Contract

Exhibit 4.4

TRADEMARK SECURITY AGREEMENT dated as of August 17, 2012 (this “Agreement”), among CHS/COMMUNITY HEALTH SYSTEMS, INC., a Delaware corporation, BLUE ISLAND HOSPITAL COMPANY, LLC, a Delaware limited liability company, CHS WASHINGTON HOLDINGS, LLC, a Delaware limited liability company, QUORUM HEALTH RESOURCES, LLC, a Delaware limited liability company, TRIAD HEALTHCARE CORPORATION, a Delaware corporation and YOUNGSTOWN OHIO HOSPITAL COMPANY, LLC, a Delaware limited liability company (each a “Grantor”, and collectively, the “Grantors”) and CREDIT SUISSE AG, as Collateral Agent (the “Collateral Agent”).

Reference is made to (a) the Amended and Restated Guarantee and Collateral Agreement dated as of July 25, 2007, as amended and restated as of November 5, 2010 (as further amended, restated, supplemented or otherwise modified from time to time, the “Security Agreement”), among CHS/Community Health Systems, Inc., a Delaware corporation (the “Company”), Community Health Systems, Inc., a Delaware corporation (the “Parent”), the Subsidiaries of the Company party thereto and the Collateral Agent, (b) the Underwriting Agreement dated as of August 8, 2012 (as amended, restated, supplemented or otherwise modified from time to time, the “Underwriting Agreement”) among the Company, the Guarantors party thereto and Credit Suisse Securities (USA) LLC, as representative of the several underwriters specified therein (the “Representative”), (c) the Indenture dated as of August 17, 2012 (as amended, restated, supplemented or otherwise modified from time to time, the “Indenture”), among the Company, the Guarantors party thereto, the Collateral Agent and Regions Bank, as trustee (the “Trustee”), and (d) that certain designation certificate delivered to the Collateral Agent pursuant to Section 7.09(c) of the Security Agreement in order to secure the Notes and related obligations on a pari passu basis with the other obligations secured under the Security Agreement (subject to certain exceptions in the case of pledged stock). The Trustee and underwriters referred to above have agreed to purchase $1,600,000,000 aggregate principal amount of 5.125% Senior Secured Notes due 2018 of the Company (the “Notes”) on the terms and subject to the conditions set forth in the Underwriting Agreement. The obligations of the underwriters to purchase the Notes are conditioned upon, among other things, the execution and delivery of this Agreement. The Grantor will derive substantial benefits from the issuance of the Notes pursuant to the Indenture and is willing to execute and deliver this Agreement in order to induce the underwriters to purchase the Notes. Accordingly, the parties hereto agree as follows:

SECTION 1.  Terms.  Capitalized terms used in this Agreement and not otherwise defined herein have the meanings specified in the Security Agreement. The rules of construction specified in Section 1.01(b) of the Security Agreement also apply to this Agreement.

SECTION 2.  Grant of Security Interest.  As security for the payment or performance, as the case may be, in full of the Obligations, each Grantor, pursuant to the Security Agreement, did and hereby does grant to the Collateral Agent, its successors and assigns, for the benefit of the Secured Parties, a security interest in and lien on, all right, title or interest in or to any and all of the following assets and properties now owned or at any time hereafter acquired by such Grantor or in which such Grantor now has or at any time in the future may acquire any right, title or interest (collectively, the “Trademark Collateral”):

(a) all trademarks, service marks, trade names, corporate names, company names, business names, fictitious business names, trade styles, trade dress, logos, other source or business identifiers, designs and general intangibles of like nature, now existing or hereafter adopted or acquired, all registrations and recordings thereof, and all registration and recording applications filed in connection therewith, including registrations and applications for registration (other than intent-to-use applications) in the United States Patent and Trademark Office (or any successor office), and all extensions or renewals thereof, including those listed on Schedule I attached hereto (the “Trademarks”);

(b) all goodwill associated with or symbolized by the Trademarks; and

(c) all assets, rights and interests that uniquely reflect or embody the Trademarks.

Notwithstanding the foregoing, no applications for registration of Trademarks filed in the United States Patent and Trademark Office on an intent-to-use basis will be included in the Trademark Collateral until such time as a statement of use has been filed and accepted by the United States Patent and Trademark Office with respect to such Trademark, to the extent that the grant of a security interest in any such Trademark application would adversely affect the validity or enforceability or result in cancelation or voiding of such Trademark application.

SECTION 3.  Security Agreement.  The security interests granted to the Collateral Agent herein are granted in furtherance, and not in limitation of, the security interests granted to the Collateral Agent pursuant to the Security Agreement. Each Grantor hereby acknowledges and affirms that the rights and remedies of the Collateral Agent with respect to the Trademark Collateral are more fully set forth in the Security Agreement, the terms and provisions of which are hereby incorporated herein by reference as if fully set forth herein. In the event of any conflict between the terms of this Agreement and the Security Agreement, the terms of the Security Agreement shall govern.

SECTION 4.  Execution in Counterparts.  This Agreement may be executed in any number of counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement.

SECTION 5.  Choice of Law.  This Agreement shall be construed in accordance with and governed by the laws of the State of New York.

[Remainder of the page intentionally left blank]

IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the day and year first above written.

		CHS/COMMUNITY HEALTH SYSTEMS, INC.,
				by
						/s/ Xxxxxx X. Xxxxxxx
						Name:		Xxxxxx X. Xxxxxxx
						Title:		Executive Vice President, Secretary and General Counsel
		BLUE ISLAND HOSPITAL COMPANY, LLC,
				by
						/s/ Xxxxxx X. Xxxxxxx
						Name:		Xxxxxx X. Xxxxxxx
						Title:		Executive Vice President
		CHS WASHINGTON HOLDINGS, LLC,
				by
						/s/ Xxxxxx X. Xxxxxxx
						Name:		Xxxxxx X. Xxxxxxx
						Title:		Executive Vice President
		QUORUM HEALTH RESOURCES, LLC,
				by
						/s/ Xxxxxx X. Xxxxxxx
						Name:		Xxxxxx X. Xxxxxxx
						Title:		Executive Vice President
		TRIAD HEALTHCARE CORPORATION,
				by
						/s/ Xxxxxx X. Xxxxxxx
						Name:		Xxxxxx X. Xxxxxxx
						Title:		Executive Vice President

[Signature Page to Trademark Security Agreement]

		YOUNGSTOWN OHIO HOSPITAL COMPANY, LLC,
				by
						/s/ Xxxxxx X. Xxxxxxx
						Name:		Xxxxxx X. Xxxxxxx
						Title:		Executive Vice President
		CREDIT SUISSE AG, CAYMAN ISLANDS BRANCH, as Collateral Agent,
				by
						/s/ Xxxxxx Xxxx
						Name:		Xxxxxx Xxxx
						Title:		Managing Director
				by
						/s/ Xxxxx Xxxxxx
						Name:		Xxxxx Xxxxxx
						Title:		Associate

[Signature Page to Trademark Security Agreement]

Schedule I

I. Trademarks

Registered Owner		U.S. Xxxx		Reg. Date		Reg. No.
CHS/Community Health Systems, Inc.				7/23/1996		1988032
CHS/Community Health Systems, Inc.		A TIP-TOP MATERNITY CLUB		4/10/2001		2442377
CHS/Community Health Systems, Inc.		Class 035		6/26/2001		2463770
CHS/Community Health Systems, Inc.		Class 041		10/30/2001		2501702
Community Health Systems Professional Services Corporation		COMMUNITY CARES Standard Character CL 35		6/26/2001		2463771
Community Health Systems Professional Services Corporation		COMMUNITY CARES standard character CL 41		10/23/2001		2499955
Community Health Systems Professional Services Corporation (assigned by Community Health Systems, Inc. on 1/13/2011)				9/28/2010		3852138

Registered Owner		Xxxx		Reg. No.		Reg. Date
Triad Healthcare Corporation		GATEWAY HOME CARE		2750685		8/12/03
Triad Healthcare Corporation		GATEWAY MEDICAL CENTER		2775950		10/21/03
Triad Healthcare Corporation		REDIMED		3037881		1/3/06
Triad Healthcare Corporation		REHABILTIATION HOSPITAL OF FORT XXXXX		3111485		7/4/06

Triad Healthcare Corporation		KCH REGIONAL REHABILITATION CENTER		3119373		7/25/06
Triad Healthcare Corporation		LUTHERAN HEART PAVILION		3131393		8/15/06
Triad Healthcare Corporation		XXXX XXXXX HEALTH SYSTEM & Design		3140091		9/5/06
Triad Healthcare Corporation		LUTHERAN CHILDREN’S HOSPITAL		3144409		9/19/06
Triad Healthcare Corporation		LUTHERAN HOSPITAL OF INDIANA		3144410		9/19/06
Triad Healthcare Corporation		LUTHERAN HEART CENTER		3156408		10/17/06
Triad Healthcare Corporation		LUTHERAN SLEEP DISORDERS CENTER		3166943		10/31/06
Triad Healthcare Corporation		(Device Only) (Leaf Design)		3167543		11/7/06
Triad Healthcare Corporation		ST. XXXXXX BEHAVIORAL HEALTH		3179375		12/5/06
Triad Healthcare Corporation		LUTHERAN HEALTH NETWORK		3185051		12/12/06
Triad Healthcare Corporation		BIRTHPLACE AT KOSCIUSKO COMMUNITY HOSPITAL & Design		3185595		12/19/06
Triad Healthcare Corporation		INNOVATIVE RECOVERIES		3191986		1/2/07
Triad Healthcare Corporation		NORTHWEST HEALTH SYSTEM		3322657		10/30/07
Triad Healthcare Corporation		NORTHWEST HEALTH SYSTEM (Design ONLY)		3285337		8/28/07
Triad Healthcare Corporation		NOTHWEST HEALTH SYSTEM & Design		3322661		10/30/07
Triad Healthcare Corporation		FAMILY TREE HEALTHCARE		3361686		1/1/08
Triad Healthcare Corporation				3444757		6/10/08
Triad Healthcare Corporation		THOUGHTFUL CARE		3437433		5/27/08
Triad Healthcare Corporation		LABCARE PLUS		3299222		9/25/07
Triad Healthcare Corporation		LABCARE PLUS & Design		3299223		9/25/07

Triad Healthcare Corporation		TRINITY MEDICAL CENTER		3321061		10/23/07
Triad Healthcare Corporation		TRINITY MEDICAL CENTER & Design		3321062		10/23/07

Registered Owner		U.S. Xxxx		Reg. Date		Reg. No.
Quorum Health Resources, LLC		QHR		3/28/2006		3074195
Quorum Health Resources, LLC		QHR		10/10/2006		3153336
Quorum Health Resources, LLC		SURVIVE AND THRIVE		11/27/2007		3345425
Quorum Health Resources, LLC				12/1/2009		3719929
Quorum Health Resources, LLC				1/12/2010		3737811
Quorum Health Resources, LLC				2/8/2011		3916779
Quorum Health Resources, LLC		REFORM READY		9/27/2011		4030986
Quorum Health Resources, LLC		VANTAGE SCORECARD		8/24/2010		3836740
Quorum Health Resources, LLC		VANTAGE LMS		9/13/2011		4024411
Quorum Health Resources, LLC				9/27/2011		4032424

Quorum Health Resources, LLC     4/16/2012 4128270

Registered Owner		U.S. Xxxx		Reg. Date		Reg. No.
Youngstown Ohio Hospital Company, LLC				10/22/1991		1662085
Youngstown Ohio Hospital Company, LLC		TMH		10/13/1998		2194834

Registered Owner		U.S. Xxxx		Reg. Date		Reg. No.
Blue Island Hospital Company, LLC		METROSOUTH MEDICAL CENTER		11/17/2009		3710989

II. Trademark Applications

Registered Owner		U.S. Xxxx		App. Date		App. No.
CHS Washington Holdings LLC		HEALTHCARE NORTHWEST INTEGRATED DELIVERY SYSTEM		Filed 2/5/2010		S.N. 77/929467
CHS Washington Holdings LLC		ROCKWOOD HEALTH SYSTEM		Filed 11/2/2011		S.N. 85/462,774
Quorum Health Resources, LLC				Filed 1/11/2010		S.N. 77/909121

III. Trademark Licenses

None.