EXHIBIT 4.5 AMENDMENT NO. 3 TO CREDIT AGREEMENT AMENDMENT NO. 3 dated as of November 27, 1995 to the Credit Agreement dated as of September 11, 1995 among Vencor, Inc., the other Borrowers referred to therein and the Banks, Co-Agents, LC Issuing Banks and Agents referred to therein, as heretofore amended (the "Credit Agreement"). WHEREAS terms defined in the Credit Agreement have the same respective meanings when used herein; WHEREAS Vencor desires to (i) purchase shares of its own common stock and/or (ii) purchase securities of Tenet Healthcare Corporation convertible into or exchangeable for shares of Vencor's common stock; and WHEREAS Vencor has asked the Banks to amend Section 5.11 of the Credit Agreement to permit Vencor to make the foregoing purchases for an aggregate purchase price up to $50,000,000 without restricting Vencor's ability to make any other Restricted Payments; NOW, THEREFORE, the undersigned parties hereto agree as follows: SECTION 1. Restricted Payments. Section 5.11 of the Credit Agreement ------------------- is amended as follows: 1. Clause (d) of Section 5.11 is redesignated as clause (e) and the word "and" at the end of clause (c) is deleted. 2. The following new clause (d) is added to Section 5.11 immediately after clause (c): (d) payments after November 27, 1995 to (i) purchase common stock of Vencor and/or (ii) purchase securities of Tenet Healthcare Corporation convertible into or exchangeable for common stock of Vencor; provided that -------- the aggregate purchase price for all such common stock and securities purchased pursuant to this clause (d) shall not exceed $50,000,000; and 3. The reference in the proviso at the end of Section 5.11 to "clause (c) or (d)" is changed to "clause (c), (d) or (e)". 4. The first page of the exhibit entitled "Calculation of Compliance with Financial Covenants" included in Exhibit E to the Credit Agreement is deleted and replaced by the first page of such exhibit attached hereto. SECTION 2. Transactions with Affiliates. The undersigned parties ---------------------------- hereby waive compliance with the provisions of Section 5.13 of the Credit Agreement to the extent (and only to the extent) required to permit Vencor to purchase directly from Tenet Healthcare Corporation any or all of the securities convertible into or exchangeable for Vencor's common stock permitted to be purchased pursuant to Section 5.11(d) of the Credit Agreement as amended hereby. SECTION 3. Rights Otherwise Unaffected. This Amendment is limited --------------------------- to the matters expressly set forth herein. Except to the extent specifically amended or waived hereby, all terms of the Credit Agreement shall remain in full force and effect. SECTION 4. Governing Law. This Amendment shall be governed by and ------------- construed in accordance with the laws of the State of New York. SECTION 5. Counterparts. This Amendment may be signed in any number ------------ of counterparts, each of which shall be an original, with the same effect as if the signatures thereto and hereto were upon the same instrument. SECTION 6. Effectiveness. This Amendment shall become effective ------------- when the Documentation Agent shall have received from each of the Required Banks and each of the Borrowers either a counterpart hereof signed by such party or telegraphic, telex or other written confirmation from such party that it has signed a counterpart hereof. IN WITNESS WHEREOF, the undersigned parties have caused this Amendment to be duly executed as of the date first above written. BORROWERS --------- VENCOR, INC. By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer FIRST HEALTHCARE CORPORATION By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer 2 NORTHWEST HEALTH CARE, INC. By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer MEDISAVE PHARMACIES, INC. By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer HILLHAVEN PROPERTIES, LTD. By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer HILLHAVEN OF CENTRAL FLORIDA, INC. By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer NATIONWIDE CARE, INC. By: /s/ Robert K. Schneider -------------------------------- Name: Robert K. Schneider Title: Treasurer 3 BANKS ----- BANK OF AMERICA NATIONAL TRUST AND SAVINGS ASSOCIATION By: /s/ Ruth Z. Edwards -------------------------------- Name: Ruth Z. Edwards Title: Vice President THE BANK OF NEW YORK By: /s/ Douglas Ober -------------------------------- Name: Douglas Ober Title: Vice President CHEMICAL BANK By: /s/ Peter C. Eckstein -------------------------------- Name: Peter C. Eckstein Title: Vice President CREDIT SUISSE By: /s/ Harry R. Olsen -------------------------------- Name: Harry R. Olsen Title: Member of Senior Management By: /s/ Kristinn R. Kristinsson -------------------------------- Name: Kristinn R. Kristinsson Title: Associate MELLON BANK, N.A. By: /s/ Marsha Wicker -------------------------------- Name: Marsha Wicker Title: Vice President 4 PNC BANK, KENTUCKY, INC. By: /s/ Todd D. Munson -------------------------------- Name: Todd D. Munson Title: Vice President TORONTO-DOMINION (TEXAS), INC. By: /s/ Lisa Allison -------------------------------- Name: Lisa Allison Title: Vice President WACHOVIA BANK OF NORTH CAROLINA, N.A. By: /s/ Robert G. Brookby -------------------------------- Name: Robert G. Brookby Title: Executive Vice President BANK OF LOUISVILLE AND TRUST COMPANY By: /s/ Roy L. Johnson, Jr. -------------------------------- Name: Roy L. Johnson, Jr. Title: Senior Vice President BANK ONE, COLUMBUS, NA By: /s/ James Zook -------------------------------- Name: James Zook Title: Vice President 5 FIRST UNION NATIONAL BANK OF NORTH CAROLINA By: /s/ Joseph H. Towell -------------------------------- Name: Joseph H. Towell Title: Senior Vice President FLEET BANK OF MASSACHUSETTS By: /s/ Ginger Stolzenthaler -------------------------------- Name: Ginger Stolzenthaler Title: Vice President LTCB TRUST COMPANY By: /s/ Rene O. LeBlanc -------------------------------- Name: Rene O. LeBlanc Title: Senior Vice President MORGAN GUARANTY TRUST COMPANY OF NEW YORK By: /s/ Diana H. Imhof -------------------------------- Name: Diana H. Imhof Title: Vice President NATIONAL CITY BANK, KENTUCKY By: /s/ Deroy Scott -------------------------------- Name: Deroy Scott Title: Vice President 6 NATIONSBANK, N. A. By: /s/ Ashley M. Crabtree -------------------------------- Name: Ashley M. Crabtree Title: Vice President NBD BANK By: /s/ Randall K. Stephens -------------------------------- Name: Randall K. Stephens Title: Vice President U.S. BANK OF WASHINGTON NATIONAL ASSOCIATION By: /s/ Arnold J. Conrad ------------------------------ Name: Arnold J. Conrad Title: Vice President 7 CALCULATION OF COMPLIANCE WITH FINANCIAL COVENANTS (Dollars in Thousands) [Date] RESTRICTED PAYMENTS [Section 5.11] - ---------------------------------- Restricted Payments Made Pursuant to Section 5.11(d): Cumulative amount in prior periods $___________ Current fiscal quarter $___________ Total cumulative amount $___________ Restricted Payments Allowed Pursuant to Section 5.11(d): $50,000,000 Restricted Payments Made Pursuant to Section 5.11(e): Cumulative amount in prior periods $___________ Current fiscal quarter $___________ Total cumulative amount $___________ Restricted Payments Allowed Pursuant to Section 5.11(e): Base amount $20,000,000 10% of cumulative Consolidated Net Income from October 1, 1995 $___________ Net cash proceeds of common stock sold after Closing Date $___________ Total allowable amount $___________ 8