0001193125-12-348781 Sample Contracts

AMENDED AND RESTATED OPERATING AGREEMENT
Operating Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Florida

This Amended and Restated Operating Agreement (this “Agreement”) of Bartow HMA, LLC (the “Company”) is made effective as of January 1, 2009.

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OPERATING AGREEMENT
Operating Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Florida
AMENDED AND RESTATED LIMITED LIABILITY COMPANY AGREEMENT
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Mississippi

This Amended and Restated Limited Liability Company Agreement (this “Agreement”) of Madison HMA, LLC (the “Company”) is made effective as of January 1, 2009.

LIMITED PARTNERSHIP AGREEMENT OF CAROLINAS JV HOLDINGS, L.P.
Limited Partnership Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware

THIS LIMITED PARTNERSHIP AGREEMENT (this “Agreement”) is made as of the 19th day of March, 2008, by and between CAROLINAS JV HOLDINGS GENERAL, LLC, a Delaware limited liability company (referred to as “General Partner”), and HEALTH MANAGEMENT ASSOCIATES, INC., a Delaware corporation (referred to as “Limited Partner”). General Partner and Limited Partner are herein collectively referred to as “Partners” and are Partners in the partnership known as Carolinas JV Holdings, L.P. (the “Partnership”), which was formed on March 19, 2008 when the General Partner caused a certificate of limited partnership (the “Certificate”) to be filed in the office of the Secretary of State of Delaware in accordance with the provisions of the Delaware Revised Uniform Limited Partnership Act (the “Act”).

LIMITED LIABILITY COMPANY AGREEMENT OF MISSISSIPPI HMA HOLDINGS I, LLC
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware

THIS LIMITED LIABILITY COMPANY AGREEMENT (this “Agreement”) is made as of the 16th day of December, 2008, by and between HMA HOSPITALS HOLDINGS, LLC, a Delaware limited liability company, and HEALTH MANAGEMENT ASSOCIATES, INC., a Delaware corporation (each a “Member” and collectively the “Members”).

AMENDED AND RESTATED OPERATING AGREEMENT
Amended And • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Florida

This Amended and Restated Operating Agreement (this “Agreement”) of Lehigh HMA, LLC (the “Company”) is made effective as of January 1, 2009.

STATESVILLE HMA, LLC AMENDED AND RESTATED OPERATING AGREEMENT
Operating Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • North Carolina
LIMITED LIABILITY COMPANY AGREEMENT OF CENTRAL FLORIDA HMA HOLDINGS, LLC
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware

THIS LIMITED LIABILITY COMPANY AGREEMENT (this “Agreement”) is made as of the 16th day of December, 2008, by and between HMA HOSPITALS HOLDINGS, LLC, a Delaware limited liability company, and HEALTH MANAGEMENT ASSOCIATES, INC., a Delaware corporation (each a “Member” and collectively the “Members”).

FORT SMITH HMA, LLC OPERATING AGREEMENT
Operating Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Arkansas
AGREEMENT OF LIMITED PARTNERSHIP OF LONE STAR HMA, L.P. A Delaware Limited Partnership
Winder HMA, LLC • August 10th, 2012 • Services-general medical & surgical hospitals, nec • Delaware

This Agreement of Limited Partnership is entered into and shall be effective as of the 1st day of May, 2002 pursuant to the provisions of the Delaware Revised Uniform Limited Partnership Act, by and among MESQUITE HMA GENERAL, LLC, a Delaware limited liability company (“Mesquite General”), as the General Partner (the “General Partner”), and MESQUITE HMA LIMITED, LLC, a Delaware limited liability company (“Mesquite Limited”), and MANORCARE OF HINSDALE, INC., an Illinois corporation (“MHI”), as the Limited Partners (Mesquite Limited and MHI are hereinafter referred to individually as a “Limited Partner” and collectively as the “Limited Partners”) and, for purposes of Article 14 hereof only, HEALTH MANAGEMENT ASSOCIATES, INC, a Delaware corporation (“HMA”) and MANOR CARE, INC., a Delaware corporation (“MCI”).

AMENDED AND RESTATED OPERATING COMPANY AGREEMENT
Operating Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Mississippi

This Amended and Restated Limited Liability Company Agreement (this “Agreement”) of Jackson HMA, LLC (the “Company”) is made effective as of January 1, 2009.

THIRD SUPPLEMENTAL INDENTURE
Third Supplemental Indenture • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • New York

This Third Supplemental Indenture (this “Supplemental Indenture”), dated as of July 31, 2012, among Brevard HMA ALF, LLC, a Florida limited liability company (“Brevard ALF”), Brevard HMA HME, LLC, a Florida limited liability company (“Brevard HME”), Brevard HMA Home Health, LLC, a Florida limited liability company (“Brevard Home Health”), Brevard HMA Hospice, LLC, a Florida limited liability company (“Brevard Hospice”), Brevard HMA Investment Properties, LLC, a Florida limited liability company (“Brevard Investment”), Brevard HMA Nursing Home, LLC, a Florida limited liability company (“Brevard Nursing Home”), Carlisle HMA, LLC, a Pennsylvania limited liability company (“Carlisle”) and Yakima HMA, LLC, a Washington limited liability company (“Yakima” and together with Brevard ALF, Brevard HME, Brevard Home Health, Brevard Hospice, Brevard Investment, Brevard Nursing Home and Carlisle, each individually a “Guaranteeing Subsidiary” and collectively, the “Guaranteeing Subsidiaries”), each

LIMITED LIABILITY COMPANY AGREEMENT OF MISSISSIPPI HMA HOLDINGS II, LLC
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware

THIS LIMITED LIABILITY COMPANY AGREEMENT (this “Agreement”) is made as of the 16th day of December, 2008, by and between HMA HOSPITALS HOLDINGS, LLC, a Delaware limited liability company, and HEALTH MANAGEMENT ASSOCIATES, INC., a Delaware corporation (each a “Member” and collectively the “Members”).

LIMITED LIABILITY COMPANY AGREEMENT OF MESQUITE GENERAL HMA, LLC
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware

Health Management Associates, Inc., a Delaware Corporation (“HMA” or the “Member”), hereby forms a limited liability company pursuant to and in accordance with the Delaware Limited Liability Company Act, 6 Del. C. §§ 18-101, et seq. (the “Act”) and hereby declares the following to be the limited liability company agreement (the “Agreement”) of such limited liability company:

SECOND AMENDED AND RESTATED LIMITED LIABILITY COMPANY AGREEMENT OF YAKIMA HMA, LLC A WASHINGTON LIMITED LIABILITY COMPANY
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Washington

This Second Amended and Restated Limited Liability Company Agreement (this “Agreement”) of Yakima HMA, LLC is made effective as of July 16, 2012 (the “Effective Date”), by and among the Company (as defined below) and the Member (as defined below).

SECOND AMENDED AND RESTATED OPERATING AGREEMENT OF POPLAR BLUFF REGIONAL MEDICAL CENTER, LLC A MISSOURI LIMITED LIABILITY COMPANY
Operating Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Missouri

This Second Amended and Restated Operating Agreement (this “Agreement”) of Poplar Bluff Regional Medical Center, LLC is made effective as of January 25, 2012 (the “Effective Date”), by and among the Company (as defined below) and the Member (as defined below).

CAROLINAS JV HOLDINGS GENERAL, LLC LIMITED LIABILITY COMPANY AGREEMENT
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware
LIMITED LIABILITY COMPANY AGREEMENT
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware
SECOND SUPPLEMENTAL INDENTURE
Second Supplemental Indenture • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • New York

This Second Supplemental Indenture (this “Supplemental Indenture”), dated as of July 25, 2012, among HMA CAT, LLC, a Texas limited liability company (the “Guaranteeing Subsidiary”), a subsidiary of Health Management Associates, Inc., a Delaware corporation (the “Company”), and U.S. Bank National Association, as trustee (the “Trustee”).

HEALTH MANAGEMENT ASSOCIATES, LLC LIMITED LIABILITY COMPANY AGREEMENT
Limited Liability Company Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Delaware

This Limited Liability Company Agreement of Health Management Associates, LLC is made as of the 18th day of December, 2009 (the “Agreement”).

ACKNOWLEDGMENT AND RELEASE
Acknowledgment and Release • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec

Reference is made to the Credit Agreement dated as of November 18, 2011 (the “Credit Agreement”) among Health Management Associates, Inc. (the “Borrower”), the lenders listed on the signature pages thereof (the “Lenders”), Wells Fargo Bank, N.A., as L/C Issuer and as Swingline Lender and Wells Fargo Bank, N.A. as Administrative Agent (the “Administrative Agent”).

SECOND AMENDED AND RESTATED OPERATING AGREEMENT OF CARLISLE HMA, LLC A PENNSYLVANIA LIMITED LIABILITY COMPANY
Operating Agreement • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • Pennsylvania

This Second Amended and Restated Operating Agreement (this “Agreement”) of Carlisle HMA, LLC is made effective as of June 30, 2012 (the “Effective Date”), by and among the Company (as defined below) and the Member (as defined below).

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SUPPLEMENTAL INDENTURE
Supplemental Indenture • August 10th, 2012 • Winder HMA, LLC • Services-general medical & surgical hospitals, nec • New York

This Supplemental Indenture (this “Supplemental Indenture”), dated as of April 20, 2012, among Poplar Bluff Regional Medical Center, LLC, a Missouri limited liability company (the “Guaranteeing Subsidiary”), a subsidiary of Health Management Associates, Inc., a Delaware corporation (the “Company”), and U.S. Bank, National Association, as trustee (the “Trustee”).

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