EX-10.1 2 uhs-ex101_20.htm EX-10.1

EXHIBIT 10.1

EXECUTION VERSION

FIFTH AMENDMENT
TO
AMENDED AND RESTATED CREDIT AND SECURITY AGREEMENT

This FIFTH AMENDMENT TO AMENDED AND RESTATED CREDIT AND SECURITY AGREEMENT (this “Amendment”), dated as of July 7, 2017, is entered into by and among the following parties:

| (i) | the Borrowers identified on the signature pages hereto;

| (ii) | UHS Receivables Corp., as Collection Agent;

| (iii) | UHS of Delaware, Inc., as Servicer;

| (iv) | Universal Health Services, Inc., as Performance Guarantor;

| (v) | Victory Receivables Corporation (“Victory”), as a Conduit;

| (vi) | The Bank of Tokyo-Mitsubishi UFJ, Ltd., New York Branch, as Liquidity Bank, LC Participant and Co-Agent for Victory’s Lender Group;

| (vii) | SunTrust Bank (“SunTrust”), as Liquidity Bank, LC Participant and Co‑Agent for SunTrust’s Lender Group;

| (viii) | Atlantic Asset Securitization LLC (“Atlantic”), as a Conduit;

| (ix) | Credit Agricole Corporate and Investment Bank (“CACIB”), as Liquidity Bank, LC Participant and Co-Agent for Atlantic’s Lender Group; and

| (x) | PNC Bank, National Association (“PNC”), as Liquidity Bank, LC Participant for PNC’s Lender Group, Co‑Agent for PNC’s Lender Group, LC Bank, and Administrative Agent.

Capitalized terms used but not otherwise defined herein have the respective meanings set forth in the Credit and Security Agreement defined below.

BACKGROUND

1.The parties hereto have entered into that certain Amended and Restated Credit and Security Agreement, dated as of October 27, 2010 (as amended, supplemented and otherwise modified from time to time, the “Credit and Security Agreement”).

2.Concurrently herewith, the parties hereto are entering into that certain Amended and Restated Fee Letter, dated as of the date hereof (the “Amendment Fee Letter”).

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3.The parties hereto desire to amend the Credit and Security Agreement as set forth herein.

4.Prior to the date hereof, (a) UHS of Oklahoma, Inc. changed its name (from “UHS of Oklahoma, Inc.” to “UHS of Oklahoma, LLC”) without complying with requirements of Section 4.2(a) of that certain Receivables Sale Agreement, dated as of August 31, 2007 between UHS of Oklahoma, LLC (formerly UHS of Oklahoma, Inc.) and UHS of Oklahoma Receivables, L.L.C. and (b) Wellington Regional Medical Center, Incorporated changed its name (from “Wellington Regional Medical Center, Incorporated” to “Wellington Regional Medical Center, LLC”) without complying with requirements of Section 4.2(a) of that certain Receivables Sale Agreement, dated as of August 31, 2007 between Wellington Regional Medical Center, LLC (formerly Wellington Regional Medical Center, Incorporated) and Wellington Regional Receivables, L.L.C. (such name changes as described in clauses (a) and (b) above, the “Subject Name Changes).

5.Prior to the date hereof, certain UHS Parties (as defined below) directed Obligors to remit Collections relating to Receivables originated by Valley Health System LLC to account numbered 81883-96670 maintained at Bank of America, N.A., which account was opened without prior notice to the Administrative Agent and was not then listed on an exhibit to such Originator’s Receivables Sale Agreement (the “Subject Deposits”).

6.The occurrence of the Subject Name Changes and the Subject Deposits constitute and/or resulted in certain Amortization Events under the Credit and Security Agreement and certain Termination Events under the relevant Receivables Sale Agreements (such Amortization Events and Termination Events, collectively, but solely to the extent (x) occurring and cured prior to the date hereof and (y) resulting solely from the Subject Name Changes, the Subject Deposits or any failure by UHS of Oklahoma, LLC, Wellington Regional Medical Center, LLC, Valley Health System LLC, the Borrowers or the Servicer to notify the Administrative Agent or any other party hereto of the occurrence thereof prior to the date hereof, the “Subject Events”).

7.The Borrowers, the Servicer, the Collection Agent, the Parent and the Performance Guarantor (collectively, the “UHS Parties”) have requested that the LC Bank, the Administrative Agent, the Conduits, the Liquidity Banks, the Co-Agents, the LC Participants and, each solely in its capacity as buyer under its respective Receivables Sale Agreement, UHS of Oklahoma Receivables, L.L.C., Wellington Regional Receivables, L.L.C. and Valley Health System Receivables, L.L.C. (collectively, the “Waiving Parties”) waive the occurrence of the Subject Events on the terms and subject to the conditions set forth herein.

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

SECTION 1.Amendments to the Credit and Security Agreement. The Credit and Security Agreement is hereby amended to incorporate the changes shown on the marked pages attached hereto as Exhibit A.

SECTION 2.Waiver; Limitations.

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(a)Limited Waiver. On the terms and subject to the conditions set forth herein, each of the Waiving Parties hereby waives the occurrence of each of the Subject Events.

(b)General Limitations. Notwithstanding anything to the contrary herein or in the Transaction Documents, by executing this Agreement, no Waiving Party is now waiving, nor has it agreed to waive in the future (i) the breach of any provision of the Transaction Documents (whether presently or subsequently existing or arising), other than as expressly set forth in clause (a) above, (ii) any Amortization Event under the Credit and Security Agreement or, with respect to UHS of Oklahoma Receivables, L.L.C., Wellington Regional Receivables, L.L.C. and Valley Health System Receivables, L.L.C., any Termination Event under its respective Receivables Sale Agreement (in each case, whether presently or subsequently existing or arising), other than as expressly set forth in clause (a) above or (iii) any rights, powers or remedies presently or subsequently available to any of the Waiving Parties or any other Person against the UHS Parties and/or any other Person under the Credit and Security Agreement, any of the other Transaction Documents, applicable law or otherwise, relating to any matter other than solely to the extent expressly waived herein, each of which rights, powers or remedies is hereby specifically and expressly reserved and continue.

(c)No Waiver of Indemnification, Etc. Without limiting the generality of the foregoing and for the avoidance of doubt, the Waiving Parties are not hereby waiving or releasing, nor have they agreed to waive or release in the future, any right or claim to indemnification or reimbursement by, or damages from, any UHS Party or any other Person under any Transaction Document, including without limitation, for any liability, obligation, loss, damage, penalty, judgment, settlement, cost, expense or disbursement resulting or arising directly or indirectly from any Subject Event or otherwise.

SECTION 3.Representations and Warranties. Each Borrower, the Collection Agent, the Servicer and the Performance Guarantor hereby represents and warrants to the Lenders, the Co-Agents and the Administrative Agent as follows:

(a)Representations and Warranties. The representations and warranties made by such Person in the Transaction Documents are true and correct as of the date hereof and after giving effect to this Amendment (unless stated to relate solely to an earlier date, in which case such representations or warranties were true and correct as of such earlier date).

(b)Enforceability. The execution and delivery by such Person of this Amendment, and the performance of each of its obligations under this Amendment and the other Transaction Documents to which such Person is a party, as amended hereby, are within each of its organizational powers and have been duly authorized by all necessary organizational action on its part. This Amendment and the other Transaction Documents to which such Person is a party, as amended hereby, are such Person’s valid and legally binding obligations, enforceable in accordance with its terms.

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(c)No Amortization Event. After giving effect to this Amendment and the transactions contemplated hereby, no Amortization Event or Unmatured Amortization Event has occurred and is continuing.

SECTION 4.Effectiveness. This Amendment shall become effective on the date hereof (the “Effective Date”) upon (a) payment of the “Amendment Fee” (under and as defined in the Amendment Fee Letter) in accordance with the terms of the Amendment Fee Letter and (b) receipt by the Administrative Agent of each of the documents, agreements (in fully executed form), opinions of counsel, lien search results, UCC filings, certificates and other deliverables listed on the closing index attached as Exhibit B hereto, in each case in form and substance acceptable to the Administrative Agent.

SECTION 5.CHOICE OF LAW; CONSENT TO JURISDICTION.

(a)THIS AMENDMENT SHALL BE GOVERNED AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK, WITHOUT REGARD TO ANY PRINCIPLES OF CONFLICTS OF LAWS THEREOF.

(b)EACH PARTY TO THIS AMENDMENT HEREBY IRREVOCABLY SUBMITS TO THE NON-EXCLUSIVE JURISDICTION OF ANY UNITED STATES FEDERAL OR NEW YORK STATE COURT SITTING IN THE BOROUGH OF MANHATTAN, NEW YORK, IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS AMENDMENT OR ANY DOCUMENT EXECUTED BY SUCH PERSON PURSUANT TO THIS AMENDMENT, AND EACH SUCH PARTY HEREBY IRREVOCABLY AGREES THAT ALL CLAIMS IN RESPECT OF SUCH ACTION OR PROCEEDING MAY BE HEARD AND DETERMINED IN ANY SUCH COURT AND IRREVOCABLY WAIVES ANY OBJECTION IT MAY NOW OR HEREAFTER HAVE AS TO THE VENUE OF ANY SUCH SUIT, ACTION OR PROCEEDING BROUGHT IN SUCH A COURT OR THAT SUCH COURT IS AN INCONVENIENT FORUM. NOTHING HEREIN SHALL LIMIT THE RIGHT OF ANY AGENT OR ANY LENDER TO BRING PROCEEDINGS AGAINST ANY LOAN PARTY IN THE COURTS OF ANY OTHER JURISDICTION. ANY JUDICIAL PROCEEDING BY ANY LOAN PARTY AGAINST THE AGENT OR ANY LENDER OR ANY AFFILIATE OF THE AGENT OR ANY LENDER INVOLVING, DIRECTLY OR INDIRECTLY, ANY MATTER IN ANY WAY ARISING OUT OF, RELATED TO, OR CONNECTED WITH THIS AMENDMENT OR ANY DOCUMENT EXECUTED BY SUCH LOAN PARTY PURSUANT TO THIS AMENDMENT SHALL BE BROUGHT ONLY IN A COURT IN THE BOROUGH OF MANHATTAN, NEW YORK.

SECTION 6.Effect of Amendment. All provisions of the Credit and Security Agreement, as expressly amended and modified by this Amendment, shall remain in full force and effect. After this Amendment becomes effective, all references in the Credit and Security Agreement (or in any other Transaction Document) to “this Agreement”, “hereof”, “herein” or words of similar effect referring to the Credit and Security Agreement shall be deemed to be references to the Credit and Security Agreement as amended by this Amendment. This Amendment shall not be deemed, either

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expressly or impliedly, to waive, amend or supplement any provision of the Credit and Security Agreement other than as set forth herein.

SECTION 7.Counterparts. This Amendment may be executed in any number of counterparts and by different parties on separate counterparts, each counterpart shall be deemed to be an original, and all such counterparts shall together constitute but one and the same agreement. Delivery of an executed counterpart of a signature page to this Amendment by facsimile or other electronic means shall be effective as delivery of a manually executed counterpart of this Amendment.

SECTION 8.Transaction Document. This Amendment shall constitute a Transaction Document for all purposes.

SECTION 9.Section Headings. The various headings of this Amendment are included for convenience only and shall not affect the meaning or interpretation of this Amendment, the Credit and Security Agreement or any provision hereof or thereof.

SECTION 10.Severability. If any one or more of the agreements, provisions or terms of this Amendment shall for any reason whatsoever be held invalid or unenforceable, then such agreements, provisions or terms shall be deemed severable from the remaining agreements, provisions and terms of this Amendment and shall in no way affect the validity or enforceability of the provisions of this Amendment or the Credit and Security Agreement.

SECTION 11.Ratification. After giving effect to this Amendment and each of the other agreements, documents and instruments contemplated in connection herewith, the Performance Undertaking, along with each of the provisions thereof, remains in full force and effect and is hereby ratified and reaffirmed by the Performance Guarantor and each of the other parties hereto.

[Signature pages follow.]

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IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first written above.

Aiken Regional Receivables, L.L.C.,

District Hospital Partners Receivables, L.L.C.,

Fort Duncan Medical Receivables, L.L.C.,

Lancaster Hospital Receivables, L.L.C.,

Laredo Regional Receivables, L.L.C.,

Manatee Memorial Receivables, L.L.C.,

McAllen Hospitals Receivables, L.L.C.,

Northwest Texas Healthcare Receivables, L.L.C.,

Sparks Family Hospital Receivables, L.L.C.,

Summerlin Hospital Receivables, L.L.C.,

Temecula Valley Hospital Receivables, L.L.C.,

TEXOMA HEALTHCARE SYSTEM RECEIVABLES, L.L.C.,

UHS of Oklahoma Receivables, L.L.C.,

UHS-Corona Receivables, L.L.C.,

Rancho Springs Receivables, L.L.C.,

Valley Health System Receivables, L.L.C. and

Wellington Regional Receivables, L.L.C.,
as Borrowers

By: /s/ Steve Filton_________________________________________

Name:Steve Filton

Title:Vice President

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UHS RECEIVABLES CORP.,
as Collection Agent

By:_/s/ Steve Filton__________________

Name:Steve G. Filton

Title:Vice President

UHS OF DELAWARE, INC.,
as Servicer

By:_/s/ Steve Filton__________________

Name:Steve G. Filton

Title:Vice President

UNIVERSAL HEALTH SERVICES, INC.,
as Performance Guarantor

By:_/s/ Steve Filton__________________

Name:Steve G. Filton

Title:Senior Vice President

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THE BANK OF TOKYO-MITSUBISHI UFJ, LTD.,
NEW YORK BRANCH, as Liquidity Bank and
LC Participant for Victory’s Lender Group

By:__/s/ Luna Mills___________________________

Name:Luna Mills

Title:Managing Director

THE BANK OF TOKYO-MITSUBISHI UFJ, LTD.,
NEW YORK BRANCH,
as Co-Agent for Victory’s Lender Group

By:__/s/ Luna Mills___________________________

Name:Luna Mills

Title:Managing Director

VICTORY RECEIVABLES CORPORATION,
as a Conduit

By:__/s/ David DeAngelis______________________

Name:David V. DeAngelis

Title:Vice President

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SunTrust Bank,
as Liquidity Bank, LC Participant for
SunTrust’s Lender Group and Co-Agent for
SunTrust’s Lender Group

By:__/s/ Pawan Churiwal_______________________

Name:Pawan Churiwal

Title:Vice President

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PNC BANK, NATIONAL ASSOCIATION,
as LC Participant, Liquidity Bank
and as LC Bank

By:__/s/ Eric Bruno___________________________

Name:Eric Bruno

Title:Senior Vice President

PNC BANK, NATIONAL ASSOCIATION,
as Co-Agent and Administrative Agent

By:__/s/ Eric Bruno____________________________

Name:Eric Bruno

Title:Senior Vice President

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CREDIT AGRICOLE CORPORATE AND

INVESTMENT BANK, as Liquidity Bank, LC

Participant for Atlantic’s Lender Group and

Co-Agent for Atlantic’s Lender Group

By:__/s/ Kostantina Kourmpetis________________

Name:Kostantina Kourmpetis

Title:Managing Director

By:__/s/ Michael Regan_______________________

Name:Michael Regan

Title:Managing Director

ATLANTIC ASSET SECURITIZATION LLC,
as a Conduit

By:__/s/ Kostantina Kourmpetis________________

Name:Kostantina Kourmpetis

Title:Managing Director

By:__/s/ Michael Regan_______________________

Name:Michael Regan

Title:Managing Director

Exhibit A

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EXHIBIT A

AMENDMENTS TO THE CREDIT AND SECURITY AGREEMENT

Exhibit A

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C o n f or m e d t h ro u gh:

First Amendment dated May 16, 2012

Second Amendment, dated October 25, 2013

Third A m endment, dated August 1, 2014

Fourth Amendment, dated December 22, 2015

F i f th Am e ndm e nt, d a t e d J uly 7, 2017

AM ENDED AND RESTATED CR EDIT AND SECURITY AGREE M ENT DAT E D AS OF OCT OBE R 27, 2010

AM O NG

AIK EN RE GIONAL RECEIVABLES, L.L.C., AUBURN RE GIO NAL RE C EIVA BLES, L.L.C., DIS TRICT HOS PITAL PARTNERS R E C EIVA BLES, L.L.C., FORT DUNCAN M EDICAL RECEIVA BLES, L.L.C., LANCASTER HOS PITAL RECEIVABLES, L.L.C., LAR EDO REGIONAL R ECEIVABLES, L.L.C., MANATEE M E M O RIAL RECEIVABLES, L.L.C., MCALLEN HOS PITALS RECEIVABLES, L.L.C., NORTHWEST TEXAS HEALTH CARE RECEIVA BLES, L.L.C., S PARKS FAMILY HOS PITAL RECEIVA BLES, L.L.C., SUMM ERLIN HOS PITAL RE C EIVA BLES, L.L.C., TE M ECULA VALLEY HOS PIT AL RECEIVA BLES, L.L.C., TEXOMA HEALTHCARE SYSTEM RECEIVA BLES, L.L.C., U HS OF OK LAHOMA RECEIVABLES, L.L.C., U HS-CORONA RECEIVA BLES, L.L.C., RANCHO S PRINGS RECEIVABLES, L.L.C., VALLEY HEALTH SYSTEM RECEIVABLES, L.L.C. A N D WELLING TON RE GIONAL RECEIVABLES, L.L.C., AS B O R R O W E R S

UHS R E C EIVA BLES C O R P., A S CO LLE C T ION A GE N T, UHS OF DELAWARE, INC., AS S E R V IC E R,

UNIVERSAL HEALTH SERVICES, INC., A S P E RF O R M A N CE G U A R A N TO R,

THE CONDUITS, LIQUIDITY BANKS, CO-AGENTS AND LC PARTICIPANTS FROM TIME TO TIME P ARTY HERETO,

AND

PNC BANK, NATIO NAL A SSOCIATION, AS LC B A N K A N D AD M I N I ST R A T I V E A GE NT

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(aa)

L i quidity C ov era g e R a tio. No B o rr ow er (x) h a s issu e d, do e s issue or wi l l is s ue

a ny obli g a tions th a t (A) c ons t itute a ss e t-b ac k e d c omm erc i a l p a p er, or (B) ar e s ec u r it i e s re qu i re d to be re g is t ere d und e r the S ec u r iti e s Ac t of 1933 (the “33 A c t”) or th a t m a y be o ffere d f or s a le und e r R ule 144A or a s i mil a r e x e mption fr om re g is t ra tion und e r the 33 A c t or the r ul e s p r omul g a t e d th ere und er, or (y) h a s is s u e d, do e s is s ue or wi l l is s ue a ny oth e r d e bt obl i g a tions or e quity int ere sts oth e r th a n d e bt obli g a t i ons sub st a nt i a l l y s i mi l a r to t he ob l i g a tions of su c h B o rr ow e r und e r this A g ree m e nt th a t ar e (A) issu e d to oth e r b a nks or a sset-b ac k e d c omm erc i a l p a p e r c onduits in p r iv a tely n e g ot i a t e d t ra ns ac tions, a nd (B) sub j ec t to t ra ns fe r re s t r i c tions subst a nti a lly s i mil a r to the t ra nsf e r re s t r i c tions s e t f o r th i n this A g ree m e nt. E ac h B o rr ow e r f u r th e r re p re sents a nd w arra nts th a t its a ss e ts a nd l i a b i liti e s ar e c onso l id a t e d w i th the a ss e ts a nd li a bi l i t i e s of P are nt f or pu r pos e s of g e n era lly acce pt e d acc ounting p r in c ipl e s. h a s is s u e d a ny L C R S ec u r it i e s, a nd eac h B o rr ow e r is a c onso li d a t e d sub si di ar y of the P erf o r man c e Gu ara ntor und e r GAA P.

(bb)

S a n c tions. No C ov ere d Entity is a S a n c t i on e d P er son. No C ov ere d Entit y, (i) h a s

any of its assets in a Sanctioned Country or, to its knowledge, in the possession, custody or control of a Sanctioned Person, in each case, in violation of any Anti-Terrorism Law; (ii) does business in or with, or derives any of its income from investments in or transactions with, any Sanctioned Country or Sanctioned Person in violation of any Anti-Terrorism Law; or (iii) engages in any dealings or transactions prohibited by any Anti-Terrorism Law.

Section 5.2

L e nd e r R e p re s e nt a t i ons a nd W arra nt i e s.

Each Liquidity Bank and LC P ar tic ipant hereby represents and warrants (as to itself) to the Ag ents, the L enders and the Loan P arties that:

(a)

E x is t e n c e a nd P ow er. S u c h P er son i s du l y o r g a ni z e d, v a l idly e x isting a nd in g ood

st anding under the laws of its jurisdic tion of or g aniz ation, and has a ll or g aniz ational power to perform its oblig ations hereunder.

(b)

No C on f li c t. The e x ec ut i on a nd d e liv er y by su c h P er son of this A g ree m e nt a nd

the performance of its oblig ations hereunder and thereunder are within its corpora te powers, have been duly authoriz ed by all necessary corporate action, do not contravene or violate (i) its certificate or ar tic l es of incorporation or association or by-laws or similar governing documents, (ii) any law, rule or re gula tion applicable to it, (iii) any rest rictions under any a g reement, contract or inst rument to which it is a party or any of its property is bound, or (iv) any order, writ, judg m ent, award, injunction or decree binding on or affecting it or its property, and do not result in the creation or imposition of any L i en on its ass e ts. This Ag reement has been duly authoriz ed, e x ecuted and delivered by such P erson.

(c)

Gov er nm e nt a l Autho r i z a t ion. No a u t ho r iz a t i on or a pp r ov a l or oth e r ac t i on b y,

and no notice to or filing with, any governmental authority or regulatory body is required for the due execution and delivery by such Person of this Agreement and the performance of its obligations hereunder.

(d)

B inding E ffec t.This A g ree m e nt c ons ti tut e s the l e g a l, v a lid a nd b i nding

obli g a t i on of such P er son e n f o rcea ble a g a i nst su c h P er son in acc o r d a n c e with its t er ms, e x ce pt a s

(f)

T er m in a t ion D a te D e t er m i n a t i on. N o B o rr ow e r will d e s i g n a te t he T er min a tion

Date, or send any written notice to any Originator in respect thereof, w ithout the pr ior written consent of the Administ ra tive Ag ent, e x cept with respect to the occurrence of a Termination Date ar ising pursuant to S ection 5.1(f) of the applicable R eceivables S ale Ag reement.

(g)

R e s t rict e d J un i or P a y m e n t s.No B o rr ow e r will m a ke a ny R e s t r i c t e d J unior

Pa yment if after giving effect thereto, such Borrower’s Net Worth (as defined in the applicable Receivables Sale Ag reement) would be less than the Required Capital Amount (as defined in the applicable Receivables Sale Ag reement).

(h)

D e bt. The C ol l ec t i on A g e nt wi l l not, nor will a ny B o rr ow er, in c ur or p er mit to

ex ist any Debt or liability on account of deposits except: (i) the Obligations, (ii) the Subordinated Loans, and (iii) other current accounts payable arising in the ordinary course of business and not overdue.

(i)

S a n c tions. No L o a n P ar ty wi l l b ec o m e a S a n c t i on e d P er son. No C ov ere d Ent i ty

will (i) have any of its ass e ts in a S anctioned Country or, to its knowledg e, in the poss ession, custody or control of a S anctioned P erson, in each case, in viola tion of any Anti-Terrorism L aw; (ii) do business in or with, or der ive any of its income from investments in or transactions with, any S anctioned Country or S anctioned P erson in violation of any Anti-Te rrorism L aw; (iii) eng a ge in any dealings or transactions prohibited by any Anti-Terror ism L aw or (iv) use the proceeds of any Advances to fund any operations in, finance any investments or activiti es in, or, make any pa y m ents to, a S anctioned Country or S anctioned P erson in violation of any Anti-Terrorism L aw. Ea ch Loan P ar ty shall comply w ith all Anti-Terrorism L aws. Ea ch Loan P arty shall promptly notify the Administ rative Ag ent and each Co-Ag ent in writing upon the occurrence of a R eportable Compliance Event. No Loan P arty has used or will use the proceeds of any Advances to fund any operations in, finance any investments or activities in or m ake any pa yments to, a S anctioned P erson or a S anctioned Countr y, in each case, in viola tion of any Anti-Terrorism L aw.

(j)

L i quidity C ov era g e R a t i o. N o B o rr ow e r sh a l l is s ue a ny L C R S ec u r it y.

AR T IC L E VI I I. AD M INI ST R A T I O N A N D CO LLE C T I O N

Section 8.1

D e s i g n a tion of S er vi cer.

(a)

The se r vi c in g, a dminis t ra tion a nd c oll ec t ion of the R ece iv a bl e s sh a ll be c ondu c t e d

by such P erson (the “S e r v i ce r”) so desi gna t ed from time to time in accordance with this S ection

8.1. UHS of De l aware is hereby desi gnated as, and hereby a g rees to perform the duties and oblig ations of, the S ervicer pursuant to the terms of this Ag reement. After the occurrence of an Amortiz ation Event, the Administrative Ag ent may at any time desi gna te as S ervicer any P erson

to suc cee d UHS of D e l a w ar e or a ny su cce ssor S er vi cer.

(b)

Wi thout the p r ior wr i t t e n c ons e nt of the A g e nts a nd the R e qui re d C o-A g e nts,

UHS of D e law ar e sh a l l not be p er m itt e d to d e l e g a te a ny of its duti e s or re spons i biliti e s a s S er vi ce r to a ny P er son e x ce pt with re sp ec t t o cer t a in D efa ult e d R ece ivabl e s, with re sp ec t to whi c h i t m a y e n g a g e outside c ol l ec tion a g e n c i e s i n acc o r d a n c e wi t h i ts c us t om ar y pr ac t i ce s.

omis si ons of su c h B us i n e ss A s s o c i a t e,its e mplo y ee s,o ff i cer s,di rec tors,a g e nts,or sub-c ont rac to r s f or uses or disclosur e s in viol a tion of this S ec t i on.

(g)

Am e ndm e nt.E ac h of the B us i n e ss As s o c i a t e s a nd U HS of D e la war e a g re e to

amend this Section in such manner as is reasonably necessary to comply with any amendment of (i) HI PAA, HITECH or other applicable law, (ii) the HI PAA Regulations or other applicable regulations, or (iii) any applicable court decision or binding governmental policy. If the parties are unable to agree on an amendment within 30 days of notice from UHS of Delaware to each Business Associate of the requirement to amend this Section, UHS of Delaware and the other Loan Parties may, at the option of UHS of Delaware, terminate this Agreement or cease to provide PHI to any Business Associate with whom UHS of Delaware has been unable so to agree, upon written notice to the Business Associates.

(h)

S u r viv a l.This S ec t i on a nd the c on f id e nti a lit y, p r i v ac y, s ec u r it y, a nd o t h e r

requirements established herein shall survive termination of this Agreement.

(i)

I nt er p re t a t i on.Any a m bi g ui t y in this S ec t i on sh a ll be re so l v e d in f a vor of a

meaning that permits UHS of Delaware and the other Loan P ar ties to comply with the HI PAA R e gulations and the EDI Rule.

(j)

S e v era l L i a bility of B us i n e ss As s o c i a t e s. No B us i n e ss Asso c i a te sh a l l h a ve a ny

liability to UHS of Delaware or any third party of any kind or nature, whether such liability is ass erted on the basis of contract, tort (including ne glig ence or st rict liability), or otherwise, ar ising from the failure of any other Business Associate to fulfill its oblig ations under this S ection.

Section 14.15

R a t i fic a tion. A f t e r g iv i ng effec t to this A g ree m e nt a nd eac h of the o t h e r

agreements, documents and instruments contemplated in connection herewith, the Performance Undertaking, along with each of the provisions thereof, remains in full force and effect and is hereby ratified and reaffirmed by the Performance Guarantor and each of the other parties hereto.

S ec tion 14.16

A c kno w l e d g e m e nt a nd C ons e nt to B a il-I n of E E A F in a n c i a l I ns t i t utions.

Notwiths t a nding a n y t h i ng t o the c ont rar y in a ny T ra ns ac tion Do c u m e nt or i n a ny o t h e r a g ree m e nt, arra n g e m e nt or und er s t a nding a mong a ny su c h p ar ti e s, eac h p ar ty h ere to ac knowl e d g e s th a t a ny l i a b i lity of a ny E E A F in a n c i a l I ns ti tution ar is i ng und e r a ny T ra nsa c tion Do c um e n t, to the e x t e nt su c h l i a b i lity is uns ec u re d, m a y be sub j ec t to the W r i t e-Down a nd C onv er s i on P ow er s of a n E E A R e so l ut i on Autho r ity a nd a g ree s a nd c onsents to, a nd ac knowl e d g e s a nd a g ree s to be bound b y:

(a)

the a ppl i ca tion of a ny W r it e-Down a nd C onv er s i on P ow er s by a n E E A R e so l ution

Autho r ity to a ny su c h li a bilit i e s ar ising h ere und e r whi c h m a y be p a y a ble to it by a ny p ar ty h ere to th a t is a n E E A F in a n c i a l I ns t i t ution; a nd

(b)

the effec t s of a ny B a il-I n Ac tion on a ny su c h li a bilit y, in c ludin g, if a ppli ca bl e:

(i)

a re du c tion in f ull or in p ar t or ca n ce l l a t ion of a ny su c h li a bilit y;

(ii)

a c onv er s i on of a ll, or a po r t i on o f, su c h l i a bi li ty into sh are s or o t h e r

ins t r um e nts of own er sh i p in su c h E E A F inan c i a l I nstitution, i t s p are nt und er t a kin g, or a b r id g e ins t i t ution th a t m a y be is s u e d to it or oth er wise c on ferre d on i t, a nd th a t su c h sh are s or oth e r ins t r um e nts of own er sh i p wi l l be acce p t e d by it in li e u of a ny r i g hts with re sp ec t to a ny su c h li a b i lity und e r t his A g ree m e nt or a ny oth e r T ra ns ac tion Do c um e n t; or

(iii)

the v ar i a tion of the t er ms of su c h li a bi l i t y in c onn ec t i on with t he e x erc ise

of the W r it e-D own a nd C onv er s i on P ow er s of a ny E E A R e so l ution Autho r it y.

<Signature pages follow>

E XHI B IT I D E F INITI O NS

As used in this Agree m ent, (a) capitalized terms used and not otherwise defined in this Agree m ent (whether or note included in the list below) shall have the m eanings attributed thereto in the Receivables Sale Agree m ents, and (b) the following terms shall have the following m eanings (su ch m eanings to be equally applicable to both the singular and plural forms of the terms defined):

“Adjusted D ilution Ratio” m ea ns, a t a ny tim e, the r olling a v era g e of the D i lution

Ratio for the 12 Calculation Periods then most recently ended.

“Adjusted LC Participation A mount” m ea ns, a t a ny tim e, the L C P ar ti c ip a tion

Amount less the amount of cash collateral held in the LC Collateral Account at such time.

Ag reement.

“A d m i n is t ra t i v e A g e n t” h a s the m ea ning set f o r th i n the p rea m ble to this

“Advan ce” m ea ns a bo rr owing h ere und e r c ons i s t ing of the a gg re g a te a mount of the sev era l L o a ns m a de on the s a me B o rr owing D a t e.

“A ff iliate” m ea ns, with re sp ec t to a ny P er son, a ny o t h e r P er son di rec tly or indi rec t ly c ont r o l lin g, c ont r oll e d b y, or und e r di rec t or indi rec t c ommon c ontrol w i th, su c h P er son or a ny S ubs i di ar y of su c h P er son. A P er son sh a ll be d ee m e d t o c on t r ol a noth e r P er son if (a) t he c ontrol l ing P er son owns 10-50% of a ny c lass of voting se c u r i t i e s of the c ont r oll e d P er son only if it a lso poss e s s e s, dir ec t l y or indi rec t l y, the pow e r to di rec t or ca use the di rec tion of the m a n a g e m e nt or poli c i e s of the c ont r oll e d P er son, wh e ther throu g h o w n er ship of s t o c k, by c ont rac t or oth er wise, or (b) if the c ont r olling P er son owns m o r e t h a n 50% of a ny c l a ss of vo t ing s ec u r i ti e s of the c ont r oll e d P er son.

“Age nts” m ea ns the Adminis t ra tive A g e nt a nd the C o-A g e nts.

“Aggregate Commitm e nt” m ea ns, on a ny d a te of d e t er min a tion, the a gg re g a te a mount of the L e nd e r G r oup C omm i tm e nts of a ll L e nd e r G r oups (e x c lud i ng the L e nd e r G r oup C om m itm e nt of a ny D efa ulting L e nd er’s L e nd e r G r oup). As of t he d a t e h ere o f, the A gg re g a te C om m itm e nt is $400,000,000.440,000,000.

“Aggregate Prin cipal” m ea ns, on a ny d a te of d e t er m in a t ion, the a gg re g a te outs t a nding p r in c ip a l a mount of a ll L o a ns outs t a nding on su c h d a t e.

“Aggregate R edu ction” h a s the m ea ning sp ec i f i e d in S ec t i on 1.3.

“Agree m e nt” m ea ns t h i s Am e nd e d a nd R e st a t e d C re dit a nd S ec u r i t y A g ree m e nt, a s it m a y be a m e nd e d or m od i f i e d a nd in effec t fr om time to tim e.

“A l t e r n ate B ase R a t e” m ea ns f or a ny d a y, the ra te p e r annum e qu a l to the hi g h e r a s of su c h d a y of (i) t he P r ime R a t e, or (i i) on e-h a lf of one p erce nt (0.50%) a bove the Fe d era l F unds R a t e. F or pu r pos e s of d e t er m ining the Alt er n a te B a se R a te f or a ny d a y, c h a n g e s in the P r ime R a te or the Fe d era l F unds R a te sh a ll be effec tive on the d a te of eac h su c h c h a n g e.

“Alt ernate Base Rate Loan” m ea ns a L o a n w h i c h b ear s int ere st a t the Alt er n a te

Base R ate or the Default R ate.

“A mortization Date” m ea ns the ear li e st to o cc ur of (i) the d a y on w h i c h a ny of the c onditions p rece d e nt set f o r th in S ec tion 6.2 (oth e r th a n S ec tion 6.2(d)(ii)(B)) ar e not s a tisfi e d, (ii) t he B us i n e ss D a y imm e di a t e ly p r ior t o t he o cc u rre n c e of a n Ev e nt of Ba nk r upt c y with re sp ec t to a ny L o a n P ar t y, (i i i) t he B us i n e ss D a y sp ec i f i e d i n a w r i tt e n noti c e fr om the Adminis t ra t i ve A g e nt f ol l o w i ng the o cc u rre n c e of a ny oth e r Amo r ti z a tion Ev e nt, a nd (i v) the d a te whi c h is 10 B us i n e ss D a y s af t e r the Admin i s t ra t i ve A g e n t’s rece ipt of w r i t t e n noti c e fr om the C oll ec tion A g e nt, on b e h a lf of B o rr ow er s, th a t B o rr ow er s wish to t er m in a t e t he fac ility e vid e n ce d by this A g ree m e nt.

“A mortization E ve nt” h a s the m ea n i ng sp ec i f i e d in A r ti c le I X.

“An ti-T e r r or i sm Laws” m ea ns a ny Appli ca ble L a w re l a t i ng to t err o r is m, t ra de s a n c ti ons p r o g ra ms a nd e mb ar g o e s, impo r t/e x po r t l i ce ns i n g, mon e y l a und er in g, c o rr upt i on or b r ib er y, a nd a ny re g ul a t i on, o r d er, or di rec t i ve p r o m ul g a t e d, is s u e d or e n f o rce d pu r su a nt t o su c h Appli ca ble L aw s, a ll a s a m e nd e d, supp l e m e nt e d or re pl ace d fr om ti m e to t im e.

“A ppl i c able Law” m ea ns, with re sp ec t to a ny P er son, a ll p r ovisions of l aw,

st atut e, treaty, constitution, ordinance, rul e, re gulation, requirement, rest riction, permit, e x ecutive order, certi f i cate, decision, directive or order of any Governmental Authority applicable to such P erson or any of its proper t y.

“Appli cable Perce ntage” m ea ns, on a ny d a t e of d e t er min a tion, the “A pp l i ca ble M ar g in f or Eu r odo l l a r L o a ns” a s set fo r th in the “Appli ca b l e P r i c i ng G r id” (a s eac h of the f o re g o i ng t er ms is d ef i n e d in t he P are nt C r e dit A g ree m e nt).

“Assign m e nt Agree m e nt” h a s t he m ea ning set fo r th i n S ec tion 12.1(b). “Atlantic” m ea ns Atl a ntic As s e t S ec u r i t i z a tion LL C, a D e l a w ar e limit e d

liability company.

“Authorized Officer” m ea ns, with re sp ec t to a ny P er son, its p re s i d e nt, c omp a ny c ont r oll er, t rea su re r or c h i e f f in a n c i a l o ff i cer.

“B ail-In A c tio n” m ea ns the e x erc i s e of a ny W r i t e-Down a nd C onv er sion P o wer s by the a ppli ca ble EEA R e so l ut i on Authori t y i n re sp ec t of a ny l i a bi l ity of a n EEA F i n a n c i a l I ns t itution.

“B ail-In L e gis l atio n” m ea ns, with re sp ec t to a ny EEA Memb e r C ount r y impl e m e nting A r ti c le 55 of Di rec tive 2014/59/EU of the Eu r op ea n P ar li a m e nt a nd of the C oun c il

of the Eu r op ea n Union, the impl e m e nting l a w f or su c h E E A M e mb e r C ountry fr om t i me to time whi c h i s d e s cr ib e d in the EU B a il-I n L e g is l a tion S c h e dul e.

“Bankruptcy Code” m ea ns the B a nk r upt c y C ode of 1978, a s a m e nd e d a nd in effec t fr om t ime to time (11 U.S.C. § 101 e t seq.) a nd a ny su cce s s or s t a tu t e th ere to.

“B asel III” means the agreements reached by the Basel Committee on Banking Supervision in “Basel I I I: A Global Regulatory Framework for More Resilient Banks and Banking S ystems” (as amended, supplemented or otherwise modified or replaced from time to time).

“Blocked Sw eep A ccount” m ea ns acc ount no. 81884-16729 in the C oll ec tion

Ag ent’s na me at Bank of America, N.A., in Chica go, Illinois.

“Borrow er(s)” h a s the m ea ning s e t f o r th in the pr ea mb l e to t his A g ree m e nt.

“Borrowing Base” m ea ns, on a ny d a t e of d e t er min a tion, the N e t P ool B a l a n c e a s of the l a st d a y of the p er i od c ov ere d by the most rece nt Mon t h l y R e po r t, m inus the R e qu i re d R e s er ve a s of the l a st d a y of the p er iod c ov ere d by the most rece nt Mon t hly R e po r t, minus D ee m e d C oll ec tions th a t h a ve o cc u rre d s i n c e the most rece nt C ut-O f f D a te to the e x t e nt th a t su c h D ee m e d C oll ec t i ons e x cee d the Dilu ti on R e se r v e, plus the S e l f-P a y B o rr owing B a se a s of t he l a st d a y of t he p er iod c ov ere d by t he most rece nt Mon t hly R e po r t.

hereunder.

“B or r o w i n g Dat e” m ea ns a B us i n e ss D a y on whi c h a n Adv a n c e is m a de

“Borrowing Notice” h a s t he m ea ning set fo r th i n S ec tion 1.2.

“Broken Funding Costs” m ea ns f or a ny C P R a te L o a n or L I B O R a te L o a n whi c h: (a) in the ca se of a C P R a te L o a n, h a s its p r in c ipal r e du ce d without c o m pli a n c e by B o rr ow er s (or the C oll ec tion A g e nt on th e ir b e h a l f) with the noti c e r e qui re m e nts h ere und er, (b) in the ca se of a C P R a te L o a n or a L I B O R a te L o a n, do e s not b ec ome subj ec t to a n A gg re g a te R e du c tion f ollowing the d e liv er y of a ny R e du c t i on Noti ce, (c) in the ca se of a C P R a te L o a n, is a s s i g n e d und e r the L iquidity A g ree m e nt, or (d) in the ca se of a L I B O R a te L o a n, is t er min a t e d or re du ce d prior t o the l a st d a y of its I nt ere st P er iod, a n a mount e qu a l to the e x ce s s, i f a n y, of (i) the C P C os t s or I nt ere st (a s a ppl i ca bl e) t h a t would h a ve accr u e d du r ing the re m a i nd e r of the I n t ere st P er iods or the t ra n c he p er i ods f or C omm erc i a l P a p e r d e t er min e d by t he Administ ra tive A g e nt to re l a te to su c h L o a n (a s a pp l i ca bl e) sub s e qu e nt to the d a te of su c h re du c t ion, a s s i g nm e nt or t er min a tion (or in re sp ec t of c l a use (b) a bov e, the d a te su c h A gg re g a te R e du c t i on w a s d e si g n a t e d to o cc ur pursu a nt to the R e du c tion Noti ce) of the p r in c ipal of su c h L o a n if su c h re du c tion, a s s i g nm e nt or t er m in a t ion h a d not o cc u rre d or su c h R e du c tion N o t i c e h a d not b ee n d e liv ere d, ov e r (i i) t he sum of (x) t o the e x t e nt a ll or a po r tion of su c h prin c ip a l is a l l o ca ted to a no t h e r L o a n, the a mount of C P C os t s or I nt ere st ac tu a l ly accr u e d du r ing t he re m a ind e r of su c h p er iod on su c h p r in c ip a l f or the n e w L o a n, a nd (y) to t he e x t e nt such p r i n c ip a l is not a l l o ca t e d to a no t h e r L o a n, t he in c o m e, if a n y, ac tu a lly rece iv e d du r ing the re m a ind e r of su c h p er i od by the hold e r of su c h L o a n f r om inv e s t ing the port i on of su c h p r i n c ip a l not so a llo ca t e d. I n the e v e nt th a t the a mount referre d to i n c l a use (B) e x cee ds the a mount referre d t o in c l a use (A), t he re l e v a nt L e nd e r

P er iod e nding on su c h C u t-O f f D a t e, by (i i) the a gg re g a te N e t Eli g i ble B illin g s g e n era t e d by the O r i g in a tors du r ing the C a l c u l a t i on P er iod imm e diat e ly prior t o the C a l c u l a t i on P er iod e nding on su c h C ut-O f f D a t e.

“Dilution R eserve” m ea ns, for a ny C a l c ul a tion P er iod, t he p r odu c t (e x p re s s e d a s a p erce n t a g e) o f:

(a) the sum of (i) two (2) times the Adjusted Dilution Ratio as of the immediately preceding Cut-Off Date, plus (ii) the Dilution Volatility Component as of the immediately preceding Cut-Off Date, ti m e s

(b)the Dilution Horizon Ratio as of the immediately preceding Cut-Off Date.

“D ilution Volatility Compon e nt” m ea ns the p r odu c t (e x p re ss e d a s a p erce n t a g e) of (i) the d i ffere n c e b e tw ee n (a) the hi g h e st th re e (3)-month r oll i ng a v era g e Dilu t ion R a tio ov e r the p a st 12 C a l c ul a tion P er iods a nd (b) the Adjus t e d Dilu t ion R a tio, a nd (ii) a frac tion, the num era tor of whi c h is e qu a l to the a mount ca l c u l a t e d in (i)(a) of t his d ef ini t ion a nd the d e nomin a tor of whi c h is e qu a l to the a m ount ca l c ul a t e d in (i)(b) of this d ef inition.

“Drawing Dat e” h a s the m ea n i ng set f o r th i n S ec t i on 1.10(b).

“EE A F i n a n c ial I n s t it u tion” m ea ns (a) a ny cre dit ins ti tu t ion or inv e s tm e nt f i r m e s t a blish e d in a ny E E A M e mb e r C ount r y whi c h is sub j ec t to the supe r vision of a n E E A R e solution A u t ho r i t y, (b) a ny e ntity e s t a blish e d in a n E E A Memb e r C oun t r y w h i c h is a p are nt of a n ins t itut i on d e sc r ib e d i n c l a use (a) of th i s d ef ini t ion, or (c) a ny f i n a n c ial ins t itution e s t a bl i sh e d in a n E E A M e mb e r C ount r y whi c h is a sub s idi ar y of a n institution d e s cr ib e d in c l a us e s (a) or (b) of this d ef inition a nd is sub j ec t to c onso l id a t e d sup er vis i on w i th its p are nt.

“EE A Me m b e r C o un tr y” m ea ns a ny of the m e mb e r s t a t e s of the Eu r op ea n Union, I ce l a nd, L i ec ht e ns t e in, a nd No r w a y.

“EE A R e so lut ion Au t h or i t y” m ea ns a ny public a dm i nis t ra t ive a utho r i t y or a ny p er son e nt r us t e d wi t h public a dmin i s t ra t i ve a utho r ity of a ny E E A M e m b e r C ount r y (in c l uding a ny d e l e g ee) h a ving re sponsibi l ity f or the r e so l ution of a ny E E A F in a n c i a l I ns t itution.

“Eligible Assign ee” m ea ns a c om m erc i a l b a nk h a ving a c omb i n e d ca pi t a l a nd surplus of a t l ea st $250,000,000 wi t h a ra t i ng of its (or its p are nt holding c omp a n y’s) sho r t-t er m s ec u r i ti e s e qu a l to or hi g h e r th a n (i) A-1 by S&P a nd (i i) P-1 by Mood y’s.

“Eligible In vest m e nts” m ea ns book-e n t r y se c u r i ti e s e nt ere d on the books of the re g is t r a r of su c h se c u r i ti e s a nd h e ld in the n a m e or on b e h a lf of the A d m inis t ra tive A g e nt, n e g ot i a ble ins t r um e nts or se c u r iti e s r e p re s e nt e d by ins t r um e nts i n b eare r or re g is t ere d f o r m re g is t ere d in t he n a me of the Adm i nis t ra t ive A g e nt or its no m in e e whi c h e vid e n ce:

(a) readily marketable direct obligations of the Government of the United States or any agency or instrumentality thereof or obli gations unconditionally guaranteed by the full faith and credit of the United States;

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“E U B ail-In L e g i slation S c h e d ul e” m ea ns the EU Ba i l-I n L e g is l a t i on S c h e dule publish e d by the L o a n M ar k e t Associ a tion (or a ny su cce s s or p er son), a s in effec t fr om t ime to tim e.

if either:

“E ve n t of B a n kr u pt cy” sh a ll be d ee m e d to h a ve o cc u rre d wi t h re sp ec t to a P er son

(a) a case or other proceeding shall be commenced, without the application or consent of such Person, in any court, seeking the liquidation, reorganization, debt arrangement, dissolution, winding up, or composition or readjustment of debts of such Person, the appointment of a trustee, receiver, custodian, liquidator, assi gnee, sequestrator or the like for such Person or all or substantially all of its assets, or any similar action with respect to such Person under any law relating to bankruptcy, insolvency, reorganization, winding up or composition or adjustment of debts, and such case or proceeding shall continue undismissed, or unstayed and in effect, for a period of 60 consecutive days; or an order for relief in respect of such Person shall be entered in an involuntary case under the federal bankruptcy laws or other similar laws now or hereafter in effect; or

(b) such Person shall commence a voluntary case or other proceeding under any applicable bankruptcy, insolvency, reorganization, debt arrangement, dissolution or other similar law now or hereafter in effect, or shall consent to the appointment of or taking possession by a receiver, liquidator, assignee, trustee (other than a trustee under a deed of trust, indenture or similar instrument), custodian, sequestrator (or other similar official) for, such Person or for any substantial part of its property, or shall make any general assignment for the benefit of creditors, or shall be adjudicated insolvent, or admit in writing its inability to pay its debts generally as they become due, or, if a corporation or similar entity, its board of directors shall vote to implement any of the foregoing.

Ag reements.

“E x ec u ti v e O ff i ce r” h a s the m ea ning p r ovid e d in t he R ece iv a bl e s S a le

“Facility A ccount” m ea ns the C o l l ec tion A g e nt’s acc ount no. 81889-03045 (A B A no. 026-009-593, ref: C omm erc i a l P a p e r P r o cee ds) a t B a nk of Am er i ca, N.A., i n C hi ca g o, I l l inois.

“Facility Termination Dat e” m ea ns the ear l i e r of (i) Dece m b e r 21, 2018 a nd (i i)

the Amortiz ation Date.

“F ederal Funds E ffec tive Rate” m ea ns, f or a ny d a y, the p e r a nnum ra te s e t f o r th in the w ee kly st a tis t i ca l re l ea se d e s i g n a t e d a s H.15(519), or a ny su cce s s or publi ca t ion, publish e d by the F e d era l R e s er ve B o ar d (in c l uding a ny su c h su cce ssor, “H.15(519)”) f or su c h d a y oppos i te the ca ption “F e d era l F unds (E ffec t i v e).” I f on a ny r e l e v a nt d a y such ra te is not y e t publish e d in H.15(519), the ra te f or su c h d a y will be t he ra t e set f o r th in the d a ily s t a t i s ti ca l re l ea se d e si g n a t e d a s the C o m pos i te 3:30 p.m. Quot a t ions f or U.S. Gov er n m e nt S ec u r iti e s, or a ny su cce s s or publi ca tion, publish e d by the Fe d era l R e s er ve B a nk of N e w Yo r k (in c luding a ny such su cce s s or,

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the “Compos it e 3:30 p.m. Q uo t a t i ons”) f or su c h d a y und e r t he ca ption “F e d era l F unds E ffec tive

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C o-A g e nt; pro v id e d that no su c h p er iod sh a ll e x cee d one m onth a nd, in the a bs e n c e of su c h s e l ec t i on by the a ppli ca ble C o-A g e nt, su c h I nt ere st P er iods f or su c h L o a n sh a ll be the C a l c ul a t ion P er iods.

In the case of any Int erest P er iod for any Loan which commences before the A mortiz ation Date and would otherwise end on a date occurr ing after the Amorti z ation Date, such Int erest P eriod shall end on the Amorti z ation Da t e. The duration of each Interest P eriod which commences after the A mor tiz ation Date shall be of such dura tion as selected by the applicable Co-Ag ent.

“Int erest Rate” m ea ns, w i th r e sp ec t t o eac h L o a n of the L iquidity Ba nks or a ny oth e r L o a n b e i ng f und e d or m a int a in e d by a L e nd e r oth e r th a n th r ou g h the is s u a n c e of C om m erc i a l P a p er, the LI B O R a t e, the Alt er n a te B a se R a te or the D efa ult R a t e, a s a ppli ca bl e.

“Laws” m ea ns, c oll ec tiv e l y, a l l c ommon l a w a nd a l l i n t er n a tion a l, f o re i g n, fe d era l, s t a te a nd l o ca l st a t ut e s, t rea ti e s, r u l e s, g uid e lin e s, re g ul a t ions, o r din a n ce s, c od e s a nd a dminis t ra tive or judi c i a l pr ece d e nts, in c luding without limit a tion the int er p re t a tion th ere of by a ny g ov er nm e nt a l a utho r ity c h ar g e d with the e n f o rce m e nt t h ere o f.

“LC Bank” h a s t he m ea ning set fo r th in the p rea mble to this A g ree m e nt.

“LC Collateral A ccount” m ea ns the acc ount d e s i g n a t e d a s the L C C oll a t era l A cc ount e s t a blish e d a nd m a int a in e d by the Adm i nis t ra t ive A g e nt (f or the b e n ef i t of t he L C B a nk a nd the L C P ar ti c ip a n t s), or su c h o t h e r acc ount a s m a y be so d e s i g n a t e d a s su c h by the Adminis t ra t i ve A g e nt.

“LC Participant” m ea ns eac h P er son list e d a s su c h (a nd i ts r e sp ec tive C om m itm e nt) f or eac h L e nd e r G r oup a s s e t f o r th on the s i g n a ture p a g e s of this A g ree m e nt or in a ny A s s i g nment A g ree m e nt pu r su a nt to whi c h it b eca me a p ar ty h ere to.

“LC Partic ipation A mount” m ea ns, a t a ny tim e, the e x ce s s, if a n y, of (a) a g g re g a te fac e a mount of the outst a nd i ng L e t t er s of C r e dit a t su c h ti m e ov e r (b) the a mount of a ny d ra win g s m a de und e r su c h L e t t er s of C re d i t.

“LCR S ec u r i t y” m ea ns a ny c omm erc i a l p a p e r or se c u r i t y (o t h e r th a n e quity s ec u r i ti e s is s u e d to the P erf o r m a n c e Gu ara ntor or a ny Or i g in a t or th a t is a c onso l id a t e d sub si di ar y

of the P erf o r m a n c e Gu ara ntor und e r G A A P) within the m ea ning of P ara g ra ph

.32(e)(viii) of

the f in a l r ul e s tit l e d L iquidi t y C ov era g e R a t i o: L iquid i ty R isk M ea sur e m e nt St a nd ar ds, 79 F e d. R e g. 197, 61440 e t seq. (Oc tob e r 10, 2014).

LC B ank.

“L e n d e r” m ea ns eac h C ondu i t, eac h L i quidity Ba nk, eac h L C P ar t i c ipant a nd t he

“Le nder Group” m ea ns, (A) wi t h re sp ec t t o a ny C ondui t, (i) such C onduit, (ii) its L i quidity B a nk(s), (ii i) its C o-A g e nt a nd (i v) it’s L C P ar t i c ip a nt(s), (B) w i th re sp ec t t o P N C, P NC a s (i) a L iquidi t y Ba nk, (ii) a C o-A g e nt, (i ii) a n L C P ar ti c ip a n t, (iv) the L C B a nk a nd (v) the Adminis t ra t i ve A g e nt a nd (C) with re sp ec t t o S unT r us t, (i) S unT r ust a s a L iquidity B a nk, (ii) S TRH a s its C o-A g e nt a nd (i i i) S unT r ust a s a n L C P ar t i c ip a nt.

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lim i t sh a ll be d e t er min e d acc o r ding t o public d e bt ra ting of su c h Obli g or b a s e d t he f o l lowing t a bl e:

S&P Rating | Moody’s R ating | Allowable % of the Elig ible R eceivables and Eli gible P articipation Int erests, in the a g g re g ate
A-1+ or at least AA- | P-1 or at least A2 | 10.00%
A-1 or at least A | P-1 or at least A2 | 8.00%
A-2 or at least A- | P-2 or at least Baa1 | 6.00%
A-3 or at least B B B- | P-3 or at least Baa3 | 5.00%
Below A-3 or Not R ated by either S&P or Moody’s | Below P-3 or Not Rated by either S&P or Moody’s | 3.85%

; pro v id e d, h o w eve r, that (i) if any Obli gor has a split rating, the applicable rating will be the lower of the two, (ii) if any Obli gor is not ra t ed by either S&P or Moody’s, the applicable Obligor Concentration Limit shall be the one set forth in the last line of the table above, (iii) if an Obligor has an A.M. Best Financial Streng th R a ting of “A” or bett er, the applicable concentration limit for such Obligor shall be 10%, notwithst anding the S&P R ating or the Moody’s R ating, (iv) if any Obligor has no short-term unsecured rating from either S&P or Moody’s, but has a long-term rating from S&P or Moody’s, then such long-term ratings shall be used as set forth in the above chart in li eu of short-term ratings, subj ect to the fore going and (v) subj ect to rating a g ency approval and/or an increase in the R equi red R eserve Fac tor F loor, upon request of the Collection Ag ent, on beha lf of Borrowers, from time to time, the Administ rative Ag ent and the L enders m ay a g ree to a higher percenta ge of Eli gible R eceivables for a par ticul ar Obligor and its Affilia t es, in the a gg re g ate, as set forth on S c h e dule D hereto, or as the Administ rative Ag ent may otherw ise designate from time to time (each such hi gher percenta g e, a “S p ec ial Obligor C o n ce n tra t ion Li m i t”), it being understood that any Special Obligor Concentration Limit may be cance lled upon not less than five (5) Business Da ys’ written noti ce by the Administrative Ag ent to the Collection Ag ent, on behalf of Borrowers.

“Order” h a s t he m ea ning set fo r th in S ec tion 1.16.

“Original Agree m e nt” h a s the m ea ning s e t f o r t h in the rec it a ls to this A g ree m e nt. “Originator” m ea ns eac h of Aik e n R e g ion a l M e di ca l C e nt er s, I n c., Dis t r ict

Hospital P artners, L.P., Fort Duncan Medical C enter, L.P., L ancaster Hospit al Corporation, L aredo R e gional Medical C enter, L.P., Manatee Memorial Hospital, L.P., McAllen Hospitals, L.P., Northwest Te x as Healthcare S yst em, Inc., Sparks Family Hospita l, Inc., Summerlin Hospital Medi cal C enter LL C, Temecula Valley Hospital, Inc., UHS of Te xoma, Inc., UHS of Oklahoma, I n c.LL C, UH S-C o r on a, I n c., Univ er s a l H ea lth S er v i ce s of R a n c ho S prin g s, I n c., V a ll e y H ea lth S y s t e m LL C a nd W e ll i n g ton R e g ion a l Medic a l C e nt er, I n c o r po ra t e d LL C.

“Outstanding Balan ce” m ea ns a t a ny time (i) wi t h r e sp ec t to a ny P r iv a te

Receivable, the then outstanding principal balance thereof after giving effect to the Initial

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c omp a n y, joint v e nture or s im il a r bus i n e ss or g a ni z a tion mo r e th a n 50% of the own er sh i p int ere sts h a v i ng o r din ar y voting pow e r of whi c h sh a ll a t the ti m e be so own e d or c ont r oll e d.

“SunTrust” h a s the m ea ning set f o r th in the p rea mble to this A g ree m e n t.

“Tax Code” m ea ns the I nte r n a l R e v e nue C ode of 1986, a s the same m a y be a m e nd e d f r om time to t i m e.

Ag reements.

“T e r m i n ation Dat e” h a s the m ea ning s e t fo r th i n the R ece iv a bl e s S a le

“TP F” h a s the m ea ning s e t f o r th in t he p rea m ble t o this A g ree m e nt.

“Transaction Doc u m e nts” m ea ns, c o l l ec tiv e l y, th i s A g ree m e nt, eac h B o rr owing Noti ce, eac h R ece iv a bl e s S a l e A g ree m e nt, eac h C oll ec t i on A cc ount A g ree m e nt, eac h P erf o r m a n c e U nd er takin g, t he Fe e L e tt er, eac h S ubordin a t e d Note (a s d ef in e d in the R ece iv a bl e s S a le A g ree m e n t s) a nd a ll oth e r ins t r um e nts, do c uments a nd a g ree m e nts e x ec ut e d a nd d e liv ere d in c onn ec t i on h erew i th.

Ag reements.

“Tra n sf e r r e d A s s e ts” h a s the m ea ning set f o r th in the R ece iv a bl e s S a le

“TRICARE” h a s the m ea ning p r ovid e d i n the R ece iv a b l e s S a l e A g ree m e nts.

“UCC” m ea ns t he Uni f o r m C omm erc i a l C ode a s fr om time to ti m e in effec t in the sp ec i f i e d ju r isd i c t i on.

“UHS of Delaware” h a s the m ea ning set f o r th in the p rea mble to th i s A g ree m e nt.

“Un matured A mortization E ve nt” m ea ns a n e v e nt whi c h, with the p a ssa g e of time or the g iving of no t i ce, or both, would c ons t itute a n Amo r ti z a t i on Ev e nt.

“VFCC” h a s the m ea ning set f o r th in the p rea mble to this A g ree m e n t. “V i ctory” h a s the m ea n i ng set f o r th i n the p rea mble to this A g ree m e nt. “Wells” h a s the m ea ning s e t f o r th i n t he p rea m ble t o this A g ree m e nt.

“Wells Assign m e nt” h a s the m ea ning s e t f o r th in t he rec i t a l s to this A g ree m e nt.

“W r it e-D o w n a n d C o n ve r s ion Pow e rs” m ea ns, with re sp ec t to a ny E E A R e solution Authori t y, the w r it e-down a nd c onv er s i on po wer s of su c h EEA R e so l ution Authori t y fr om time t o t i me und e r the Ba il-I n L e g is l a t i on f or the a pp l i ca ble E E A Memb e r C ountr y, whi c h w r it e do w n a nd c onv er s i on pow er s ar e d e s cr ib e d in the EU B a i l-I n L e g is l a t i on S c h e dule.

“Yie ld R eserve” m ea ns, f or a ny C a l c u l a t i on P er iod, the p r odu c t (e x p re ssed a s a p erce nt a g e) of (i) 1.5 t i m e s (i i) the Alt er n a te B a se R a te a s of the i mm e di a t e ly p rece ding C ut-Of f D a te ti m e s (iii) a frac t i on the nu m era tor of whi c h is t he h i g h e st D a y s S a l e s Outs t a nding f or the

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most rece nt 12 C a l c ul a tion P er iods a nd the d e no m in a t or of whi c h is 360.

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S CHEDULE A CO MM I T M E N T S

V ICT O R Y’S L E N D E R G ROUP | C O MM I T M E N T
Lender Group Commitm ent | $95,000,000 104,500,000
BTMU’s Commitment as a Liquidity Bank | $95,000,000 104,500,000
BTMU’s Commitment as an LC Participant | $95,000,000 104,500,000

S UN T R U ST’S L E N DER G RO U P | C O MM I T M E N T
Lender Group Commitm ent | $100,000,000 110,000,000
SunTrust’s Commitment as a Liquidity B ank | $100,000,000 110,000,000
SunTrust’s Commitment as an LC Participant | $100,000,000 110,000,000

P N C’S L E N D E R G R O UP | C O MM I T M E N T
Lender Group Commitm ent | $115,000,000 126,500,000
PNC’s Commitment as a Liquidity B ank | $115,000,000 126,500,000
PNC’s Commitment as an LC Participant | $115,000,000 126,500,000

A TL A NTIC’S L E N DER G RO U P | C O MM I T M E N T
Lender Group Commitm ent | $90,000,000 99,000,000
CACI B’s Commitment as a Liquidity Bank | $90,000,000 99,000,000
CACI B’s Commitment as an LC Participant | $90,000,000 99,000,000

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SC HE D U L E D

SPECIAL OB L IGOR CONCENTRATION L IMIT

In addition to the other Obligor Concentration Limits specified in the Agree m ent:

(a) All Private Receivables owed by m e mbers of the BlueCross BlueShield Association shall be subject to a Special Concentration Limit of 15% of the Eligible Receivables and Eligible Participation Interests, in the a g g re g ate; pro v id e d, h o w eve r, that (i) the aggregate outstanding balance of such Private Receivables originated by facilities located in the State of Nevada shall be subject to a state sub-limit of 10% of the Eligible Receivables and Eligible Participation Interests, in the a g g re g ate, and (ii) the aggregate outstanding balance of such receivables originated by facilities located within any other state (or District of Columbia), shall be subject to a state sub-limit of 5% of the Eligible Receivables and Eligible Participation Interests, in the a g g re g ate; and

(b) The combined company that was form ed by the m erger of Sierra Health Services, Inc. with United HealthCare Services, Inc. (the “C ombined C ompany”) and its Affiliates will have a Special Concentration Limit of 15.0 18.0% of t h e E l i gible Rece i v a b l e s a nd E li g ib l e P a r ti c i p a t i on I n t e r es t s, in t h e a gg r e g a t e, unl e s s a nd un t il ca n ce l l e d upon not l es s th a n f ive (5) B u s i n e s s Da y s’ w r it t e n noti c e by the A d m in is t r a t i ve A g e nt to B o rr o we r s a f t e r t h e o cc u rr e n c e of a U ni t e d Hea l t h Ca r e Cr e dit E v e n t, p r ovid e d t h e Re qui r e d Re s e r ve F ac tor F loor is a d j u s t e d (if a ppli ca bl e) b a s e d on the C o m b i n e d C o m p a ny’s ac t u a l d e bt r a t i ngs a t th a t ti m e.

As used in this Schedule D, the following ter ms have the following meanings:

“Unit ed H ealthCare Credit E ve nt” m ea ns the o cc u rr e n c e of e it h e r (i) a ny ma t e r i a l a dv e rs e e ff ec t on t h e bu s in e ss, op e r a t i on s, f in a n c i a l c ondi t ion or a ss e ts of the C o m bin e d C o m p a ny a nd its A ff i l i a t e s, t a k e n a s a w hole or (ii) a ny of the publ i c d e bt r a t i ngs of the C o m bin e d C o m p a ny or a ny of i t s A ff il i a t e s a r e do w ng r a d e d or w ithd r aw n.

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EXHIBIT B

CLOSING MEMORANDUM

Exhibit B

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