Document:

<PAGE>
                                                                    Exhibit 10.3

                       CHS/COMMUNITY HEALTH SYSTEMS, INC.

                              OFFICER'S CERTIFICATE

The undersigned, Linda Parsons, in her capacity as Vice President of
CHS/Community Health Systems, Inc. (the "Company"), does hereby certify on
information and belief the following with respect to the Community Health
Systems, Inc. 401(k) Plan (the "Plan"):

         1.       The Fourth Amendment to the Plan, restated as of January 1,
                  2002, was executed on April 8, 2003.

         2.       The Fifth Amendment to the Plan, restated as of January 1,
                  2002, was executed on May 7, 2003.

         3.       The Sixth Amendment to the Plan, restated as of January 1,
                  2002, was executed on July 18, 2003.

         IN WITNESS WHEREOF, I have executed this Officer's Certificate solely
in my capacity as an officer of the Company on the 14th day of May, 2004.

                                         CHS/COMMUNITY HEALTH SYSTEMS, INC.

                                         By: /s/ LINDA PARSONS, V. P.
                                             -----------------------------------
                                             Linda Parsons, Vice President<PAGE>
                                                                    EXHIBIT 10.4

                             THIRD AMENDMENT TO THE

                   COMMUNITY HEALTH SYSTEMS, INC. 401(K) PLAN

         WHEREAS, CHS/Community Health Systems, Inc. (the "Company") has
previously established and currently maintains the Community Health Systems,
Inc. 401(k) Plan (the "Plan"); and

         WHEREAS, the Company has retained the right to amend the Plan in
Section 8.1 of the Plan; and

         WHEREAS, the Company wishes to amend the Plan to clarify provisions
relating to eligibility for Employer Matching Contributions under the Plan,
effective as of January 1, 2004; and

         WHEREAS, the Company wishes to amend the Plan in connection with the
acquisition of Galesburg Cottage Hospital to include special provisions relating
to the transfer and assignment to the Plan of the accounts of participants in
the Galesburg Cottage Hospital Retirement Plan, effective as of July 1, 2004;
and

         WHEREAS, the Company wishes to amend the Plan exhibits relating to
eligibility and employer contributions; and

         WHEREAS, the Board of Directors has approved of such amendment to the
Plan.

         NOW, THEREFORE, the Plan is hereby amended in the following respects,
effective as of the dates set forth herein:

         1. The following subsection shall be added to the Plan as Section
4.1(h), effective as of July 1, 2004:

                  (h) The amount of the total after-tax contributions made by
         Participants who were participants in the Galesburg Cottage Hospital
         Retirement Plan prior to July 1, 2004, which contributions were
         transferred to the Plan.

         2. Paragraph (2) of subsection (b) of Section 4.4 of the Plan,
"Allocation of Contribution, Forfeitures and Earnings," is hereby deleted and
replaced in its entirety as follows, effective as of January 1, 2004:

         (2) With respect to the Employer Matching Contribution made pursuant to
         Section 4. l(b), except for the Employer Elective Contribution to
         another plan maintained by the Employer, to each Participant's matching
         Account in an amount to be determined in accordance with Section
         4.1(b). Such Account shall be subject to the applicable vesting
         schedule. Only Participants who are actively employed at the beginning
         of the last day of the Plan Year by the Employer or an Affiliated
         Employer whose Employees are eligible for a matching contribution

                                      -1-

<PAGE>

                                                                    EXHIBIT 10.4

         under Section 4.1(b) shall be eligible to share in the Employer
         Matching Contribution for the year. However, if a Participant incurs a
         1-Year Break in Service while still employed by the Employer, such
         Participant will not be eligible to share in any matching contributions
         for future Plan Years until the Participant completes 500 Hours of
         Service during a Plan Year, at which point the Participant will be
         eligible to share in the Employer Matching Contributions for all
         succeeding Plan Years in accordance with the other provisions of the
         Plan. Notwithstanding the foregoing, a Participant who is employed by
         the Employer or an Affiliated Employer whose Employees are eligible for
         a matching contribution under Section 4.1(b) and who retires (normal or
         late), has a Total and Permanent Disability, or dies during the Plan
         Year, shall be deemed to have been employed at the beginning of the
         last day of such Plan Year.

         3. Subsection (e) is hereby added to Section 6.10 of the Plan,
"Pre-Retirement Distribution," as follows, effective July 1, 2004:

                  (e) Notwithstanding any provision of this Section 6.10 to the
         contrary, pre-retirement distributions may be made pursuant to Section
         6.10(a) from the vested portion of a Participant's Account that is
         attributable to employer matching contributions under the Galesburg
         Cottage Hospital Retirement Plan.

         4. Paragraph (1) of Section 5 of the Good Faith Amendment of the
Community Health Systems, Inc. 401(k) Plan for the Economic Growth and Tax
Relief Reconciliation Act of 2001 (the "EGTRRA Addendum") is hereby deleted and
replaced in its entirety, effective July 1, 2004:

                  1. Effective March 1, 2002, with the consent of the
         Administrator, provided the trust from which such funds are transferred
         permits the transfer to be made and the transfer will not jeopardize
         the tax exempt status of the Plan or Trust or create adverse tax
         consequences for the Employer, amounts may be transferred (within the
         meaning of Code Section 414(l)) to this Plan in a direct rollover from
         a qualified plan described in section 401(a) or 403(a) of the Code,
         excluding after-tax employee contributions, an annuity contract
         described in section 403(b) of the Code, excluding after-tax employee
         contributions, and an eligible plan under section 457(b) of the Code
         that is maintained by a state, political subdivision of a state, or any
         agency or instrumentality of a state or political subdivision of a
         state. Notwithstanding the preceding sentence, effective July 1, 2004,
         amounts attributable to after-tax employee contributions may be
         transferred to this Plan from the Galesburg Cottage Hospital Retirement
         Plan.

         5. Exhibits A, B, and C of the Plan are hereby deleted and replaced in
their entirety in substantially the same form as set forth in the Exhibits
attached hereto, effective as of the dates set forth therein.

         6. Except as otherwise provided in this Third Amendment, the Plan shall
remain in full force and effect.

                                      -2-

<PAGE>

                                                                    EXHIBIT 10.4

         SIGNED this 18th day of May, 2004, effective as of the dates set forth
herein.

                                    CHS/COMMUNITY HEALTH SYSTEMS, INC.

                                    By:    /s/ LINDA K PARSONS
                                           ------------------------------------

                                    Title: Vice President
                                           ------------------------------------

                                      -3-

<PAGE>

                                                                    EXHIBIT 10.4

                       CHS/COMMUNITY HEALTH SYSTEMS, INC.

                   WRITTEN CONSENT OF THE BOARD OF DIRECTORS

         The undersigned, being all of the members of the Board of Directors of
CHS/Community Health Systems, Inc. (the "Company"), do hereby consent to the
taking of this action without a meeting, and, as evidenced by their signatures
below, the following resolutions are hereby adopted, ratified, and confirmed:

         WHEREAS, the Company has previously established and currently maintains
the Community Health Systems, Inc. 401(k) Plan (the "Plan"); and

         WHEREAS, the Company has retained the right to amend the Plan in
Section 8.1 of the Plan; and

         WHEREAS, the Company wishes to amend the Plan to clarify provisions
relating to eligibility for Employer Matching Contributions under the Plan,
effective as of January 1, 2004; and

         WHEREAS, the Company wishes to amend the Plan in connection with the
acquisition of Galesburg Cottage Hospital to include special provisions relating
to the transfer and assignment to the Plan of the accounts of participants in
the Galesburg Cottage Hospital Retirement Plan, effective July 1, 2004; and

         WHEREAS, the Company wishes to amend the Plan exhibits relating to
eligibility and employer contributions; and

         WHEREAS, the directors have received a copy of the Third Amendment to
the Plan attached hereto for such purposes and wish to approve of the Third
Amendment to the Plan.

         NOW, THEREFORE, BE IT RESOLVED, that the Plan be and the same is hereby
amended as reflected in the Third Amendment, effective as of the dates set forth
therein.

         BE IT FURTHER RESOLVED, that any officer of the Company be and he or
she is hereby authorized and directed to execute the attached Third Amendment
and to take all other such actions, and to sign all such other documents, as may
be necessary to carry out the intent of the foregoing resolutions.

         SIGNED this 18th day of May, 2004, effective as of the dates set forth
herein.

                                             /s/ WAYNE T. SMITH
                                             -----------------------------------
                                             Wayne T. Smith

                                             /s/ W. LARRY CASH
                                             -----------------------------------
                                             W. Larry Cash

                                             /s/ RACHEL A. SEIFERT
                                             -----------------------------------
                                             Rachel A. Seifert

<PAGE>

                                                                    EXHIBIT 10.4

                                    EXHIBIT A

                                   ELIGIBILITY

         Notwithstanding any provision of the Plan to the contrary, the
following provisions shall apply to eligibility to participate in the Plan under
Section 1.17:

1.       Effective as of July 1, 2002, Employees of Northampton Hospital
         Corporation shall be eligible to participate in the Plan including
         Employees whose employment is governed by a collective bargaining
         agreement between the Affiliated Employer and "employee
         representatives" under which retirement benefits were the subject of
         good faith bargaining.

2.       Effective as of January 1, 2003, Employees of Watsonville Hospital
         Corporation shall not be Eligible Employees except for Employees who
         have ever been Highly Compensated Employees of Watsonville Hospital
         Corporation and who are not Employees whose employment is governed by a
         collective bargaining agreement between the Affiliated Employer and
         "employee representatives" under which retirement benefits were the
         subject of good faith bargaining.

3.       Effective for the period beginning August 1, 2003, and ending December
         31, 2003, Employees of Pottstown Hospital Company, LLC who are
         hospital-based physicians shall not be eligible to participate in the
         Plan. For purposes of the foregoing, "hospital-based physician" means a
         physician Employee of Pottstown Hospital Company, LLC whose primary
         place of employment is Pottstown Memorial Medical Center.

4.       Effective for the period beginning August 1, 2003, and ending December
         31, 2003, Employees of Pottstown Imaging Center, LLC shall be eligible
         to participate in the Plan for purposes of allocation of the
         discretionary contribution described in Exhibit C; provided, however,
         that such Employees shall not be eligible to make elective
         contributions under the Plan.

5.       Effective as of July 1, 2004, Employees of Pottstown Hospital Company,
         LLC whose employment is governed by a collective bargaining agreement
         between the Affiliated Employer and "employee representatives" under
         which retirement benefits were the subject of good faith bargaining
         shall be eligible to participate in the Plan.

                                      A-1

<PAGE>

                                                                    EXHIBIT 10.4

                                   EXHIBIT B

                        EMPLOYER MATCHING CONTRIBUTIONS

         Notwithstanding any provision of the Plan to the contrary, the
following provisions shall apply to the Employer matching contributions under
Section 4.1(b) of the Plan:

1.       Effective as of January 1, 2002, Eligible Employees of Northampton
         Hospital Corporation whose employment is governed by a collective
         bargaining agreement shall not be eligible to share in matching
         contributions made pursuant to Section 4.1(b).

2.       Effective as of January 1, 2003, the matching contribution made on
         behalf of those Participants who are eligible to share in matching
         contributions and who are employed by Northampton Hospital Corporation
         shall be 50% of such Participant's Elective Contribution for such Plan
         Year that does not exceed 6% of the Participant's Compensation for the
         Plan Year. For the period beginning on July 1, 2002, and ending on
         December 31, 2002, the discretionary matching contribution was 50% of
         such Participant's Elective Contribution for such Plan Year that does
         not exceed 6% of the Participant's Compensation for the Plan Year.

3.       For the Plan Years beginning January 1, 2003, and ending December 31,
         2004, each Employee of Petersburg Hospital Company, LLC who is a
         Participant in the Plan and (i) has at least 1,000 Hours of Service for
         an Affiliated Employer during the applicable Plan Year, and (ii) is
         otherwise eligible to share in matching contributions shall receive a
         discretionary matching contribution in an amount equal to:

                  (A) 1/3 of such Participant's Elective Contribution for such
                  Plan Year that does not exceed 6% of the Participant's
                  Compensation for the Plan Year if the Participant has at least
                  one (1) but no more than nine (9) Years of Service;

                  (B) 1/2 of such Participant's Elective Contribution for such
                  Plan Year that does not exceed 6% of the Participant's
                  Compensation for the Plan Year if the Participant has at least
                  ten (10) but no more than nineteen (19) Years of Service; and

                  (C) 2/3 of such Participant's Elective Contribution for such
                  Plan Year that does not exceed 6% of the Participant's
                  Compensation for the Plan Year if the Participant has at least
                  twenty (20) Years of Service.

         Notwithstanding the foregoing, an Employee of Petersburg Hospital
         Company, LLC who is a Participant in the Plan and is a Highly
         Compensated Employee who is eligible to share in matching contributions
         for the Plan Year shall only receive a discretionary matching
         contribution that is a percentage of such Participant's Elective
         Contribution for the Plan Year that does not exceed 6% of the
         Participant's Compensation for the Plan Year.

                                      B-l

<PAGE>

                                                                    EXHIBIT 10.4

4.       Effective as of August 1, 2003, each Employee of Pottstown Hospital
         Company, LLC who is a Participant in the Plan shall not be eligible to
         share in matching contributions made pursuant to Section 4.1(b).
         Notwithstanding the foregoing, effective as of January 1, 2004, each
         Employee of Pottstown Hospital Company, LLC who is a Participant in the
         Plan and (i) is a Highly Compensated Employee, and (ii) is otherwise
         eligible to share in matching contributions for the Plan Year shall
         receive a discretionary matching contribution that is a percentage of
         such Participant's Elective Contribution for the Plan Year that does
         not exceed 6% of the Participant's Compensation for the Plan Year.
         Notwithstanding the foregoing, effective for the Plan Year beginning
         January 1, 2004, each physician Employee of Pottstown Hospital Company,
         LLC who is a Participant in the Plan and (i) is not a hospital-based
         physician, (ii) is a Non-Highly Compensated Employee, and (iii) is
         otherwise eligible to share in matching contributions shall receive a
         discretionary matching contribution in an amount equal to fifty percent
         (50%) of such Participant's Elective Contribution for such Plan Year
         that does not exceed 6% of the Participant's Compensation for the Plan
         Year. For purposes of the foregoing, "hospital-based physician" means a
         physician Employee of Pottstown Hospital Company, LLC whose primary
         place of employment is Pottstown Memorial Medical Center.

5.       For the period beginning August 1, 2003, and ending December 31, 2004,
         each Employee of Pottstown Clinic Company, LLC who is a Participant in
         the Plan and (i) has at least 1,000 Hours of Service for the Affiliated
         Employer during the applicable Plan Year, (ii) is a Non-Highly
         Compensated Employee, and (iii) is otherwise eligible to share in
         matching contributions shall receive a discretionary matching
         contribution in an amount equal to fifty percent (50%) of such
         Participant's Elective Contribution for such Plan Year that does not
         exceed 6% of the Participant's Compensation for the Plan Year.

6.       For the period beginning January 1, 2004, and ending December 31, 2004,
         each Employee of Pottstown Imaging Center, LLC who is a Participant in
         the Plan and (i) has at least 1,000 Hours of Service for the Affiliated
         Employer during the applicable Plan Year, (ii) is a Non-Highly
         Compensated Employee, and (iii) is otherwise eligible to share in
         matching contributions shall receive a discretionary matching
         contribution in an amount equal to fifty percent (50%) of such
         Participant's Elective Contribution for such Plan Year that does not
         exceed 6% of the Participant's Compensation for the Plan Year.

                                      B-2

<PAGE>

                                                                    EXHIBIT 10.4

                                   EXHIBIT C
                         EMPLOYER SPECIAL CONTRIBUTIONS

         Notwithstanding any provision of the Plan to the contrary, the
following provisions shall apply to the Employer special contributions in
Section 4.1(g) of the Plan:

         1.    The Employer shall make a special one-time contribution of
               $500 to the Plan as of August 1, 2002, for each Eligible Employee
               who was eligible to participate in the Easton Hospital Employees'
               Pension Plan immediately prior to June 30, 2002. Such
               contribution shall be 100% vested and shall be made regardless of
               an Eligible Employee's election not to participate in the Plan.

         2.    Effective for the period beginning August 1, 2003, and ending
               December 31, 2003, each Participant who is an Employee of
               Pottstown Imaging Center, LLC and who completes at least 1,000
               Hours of Service for the Pottstown Imaging Center, LLC during a
               Plan Year shall receive an allocation of a discretionary
               contribution in an amount equal to 3% of the Participant's
               Compensation for such Plan Year. If the discretionary
               contribution allocated to such Participants is not large enough
               to provide such an allocation to all such Participants, each
               Participant shall receive a fractional share of the discretionary
               contribution, the numerator of which is the Participant's
               Compensation and the denominator of which is the total
               Compensation of all similarly situated Participants. The Vested
               portion of such Participant's Account attributable to the
               Employer's discretionary contribution shall be a percentage of
               the total amount credited to the Participant's Account,
               determined on the basis of Years of Service and prior service
               credits, if any, according to the following schedule:
<Table>
<Caption>

         Years of Service                             Vesting Percentage
<S>                                                   <C>
          Less than 5                                          0%
          5 or more                                          100%
</Table>

                                      C-1

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