0001045829-12-000012 Sample Contracts

REGISTRATION RIGHTS AGREEMENT by and among Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., Vanguard Health Systems, Inc. and the Other Guarantors Party Hereto and Merrill Lynch, Pierce, Fenner & Smith Incorporated Barclays...
Registration Rights Agreement • April 2nd, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans • New York

This Registration Rights Agreement (this “Agreement”) is made and entered into as of March 30, 2012, by and among Vanguard Health Holding Company II, LLC, a Delaware limited liability company (the “Company”), and Vanguard Holding Company II, Inc., a Delaware corporation (together with the Company, the “Companies”), Vanguard Health Systems, Inc., a Delaware corporation (the “Parent”), the other entities listed on the signature pages hereof as “Guarantors” (collectively, the “Guarantors”), and Merrill Lynch, Pierce, Fenner & Smith Incorporated and Barclays Capital Inc., on behalf of themselves and as representatives of the several initial purchasers listed on Schedule I hereto (collectively, the “Initial Purchasers”), each of whom has agreed to purchase the Companies’ 7.750% Senior Notes due 2019 (the “Initial Notes”) fully and unconditionally guaranteed by the Guarantors (the “Guarantees”) pursuant to the Purchase Agreement (as defined below). The Initial Notes and the Guarantees attach

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SUPPLEMENTAL INDENTURE
Supplemental Indenture             Second Supplemental Indenture • April 2nd, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans • New York

SECOND SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of March 30, 2012, among VANGUARD HEALTH HOLDING COMPANY II, LLC, a Delaware limited liability company (the “Company”), VANGUARD HOLDING COMPANY II, INC., a Delaware corporation (the “Co-Issuer” and, together with the Company, the “Issuers”), the guarantors listed on the signature pages hereto (the “Guarantors”) and U.S. BANK NATIONAL ASSOCIATION, as trustee under the Indenture referred to below (the “Trustee”).

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