PARTNERSHIP,
                a Tennessee general partnership
                BHC ALHAMBRA HOSPITAL, INC.,
                a Tennessee corporation
                BHC BELMONT PINES HOSPITAL, INC.,
                a Tennessee corporation
                BHC CEDAR VISTA HOSPITAL, INC.,
                a California corporation
                BHC COLUMBUS HOSPITAL, INC.,
                a Tennessee corporation
                BHC FAIRFAX HOSPITAL, INC.,
                a Tennessee corporation
                BHC FOX RUN HOSPITAL, INC.,
                a Tennessee corporation
                BHC FREMONT HOSPITAL, INC.,
                a Tennessee corporation
                BHC GULF COAST MANAGEMENT GROUP, INC.,
                a Tennessee corporation
                BHC HEALTH SERVICES OF NEVADA, INC.,
                a Nevada corporation
                BHC HERITAGE OAKS HOSPITAL, INC.,
                a Tennessee corporation
                BHC HOSPITAL HOLDINGS, INC.,
                a Delaware corporation
                BHC INTERMOUNTAIN HOSPITAL, INC.,
                a Tennessee corporation
                BHC LEBANON HOSPITAL, INC.,
                a Tennessee corporation
                BHC MANAGEMENT HOLDINGS, INC.,
                a Delaware corporation
                BHC MANAGEMENT SERVICES, LLC,
                a Delaware limited liability company
                BHC MANAGEMENT SERVICES OF INDIANA, LLC,
                a Delaware limited liability company
                BHC MANAGEMENT SERVICES OF KENTUCKY, LLC,
                a Delaware limited liability company

                By: /s/ R. Dirk Allison
                    -----------------------------
                Name:  R. Dirk Allison
                Title: Senior Vice President of each of the foregoing Guarantors

<PAGE>

                BHC OF NORTHERN INDIANA, INC.,
                a Tennessee corporation
                BHC PHYSICIAN SERVICES OF KENTUCKY, LLC,
                a Delaware limited liability company
                BHC PINNACLE POINTE HOSPITAL, INC.,
                a Tennessee corporation
                BHC PROPERTIES, INC.,
                a Tennessee corporation
                BHC SIERRA VISTA HOSPITAL, INC.,
                a Tennessee corporation
                BHC SPIRIT OF ST. LOUIS HOSPITAL, INC.,
                a Tennessee corporation
                BHC STREAMWOOD HOSPITAL, INC.,
                a Tennessee corporation
                BHC VALLE VISTA HOSPITAL, INC.,
                a Tennessee corporation
                BHC WINDSOR HOSPITAL, INC.,
                an Ohio corporation
                BLOOMINGTON MEADOWS, G.P.,
                a Delaware general partnership
                COLUMBUS HOSPITAL, LLC,
                a Delaware limited liability company
                INDIANA PSYCHIATRIC INSTITUTES, INC.,
                a Delaware corporation
                LEBANON HOSPITAL, LLC,
                a Delaware limited liability company
                MESILLA VALLEY GENERAL PARTNERSHIP,
                a New Mexico general partnership
                MESILLA VALLEY MENTAL HEALTH ASSOCIATES, INC.,
                a New Mexico corporation
                NORTHERN INDIANA HOSPITAL, LLC,
                a Delaware limited liability company
                VALLE VISTA, LLC,
                a Delaware limited liability company
                WILLOW SPRINGS, LLC,
                a Delaware limited liability company
                AHS RESEARCH AND REVIEW, LLC,
                a New Mexico limited liability company
                BHC NORTHWEST PSYCHIATRIC HOSPITAL, LLC,
                a Delaware limited liability company

                By: /s/ R. Dirk Allison
                    -----------------------------
                Name:  R. Dirk Allison
                Title: Senior Vice President of each of the foregoing Guarantors

<PAGE>

ADMINISTRATIVE
AGENT:                       BANK ONE, NA,
                             as Administrative Agent

                             By: /s/ Timothy K. Boyle
                                 -----------------------------------------------
                             Name:  Timothy K. Boyle
                             Title: First Vice President

LENDERS:                     BANK ONE, NA,

                             By: /s/ Timothy K. Boyle
                                 -----------------------------------------------
                             Name:  Timothy K. Boyle
                             Title: First Vice President

                             BANK OF AMERICA, N.A.

                             By: /s/ James W. Ford
                                 -----------------------------------------------
                             Name:  James W. Ford
                             Title: Managing Director

                             UBS AG, CAYMAN ISLANDS BRANCH

                             By: /s/ Wilfred V. Salmi
                                 -----------------------------------------------
                             Name:  Wilfred V. Salmi
                             Title: Director
                                    Banking Products Services, US

                             By: /s/ Salloz Sikka
                                 -----------------------------------------------
                             Name:  Salloz Sikka
                             Title: Associate Director
                                    Banking Products Services, US

                             MERRILL LYNCH CAPITAL, A DIVISION OF
                             MERRILL LYNCH BUSINESS FINANCIAL SERVICES INC.

                             By: _______________________________________________
                             Name:
                             Title:

                             GENERAL ELECTRIC CAPITAL CORPORATION

                             By: /s/ R. Hanes Whiteley
                                 -----------------------------------------------
                             Name:  R. Hanes Whiteley
                             Title: Vice President

                             RESIDENTIAL FUNDING CORPORATION

                             By: _______________________________________________
                             Name:
                             Title:

<PAGE>

                             FLEET NATIONAL BANK

                             By: /s/ James W. Ford
                                 -----------------------------------------------
                             Name:  James W. Ford
                             Title: Managing Director

                             FIFTH THIRD BANK

                             By: _______________________________________________
                             Name:
                             Title:<PAGE>
\
                                                                   EXHIBIT 10.3

                                                               EXECUTION VERSION

            SECOND AMENDED AND RESTATED INTERCOMPANY PROMISSORY NOTE

$43,000,000                                                        July 12, 2004

      FOR VALUE RECEIVED, LOVELACE SANDIA HEALTH SYSTEM, INC. (formerly known as
Lovelace Health Systems, Inc. and as successor in interest to AHS Albuquerque
Regional Medical Center LLC), a New Mexico corporation (together its successors
and permitted assignees, the "Company"), promises to pay to the order of ARDENT
MEDICAL SERVICES, INC. (as successor in interest to Ardent Health Services,
Inc.), a Delaware corporation (the "Holder"), the Principal Sum (defined below),
together with interest thereon as set forth below.

      WHEREAS, the Company was indebted to the Holder (as successor to Ardent
Health Services, Inc.) under the terms of that certain Amended and Restated
Intercompany Promissory Note dated October 1, 2003 with a stated principal
amount equal to $70,000,000 the ("Existing Note"); and

      WHEREAS the Company and the Holder desire to amend and restate the
Existing Note to reflect a new stated principal amount equal to $43,000,000.

1.    Definitions. All capitalized terms used herein but not otherwise defined
herein shall have the meanings assigned to such terms in the Credit Agreement.
For purposes of this Second Amended and Restated Intercompany Promissory Note
(this "Note"), the following terms shall have the meanings specified below:

      (a)   "Credit Agreement" shall mean that Credit Agreement dated as of
August 19, 2003 by and among the Ardent Health Services, Inc., as borrower,
Holder and the other guarantors identified therein, the lenders identified
therein and Bank One, NA, as administrative agent (together with its successors
and assigns, the "Administrative Agent"), as the same may be amended, modified,
supplemented, extended, increased, refinanced, restated or replaced from time to
time.

      (b)   "Default Rate" shall mean an interest rate equal to the interest
rate required by Section 2(a) plus two percent per annum.

      (c)   "Intercompany Security Documents" means any security agreement,
pledge, mortgage, deed of trust, or other security document executed by the
Company in favor of the Holder, as amended or modified in accordance with the
terms of the Credit Agreement.

      (d)   "Maturity Date" shall have the meaning assigned to such term in
Section 3 hereof.

      (e)   "Obligations" shall have the meaning assigned to such term in the
Credit Agreement.

      (f)   "Principal Sum" means $43,000,000.

<PAGE>

      (g)   "Responsible Officer" means the chief executive officer, president,
chief financial officer controller, or treasurer of the Company.

      (h)   "Secured Obligations" has the meaning set forth in the Intercreditor
and Subordination Agreement

2.    Interest. (a) Interest shall accrue on the Principal Sum from the date
hereof at the rate equal to the greater of (a) Base Rate plus four percent
(4.0%) per annum, and (b) six percent (6.0%) per annum (each calculated on the
basis of a 365 day year). Interest shall be due and payable on demand.

      (b)   Upon the occurrence and during the continuation of an Event of
Default, interest on the Principal Sum shall accrue at the Default Rate to the
fullest extent permitted by law.

3.    Maturity Date. The Principal Sum plus all accrued interest shall be due
and payable on the later of (a) November 19, 2008, and (b) 30 days after the
date all Obligations under the Credit Agreement (other than contingent indemnity
obligations that expressly survive termination of the Credit Agreement) are
satisfied in cash in full and all Commitments thereunder have been terminated,
unless accelerated sooner pursuant to Section 6 (the applicable date being
referred to herein as the "Maturity Date"). The Principal Sum shall not be
subject to any scheduled amortization installments.

4.    Prepayments. Subject to Section 6, the Company shall not make, and the
Holder shall not accept, any prepayment (voluntary or mandatory) prior to the
Maturity Date.

5.    Events of Default. The occurrence of any of the following events shall
constitute an Event of Default (each "Event of Default"):

      (a)   the Company shall fail to pay within five (5) days of when required
to be paid herein, any principal, interest or other amounts under this Note; or

      (b)   the Company shall fail to perform or observe any covenant or
agreement contained in this Note or in any Intercompany Security Document on its
part to be performed or observed and such failure continues for thirty days
after the earlier of a Responsible Officer of the Company becoming aware of such
default or notice thereof by the Collateral Agent; or

      (c)   the occurrence of an "Event of Default"' under, and as defined in,
the Credit Agreement, the effect of which is to cause the "Obligations" (as
defined in the Credit Agreement) to be accelerated, demanded due or to otherwise
become due and payable.

6.    Remedies. Upon the occurrence of an Event of Default, the Holder may take
any or all of the following actions:

            (a)   declare the Principal Sum and all accrued interest to be
      immediately due and payable, without presentment, demand, protest or other
      notice of any kind, all of which are hereby expressly waived by the
      Company; and

                                        2
<PAGE>

            (b)   exercise all rights and remedies available to it under the
      Intercompany Security Documents or applicable law;

      provided, however, that upon the occurrence of an actual or deemed entry
      of an order for relief with respect to the Company under the Bankruptcy
      Code of the United States, the Principal Sum and all accrued interest
      shall automatically become due and payable, in each case without further
      act of the Holder.

7.    Assignment. The Holder will, immediately upon receipt of this Note, grant
a security interest in, and collateral assign, all of its rights and benefits
under this Note to the Collateral Agent as collateral security for the Secured
Obligations. The Holder may not assign this Note, in whole or in part, to any
other party without the consent of the Collateral Agent (and any purported
assignment or transfer without such consent shall be void). The Company may not
assign this Note, in whole or in part, to any party without the consent of the
Collateral Agent (and any purported assignment or transfer without such consent
shall be void).

8.    Amendments. This Note may not be amended, waived, modified or supplemented
without the prior written consent of the Company and the Collateral Agent.

9.    Third Party Beneficiary Rights. The holders of the Secured Obligations
have made loans and other extensions of credit to the Holder in reliance on the
provisions of this Note, including, without limitation, the provisions of
Sections 4, 5, 6 and 7. The holders of the Secured Obligations are third party
beneficiaries of this Note including, without limitation, the provisions of
Sections 4, 5, 6 and 7. Accordingly, the Collateral Agent shall be entitled to
enforce the provisions of this Note including, without limitation, the
provisions of Sections 4, 5, 6 and 7, against the Holder and/or the Company.

10.   Interest Rate Limitations. Notwithstanding anything to the contrary
contained herein, the interest paid or agreed to be paid under this Note shall
not exceed the maximum rate of non-usurious interest permitted by applicable law
(the "Maximum Rate"). If the Holder shall receive interest in an amount that
exceeds the Maximum Rate, the excess interest shall be refunded to the Company.

11.   Severability. In the event any one or more of the provisions contained in
this Note should be held invalid, illegal or unenforceable in any respect, the
validity, legality and enforceability of the remaining provisions contained
herein or therein shall not in any way be affected or impaired thereby. The
parties shall endeavor in good-faith negotiations to replace the invalid,
illegal or unenforceable provisions with valid provisions the economic effect of
which comes as close as possible to that of the invalid, illegal or
unenforceable provisions.

12.   Counterparts. This Note may be executed in any number of counterparts,
each of which when so executed and delivered shall be an original, but all of
which shall constitute one and the same instrument.

13.   Governing Law. This Note shall be construed in accordance with and
governed by the laws of the State of New Mexico (other than the conflicts of law
principles thereof). Except as prohibited by law, each party hereto hereby
waives any right it may have to a trial by jury in

                                        3
<PAGE>

respect of any litigation directly or indirectly arising out of, under or in
connection with this Note.

14.   Applicable Law Limitations. The Principal Sum may be reduced at any time
prior to the Maturity Date by the minimum amount necessary to maintain the
Company's compliance with minimum net worth or other applicable solvency
requirements set forth in Chapter 59A NMSA 1978 or the regulations promulgated
thereunder. The Company will provide Holder with written notice of such
reduction within five (5) Business Days after it occurs, and shall include an
explanation regarding the reasons for the reduction and its anticipated
duration.

15.   No Novation. The principal amount of this Note includes the indebtedness
heretofore evidenced by the Existing Note. This Note (i) merely re-evidences the
indebtedness heretofore evidenced by the Existing Note, (ii) is given in
substitution for, and not as payment of, the Existing Note and (iii) is in no
way intended to constitute a novation of the Company's indebtedness which was
evidenced by the Existing Note.

                            [Signature Page Follows]

                                        4
<PAGE>

      IN WITNESS WHEREOF, the Company has caused this Note to be duly executed
as of the day and year first above written.

                             LOVELACE SANDIA HEALTH SYSTEM, INC.,
                             as the Company

                             By: /s/ R. Dirk Allison
                                 -------------------------------
                             Name: R. Dirk Allison
                             Title: Senior Vice President

ACKNOWLEDGED AND AGREED:

ARDENT MEDICAL SERVICES, INC.,
as the Holder

By: /s/ R. Dirk Allison
    ----------------------------------
Name:  R. Dirk Allison
Title: Senior Vice President

BANK ONE, NA,
as Collateral Agent

By: /s/ Timothy K. Boyle
    ----------------------------------
Name:  Timothy K. Boyle
Title: First Vice President

            Second Amended and Restated Intercompany Promissory Note

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00070-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00070-of-00352.parquet"}]]