Quorum Health Corporation $400,000,000 11.625% Senior Notes due 2023 REGISTRATION RIGHTS JOINDER

Exhibit 4.2

EXECUTION VERSION

Quorum Health Corporation

$400,000,000 11.625% Senior Notes due 2023

REGISTRATION RIGHTS JOINDER

April 29, 2016

CREDIT SUISSE SECURITIES (USA) LLC,

  As Representative of the several Initial Purchasers,

        C/O CREDIT SUISSE SECURITIES (USA) LLC

Eleven Xxxxxxx Xxxxxx

Xxx Xxxx, Xxx Xxxx 00000

Ladies and Gentlemen:

Reference is made to the Registration Rights Agreement (the “Registration Rights Agreement”) dated April 22, 2016, among Quorum Health Corporation, a Delaware corporation (the “Issuer” or the “Company”), and the several Initial Purchasers listed on Schedule A thereto (the “Initial Purchasers”), for whom Credit Suisse Securities (USA) LLC is acting as representative (in such capacity, the “Representative”), concerning certain registration rights provisions with respect to the $400,000,000 aggregate principal amount of 11.625% Senior Notes due 2023 issued by the Issuer. Capitalized terms used and not otherwise defined herein have the meanings ascribed to them in the Registration Rights Agreement. This agreement (this “Registration Rights Joinder”) is the “Registration Rights Joinder” referred to in the Registration Rights Agreement.

Each of the Guarantors, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, hereby agrees to join, and to become bound by the terms, conditions, covenants, agreements, indemnities and other provisions of, the Registration Rights Agreement as a “Guarantor”, in each case with all attendant rights, duties and obligations stated therein, with the same force and effect as if originally a party thereto, and as if such party executed the Registration Rights Agreement on the date thereof.

If the foregoing is in accordance with your understanding, please indicate your acceptance of this Registration Rights Joinder by signing in the space provided below.

								Very truly yours,
				By:				/s/ Xxxxxxx X. Xxxxxxx
				Name:				Xxxxxxx X. Xxxxxxx
				Title:				President
								Acting on behalf of each of the Guarantors set
								forth below
Xxxx Hospital Corporation								Massillon Community Health System LLC
Big Bend Hospital Corporation								Massillon Health System LLC
Big Spring Hospital Corporation								Massillon Holdings, LLC
Blue Island Hospital Company, LLC								XxXxxxxx Tennessee Hospital Company, LLC
Blue Island Illinois Holdings, LLC								MMC of Nevada, LLC
Blue Ridge Georgia Holdings, LLC								Monroe HMA, LLC
Centre Hospital Corporation								MWMC Holdings, LLC
Clinton Hospital Corporation								National Healthcare of Mt. Xxxxxx, Inc.
CSRA Holdings, LLC								Xxxxxxxx Hospital Corporation
Xxxxxx Hospital Corporation								QHC California Holdings, LLC
DHSC, LLC								QHG of Massillon, Inc.
Evanston Hospital Corporation								Quorum Health Investment Company, LLC
Forrest City Arkansas Hospital Company, LLC								Quorum Health Resources, LLC
Xxxxxxx City Hospital Corporation								Red Bud Hospital Corporation
Fort Xxxxx Hospital Corporation								Red Bud Illinois Hospital Company, LLC
Galesburg Hospital Corporation								San Xxxxxx Hospital Corporation
Granite City Hospital Corporation								Sunbury Hospital Company, LLC
Granite City Illinois Hospital Company, LLC								Tooele Hospital Corporation
Greenville Hospital Corporation								Triad of Oregon, LLC
Hamlet H.M.A., LLC								Watsonville Hospital Corporation
Hospital of Barstow, Inc.								Waukegan Hospital Corporation
Hospital of Louisa, Inc.								Waukegan Illinois Hospital Company, LLC
Xxxxxxx Hospital Corporation (KY)								Williamston Hospital Corporation
Lexington Hospital Corporation								Winder HMA, LLC
Xxxxxx Hospital Corporation

[Signature Page to the Registration Rights Agreement Joinder]

The foregoing Registration Rights Joinder

is hereby accepted as of the date first above written.

CREDIT SUISSE SECURITIES (USA) LLC,
By:		/s/ Xxxxxxxx Xxxxx
Name:		Xxxxxxxx Xxxxx
Title:		Director
		Acting on behalf of itself and as Representative of the several Initial Purchasers

[Signature Page to the Registration Rights Agreement Joinder]