EXHIBIT 10(d) FIRST AMENDMENT FIRST AMENDMENT, dated as of June 17, 1997 (this "First Amendment") to --------------- the Agreement and Amendment dated as of February 26, 1997, (the "February 1997 ------------- Five-Year Agreement and Amendment") among COLUMBIA/HCA HEALTHCARE CORPORATION, a - --------------------------------- Delaware corporation formerly known as Columbia Healthcare Corporation (the "Company"), the several banks and other financial institutions from time to time - -------- parties hereto (the "Banks"), BANK OF AMERICA NATIONAL TRUST & SAVINGS ----- ASSOCIATION, THE BANK OF NEW YORK, DEUTSCHE BANK AG, FLEET NATIONAL BANK, THE FUJI BANK LIMITED, THE INDUSTRIAL BANK OF JAPAN, LIMITED, ATLANTA AGENCY, MORGAN GUARANTY TRUST COMPANY OF NEW YORK, NATIONSBANK, N.A., PNC BANK, KENTUCKY, INC., TORONTO DOMINION (TEXAS), INC., UNION BANK OF SWITZERLAND, NEW YORK BRANCH AND WACHOVIA BANK OF GEORGIA, N.A., as Co-Agents (collectively, the "Co-Agents"), --------- THE SAKURA BANK, LTD. NEW YORK BRANCH, THE SUMITOMO BANK LIMITED, SUNTRUST BANK, NASHVILLE, N.A., WELLS FARGO BANK, N.A., as Lead Managers (collectively, the "Lead Managers") and THE CHASE MANHATTAN BANK, a New York banking corporation - -------------- formerly known as Chemical Bank, as agent for the Banks hereunder (in such capacity, the "Agent") and as CAF Loan agent (in such capacity, the "CAF Loan ----- -------- Agent"). - ----- W I T N E S S E T H : -------------------- WHEREAS, for the convenience of the parties to the agreement and amendment dated as of February 28, 1996 (the "February 1996 Agreement and --------------------------- Amendment"), among the Company, the several banks and other financial - --------- institutions from time to time parties thereto and Chase, as agent for the Banks hereunder and as CAF Loan Agent, a composite conformed copy (the "Five-Year --------- Composite Conformed Credit Agreement") of the Credit Agreement, dated as of - ------------------------------------ February 10, 1994 as incorporated by reference into and amended by the September 1994 Agreement and Amendment, the February 1995 Agreement and Amendment and the February 1996 Agreement and Amendment was prepared and delivered to such parties; WHEREAS, the February 1997 Five-Year Agreement and Amendment adopts and incorporates by reference all of the terms and provisions of the Five-Year Composite Conformed Credit Agreement, subject to the amendment thereto provided for in the February 1997 Five-Year Agreement and Amendment. WHEREAS, the parties hereto wish to amend certain provisions of the February 1997 Five-Year Agreement and Amendment on the terms set forth herein; NOW, THEREFORE, in consideration of the premises and of the mutual agreements herein contained, the parties hereto agree as follows: 1. Definitions. Unless otherwise defined herein, terms defined in ----------- the February 1997 Five-Year Agreement and Amendment shall be used as so defined. 2 2. Amendments to the February 1997 Five-Year Agreement and Amendment. ----------------------------------------------------------------- (a) SECTION 3 of the February 1997 Five-Year Agreement and Amendment is hereby amended by deleting the defined term "Agreement" in its entirety and substituting in lieu thereof the following new defined term: "`Agreement': the Five-Year Composite Conformed Credit Agreement --------- as adopted and incorporated by reference into, and as amended by, the February 1997 Five-Year Agreement and Amendment and as further amended, supplemented or otherwise modified from time to time." (b) The February 1997 Five-Year Agreement and Amendment is hereby amended by deleting Section 7 thereof in its entirety and substituting in lieu thereof the following new Section 7: "SECTION 7. Litigation. For purposes of this Agreement, subsection ---------- 3.6 of the Composite Conformed Credit Agreement as adopted and incorporated by reference into this Agreement is hereby amended by deleting such subsection in its entirety and substituting in lieu thereof the following: `3.6 Litigation. Except as disclosed in the Company's Annual Report ---------- on Form 10-K for its fiscal year ended December 31, 1996 and its Quarterly Report on Form 10-Q for its fiscal quarter ended March 31, 1997, in each case as filed with the Securities and Exchange Commission and previously distributed to the Banks, and except as set forth on Schedule VI hereto, there is no litigation, at law or in equity, or any proceeding before any federal, state, provincial or municipal board or other governmental or administrative agency pending or to the knowledge of the Company threatened which, after giving effect to any applicable insurance, may involve any material risk of a material adverse effect on the business or assets or on the condition, financial or otherwise, of the Company and its Subsidiaries on a consolidated basis or which seeks to enjoin the consummation of any of the transactions contemplated by this Agreement or any other Loan Document and involves any material risk that any such injunction will be issued, and no judgment, decree, or order of any federal, state, provincial or municipal court, board or other governmental or administrative agency has been issued against the Company or any Subsidiary which has, or may involve, a material risk of a material adverse effect on the business or assets or on the condition, financial or otherwise, of the Company and its Subsidiaries on a consolidated basis. The Company does not believe that the final resolution of the matters disclosed in its Annual Report on Form 10-K for its fiscal year ended December 31, 1996 and its Quarterly Report on Form 10-Q for its fiscal quarter ended March 31, 1997, in each case as filed with the Securities and Exchange Commission and previously distributed to the Banks, and of the matters set forth on Schedule VI hereto will have a material adverse effect on the business or assets or condition, financial or otherwise, of the Company and its Subsidiaries on a consolidated basis.'". 3 (c) The February 1997 Five-Year Agreement and Amendment is hereby amended by adding the following new paragraph after Section 8 reading as follows: "SECTION 8A. Ratio of Total Debt to Tangible Net Worth. Subsection ----------------------------------------- 5.6 of the Five-Year Composite Conformed Credit Agreement as adopted and incorporated by reference into this February 1997 Five-Year Agreement and Amendment is hereby amended by deleting such subsection in its entirety and substituting in lieu thereof the following: `5.6 Ratio of Total Debt to Tangible Net Worth. At any time after ----------------------------------------- March 31, 1997 the Company and its Subsidiaries will not at any such time have outstanding Consolidated Total Debt in an amount in excess of 300% of Consolidated Tangible Net Worth.'" (d) Schedules II and III to the February 1997 Five-Year Agreement and Amendment are hereby amended by deleting Schedules II and III in their entirety and substituting in lieu thereof Schedules II and III attached hereto as Schedule II and III, respectively. 3. Effective Date; Conditions Precedent. This First Amendment will ------------------------------------ become effective on June 17, 1997 (the "Effective Date") subject to the -------------- compliance by the Company with its agreements herein contained and to the satisfaction on or before the Effective Date of the following further conditions: (a) Loan Documents. The Agent shall have received copies of this -------------- First Amendment, executed and delivered by a duly authorized officer of the Company, with a counterpart for each Bank, and executed and delivered by the Required Lenders. (b) Company Officers' Certificate. The representations and ----------------------------- warranties contained in Section 3 of the Five-Year Composite Conformed Credit Agreement as adopted and incorporated by reference into, and as amended by, the February 1997 Five-Year Agreement and Amendment shall be true and correct on the Effective Date with the same force and effect as though made on and as of such date; on and as of the Effective Date and after giving effect to this First Amendment, no Default shall have occurred (except a Default which shall have been waived in writing or which shall have been cured); and the Agent shall have received a certificate containing a representation to these effects dated the Effective Date and signed by a Responsible Officer. 4. Legal Obligation. The Company represents and warrants to each ---------------- Bank that this First Amendment constitutes the legal, valid and binding obligation of the Company, enforceable against it in accordance with its terms, subject to the effects of bankruptcy, insolvency, fraudulent conveyances, reorganization, moratorium and other similar laws relating to or affecting creditors' rights generally, general equitable principles (whether considered in a proceeding in equity or at law) and an implied covenant of good faith and fair dealing. 4 5. Continuing Effect. Except as expressly amended hereby, the ----------------- February 1997 Five-Year Agreement and Amendment shall continue to be and shall remain in full force and effect in accordance with its terms. 6. Expenses. The Company agrees to pay or reimburse the Agent for -------- all of its reasonable out-of-pocket costs and expenses incurred in connection with the development, preparation and execution of, and any amendment, supplement or modification to, this First Amendment and any other documents prepared in connection herewith, and the consummation of the transactions contemplated hereby and thereby, including, without limitation, the reasonable fees and disbursements of counsel to the Agent. 7. GOVERNING LAW. THIS FIRST AMENDMENT AND THE RIGHTS AND ------------- OBLIGATIONS OF THE PARTIES UNDER THIS FIRST AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED AND INTERPRETED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK. 8. Counterparts. This First Amendment may be executed by one or ------------ more of the parties to this First Amendment on any number of separate counterparts and all of said counterparts taken together shall be deemed to constitute one and the same instrument. A set of the copies of this First Amendment signed by all the parties shall be lodged with the Company and the Agent. IN WITNESS WHEREOF, the parties hereto have caused this First Amendment to be duly executed and delivered by their proper and duly authorized officers as of the day and year first above written. COLUMBIA/HCA HEALTHCARE CORPORATION By: /s/ David G. Anderson ---------------------- Name: David G. Anderson Title: Vice President - Finance and Treasurer THE CHASE MANHATTAN BANK, as Agent, as CAF Loan Agent and as a Bank By: /s/ Dawn Lee Lum ---------------- Name: Dawn Lee Lum Title: Vice President ABN AMRO BANK N.V., as a Bank By: /s/ Larry Kelley ---------------- Name: Larry Kelley Title: Group Vice President By: /s/ Steven Hipsman ------------------ Name: Steven Hipsman Title: Vice President ARAB BANK PLC, GRAND CAYMAN BRANCH, as a Bank By: /s/ Nofal S. Barbar ------------------- Name: Nofal S. Barbar Title: EVP & Regional Manager BANCA MONTE DEI PASCHI DI SIENA SpA, as a Bank By: /s/ G. Natalicchi ----------------- Name: G. Natalicchi Title: S.V.P. & General Manager By: /s/ S.M. Sondak --------------- Name: S.M. Sondak Title: F.V.P. & Dep. General Manager BANK OF AMERICA NATIONAL TRUST AND SAVINGS ASSOCIATION, as a Co-Agent and as a Bank By: /s/ Anthony L. Trunzo --------------------- Name: Anthony L. Trunzo Title: THE BANK OF NEW YORK, as a Co-Agent and as a Bank By: /s/ Ann Marie Hughes -------------------- Name: Ann Marie Hughes Title: Assistant Vice President THE BANK OF NOVA SCOTIA, as a Bank By: /s/ W.J. Brown -------------- Name: W.J. Brown Title: Vice President BANK OF TOKYO-MITSUBISHI TRUST COMPANY, as a Bank By: /s/ Douglas J. Weir ------------------- Name: Douglas J. Weir Title: Vice President BANQUE NATIONALE DE PARIS - Houston Agency, as a Bank By: /s/ David P. Camp ----------------- Name: David P. Camp Title: Banking Officer BARNETT BANK, N.A., as a Bank By: /s/ Bradley M. Harrell ---------------------- Name: Bradley M. Harrell Title: Senior Vice President CITIBANK, N.A., as a Bank By: /s/ Margaret Au Brown --------------------- Name: Margaret Au Brown Title: Managing Director CORESTATES BANK, N.A., as a Bank By: /s/ Elizabeth D. Morris ------------------------- Name: ELizabeth D. Morris Title: Vice President CRESTAR BANK, as a Bank By: /s/ C. Gray Key --------------- Name: C. Gray Key Title: Vice President THE DAI-ICHI KANGYO BANK, LIMITED, ATLANTA AGENCY, as a Bank By: /s/ Tatsuji Noguchi ------------------- Name: Tatsuji Noguchi Title: Joint General Manager DEN DANSKE BANK AKTIESELSKAB, as a Bank CAYMAN ISLANDS BRANCH c/o New York Branch By: /s/ Mogens Sondergaard ---------------------- Name: Mogens Sondergaard Title: Vice President By: /s/ George B. Wendell --------------------- Name: George B. Wendell Title: Vice President DEUTSCHE BANK AG, NEW YORK AND/OR CAYMAN ISLANDS BRANCH, as a Co-Agent and as a Bank By: /s/ Alka Jain Goyal ------------------- Name: Alka Jain Goyal Title: Assistant Vice President By: /s/ Iain Stewart ---------------- Name: Iain Stewart Title: Vice President FIRST AMERICAN NATIONAL BANK, as a Bank By: /s/ Sandy Hamrick ----------------- Name: Sandy Hamrick Title: Vice President THE FIRST NATIONAL BANK OF CHICAGO, as a Bank By: /s/ Jay G. Sepanski, as Authorized Agent ---------------------------------------- Name: Jay G. Sepanski Title: Assistant Vice President FLEET NATIONAL BANK, as a Co-Agent and as a Bank By: /s/ Amy E. Fredericks --------------------- Name: Amy E. Fredericks Title: Senior Vice President THE FUJI BANK LIMITED, as a Co-Agent and as a Bank By: /s/ Toshihiro Mitsui -------------------- Name: Toshihiro Mitsui Title: Vice President and Manager THE INDUSTRIAL BANK OF JAPAN, LIMITED, ATLANTA AGENCY, as a Co-Agent and as a Bank By: /s/ Kazuo Iida -------------- Name: Kazuo Iida Title: General Manager KEYBANK NATIONAL ASSOCIATION, as a Bank By: /s/ Thomas Purcell ------------------ Name: Thomas Purcell Title: Vice President THE MITSUBISHI TRUST AND BANKING CORPORATION, as a Bank By: /s/ Patricia Loret de Mola -------------------------- Name: Patricia Loret de Mola Title: Senior Vice President THE MITSUI TRUST AND BANKING COMPANY, LIMITED, NEW YORK BRANCH, as a Bank By: /s/ Margaret Holloway --------------------- Name: Margaret Holloway Title: Vice President & Manager MORGAN GUARANTY TRUST COMPANY OF NEW YORK, as a Co-Agent and as a Bank By: /s/ Penelope J.B. Cox --------------------- Name: Penelope J.B. Cox Title: Vice President NATIONAL CITY BANK OF KENTUCKY, as a Bank By: /s/ Deroy Scott --------------- Name: Deroy Scott Title: Vice President NATIONSBANK, N.A. as a Co-Agent and as a Bank By: /s/ Kevin Wagley ---------------- Name: Kevin Wagley Title: Vice President THE NORINCHUKIN BANK, NEW YORK BRANCH, as a Bank By: /s/ Takeshi Akimoto ------------------- Name: Takeshi Akimoto Title: General Manager THE NORTHERN TRUST COMPANY, as a Bank By: /s/ James F.T. Monhart ---------------------- Name: James F.T. Monhart Title: Vice President PNC BANK, KENTUCKY, INC. as a Co-Agent and as a Bank By: /s/ Kathryn M. Bohr ------------------- Name: Kathryn M. Bohr Title: Vice President THE SAKURA BANK, LTD. NEW YORK BRANCH, as a Lead Manager and as a Bank By: /s/ Yasumasa Kikuchi -------------------- Name: Yasumasa Kikuchi Title: Senior Vice President THE SUMITOMO BANK, LIMITED, as a Lead Manager and as a Bank By: /s/ Masayuki Fukushima ---------------------- Name: Masayuki Fukushima Title: Joint General Manager THE SUMITOMO TRUST & BANKING CO., LTD., NEW YORK BRANCH, as a Bank By: /s/ Suraj P. Bhatia ------------------- Name: Suraj P. Bhatia Title: Senior Vice President Manager, Corporate Finance Dept. SUNTRUST BANK, NASHVILLE, N.A., as a Lead Manager and as a Bank By: /s/ Mark D. Mattson ------------------- Name: Mark D. Mattson Title: Vice President THE TOKAI BANK, LIMITED, NEW YORK BRANCH, as a Bank By: /s/ Stuart Schulman ------------------- Name: Stuart Schulman Title: Deputy General Manager TORONTO DOMINION (TEXAS), INC., as a Co-Agent and as a Bank By: /s/ Lisa Allison ---------------- Name: Lisa Allison Title: Vice President THE TOYO TRUST & BANKING CO., LTD., as a Bank By: /s/ K. Yamauchi --------------- Name: K. Yamauchi Title: Vice President UNION BANK OF SWITZERLAND, NEW YORK BRANCH, as a Co-Agent and as a Bank By: /s/ Stephen A. Cayer -------------------- Name: Stephen A. Cayer Title: Assistant Vice President By: /s/ Eduardo Salazar ------------------- Name: Eduardo Salazar Title: Vice President UNION PLANTERS BANK OF MIDDLE TENNESSEE, N.A. By: /s/ Steven A. Koenig -------------------- Name: Steven A. Koenig Title: Vice President WACHOVIA BANK OF GEORGIA, N.A., as a Co-Agent and as a Bank By: /s/ Charles Dee O'Dell II ------------------------- Name: Charles Dee O'Dell II Title: Vice President WELLS FARGO BANK, N.A., as a Lead Manager and as a Bank By: /s/ David B. Hollingsworth -------------------------- Name: David B. Hollingsworth Title: Vice President By: /s/ Rachel T. Uyama ------------------- Name: Rachel T. Uyama Title: Assistant Vice President YASUDA TRUST AND BANKING, as a Bank By: /s/ Price Chenault ------------------ Name: Price Chenault Title: First Vice President