FOURTH AMENDMENT TO STOCK PLEDGE AGREEMENT

Exhibit 10(k)

FOURTH AMENDMENT TO STOCK PLEDGE AGREEMENT

This Fourth Amendment to Stock Pledge Agreement (this “Amendment”) is entered into as of March 23, 2015, among Tenet Healthcare Corporation, a Nevada corporation (the “Company”), each of the other entities listed on the signature pages hereof as Pledgors, and The Bank of New York Mellon Trust Company, N.A., as collateral trustee for the Secured Parties (in such capacity, the “Collateral Trustee”).

RECITALS

WHEREAS, reference is made to that certain Stock Pledge Agreement, dated as of March 3, 2009, by the Company and the other Pledgors in favor of the Collateral Trustee, as amended by that certain First Amendment to Stock Pledge Agreement, dated as of May 8, 2009, among the Company, the other Pledgors and the Collateral Trustee, as amended by that certain Second Amendment to Stock Pledge Agreement, dated as of June 15, 2009, among the Company, the other Pledgors and the Collateral Trustee, as amended by that certain Joinder Agreement to the Stock Pledge Agreement, dated as of May 15, 2013 and executed by the pledgors party thereto, as amended by that certain Pledge Amendment to the Stock Pledge Agreement, dated as of May 15, 2013, between the Company and the Collateral Trustee, as amended by that certain Joinder Agreement to the Stock Pledge Agreement, dated as of October 1, 2013 and executed by the pledgors party thereto, as amended by that certain Pledge Amendment to the Stock Pledge Agreement, dated as of October 1, 2013, by the Company and the Collateral Trustee, as amended by that certain Third Amendment to Stock Pledge Agreement, dated as of March 7, 2014,  as amended by that certain Joinder Agreement to the Stock Pledge Agreement, dated as of March 23, 2015 and executed by the pledgors party thereto, and as amended by that certain Pledge Amendment to the Stock Pledge Agreement, dated as of March 23, 2015, by the Company and the Collateral Trustee (as so amended, the “Stock Pledge Agreement”);

WHEREAS, pursuant to that that certain Interim Loan Agreement, dated as of the date hereof, by and among the Company, Barclays Bank PLC, as administrative agent (in such capacity, together with its successors and assigns in such capacity, the “Administrative Agent”) and each Person from time to time party thereto as a lender (collectively, the “Lenders” and individually, a “Lender”) (as amended, amended and restated or otherwise modified from time to time, the “Interim Loan Agreement”), the Lenders have agreed to provide a term loan credit facility to the Company on the terms set forth in such Interim Loan Agreement;  

WHEREAS, the Secured Obligations in respect of which a security interest in the Collateral was created by the Stock Pledge Agreement is limited to only the obligations in respect of the:

(a) Fourteenth Supplemental Indenture to the Base Indenture, dated as of November 21, 2011, by and among the Company, The Bank of New York Mellon Trust Company, N.A., as trustee (the “Trustee”) and the guarantors party thereto and relating to the Company’s 6.250% Senior Secured Notes due 2018 (the “2018 Notes” and, as supplemented by the Nineteenth Supplemental Indenture, dated as of May 15, 2013, between the Company, the Trustee and the

guarantors party thereto, and the Twenty Second Supplemental Indenture, dated as of October 1, 2013, between the Company, the Trustee and the guarantors party thereto, the “Fourteenth Supplemental Indenture”);

(b) Fifteenth Supplemental Indenture to the Base Indenture, dated as of October 16, 2012, by and among the Company, the Trustee and the guarantors party thereto and relating to the Company’s 4.75% Senior Secured Notes due 2020 (the “2020 Notes” and, as supplemented by the Nineteenth Supplemental Indenture, dated as of May 15, 2013, between the Company, the Trustee and the guarantors party thereto, and the Twenty Second Supplemental Indenture, dated as of October 1, 2013, between the Company, the Trustee and the guarantors party thereto, the “Fifteenth Supplemental Indenture”);

(c) Seventeenth Supplemental Indenture to the Base Indenture, dated as of February 5, 2013, by and among the Company, the Trustee and the guarantors party thereto and relating to the Company’s 4.500% Senior Secured Notes due 2021 (the “4.500% 2021 Notes” and, as supplemented by the Nineteenth Supplemental Indenture, dated as of May 15, 2013, between the Company, the Trustee and the guarantors party thereto, and the Twenty Second Supplemental Indenture, dated as of October 1, 2013, between the Company, the Trustee and the guarantors party thereto, the “Seventeenth Supplemental Indenture”);

(d) Twentieth Supplemental Indenture to the Base Indenture, dated as of May 30, 2013, by and among the Company, the Trustee and the guarantors party thereto and relating to the Company’s 4.375% Senior Secured Notes due 2021 (the “4.375% 2021 Notes” and, as supplemented by the Nineteenth Supplemental Indenture, dated as of May 15, 2013, between the Company, the Trustee and the guarantors party thereto, and the Twenty Second Supplemental Indenture, dated as of October 1, 2013, between the Company, the Trustee and the guarantors party thereto, the “Twentieth Supplemental Indenture”);

(e) Indenture dated as of September 27, 2013 (the “2013 Base Indenture”), between THC Escrow Corporation and the Trustee (as supplemented on October 1, 2013 by the first supplemental indenture thereto by and among the Company, the Trustee, and the guarantors party thereto (collectively, the “2013 Indenture”)), pursuant to which the 6.00% Senior Secured Notes due 2020 were issued (the “6.000% 2020 Notes” and, together with the 4.375% 2021 Notes, the 4.500% 2021 Notes, the 2020 Notes and the 2018 Notes are collectively referred to herein as the “Notes”);

(f) the Guarantees in respect of the Notes; and

(g) the obligations under that certain Letter of Credit Facility Agreement, dated as of March 7, 2014, among the Company, certain financial institutions party thereto from time to time as letter of credit participants and issuers and Barclays Bank PLC, as administrative agent (the “LC Facility Agreement”), and the guarantees in respect thereof,

WHEREAS, subject to the terms and conditions hereof, the parties hereto desire to and have agreed to amend the Stock Pledge Agreement to secure the obligations in respect of the Loan Agreement, in each case to be designated as and entitled to the benefits of being Junior

Stock Secured Debt (as defined in the Collateral Trust Agreement) under the Collateral Trust Agreement in accordance with the requirements set forth in Section 3.8 thereof.

WHEREAS, the sole effect of this Amendment is to secure additional debt of the Company that is permitted by the terms of the Collateral Trust Agreement to be secured by the Collateral and to add references to such debt and the documents governing such debt,  and that as such, pursuant to:

(a)  Section 7.1 of the Stock Pledge Agreement; 

(b)  Section 7.1 of the Collateral Trust Agreement; 

(c)  Article VII of each of the Fourteenth Supplemental Indenture, Fifteenth Supplemental Indenture, Seventeenth Supplemental Indenture and Twentieth Supplemental Indenture, and Section 902 of the 2013 Indenture; and

(d) Section 10.8 and 11.1 of the LC Facility Agreement, this Amendment may be entered into by the Company, the other pledgors party hereto and the Collateral Trustee without (i) the consent of the holders of the Notes or the holders of LC Obligations (as defined below) or (ii) direction to the Collateral Trustee by an Act of Required Stock Secured Debtholders (as defined in the Collateral Trust Agreement); and

WHEREAS, unless otherwise indicated, capitalized terms used herein without definition have the meanings ascribed to such terms in the Stock Pledge Agreement.

NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, the Company and each other Pledgor signatory hereto hereby agrees with the Collateral Trustee as follows:

“Event of Default” means an Event of Default, as such term is defined in any Indenture, any 2013 Base Indenture, the LC Facility Agreement, the Interim Loan Agreement or any other First-Priority Stock Lien Document or Junior Stock Lien Document (as such terms are defined in the Collateral Trust Agreement).

“First Lien Secured Obligations” means all Secured Obligations described in clause (i) and (ii) of the definition of Secured Obligations.

“First Lien Secured Parties” means all Secured Parties described in clauses (i), (ii), (iv) and (v) of the definition of Secured Parties.

“Interim Loan Agreement” means that certain Interim Loan Agreement, dated as of March 23, 2015, among the Company, Barclays Bank PLC, as administrative agent (in such capacity, together with its successors and assigns in such capacity, the “Administrative Agent”) and each Person from time to time party thereto as a lender (collectively, the “Lenders” and individually, a “Lender”), as the same may be amended, amended and restated or otherwise modified from time to time.

“Interim Loan Agreement Guaranty Agreement” means that certain Guaranty Agreement, dated as of March 23, 2015, among the Company, the guarantors party thereto, the lenders party thereto and Barclays Bank PLC, as administrative agent, as the same may be amended, restated, supplemented or otherwise modified from time to time.

“Interim Loan Agreement Obligations” means the “Obligations” as defined in the Interim Loan Agreement.

“Junior Lien Secured Obligations” means all Secured Obligations described in clause (iii) of the definition of Secured Obligations.

“Junior Lien Secured Parties” means all Secured Parties described in clauses (iii) and (v) of the definition of Secured Parties.

“Loan Guarantees” means guarantees in respect of the Interim Loan Agreement Obligations pursuant to the Interim Loan Agreement Guaranty Agreement.

“Related Document” means the Indentures, the 2013 Indentures, the Notes, the Note Guarantees,  the Collateral Trust Agreement, the LC Facility Agreement, Guarantee Agreement, the Interim Loan Agreement, and the Interim Loan Agreement Guaranty Agreement.

“Secured Obligations” means (i) Obligations in respect the Notes and the Note Guarantees, (ii) LC Obligations and obligations under the LC Guarantees and (iii) Interim Loan Agreement Obligations and obligations under the Loan Guarantees.

“Secured Parties” means the (i) Holders of the Notes, (ii) the LC Participants, LC Issuers and Administrative Agent under the LC Facility Agreement and any other holders of LC Obligations, (iii) the Lenders and administrative agent under the Interim Loan Agreement and any other holders of Interim Loan Agreement Obligations,  (iv) the Trustee under each Indenture and each 2013 Indenture and (v) the Collateral Trustee.

(ii) by changing the words “Secured Parties” to “First Lien Secured Parties” and (iii) by adding the following language at the end:

“Each Pledgor, as collateral security for the full, prompt and complete payment and performance when due (whether at Stated Maturity, by acceleration or otherwise) of the Junior Lien Secured Obligations of such Pledgor, hereby mortgages, pledges and hypothecates to the Collateral Trustee for the benefit of the Junior Lien Secured Parties, and grants to the Collateral Trustee for the benefit of the Junior Lien Secured Parties a lien on and security interest in, all of its right, title and interest in, to and under the Collateral of such Pledgor. Notwithstanding anything herein to the contrary, the lien and security interest granted to the Collateral Trustee pursuant to this Agreement for the benefit of the Junior Lien Secured Parties is expressly subject and subordinate to the liens and security interests granted in favor of the holders of First Lien Secured Obligations on the terms set forth in the Collateral Trust Agreement.  In the event of any conflict between the terms of the Collateral Trust Agreement and this Agreement, the terms of the Collateral Trust Agreement shall govern and control.”

“None of the terms or provisions of this Agreement may be waived, amended, supplemented or otherwise modified except in accordance with Article Nine of the Base Indenture, as supplemented by Article Seven of each Supplemental Indenture, Section 9.02 of the 2013 Base Indenture, Section 11.1 of each of the LC Facility Agreement and corresponding provisions of any First-Priority Stock Lien Document and, solely to the extent such amendment affects any Junior Lien Secured Obligations or Junior Lien Secured Parties, Section 11.1 of the Interim Loan Agreement and corresponding provisions of any Junior Stock Lien Document (as such terms are defined in the Collateral Trust Agreement);  provided,  however, that annexes to this Agreement may be supplemented (but no existing provisions may be modified and no Collateral may be released) through Pledge Amendments and Joinder Agreements, in substantially the form of Annex 1 (Form of Pledge Amendment) and Annex 2 (Form of Joinder Agreement) respectively, in each case duly executed by the Collateral Trustee and each Pledgor directly affected thereby.” 

Agreement) be charged with knowledge of the terms of, be subject to, or be required to comply with the Interim Loan Agreement or LC Facility Agreement.  All such responsibilities of the Collateral Trustee shall be as set forth in the Collateral Trust Agreement.

[Signature Pages Follow]

IN WITNESS WHEREOF, each of the undersigned has caused this Amendment to be duly executed and delivered as of the date first above written.