Document:

EXHIBIT 4(b)

                          FIRST SUPPLEMENTAL INDENTURE

                     TENET HEALTHCARE CORPORATION, as Issuer

                                       AND

                              THE BANK OF NEW YORK,
                                   as Trustee

                          Dated as of October 30, 1995

                     Supplemental to Indenture, dated as of
                   October 16, 1995, relating to the Issuer's
                          8-5/8% Senior Notes Due 2003

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                                    TABLE OF CONTENTS

PARTIES ........................................................................

RECITALS .......................................................................

ARTICLE ONE -                 DEFINITIONS AND OTHER GENERAL
                              PROVISIONS .......................................

              SECTION 1.1     Definitions ......................................

              SECTION 1.2     Effect of Headings and Table of
                              Contents .........................................

              SECTION 1.3     Successors and Assigns ...........................

              SECTION 1.4     Separability Clause ..............................

              SECTION 1.5     Benefits of First Supplemental
                              Indenture ........................................

              SECTION 1.6     Governing Law ....................................

              SECTION 1.7     Effectiveness ....................................

ARTICLE TWO -                 AMENDMENTS .......................................

ARTICLE THREE -               NOTICE, ENDORSEMENT AND CHANGE OF FORM
                              OF SECURITIES ....................................

              SECTION 3.1     Replacement of Exhibits ..........................

              SECTION 3.2     Notation on Securities ...........................

SIGNATURES .....................................................................

ACKNOWLEDGMENTS ................................................................

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       FIRST SUPPLEMENTAL INDENTURE, dated as of October 30, 1995 (the "First
Supplemental Indenture"), between TENET HEALTHCARE CORPORATION, a Nevada
corporation (hereinafter called the "Company"), and THE BANK OF NEW YORK, as
trustee (hereinafter called the "Trustee"), under the Indenture (the
"Indenture"), dated as of October 16, 1995, between the Company and the Trustee
relating to the Company's 8-5/8% Senior Notes due 2003 (the "Securities").

                             RECITALS OF THE COMPANY

       The Company proposes to offer (the "Offering") Exchangeable Subordinated
Notes due 2007 which are exchangeable for shares of common stock of Vencor, Inc.
(the "Exchangeable Notes").

       In connection with the Offering, the Company is soliciting consents to
the amendments to the Indenture (the "Amendments") all as described in the
Solicitation of Consents, dated October 20, 1995 (the "Consent Solicitation").

       In accordance with Section 8.02 of the Indenture the Holders of a
majority of the outstanding principal amount of the Securities then outstanding
have consented to such Amendments.

       The Board of Directors of the Company has duly authorized the execution
and delivery of this First Supplemental Indenture. The Company has delivered an
Officers Certificate and an Opinion of Counsel to the Trustee pursuant to
Section 8.06 of the Indenture and has done all other things necessary to make
this First Supplemental Indenture a valid agreement of the Company in accordance
with the terms hereof and of the Indenture.

       WHEREFORE, each party agrees as follows for the benefit of the other
party and for the equal or ratable benefit of the Holders of the Securities:

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                                    ARTICLE I

                        DEFINITIONS AND OTHER PROVISIONS
                             OF GENERAL APPLICATION

       SECTION 1.1 Definitions.

       For all purposes of the Indenture and this First Supplemental Indenture,
except as otherwise expressly provided or unless the context otherwise requires:

              (1) the words "herein," "hereof" and "hereunder" and other words
       of similar import refer to the Indenture and this First Supplemental
       Indenture as a whole and not to any particular Article, Section or
       subdivision; and

              (2) certain capitalized terms used but not defined herein shall
       have the meanings assigned to them in the Indenture.

       SECTION 1.2 Effect of Heading and Table of Contents.

       The Article and Section headings and the Table of Contents are for
convenience only and shall not affect the construction hereof. All references to
Sections in the Indenture shall remain unchanged.

       SECTION 1.3 Successors and Assigns.

       All covenants and agreements in this First Supplemental Indenture by the
Company shall bind its successors and assigns, or any other obligor on the
Securities, whether expressed or not.

       SECTION 1.4 Separability Clause.

       In case any provision in this First 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.

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       SECTION 1.5 Benefits of First Supplemental Indenture.

       Nothing in this First Supplemental Indenture, express or implied, shall
give to any Person, other than the parties hereto and their successors
hereunder, any Paying Agent and the Holders, any benefit or any legal or
equitable right, remedy or claim under this First Supplemental Indenture.

       SECTION 1.6 Governing Law.

       This First Supplemental Indenture shall be governed by and construed in
accordance with the laws of the State of New York and all rights and remedies
shall be governed by such law without reference to its conflict of laws
provision.

       SECTION 1.7 Effectiveness.

       This First Supplemental Indenture shall take effect on the date (the
"Effective Date") that each of the following conditions shall have been
satisfied:

              (a) the Trustee shall have received an opinion of counsel and an
Officers' Certificate from the Company each dated the Effective Date and in the
form set forth in Section 8.06 of the Indenture.

              (b) each of the parties hereto shall have executed and delivered
this First Supplemental Indenture.

                                   ARTICLE II

                                 THE AMENDMENTS

       1. Section 1.01 of the Indenture is hereby amended, by including the
following between the definition of "Specified Assets" and the definition of
"Stockholders' Equity":

              "SPECIFIED EXCHANGE" means any retirement of Indebtedness upon the
       exercise by a holder of such Indebtedness, pursuant to the terms thereof,
       of any right to exchange such Indebtedness for shares of common stock of
       Vencor, Inc. or any successor there-

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       to or any other equity securities, other than Equity Interests of a
       Subsidiary, owned by the Company as of October 11, 1995, or for any
       securities or other property received with respect to such common stock
       or equity securities, whether or not such right is subject to the
       Company's ability to pay an amount in cash in lieu thereof.

       2. Subsection (iii) of the first paragraph of Section 3.07 of the
Indenture is hereby amended and restated, in its entirety, to state the
following:

              (iii) make any principal payment on, or purchase, redeem, defease
       or otherwise acquire or retire for value any Indebtedness that is
       subordinated to the Securities, except at the original final maturity
       date thereof or pursuant to a Specified Exchange or the Refinancing;

                                   ARTICLE III

              NOTICE, ENDORSEMENT AND CHANGE OF FORM OF SECURITIES

       SECTION 3.1 Notice to Securityholders.

       After the Amendments become effective, the Company shall mail to
Securityholders a notice briefly describing such Amendments in accordance with
Section 8.02 of the Indenture.

       SECTION 3.2 Notation on Securities.

       (a) Securities authenticated and delivered after the effectiveness of
this First Supplemental Indenture shall be affixed by the Trustee with the
following notation:

              "The Company and the Trustee have entered into a First
       Supplemental Indenture, dated as of October 30, 1995, which amended the
       covenant regarding limitations on restricted payments. Reference is
       hereby made to such First Supplemental Indenture, copies of which are on
       file with The Bank of New York, Trustee."

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       The Trustee may require holders of Securities authenticated and delivered
prior to the effectiveness of this First Supplemental Indenture to deliver such
Securities to the Trustee so that the Trustee may affix them with the
aforementioned notation.

              (b) If the Company or the Trustee so determines, the Company, in
exchange for the Securities, shall issue and the Trustee shall authenticate new
Securities that reflect the changed terms.

                                     *****

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       This First Supplemental Indenture may be executed in any number of
counterparts, each of which so executed shall be deemed to be an original, but
all such counterparts shall together constitute but one in the same instrument.

Dated as of October 30, 1995

                                        TENET HEALTHCARE CORPORATION

                                        By: /s/ Maris Andersons
                                            ----------------------
                                            Name:  Maris Andersons
                                            Title: Senior Vice President

Attest:

                                                                (Seal)
/s/ Alan Lundgren
--------------------
Name: Alan Lundgren
Title: Assistant Secretary

Dated as of _______

                                        THE BANK OF NEW YORK,
                                            as Trustee

                                        By: _________________________
                                            Name:
                                            Title:

Attest:

                                                                (Seal)
______________________
Name:
Title:

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STATE OF CALIFORNIA  )
                     :  ss.:
COUNTY OF LOS ANGELES)

       On this 30th day of October, 1995, before me personally came Maris
Andersons, to me known, who, being by me duly sworn, did depose and say that
he/she is Senior Vice President of TENET HEALTHCARE CORPORATION, one of the
corporations described in and which executed the above instrument and that
he/she signed his/her name thereto.

       FRANCES A. PAQUET
        COMM. # 1030235
    Notary Public - California          /s/ FRANCES A. PAQUET
      LOS ANGELES COUNTY
    My Comm. Expires JUN 19, 1998

STATE OF_____________)
                     :  ss.:
COUNTY OF ___________)

       On this ____ day of ______, 1995, before me personally came
________________, to me known, who, being by me duly sworn, did depose and say
that he/she is ________________ of THE BANK OF NEW YORK, one of the corporations
described in and which executed the above instrument and that he/she signed
his/her name thereto.

                                             _______________________________

0054494.01-Los Angeles Server 2a       9        Draft October 23, 1995 - 5:42 pmEXHIBIT 4(c)

                         SECOND SUPPLEMENTAL INDENTURE

                     TENET HEALTHCARE CORPORATION, as Issuer

                                       AND

                              THE BANK OF NEW YORK,
                                   as Trustee

                           Dated as of August 21, 1997

                     Supplemental to Indenture, dated as of
                   October 16, 1995, relating to the Issuer's
                          8-5/8% Senior Notes Due 2003
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                                TABLE OF CONTENTS
                                -----------------

PARTIES ...................................................................   1

RECITALS ..................................................................   1

ARTICLE ONE -       DEFINITIONS AND OTHER GENERAL
                    PROVISIONS ............................................   2

   SECTION 1.1      Definitions ...........................................   2

   SECTION 1.2      Effect of Headings and Table of
                    Contents ..............................................   2

   SECTION 1.3      Successors and Assigns ................................   2

   SECTION 1.4      Separability Clause ...................................   2

   SECTION 1.5      Benefits of Second Supplemental
                    Indenture .............................................   3

   SECTION 1.6      Governing Law .........................................   3

   SECTION 1.7      Effectiveness .........................................   3

ARTICLE TWO -       AMENDMENTS ............................................   3

   SECTION 2.1      Amendments to Section 1.01 ............................   3

   SECTION 2.2      Amendment to Section 1.02 .............................   8

   SECTION 2.3      Amendment to Section 2.15 .............................   8

   SECTION 2.4      Amendment to Section 3.07 .............................   8

   SECTION 2.5      Amendment to Section 3.08 .............................  11

   SECTION 2.6      Amendment to Section 3.09 .............................  13

   SECTION 2.7      Amendment to Section 3.10 .............................  15

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   SECTION 2.8      Amendment to Section 3.16 ............................   15

   SECTION 2.9      Amendment to Section 9.02 ............................   15

ARTICLE THREE -     NOTICE, ENDORSEMENT AND CHANGE OF FORM
                    OF SECURITIES ........................................   16

   SECTION 3.1      Notice to Securityholders ............................   16

   SECTION 3.2      Notation on Securities ...............................   16

SIGNATURES ...............................................................   17

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         SECOND SUPPLEMENTAL INDENTURE, dated as of August 21, 1997 (the "SECOND
SUPPLEMENTAL INDENTURE"), between TENET HEALTHCARE CORPORATION, a Nevada
corporation (hereinafter called the "COMPANY"), and THE BANK OF NEW YORK, as
trustee (hereinafter called the "TRUSTEE"), under the Indenture (the
"INDENTURE"), dated as of October 16, 1995, between the Company and the Trustee
relating to the Company's 8-5/8% Senior Notes Due 2003 (the "SECURITIES").

                              RECITALS OF THE COMPANY

         WHEREAS, the Company proposes to amend (the "AMENDMENTS") the Indenture
to conform the restrictive covenants contained therein to those contained in the
Indenture, dated as of January 15, 1997, between the Company and the Bank of New
York, as Trustee, relating to the Company's 7-7/8% Senior Notes due 2003, the
Indenture, dated as of January 15, 1997, between the Company and the Bank of New
York, as Trustee, relating to the Company's 8% Senior Notes due 2005, and the
Indenture, dated as of January 15, 1997, between the Company and the Bank of New
York, as Trustee, relating to the Company's 8-5/8% Senior Subordinated Notes due
2007.

         WHEREAS, the Company has solicited consents to the Amendments from the
holders of record of the Securities outstanding at the close of business on
August 7, 1997.

         WHEREAS, in accordance with Section 8.02 of the Indenture, the Holders
of a majority of the principal amount of the Securities then outstanding (other
than any Securities owned by the Company or any Affiliate of the Company) have
consented to such Amendments.

         WHEREAS, the Board of Directors of the Company has duly authorized the
execution and delivery of this Second Supplemental Indenture, the Company has
delivered an Officers' Certificate and an Opinion of Counsel to the Trustee
pursuant to Section 8.06 of the Indenture and the Company has done all other
things necessary to make this Second Supplemental Indenture a valid agreement of
the Company in accordance with the terms hereof and of the Indenture.

         NOW THEREFORE, the Company and Trustee agree as follows for the benefit
of the other party and for the equal and ratable benefit of the Holders of the
Securities:

<PAGE>

                                    ARTICLE I

                        DEFINITIONS AND 0THER PROVISIONS
                             OF GENERAL APPLICATION

         SECTION 1.1 DEFINITIONS.

         For all purposes of the Indenture and this Second Supplemental
Indenture, except as otherwise expressly provided or unless the context
otherwise requires:

                  (1) the words "herein," "hereof" and "hereunder" and other
         words of similar import refer to the Indenture and this Second
         Supplemental Indenture as a whole and not to any particular Article,
         Section or subdivision; and

                  (2) certain capitalized terms used but not defined herein
         shall have the meanings assigned to them in the Indenture.

         SECTION 1.2 EFFECT OF HEADINGS AND TABLE OF CONTENTS.

         The Article and Section headings and the Table of Contents of this
Second Supplemental Indenture are for convenience only and shall not affect the
construction hereof. Except as otherwise specifically set forth herein, all
references to Sections in the Indenture shall remain unchanged.

         SECTION 1.3 SUCCESSORS AND ASSIGNS.

         All covenants and agreements in this Second Supplemental Indenture by
the Company shall bind its successors and assigns, or any other obligor on the
Securities, whether expressed or not.

         SECTION 1.4 SEPARABILITY CLAUSE.

         In case any provision in this Second 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.

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         SECTION 1.5 BENEFITS OF SECOND SUPPLEMENTAL INDENTURE.

         Nothing in this Second Supplemental Indenture, express or implied,
shall give to any Person, other than the parties hereto and their successors
hereunder, any Paying Agent and the Holders, any benefit or any legal or
equitable right, remedy or claim under this Second Supplemental Indenture.

         SECTION 1.6 GOVERNING LAW.

         This Second Supplemental Indenture shall be governed by and construed
in accordance with the laws of the State of New York and all rights and remedies
shall be governed by such law without reference to its conflict of laws
provision.

         SECTION 1.7 EFFECTIVENESS.

         This Second Supplemental Indenture shall take effect on the date (the
"EFFECTIVE DATE") that each of the following conditions shall have been
satisfied:

                  (a) the Trustee shall have received an Opinion of Counsel and
         an Officers' Certificate from the Company each dated the Effective Date
         and in accordance with Section 8.06 of the Indenture; and

                  (b) each of the parties hereto shall have executed and
         delivered this Second Supplemental Indenture.

                                   ARTICLE II

                                 THE AMENDMENTS

         SECTION 2.1 AMENDMENTS TO SECTION 1.01.

         (a) The Definition of "ASSET SALE" in Section 1.01 of the Indenture is
hereby amended to read in its entirety as follows:

                  ""ASSET SALE" means (i) the sale, lease, conveyance or other
         disposition of any assets (including, without limitation, by way of a
         sale and leaseback) other than in the ordinary course of business
         consistent

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         with past practices and (ii) the issuance or sale by the Company or any
         of its Subsidiaries of Equity Interests of any of the Company's
         Subsidiaries, in the case of either clause (i) or (ii), whether in a
         single transaction or a series of related transactions (a) that have a
         fair market value in excess of $25.0 million or (b) for net proceeds in
         excess of $25.0 million. Notwithstanding the foregoing: (a) a transfer
         of assets by the Company to a Subsidiary or by a Subsidiary to the
         Company or another Subsidiary, (b) the issuance of Equity Interests by
         a Subsidiary to the Company or to another Subsidiary, (c) a Restricted
         Payment that is permitted by Section 3.07 hereof and (d) a Hospital
         Swap shall not be deemed to be an Asset Sale."

         (b) The definition of "EXISTING INDEBTEDNESS" in Section 1.01 of the
Indenture is hereby amended to read in its entirety as follows:

                  ""EXISTING INDEBTEDNESS" means Indebtedness of the Company and
         its Subsidiaries (other than Indebtedness under the New Credit
         Facility) in existence on January 30, 1997, until such amounts are
         repaid, including all reimbursement obligations with respect to letters
         of credit outstanding as of January 30, 1997."

         (c) The definition of "HOSPITAL" in Section 1.01 of the Indenture is
hereby amended to read in its entirety as follows:

                  ""HOSPITAL" means a hospital, outpatient clinic, long-term
         care facility or other facility or business that is used or useful in
         or related to the provision of healthcare services."

         (d) Section 1.01 of the Indenture is hereby amended by adding the
definition of "NEW CREDIT FACILITY" to read in its entirety as follows:

                  ""NEW CREDIT FACILITY" means that certain Credit Agreement by
         and among the Company and Morgan Guaranty Trust Company of New York and
         the other banks that are party thereto, providing for $2.8 billion in
         aggregate principal amount of Indebtedness, including any related
         notes, instruments and agreements executed in connection therewith, and
         in each case as amended, modified, extended, renewed, refunded,
         replaced or refinanced, in whole or in part, from time to time."

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         (e) The definition of "PERMITTED LIENS" in Section 1.01 of the
Indenture is hereby amended to read in its entirety as follows:

                  ""PERMITTED LIENS" means (i) Liens in favor of the Company;
         (ii) Liens on property of a Person existing at the time such Person is
         merged into or consolidated with the Company or any Subsidiary of the
         Company or becomes a Subsidiary of the Company; PROVIDED that such
         Liens were in existence prior to the contemplation of such merger,
         consolidation or acquisition (unless such Liens secure Indebtedness
         that was incurred in connection with or in contemplation of such
         acquisition and is used to refinance tax-exempt Indebtedness) and do
         not extend to any assets or the Company or its Subsidiaries other than
         those of the Person merged into or consolidated with the Company or
         that becomes a Subsidiary of the Company; (iii) Liens on property
         existing at the time of acquisition thereof by the Company or any
         Subsidiary of the Company; PROVIDED that such Liens were in existence
         prior to the contemplation of such acquisition (unless such Liens
         secure Indebtedness that was incurred in connection with or in
         contemplation of such acquisition and is used to refinance tax-exempt
         Indebtedness); (iv) Liens to secure the performance of statutory
         obligations, tender, bid, performance, government contract, surety or
         appeal bonds or other obligations of a like nature incurred in the
         ordinary course of business; (v) Liens existing on January 30, 1997;
         (vi) Liens for taxes, assessments or governmental charges or claims
         that are not yet delinquent or that are being contested in good faith
         by appropriate proceedings promptly instituted and diligently
         concluded; PROVIDED that any reserve or other appropriate provision as
         shall be required in conformity with GAAP shall have been made
         therefor; (vii) other Liens on assets of the Company or any Subsidiary
         of the Company securing Indebtedness that is permitted by the terms
         hereof to be outstanding having an aggregate principal amount at any
         one time outstanding not to exceed 10% of the Stockholders' Equity of
         the Company; and (viii) Liens to secure Permitted Refinancing
         Indebtedness incurred to refinance Indebtedness that was secured by a
         Lien permitted hereunder and that was incurred in accordance with the
         provisions hereof; PROVIDED that such Liens do not extend to or cover
         any property or assets of the Company or any Subsidiary other assets or
         property securing the Indebtedness so refinanced."

         (f) The definition of "PERMITTED REFINANCING INDEBTEDNESS" in Section
1.01 of the Indenture is hereby amended to read in its entirety as follows:

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                  ""PERMITTED REFINANCING INDEBTEDNESS" means any Indebtedness
         of the Company or any of its Subsidiaries issued in exchange for, or
         the net proceeds of which are used solely to extend, refinance, renew,
         replace, defease, or refund, other Indebtedness of the Company or any
         of its Subsidiaries; PROVIDED, that, except in the case of Indebtedness
         of the Company issued in exchange for, or the net proceeds of which are
         used solely to extend, refinance, renew, replace, defease, or refund,
         Indebtedness of a Subsidiary of the Company: (i) the principal amount
         of such Permitted Refinancing Indebtedness does not exceed the
         principal amount of the Indebtedness so extended, refinanced, renewed,
         replaced, defeased or refunded (plus the amount of any premiums paid
         and reasonable expenses incurred in connection therewith); (ii) such
         Permitted Refinancing Indebtedness has a final maturity date later than
         the final maturity date of, and has a Weighted Average Life to Maturity
         equal to or greater than the Weighted Average Life to Maturity of, the
         Indebtedness being extended, refinanced, renewed, replaced, defeased or
         refunded; (iii) if the Indebtedness being extended, refinanced,
         renewed, replaced, defeased or refunded is subordinated in right of
         payment to the Securities, such Permitted Refinancing Indebtedness has
         a final maturity date later than the final maturity date of, and is
         subordinated in right of payment to, the Securities on subordination
         terms at least as favorable to the Holders of the Securities as those
         contained in the documentation governing the Indebtedness being
         extended, refinanced, renewed, replaced, defeased or refunded; (iv)
         such Indebtedness is incurred by the Company if the Company is the
         obligor on the Indebtedness being extended, refinanced, renewed,
         replaced, defeased or refunded; and (v) such Indebtedness is incurred
         by the Company or a Subsidiary if a Subsidiary is the obligor on the
         Indebtedness being extended, refinanced, renewed, replaced, defeased or
         refunded."

         (g) The definition of "REFINANCING" in Section 1.01 of the Indenture is
hereby amended to read in its entirety as follows:

                  ""REFINANCING" has the meaning ascribed to it in the
         Prospectus dated January 27, 1997 relating to the Senior Notes and the
         Senior Subordinated Notes."

         (h) The definition of "RELATED BUSINESS" in Section 1.01 of the
Indenture is hereby amended to read in its entirety as follows:

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                  ""RELATED BUSINESS" means a healthcare business affiliated or
         associated with a Hospital or any business related or ancillary to the
         provision of healthcare services or information or the investment in
         management, leasing or operation of a Hospital."

         (i) Section 1.01 of the Indenture is hereby amended by adding the
definition of "SENIOR NOTES" to read in its entirety as follows:

                  ""SENIOR NOTES" means the 7-7/8% Senior Notes due 2003 and the
         8% Senior Notes due 2005 of the Company in an aggregate principal
         amount of $1.3 billion, issued pursuant to the indentures dated as of
         January 15, 1997 between the Company and the Bank of New York, as
         trustee, as amended or supplemented from time to time."

         (j) The definition of "SENIOR SUBORDINATED NOTES" in Section 1.01 of
the Indenture is hereby amended to read in its entirety as follows:

                  ""SENIOR SUBORDINATED NOTES" means the 8-5/8% Senior
         Subordinated Notes due 2007 of the Company in an aggregate principal
         amount of $700.0 million, issued pursuant to the Senior Subordinated
         Note Indenture."

         (k) The definition of "SENIOR SUBORDINATED NOTE INDENTURE" in Section
1.01 of the Indenture is hereby amended to read in its entirety as follows:

                  ""SENIOR SUBORDINATED NOTE INDENTURE" means the Indenture
         dated as of January 15, 1997 between the Company and The Bank of New
         York, as trustee, as amended or supplemented from time to time, under
         which the Senior Subordinated Notes were issued."

         (1) Section 1.01 of the Indenture is hereby amended by adding the
definition OF "SPECIFIED EXCHANGE" to read in its entirety as follows:

                  ""SPECIFIED EXCHANGE" means any retirement of Indebtedness
         upon the exercise by a holder of such Indebtedness, pursuant to the
         terms thereof, of any right to exchange such Indebtedness for shares of
         common stock of Vencor, Inc. or any successor thereto or any other
         equity securities, other than Equity Interests of a Subsidiary, owned
         by the Company as of October 11, 1995, or for any securities or other
         property received with respect to such common stock or equity
         securities or cash in lieu

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         thereof, whether or not such right is subject to the Company's ability
         to pay an amount in cash in lieu thereof."

         (m) Section 1.01 of the Indenture is hereby amended, by including the
following definitions at the end thereof:

                  ""2005 EXCHANGEABLE SUBORDINATED NOTES" means the 6%
         Exchangeable Subordinated Notes due 2005 of the Company in an aggregate
         principal amount of $320.0 million, issued pursuant to the Indenture
         dated as of January 10, 1996, between the Company and The Bank of New
         York, as trustee, as amended or supplemented from time to time."

                  "2005 SENIOR SUBORDINATED NOTES" mean the 10-1/8% Senior
         Subordinated Notes due 2005 of the Company in an aggregate principal
         amount of $900.0 million, issued pursuant to the Indenture dated as of
         March 1, 1995, between the Company and The Bank of New York, as
         trustee, as amended or supplemented from time to time."

                  SECTION 2.2 AMENDMENT TO SECTION 1.02.

                  Section 1.02 of the Indenture is hereby amended to delete the
         references therein to "Commencement Date," "Excess Proceeds," "Offer
         Amount," "Offer Period," "Purchase Price," and "Senior Asset Sale
         Offer."

         SECTION 2.3 AMENDMENT TO SECTION 2.15.

         Section 2.15 of the Indenture is hereby deleted in its entirety.

         SECTION 2.4 AMENDMENT TO SECTION 3.07.

         Section 3.07 of the Indenture is hereby amended to read in its entirety
as follows:

                  "SECTION 3.07 LIMITATIONS ON RESTRICTED PAYMENTS.

                  The Company shall not, and shall not permit any of its
         Subsidiaries to, directly or indirectly: (i) declare or pay any
         dividend or make any distribution on account of the Company's or any of
         its Subsidiaries' Equity Interests (other than (w) Physician Joint
         Venture Distributions, (x) dividends or distributions payable in
         Qualified Equity Interests of the Company,

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         (y) dividends or distributions payable to the Company or any Subsidiary
         of the Company, and (z) dividends or distributions by any Subsidiary of
         the Company payable to all holders of a class of Equity Interests of
         such Subsidiary on a PRO RATA basis); (ii) purchase, redeem or
         otherwise acquire or retire for value any Equity Interests of the
         Company; or (iii) make any principal payment on, or purchase, redeem,
         defease or otherwise acquire or retire for value any Indebtedness that
         is subordinated to the Securities, except at the original final
         maturity date thereof or pursuant to a Specified Exchange or the
         Refinancing (all such payments and other actions set forth in clauses
         (i) through (iii) above being collectively referred to as "RESTRICTED
         PAYMENTS"), unless, at the time of and after giving effect to such
         Restricted Payment (the amount of any such Restricted Payment, if other
         than cash, shall be the fair market value (as conclusively evidenced by
         a resolution of the Board of Directors set forth in an Officers'
         Certificate delivered to the Trustee within 60 days prior to the date
         of such Restricted Payment) of the asset(s) proposed to be transferred
         by the Company or such Subsidiary, as the case may be, pursuant to such
         Restricted Payment):

                  (a) no Default or Event of Default shall have occurred and be
         continuing or would occur as a consequence thereof; and

                  (b) the Company would, at the time of such Restricted Payment
         and after giving PRO FORMA effect thereto as if such Restricted Payment
         had been made at the beginning of the most recently ended four full
         fiscal quarter period for which internal financial statements are
         available immediately preceding the date of such Restricted Payment,
         have been permitted to incur at least $1.00 of additional Indebtedness
         pursuant to the Fixed Charge Coverage Ratio test set forth in the first
         paragraph of Section 3.09 hereof; and

                  (c) such Restricted Payment, together with the aggregate of
         all other Restricted Payments made by the Company and its Subsidiaries
         after March 1, 1995 (excluding Restricted Payments permitted by clauses
         (ii), (iii) and (iv) of the next succeeding paragraph), is less than
         the sum of (1) 50% of the Consolidated Net Income of the Company for
         the period (taken as one accounting period) from the beginning of the
         first fiscal quarter commencing after March 1, 1995 to the end of the
         Company's most recently ended fiscal quarter for which internal
         financial statements are available at the time of such Restricted
         Payment (or, if such Consolidated

                                        9
<PAGE>

         Net Income for such period is a deficit, less 100% of such deficit),
         PLUS (2) 100% of the aggregate net cash proceeds received by the
         Company from the issue or sale (other than to a Subsidiary of the
         Company) since March 1, 1995 of Qualified Equity Interests of the
         Company or of debt securities of the Company or any of its Subsidiaries
         that have been converted into or exchanged for such Qualified Equity
         Interests of the Company, PLUS (3) $20.0 lion.

                  If no Default or Event of Default has occurred and is
         continuing, or would occur as a consequence thereof, the foregoing
         provisions shall not prohibit the following Restricted Payments:

                  (i)      the payment of any dividend within 60 days after the
                           date of declaration thereof, if at said date of
                           declaration such payment would have complied with the
                           provisions hereof;

                  (ii)     the payment of cash dividends on any series of
                           Disqualified Stock issued after the January 30, 1997
                           in an aggregate amount not to exceed the cash
                           received by the Company since January 30, 1997 upon
                           issuance of such Disqualified Stock;

                  (iii)    the redemption, repurchase, retirement or other
                           acquisition of any Equity Interests of the Company or
                           any Subsidiary in exchange for, or out of the net
                           cash proceeds of, the substantially concurrent sale
                           (other than to a Subsidiary of the Company) of
                           Qualified Equity Interests of the Company; PROVIDED
                           that the amount of any such net cash proceeds that
                           are utilized for any such redemption, repurchase,
                           retirement or other acquisition shall be excluded
                           from clause (c)(2) of the preceding paragraph;

                  (iv)     the defeasance, redemption or repurchase of
                           subordinated Indebtedness with the net cash proceeds
                           from an incurrence of Permitted Refinancing
                           Indebtedness or in exchange for or out of the net
                           cash proceeds from the substantially concurrent sale
                           (other than to a Subsidiary of the Company) of
                           Qualified Equity Interests of the Company; PROVIDED
                           that the amount of any such net cash proceeds that
                           are utilized for any such redemption, repurchase,
                           retirement or other acquisition

                                         10
<PAGE>

                           shall be excluded from clause (c)(2) of the preceding
                           paragraph;

                  (v)      the repurchase, redemption or other acquisition or
                           retirement for value of any Equity Interests of the
                           Company or any Subsidiary of the Company held by any
                           member of the Company's (or any of its Subsidiaries')
                           management pursuant to any management equity
                           subscription agreement or stock option agreement;
                           PROVIDED that the aggregate price paid for all such
                           repurchased, redeemed, acquired or retired Equity
                           Interests shall not exceed $15.0 million in any
                           twelve-month period; and

                  (vi)     the making and consummation of a Change of Control
                           Offer with respect to the Senior Subordinated Notes,
                           the 2005 Senior Subordinated Notes or the 2005
                           Exchangeable Subordinated Notes in accordance with
                           the provisions of the indentures relating thereto.

                  Not later than the date of making any Restricted Payment, the
         Company shall deliver to the Trustee an Officers' Certificate stating
         that such Restricted Payment is permitted and setting forth the basis
         upon which the calculations required by this covenant were COMPUTED."

         SECTION 2.5 AMENDMENT TO SECTION 3.08.

         Section 3.08 of the Indenture is hereby amended to read in its entirety
as follows:

                  "SECTION 3.08. LIMITATIONS ON DIVIDEND AND OTHER PAYMENT
                                 RESTRICTIONS AFFECTING SUBSIDIARIES.

                  The Company shall not, and shall not permit any of its
         Subsidiaries to, directly or indirectly, create or otherwise cause or
         suffer to exist or become effective any consensual Transfer
         Restriction, except for such Transfer Restrictions existing under or by
         reason of:

                  (a) Existing Indebtedness as in effect on January 30, 1997,

                                       11
<PAGE>

                  (b) this Indenture and the indentures related to the Senior
         Notes and the Senior Subordinated Notes,

                  (c) applicable law,

                  (d) any instrument governing Indebtedness or Capital Stock of
         a Person acquired by the Company or any of its Subsidiaries as in
         effect at the time of such acquisition (except to the extent such
         Indebtedness was incurred in connection with or in contemplation of
         such acquisition, unless such Indebtedness was incurred in connection
         with or in contemplation of such acquisition for the purpose of
         refinancing Indebtedness which was tax-exempt, or in violation of
         Section 3.09 hereof), which encumbrance or restriction is not
         applicable to any Person, or the properties or assets of any Person,
         other than the Person, or the property or assets of the Person, so
         acquired, PROVIDED that the Consolidated Cash Flow of such Person shall
         not be taken into account in determining whether such acquisition was
         permitted by the terms hereof except to the extent that such
         Consolidated Cash Flow would be permitted to be dividends to the
         Company without the prior consent or approval of any third party,

                  (e) customary non-assignment provisions in leases entered into
         in the ordinary course of business,

                  (f) purchase money obligations for property acquired in the
         ordinary course of business that impose restrictions on the ability of
         any of the Company's Subsidiaries to transfer the property so acquired
         to the Company or any of its Subsidiaries,

                  (g) Permitted Refinancing Indebtedness, PROVIDED that the
         restrictions contained in the agreements governing such Permitted
         Refinancing Indebtedness are no more restrictive than those contained
         in the agreements governing the Indebtedness being refinanced, or

                  (h) the New Credit Facility and related documentation as the
         same is in effect on January 30, 1997 and as amended or replaced from
         time to time, provided that no such amendment or replacement is more
         restrictive as to Transfer Restrictions than the New Credit Facility
         and related documentation as in effect on the January 30, 1997."

                                        12
<PAGE>

         SECTION 2.6 AMENDMENT TO SECTION 3.09.

         Section 3.09 of the Indenture is hereby amended to read in its entirety
as follows:

                  "SECTION 3.09 LIMITATIONS ON INCURRENCE OF INDEBTEDNESS AND
                                ISSUANCE OF PREFERRED STOCK

                  The Company shall not, and shall not permit any of its
         Subsidiaries to, directly or indirectly, create, incur, issue, assume,
         Guarantee or otherwise become directly or indirectly liable,
         contingently or otherwise, with respect to (collectively, "INCUR")
         after January 30, 1997 any Indebtedness, (including Acquired Debt), and
         the Company shall not issue any Disqualified Stock and shall not permit
         any of its Subsidiaries to issue any shares of preferred stock;
         PROVIDED, HOWEVER, that the Company may incur Indebtedness (including
         Acquired Debt) and the Company may issue shares of Disqualified Stock
         if the Fixed Charge Coverage Ratio for the Company's most recently
         ended four full fiscal quarters for which internal financial statements
         are available immediately preceding the date on which such additional
         Indebtedness is incurred or such Disqualified Stock is issued would
         have been at least 2.5 to 1, determined on a PRO FORMA basis (including
         a PRO FORMA application of the net proceeds therefrom), as if the
         additional Indebtedness had been incurred or the Disqualified Stock had
         been issued, as the case may be, at the beginning of such four-quarter
         period. Indebtedness consisting of reimbursement obligations in respect
         of a letter of credit shall be deemed to be incurred when the letter of
         credit is first issued.

                  The foregoing provisions shall not apply to:

                  (a) the incurrence by the Company of Indebtedness pursuant to
         the New Credit Facility in an aggregate principal amount at any time
         outstanding not to exceed an amount equal to $2.8 billion less the
         aggregate amount of all mandatory repayments applied to permanently
         reduce the commitments with respect to such Indebtedness;

                  (b) the incurrence by the Company of Indebtedness represented
         by the Securities, the Senior Notes and the Senior Subordinated Notes;

                                       13
<PAGE>

                  (c) the incurrence by the Company and its Subsidiaries of the
         Existing Indebtedness;

                  (d) the incurrence by the Company or any of its Subsidiaries
         of Permitted Refinancing Indebtedness in exchange for, or the net
         proceeds of which are used to extend, refinance, renew, replace,
         defease or refund, Indebtedness that was permitted by this Indenture to
         be incurred (including, without limitation, Existing Indebtedness);

                  (e) the incurrence by the Company of Hedging Obligations that
         are incurred for the purpose of fixing or hedging interest rate or
         currency risk with respect to any fixed or floating rate Indebtedness
         that is permitted by the terms hereof to be outstanding or any
         receivable or liability the payment of which is determined by reference
         to a foreign currency; PROVIDED that the notional principal amount of
         any such Hedging Obligation does not exceed the principal amount of the
         Indebtedness to which such Hedging Obligation relates;

                  (f) the incurrence by the Company or any of its Subsidiaries
         of Physician Support Obligations;

                  (g) the incurrence by the Company or any of its Subsidiaries
         of intercompany Indebtedness between or among the Company and any of
         its Subsidiaries;

                  (h) the incurrence by the Company or any of its Subsidiaries
         of Indebtedness represented by tender, bid, performance, government
         contract, surety or appeal bonds, standby letters of credit or warranty
         or contractual service obligations of like nature, in each case to the
         extent incurred in the ordinary course of business of the Company or
         such Subsidiary;

                  (i) the incurrence by any Subsidiary of the Company of
         Indebtedness, the aggregate principal amount of which, together with
         all other Indebtedness of the Company's Subsidiaries at the time
         outstanding (excluding the Existing Indebtedness until repaid or
         refinanced and excluding Physician Support Obligations), does not
         exceed the greater of (1) 10% of the Company's Stockholders' Equity as
         of the date of incurrence or (2) $10.0 million; PROVIDED that, in the
         case of clause (1) only, the Fixed Charge Coverage Ratio for the
         Company's most recently ended four full

                                       14
<PAGE>

         fiscal quarters for which internal financial statements are available
         immediately preceding the date on which such Indebtedness is incurred
         would have been at least 2.5 to 1, determined on a PRO FORMA basis
         (including a PRO FORMA application of the net proceeds therefrom), as
         if such Indebtedness had been incurred at the beginning of such
         four-quarter period; and

                  (j) the incurrence by the Company of Indebtedness (in addition
         to Indebtedness permitted by any other clause of this covenant) in an
         aggregate principal amount at any time outstanding not to exceed $250.0
         million."

         SECTION 2.7 AMENDMENT TO SECTION 3.10.

         Section 3.10 of the Indenture is hereby deleted in its entirety.

         SECTION 2.8 AMENDMENT TO SECTION 3.16.

         Section 3.16 of the Indenture is amended by replacing the amount $10
million" in the last sentence with the amount "$25 million".

         SECTION 2.9 AMENDMENT TO SECTION 9.02.

         The address of the Company in Section 9.02 of the Indenture is hereby
amended to read in its entirety as follows:

         "Tenet Healthcare Corporation
         3820 State Street
         Santa Barbara, California 93105
         Telecopier No.: (805) 563-6846
         Attention: Treasurer"

                                       15
<PAGE>

                                    ARTICLE III

              NOTICE, ENDORSEMENT AND CHANGE OF FORM OF SECURITIES

         SECTION 3.1 NOTICE TO SECURITYHOLDERS.

         After the Effective Date, the Company shall mail to Securityholders a
notice briefly describing the Amendments in accordance with Section 8.02 of the
Indenture.

         SECTION 3.2 NOTATION ON SECURITIES.

         Securities authenticated and delivered after the Effective Date shall,
at the Company's expense, be affixed by the Trustee with the following notation:

                  "The Company and the Trustee have entered into a Second
         Supplemental Indenture, dated as of August 21, 1997, which amended
         certain covenants and eliminated the Company's obligation to offer to
         repurchase Securities with the proceeds from certain asset sales.
         Reference is hereby made to such Second Supplemental Indenture, copies
         of which are on file with The Bank of New York, as Trustee."

         The Trustee may, but shall not be required to, require holders of
Securities authenticated and delivered prior to the Effective Date to deliver
such Securities to the Trustee so that the Trustee may affix them with the
aforementioned notation.

                                    * * * * *

                                       16
<PAGE>

         This Second Supplemental Indenture may be executed in counterparts,
each of which when so executed shall be deemed to be an original, but all such
counterparts shall together constitute but one and the same instrument.

Dated as of August 21, 1997

                                              TENET HEALTHCARE CORPORATION

                                              By: /s/ Raymond L. Mathiasen
                                                 -------------------------------
                                                 Name: Raymond L. Mathiasen
                                                 Title: Senior Vice President

                                              THE BANK OF NEW YORK,
                                                       AS TRUSTEE

                                              By: /s/ Vivian Georges
                                                 -------------------------------
                                                 Name:  VIVIAN GEORGES
                                                 Title: Assistant Vice President

                                       17

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