TENET HEALTHCARE CORPORATION

                                     and

               DONALDSON, LUFKIN & JENRETTE SECURITIES CORPORATION
               MERRILL LYNCH, PIERCE, FENNER & SMITH INCORPORATED
                           J.P. MORGAN SECURITIES INC.
                        MORGAN STANLEY & CO. INCORPORATED
                              SALOMON BROTHERS INC
                          DEUTSCHE MORGAN GRENFELL INC.
                                      and
                         BANCAMERICA ROBERTSON STEPHENS

                      ------------------------------------

                               PURCHASE AGREEMENT

                      ------------------------------------





                             Dated as of May 8, 1998









                          TENET HEALTHCARE CORPORATION

                           7 5/8% SENIOR NOTES DUE 2008

                    8 1/8% SENIOR SUBORDINATED NOTES DUE 2008

                               PURCHASE AGREEMENT

                                                                   May 8, 1998

DONALDSON, LUFKIN & JENRETTE
  SECURITIES CORPORATION
MERRILL LYNCH, PIERCE, FENNER & SMITH
                   INCORPORATED
J.P. MORGAN SECURITIES INC.
MORGAN STANLEY & CO. INCORPORATED
SALOMON BROTHERS INC
DEUTSCHE MORGAN GRENFELL INC.
BANCAMERICA ROBERTSON STEPHENS
c/o Donaldson, Lufkin & Jenrette
    Securities Corporation
    277 Park Avenue
    New York, New York 10172

Ladies and Gentlemen:

                  Subject to the terms and conditions herein contained, Tenet 
Healthcare Corporation, a Nevada corporation (the "Company"), proposes to 
issue and sell to Donaldson, Lufkin & Jenrette Securities Corporation ("DLJ") 
and Merrill Lynch, Pierce, Fenner & Smith Incorporated, J.P. Morgan 
Securities Inc., Morgan Stanley & Co. Incorporated, Salomon Brothers Inc, 
Deutsche Morgan Grenfell Inc. and BancAmerica Robertson Stephens (together 
with DLJ, the "Initial Purchasers") an aggregate of $350.0 million principal 
amount of its 7 5/8% Senior Notes due 2008 (the "Senior Notes") and an 
aggregate of $1.0 billion principal amount of its 8 1/8% Senior Subordinated 
Notes due 2008 ( the "Senior Subordinated Notes" and, together with the 
Senior Notes, the "Securities"). The Senior Notes are to be issued pursuant 
to the provisions of an Indenture (the "Senior Note Indenture") to be dated 
as of May 21, 1998, by and between the Company and The Bank of New York, as 
Trustee (the "Senior Note Trustee"). The Senior Subordinated Notes are to be 
issued pursuant to the provisions of an Indenture (the "Senior Subordinated 
Note Indenture" and, together with the Senior Note Indenture, the 
"Indentures") to be dated as of May 21, 1998 by and between the Company and 
The Bank of New York, as Trustee (the "Senior Subordinated Note Trustee" and, 
together with the Senior Note Trustee, the "Trustees").

                  1. OFFERING MEMORANDUM. The Securities will be offered and
sold to the Initial Purchasers pursuant to one or more exemptions from the
registration requirements under the Securities Act of 1933, as amended,
including the rules and regulations thereunder (collectively, the "Act"). The
Company has prepared a preliminary




offering memorandum, dated May 1, 1998 (including the documents incorporated by
reference therein, the "Preliminary Offering Memorandum"), and a final offering
memorandum, dated May 8, 1998 (including the documents incorporated by reference
therein, the "Offering Memorandum"), relating to the Securities.

                  Upon original issuance thereof, and until such time as the
same is no longer required pursuant to the Indentures, the Securities (and all
securities issued in exchange therefor, in substitution thereof or upon
conversion thereof) shall bear the following legend:

                  "THIS NOTE (OR ITS PREDECESSORS) HAS NOT BEEN
                  REGISTERED UNDER THE U.S. SECURITIES ACT OF 1933,
                  AS AMENDED (THE "SECURITIES ACT") AND, ACCORDINGLY,
                  MAY NOT BE OFFERED, SOLD, PLEDGED OR OTHERWISE 
                  TRANSFERRED WITHIN THE UNITED STATES OR TO, OR
                  FOR THE ACCOUNT OR BENEFIT OF, U.S. PERSONS,
                  EXCEPT AS SET FORTH IN THE FOLLOWING SENTENCE.
                  BY ITS ACQUISITION HEREOF OR A BENEFICIAL 
                  INTEREST HEREIN, THE HOLDER (1) REPRESENTS THAT
                  (A) IT IS A "QUALIFIED INSTITUTIONAL BUYER" (AS 
                  DEFINED IN RULE 144A UNDER THE SECURITIES ACT)
                  (A "QIB"), OR (B) IT IS NOT A U.S. PERSON, IS NOT
                  ACQUIRING THIS NOTE FOR THE ACCOUNT OR BENEFIT
                  OF A U.S. PERSON AND IS ACQUIRING THIS NOTE IN
                  AN OFFSHORE TRANSACTION IN COMPLIANCE WITH
                  REGULATIONS UNDER THE SECURITIES ACT, (2) AGREES
                  THAT IT WILL NOT, WITHIN THE TIME PERIOD REFERRED
                  TO UNDER RULE 144(k) (TAKING INTO ACCOUNT THE
                  PROVISIONS OF RULE 144(d) UNDER THE SECURITIES
                  ACT, IF APPLICABLE) UNDER THE SECURITIES ACT AS
                  IN EFFECT ON THE DATE OF THE TRANSFER OF THIS NOTE,
                  RESELL OR OTHERWISE TRANSFER THIS NOTE EXCEPT
                  (A) TO THE COMPANY OR ANY SUBSIDIARY THEREOF,
                  (B) TO A PERSON WHOM THE HOLDER REASONABLY BELIEVES
                  IS A QIB PURCHASING FOR ITS OWN ACCOUNT OR FOR THE
                  ACCOUNT OF A QIB IN COMPLIANCE WITH RULE 144A UNDER
                  THE SECURITIES ACT, (C) OUTSIDE THE UNITED STATES 
                  IN AN OFFSHORE TRANSACTION IN COMPLIANCE WITH
                  RULE 903 OR RULE 904 UNDER THE SECURITIES ACT,
                  (D) PURSUANT TO THE EXEMPTION FROM REGISTRATION
                  PROVIDED BY RULE 144 UNDER THE SECURITIES ACT 
                  (IF AVAILABLE), (E) PURSUANT TO AN EFFECTIVE
                  REGISTRATION STATEMENT UNDER THE SECURITIES ACT
                  OR (F) IN ACCORDANCE WITH ANOTHER EXEMPTION FROM
                  THE REGISTRATION REQUIREMENTS OF THE SECURITIES
                  ACT (AND BASED UPON AN OPINION OF COUNSEL ACCEPTABLE
                  TO THE COMPANY) AND, IN EACH CASE, IN ACCORDANCE
                  WITH APPLICABLE STATE SECURITIES LAWS, AND (3) AGREES
                  THAT IT WILL DELIVER TO EACH PERSON TO WHOM THIS 
                  NOTE OR AN INTEREST HEREIN IS TRANSFERRED A NOTICE
                  SUBSTANTIALLY TO THE EFFECT OF THIS LEGEND.  AS 
                  USED HEREIN, THE TERMS "OFFSHORE TRANSACTION,"
                  "UNITED STATES" AND "U.S. PERSON" HAVE THE 
                  MEANINGS GIVEN TO THEM BY RULE 902 OF REGULATION S
                  UNDER THE SECURITIES ACT. THE INDENTURE CONTAINS A
                  PROVISION REQUIRING THE TRUSTEE TO REUSE TO REGISTER
                  ANY TRANSFER IF THIS NOTE IN VIOLATION OF THE 
                  FOREGOING RESTRICTIONS."

                  2. AGREEMENTS TO SELL AND PURCHASE. On the basis of the 
representations and warranties contained in this Agreement, and subject to 
its terms and conditions, the Company agrees to issue and sell to the Initial 
Purchasers, and the Initial Purchasers agree, severally and not jointly, to 
purchase from the Company (i) the Senior Notes in the respective principal 
amounts set forth opposite their names on Schedule I hereto, plus such amount 
as they may individually become obligated to purchase pursuant to Section 9 
hereof, at a purchase price equal to 98.588% of the principal amount of the 
Senior Notes, together with accrued interest, if any, to the Closing Date 
(the "Senior Note
                                       
                                     - 2 -



Purchase Price") and (ii) the Senior Subordinated Notes in the respective 
principal amounts set forth opposite their names on Schedule II hereto, plus 
such amount as they may individually become obligated to purchase pursuant to 
Section 9 hereof, at a purchase price equal to 97.869% of the principal 
amount of the Senior Subordinated Notes, together with accrued interest, if 
any, to the Closing Date (the "Senior Subordinated Note Purchase Price" and, 
together with the Senior Note Purchase Price, the "Purchase Price"). The 
Initial Purchasers will offer the Senior Notes to Eligible Purchasers 
initially at a price equal to 99.962% of the principal amount thereof. The 
Initial Purchasers will offer the Senior Subordinated Notes to Eligible 
Purchasers initially at a price equal to 99.612% of the principal amount 
thereof. Such prices may be changed at any time without notice.

                  The Initial Purchasers have advised the Company that the 
Initial Purchasers will make offers (the "Exempt Resales") of the Securities 
purchased hereunder on the terms set forth in the Offering Memorandum, as 
amended or supplemented, solely to (i) persons whom the Initial Purchaser 
reasonably believe to be "qualified institutional buyers" as defined in Rule 
144A under the Act ("QIBs") and (ii) to persons permitted to purchase the 
Securities in offshore transactions in reliance upon Regulation S under the 
Act (each, a "Regulation S Purchaser") (such persons specified in clauses (i) 
and (ii) being referred to herein as the "Eligible Purchasers").

                  Holders (including subsequent transferees) of the 
Securities will have the registration rights set forth in the registration 
rights agreement (the "Registration Rights Agreement"), to be dated the 
Closing Date, in substantially the form of Exhibit A hereto, for so long as 
such Securities constitute "Transfer Restricted Securities" (as defined in 
the Registration Rights Agreement). Pursuant to the Registration Rights 
Agreement, the Company will agree to file with the Securities and Exchange 
Commission (the "Commission") under the circumstances set forth therein, a 
registration statement (the "Registration Statement") relating to the 
Securities and to use its commercially reasonable efforts to cause such 
Registration Statements to be declared and remain effective and usable for 
the periods specified in the Registration Rights Agreement. This Agreement, 
the Indenture, the Securities, and the Registration Rights Agreement are 
hereinafter sometimes referred to collectively as the "Operative Documents."

                  3. DELIVERY AND PAYMENT. Delivery to you of and payment for 
the Securities shall be made at 9:00 A.M., New York City time, on May 21, 
1998 (such time and date being referred to as the "Closing Date"), at the 
offices of DLJ at 277 Park Avenue, New York, New York 10172, or such other 
place as you shall reasonably designate.

                  The Securities in definitive form shall be registered in 
such names and issued in such denominations as you shall request in writing 
not later than two full business days prior to the Closing Date, and shall be 
made available to you at the offices of DLJ (or at such other place as shall 
be acceptable to you) for inspection not later than 10:00 A.M., New York City 
time, on the business day next preceding the Closing Date. The Securities 
shall be delivered to you on the Closing Date with any transfer taxes payable 
upon initial issuance thereof duly paid by the Company, for your respective 
accounts against payment of the appropriate Purchase Price by wire transfer 
of immediately available funds to an account designated by the Company. The 
Closing Date and the location of delivery of, and the form of payment for, 
the Securities may be varied by agreement between DLJ and the Company.

                  4. AGREEMENTS OF THE COMPANY. The Company agrees with each 
of you that:

                                        -3-



                  (a) It will advise DLJ promptly and, if requested by DLJ,
         confirm such advice in writing, (i) of the issuance by any state
         securities commission of any stop order suspending the qualification
         or exemption from qualification of any Securities for offering or sale
         in any jurisdiction designated by the Initial Purchasers pursuant to
         Section 4(f), or the initiation of any proceeding by any state
         securities commission or any other federal or state regulatory
         authority for such purpose and (ii) of the happening of any event
         during the period referred to in Section 4(e), which makes any
         statement of a material fact made in the Preliminary Offering
         Memorandum or the Offering Memorandum untrue or which requires the
         making of any additions to or changes in the Preliminary Offering
         Memorandum or the Offering Memorandum in order to make the statements
         therein, in the light of the circumstances under which they were made,
         not misleading. The Company shall use its best efforts to prevent the
         issuance of any stop order or order suspending the qualification or
         exemption of the Securities under any Federal or state securities or
         Blue Sky laws, and, if at any time any state securities commission or
         other regulatory authority shall issue an order suspending the
         qualification or exemption of the Securities under any state securities
         or Blue Sky laws, the Company shall use every reasonable effort to 
         obtain the withdrawal or lifting of such order at the earliest possible
         time.

                  (b) It will furnish the Initial Purchasers and those persons
         identified by the Initial Purchasers to the Company, without charge, as
         many copies of the Preliminary Offering Memorandum and the Offering
         Memorandum, including all documents incorporated by reference therein,
         and any amendments or supplements thereto, as the Initial Purchasers
         may reasonably request for the time period referred to in Section 4(e).
         Subject to the Initial Purchasers' compliance with its representations
         and warranties and agreements set forth in Section 6 hereof, the
         Company consents to the use of the Preliminary Offering Memorandum and
         the Offering Memorandum, including all documents incorporated by
         reference therein, and any amendments and supplements thereto required
         pursuant hereto, by the Initial Purchasers in connection with Exempt
         Resales.

                  (c) If, during the period referred to in Section 4(e), any
         event shall occur as a result of which it becomes necessary to amend or
         supplement the Offering Memorandum in order to make the statements
         therein, in the light of the circumstances when such Offering
         Memorandum is delivered to an Eligible Purchaser, not misleading, or if
         it is necessary to amend or supplement the Offering Memorandum to
         comply with any law, it will promptly prepare an appropriate amendment
         or supplement to the Offering Memorandum so that the statements in the
         Offering Memorandum, as so amended or supplemented, will not, in the
         light of the circumstances existing as of the date the Offering
         Memorandum is so delivered, be misleading, and will comply with
         applicable law, and will promptly notify you of such event and
         amendment or supplement and furnish to you without charge such number
         of copies thereof as you may reasonably request.

                  (d) Whether or not the transactions contemplated hereby are
         consummated or this Agreement is terminated, it will pay and be
         responsible for all reasonable costs, charges, expenses, fees and taxes
         incurred in connection with or incident to (i) the preparation,
         printing, filing, distribution and delivery of the Offering Memorandum,
         the Preliminary Offering Memorandum and all amendments and supplements
         thereto, (ii) the issuance and delivery of the Securities, (iii) the
         printing and delivery of this Agreement, the Indentures and all other
         agreements, memoranda, reports, correspondence and other documents
         printed, distributed and delivered in connection with the offering of
         the Securities, (iv) the registration or qualification of the
         Securities for offer and sale under the securities or Blue Sky laws of
         the jurisdictions referred to in paragraph (f) below (including, in
         each case, the reasonable fees and disbursements of counsel relating to
         such registration or qualification and memoranda relating thereto and
         any filing fees in connection therewith), (v) furnishing such copies of
         the Offering Memorandum, the Preliminary Offering Memorandum, and all
         amendments and supplements to any of them, including any document
         incorporated by reference therein, as may be reasonably requested by
         the Initial Purchasers or by dealers to whom Securities may be sold,
         (vi) any filing with the National Association of Securities Dealers,
         Inc. (the "NASD") in connection with the offering of the Securities
         (including, without limitation, any filing fees in connection therewith
         but excluding the fees of Sullivan & Cromwell, legal counsel to the
         Underwriters ("Initial Purchasers' Counsel")), (vii) the application
         for quotation of the Securities in the National Association of
         Securities Dealers, Inc. ("NASD")

                                     - 4 -



         Automated Quotation System - PORTAL ("PORTAL"), (viii) the rating of
         the Securities by investment rating agencies, (ix) any "qualified
         independent underwriter" as required by Rule 2720 of the NASD
         (including fees and disbursements of counsel for such qualified
         independent underwriter) and (x) the performance by the Company of its
         other obligations under this Agreement, including (without limitation)
         the fees of the Trustees, the cost of their respective personnel
         and other internal costs, the cost of printing and engraving the
         certificates representing the Securities, and all expenses incident
         to the sale and delivery of the Securities to the Initial Purchasers.

                  (e) During such period as in the reasonable judgment of the
         Initial Purchasers an Offering Memorandum is required (or would be
         required if the sales were registered under the Securities Act) to be
         delivered in connection with Exempt Resales by the Initial Purchasers,
         it will not make any amendment or supplement to the Offering Memorandum
         (other than any document required to be filed under the Securities
         Exchange Act of 1934, as amended, including the rules and regulations
         thereunder (collectively, the "Exchange Act") that upon filing is
         deemed to be incorporated by reference therein) of which the Initial
         Purchasers shall not previously have been advised and provided a copy
         prior to the filing thereof or to which the Initial Purchasers shall
         reasonably object unless in the opinion of legal counsel to the Company
         such amendment or supplement is required by law to be filed; it will
         furnish to you at or prior to the filing thereof a copy of any document
         that upon filing is deemed to be incorporated by reference in the
         Offering Memorandum; and it will prepare, promptly upon the Initial
         Purchasers' reasonable request, any amendment or supplement to the
         Offering Memorandum which may be necessary or advisable in connection
         with such Exempt Resales and to which the Company shall not reasonably
         object.

                  (f) Prior to the sale of all Securities pursuant to Exempt
         Resales as contemplated hereby, it will cooperate with the Initial
         Purchasers and counsel to the Initial Purchasers in connection with the
         registration or qualification of the Securities for offer and sale to
         the Initial Purchasers and pursuant to Exempt Resales under the
         securities or Blue Sky laws of such United States jurisdictions as the
         Initial Purchasers may request. The Company will continue such
         qualification in effect so long as required by law for Exempt Resales
         and will file such consents to service of process or other documents as
         may be necessary in order to effect such registration or qualification
         (PROVIDED, that the Company shall not be obligated to qualify as a
         foreign corporation in any jurisdiction in which it is not so qualified
         nor to take any action that would subject it to general consent to
         service of process in any jurisdiction in which it is not now so
         subject).

                  (g) So long as any of the Securities remain outstanding and
         during any period in which the Company is not subject to Section 13 or
         15(d) of the Exchange Act, it will make available to any holder of
         Securities in connection with any sale thereof and any prospective
         purchaser of such Securities from such holder, the information ("Rule
         144A Information") required by Rule 144A(d)(4) under the Act.

                  (h) It will file timely all reports and any definitive proxy
         or information statement required to be filed by the Company with the
         Commission pursuant to Sections 13(a), 13(c), 14 or 15(d) of the
         Exchange Act and it will use its best efforts to effect the inclusion
         of the Securities in PORTAL and to maintain the listing of the
         Securities on PORTAL for so long as the Securities are outstanding.

                  (i) To the extent permitted by law, it will not voluntarily
         claim, and will actively resist any attempts to claim, the benefit of
         any usury laws against the holders of the Securities.

                  (j) It will use the proceeds from the sale of the Securities
         in the manner described in the Offering Memorandum under the caption
         "Use of Proceeds."

                  (k) During the period beginning on the date of this Agreement
         and continuing to and including the Closing Date, it will not offer,
         sell, contract to sell or otherwise dispose of any debt securities of
         the Company or warrants, rights, or options to purchase debt securities
         of the Company (other than (i) the Securities, (ii) up

                                     - 5 -



         to an additional $10 million principal amount of 8__% Senior 
         Subordinated Notes due 2008 and (iii) commercial paper issued in the
         ordinary course of business), without your prior written consent.

                  (l) It will use its best efforts to do and perform all things
         required to be done and performed under this Agreement by it prior to
         or after the Closing Date and will use its reasonable best efforts to
         satisfy all conditions precedent on its part to be satisfied prior to
         the delivery of the Securities.

                  5.     REPRESENTATIONS AND WARRANTIES.  The Company represents
and warrants to each Initial Purchaser that:

                  (a) The Preliminary Offering Memorandum and the Offering
         Memorandum do not, and any supplement or amendment to them will not,
         contain any untrue statement of a material fact or omit to state any
         material fact required to be stated therein or necessary to make the
         statements therein, in the light of the circumstances under which they
         were made, not misleading, except that the representations and
         warranties contained in this paragraph (a) shall not apply to
         statements in or omissions from the Preliminary Offering Memorandum or
         the Offering Memorandum (or any supplement or amendment thereto) based
         upon information relating to the Initial Purchasers furnished to the
         Company in writing by the Initial Purchasers expressly for use therein.
         No stop order preventing the use of the Preliminary Offering Memorandum
         or the Offering Memorandum, or any amendment or supplement thereto, or
         any order asserting that any of the transactions contemplated by this
         Agreement are subject to the registration requirements of the Act, has
         been issued.

                  (b) The documents incorporated by reference in the Offering
         Memorandum, the Preliminary Offering Memorandum or any amendment or
         supplement thereto, when they were or are filed with the Commission
         under the Exchange Act, as the case may be, conformed or will conform
         in all material respects with the requirements of the Exchange Act.

                  (c) No action has been taken and no statute, rule, regulation
         or order has been enacted, adopted or issued by any United States
         Federal or state governmental body, agency or official which prevents
         the issuance of the Securities, prevents or suspends the use of any
         Preliminary Offering Memorandum or Offering Memorandum or suspends the
         sale of the Securities in any jurisdiction referred to in Section 4(f)
         hereof; no injunction, restraining order, or order of any nature by any
         Federal or state court has been issued with respect to the Company or
         any of its subsidiaries which would prevent the issuance or sale of the
         Securities, or prevent or suspend the use of any Preliminary Offering
         Memorandum or Offering Memorandum in any jurisdiction referred to in
         Section 4(f) hereof.

                  (d) The capitalization table set forth in the Offering
         Memorandum under the caption "Capitalization" identifies in reasonable
         detail all outstanding short-term and long-term indebtedness and
         shareholders' equity of the Company and its subsidiaries, prior to and
         after giving PRO FORMA effect to the consummation of the offering of
         the Securities and the application of the net proceeds therefrom on the
         terms described in the Offering Memorandum.

                  (e) The Indentures have been duly authorized by the Company
         and, when duly executed and delivered in accordance with their terms,
         will be valid and legally binding agreements of the Company,
         enforceable against the Company in accordance with their terms, subject
         to applicable bankruptcy, insolvency, reorganization, moratorium,
         fraudulent transfer and similar laws affecting creditors' rights and
         remedies generally and to general principles of equity (regardless of
         whether enforcement is sought in a proceeding at law or in equity) and
         except to the extent that a waiver of rights under any usury laws may
         be unenforceable. On the Closing Date, the Indentures will conform in
         all material respects to the requirements of the Trust Indenture Act of
         1939, as amended (the "TIA" or "Trust Indenture Act"), and the rules
         and regulations of the Commission applicable to an indenture that is
         qualified thereunder.

                                     - 6 -



                  (f) The Securities have been duly authorized by the Company
         and, when executed and delivered by the Company and authenticated by
         the applicable Trustee in accordance with the applicable Indenture and
         paid for in accordance with the terms of this Agreement, will
         constitute legal, valid and binding obligations of the Company,
         enforceable against the Company according to their terms, subject to
         applicable bankruptcy, insolvency, reorganization, moratorium,
         fraudulent transfer and similar laws affecting creditors' rights and
         remedies generally and to general principles of equity (regardless of
         whether enforcement is sought in a proceeding at law or in equity) and
         except to the extent that a waiver of rights under any usury laws may
         be unenforceable, will be entitled to the benefits of the applicable
         Indenture and will conform in all material respects to the description
         thereof in the Offering Memorandum.

                  (g) This Agreement has been duly authorized and validly
         executed and delivered by the Company and constitutes a valid and
         legally binding agreement of the Company, enforceable against the
         Company in accordance with its terms, subject to applicable bankruptcy,
         insolvency, reorganization, moratorium, fraudulent transfer and similar
         laws affecting creditors' rights and remedies generally and to general
         principles of equity (regardless of whether enforcement is sought in a
         proceeding at law or in equity) and except to the extent that rights to
         indemnification and contribution with respect to liability in
         connection with Federal or state securities laws may be unenforceable
         under such laws or the policies underlying such laws and except to the
         extent that a waiver of rights under any usury laws may be
         unenforceable.

                  (h) The Registration Rights Agreement has been duly authorized
         by the Company and, on the Closing Date, will have been duly executed
         and delivered by the Company. When the Registration Rights Agreement
         has been duly executed and delivered, the Registration Rights Agreement
         will be a valid and binding agreement of the Company, enforceable
         against the Company in accordance with its terms except as (i) the
         enforceability thereof may be limited by bankruptcy, insolvency or
         similar laws affecting creditors' rights generally and (ii) rights of
         acceleration and the availability of equitable remedies may be limited
         by equitable principles of general applicability. On the Closing Date,
         the Registration Rights Agreement will conform in all material respects
         to the description thereof in the Offering Memorandum.

                  (i) The execution and delivery of this Agreement and the
         Indentures and issuance and sale of the Securities by the Company, the
         execution and delivery of each of the other Operative Documents by the
         Company, the performance by the Company of this Agreement, the
         Indentures and the other Operative Documents and the consummation of
         the transactions contemplated by this Agreement and the other Operative
         Documents will not conflict with or result in a breach or violation of
         any of the respective charters or bylaws of the Company or any of its
         subsidiaries (each, a "Subsidiary" and collectively, the
         "Subsidiaries") or any of the terms or provisions of, or constitute a
         default or cause an acceleration of any obligation under or result in
         the imposition or creation of (or the obligation to create or impose)
         any security interest, mortgage, pledge, claim, lien, encumbrance or
         adverse interest of any nature (each, a "Lien") with respect to, any of
         the Operative Documents or any other obligation, bond, agreement, note,
         debenture, or other evidence of indebtedness, or any indenture,
         mortgage, deed of trust or other agreement, lease or instrument
         (collectively, "Agreements") to which the Company or any of the
         Subsidiaries is a party or by which it or any of them is bound, or to
         which any properties of the Company or any of the Subsidiaries is or
         may be subject, or any order of any court or governmental agency, body
         or official having jurisdiction over the Company or any of the
         Subsidiaries or any of their properties, or violate or conflict with
         any statute, rule or regulation or administrative regulation or decree
         or court decree applicable to the Company or any of the Subsidiaries,
         or any of their respective assets or properties, where, in any such
         instance, such conflict, breach, violation, default, acceleration of
         indebtedness or Lien would have, singly or in the aggregate, a material
         adverse effect on the business, financial condition, results of
         operations or prospects of the Company and the Subsidiaries, taken as a
         whole (a "Material Adverse Effect").

                                     - 7 -


                  (j) No authorization, approval, consent or order of, or filing
         with, any court or governmental body, agency or official is necessary
         in connection with the transactions contemplated by this Agreement,
         except such as may be required by the NASD or have been obtained and
         made under the Act, the Exchange Act, the TIA, state securities or Blue
         Sky laws or regulations.

                  (k) The Company has been duly organized, is validly existing
         as a corporation in good standing under the laws of the State of Nevada
         and has the requisite power and authority to carry on its business as
         it is currently being conducted, to own, lease and operate its
         properties and to authorize the offering of the Securities, to execute,
         deliver and perform this Agreement and to issue, sell and deliver the
         Securities, and is duly qualified and is in good standing as a foreign
         corporation authorized to do business in each jurisdiction where the
         operation, ownership or leasing of property or the conduct of its 
         business requires such qualification and where failure to be so 
         qualified or in good standing would have a Material Adverse Effect.
         Each of the Subsidiaries of the Company that (i) directly or indirectly
         owns or leases any interest in any Hospital (as defined in the Offering
         Memorandum) or (ii) is otherwise material to the Company and the
         Subsidiaries, taken as a whole (collectively, the "Significant 
         Subsidiaries"), has been duly organized, is validly existing as a 
         corporation in good standing under the laws of its jurisdiction of
         incorporation and has the requisite power and authority to carry on 
         its business as it is currently being conducted and to own, lease and
         operate its properties and each is duly qualified and is in good
         standing as a foreign corporation authorized to do business in each
         jurisdiction where the operation, ownership or leasing of property or
         the conduct of its business requires such qualifications and where 
         failure to have such power and authority or to be so qualified or in
         good standing would have a Material Adverse Effect.

                  (l) Except as otherwise disclosed in the Offering Memorandum,
         all of the issued and outstanding shares of capital stock of, or other
         ownership interests in, each of the Significant Subsidiaries that are
         owned directly or indirectly by the Company, have been duly authorized
         and validly issued, and, except as otherwise disclosed in the Offering
         Memorandum, all of the shares of capital stock of, or other ownership
         interests in, each of the Significant Subsidiaries are owned, directly
         or through subsidiaries, by the Company. All such shares of capital
         stock are fully paid and nonassessable, and are owned free and clear of
         any Lien, and, except as disclosed in a certificate or opinion
         delivered to the Initial Purchasers, there are no outstanding
         subscriptions, rights, warrants, options, calls, convertible or
         exchangeable securities, commitments of sale, or Liens related to or
         entitling any person to purchase or otherwise to acquire any shares of
         the capital stock of, or other ownership interest in, any of the
         Subsidiaries.

                  (m) Neither the Company nor the Significant Subsidiaries is in
         violation of its respective charter or bylaws and neither the Company
         nor the Subsidiaries is in default in the performance of any
         obligation, bond, agreement, debenture, note or any other evidence of
         indebtedness, or any indenture, mortgage, deed of trust or other
         contract, lease or other instrument to which the Company or any of the
         Subsidiaries is a party or by which any of them is bound, or to which
         any of the property or assets of the Company or any of the Subsidiaries
         is subject, except as would not have, singly or in the aggregate, a
         Material Adverse Effect.

                  (n) Except as disclosed in the Offering Memorandum, there is
         no action, suit, proceeding or investigation before or by any court,
         governmental agency or body, arbitration board or tribunal, or
         governmental or private accrediting body, domestic or foreign, pending
         against or affecting the Company or any of the Subsidiaries, or any of
         their respective assets or properties, which is required to be
         disclosed in the Offering Memorandum, or in which there is a reasonable
         possibility of adverse decisions which in the aggregate could
         reasonably be expected to have a Material Adverse Effect, or which
         might materially and adversely affect the Company's or any of its
         Subsidiaries' performance of its obligations, as applicable, pursuant
         to this Agreement (including, without limitation, the issuance of the
         Securities), the Operative Documents or the transactions contemplated
         hereby and thereby, and to the best of the Company's knowledge, after
         due inquiry, no such action, suit, or proceeding is contemplated or
         threatened.

                                     - 8 -

                      Except as disclosed in the Offering Memorandum, neither
         the Company nor the Subsidiaries is subject to any judgment, order or
         decree of any court, governmental authority or arbitration board or
         tribunal which has had or which can reasonably be expected to have, a
         Material Adverse Effect.

                  (o) The firms of accountants that have certified or shall
         certify the applicable consolidated financial statements and supporting
         schedules and the notes thereto of the Company incorporated by
         reference in the Preliminary Offering Memorandum and the Offering
         Memorandum are, to the best of the Company's knowledge, independent
         public accountants with respect to the Company and its Subsidiaries, as
         required by the Act. The consolidated financial statements, together
         with related schedules and notes, set forth or incorporated by 
         reference in the Preliminary Offering Memorandum and the Offering
         Memorandum, comply as to form in all material respects with the
         requirements of the Act and fairly present the consolidated financial
         position of the Company and its Subsidiaries at the respective dates
         indicated and the results of their operations and their cash flows for
         the respective periods indicated, in accordance with generally accepted
         accounting principles in the United States of America ("GAAP")
         consistently applied throughout such periods and in accordance with 
         Regulation S-X. The Company's ratio of earnings to fixed charges
         (actual and PRO FORMA) included in the Offering Memorandum under the 
         relevant captions "Prospectus Summary--Summary Financial Information"
         have been calculated in compliance with Item 503(d) of the Commission's
         Regulation S-K. The other financial and statistical information and
         data of the Company included or incorporated by reference in the
         Preliminary Offering Memorandum and the Offering Memorandum are in all
         material respects accurately presented and prepared on a basis
         consistent with the books and records of the Company.

                  (p) Except as contemplated by the Offering Memorandum,
         subsequent to the respective dates as of which information is presented
         in the Offering Memorandum and up to the Closing Date (i) neither the
         Company nor the Subsidiaries has incurred any liabilities or
         obligations, direct or contingent, or entered into any transaction not
         in the ordinary course of business, which could reasonably be expected
         to have a Material Adverse Effect, (ii) there has been no decision or
         judgment in the nature of litigation or arbitration that could
         reasonably be expected to have a Material Adverse Effect, (iii) there
         has been no dividend or distribution of any kind declared, paid or made
         by the Company on any class of its capital stock and (iv) there has not
         been any material adverse change, or any development which could
         involve a material adverse change, in the business, financial
         condition, results of operations or prospects of the Company and the
         Subsidiaries, taken as a whole (any of the items set forth in clauses
         (i), (ii), (iii) or (iv) above, a "Material Adverse Change").

                  (q) (i) Except as described in the Offering Memorandum or as
         could not reasonably be expected to have a Material Adverse Effect,
         each of the Company and the Subsidiaries has all certificates,
         consents, exemptions, orders, permits, licenses, authorizations,
         accreditations or other approvals or rights (each, an "Authorization")
         of and from, and has made all declarations and filings with, all
         Federal, state, local and other governmental authorities, all
         self-regulatory organizations, all governmental and private accrediting
         bodies and all courts and other tribunals, necessary or required to
         own, lease, license, and use its properties and assets and to conduct
         its business in the manner described in the Offering Memorandum, (ii)
         all such Authorizations are valid and in full force and effect, except
         as could not reasonably be expected to have, singly or in the
         aggregate, a Material Adverse Effect, (iii) the Company and the
         Subsidiaries are in compliance with the terms and conditions of all
         such Authorizations and with the rules and regulations of the
         regulatory authorities and governing bodies having jurisdiction with
         respect thereto except as could not reasonably be expected to have a
         Material Adverse Effect and (iv) none of the Company or the
         Subsidiaries has received any notice of proceedings relating to the
         revocation or modification of any such Authorization.

                  (r) None of the Company or any agent acting on its behalf has
         taken or will take any action that is reasonably likely to cause the
         issuance or sale of the Securities to violate Regulation T, U, or X of
         the Board of Governors of the Federal Reserve System, in each case as
         in effect, on the date hereof.

                                     - 9 -


                  (s) None of the Company or any of the Significant Subsidiaries
         is (i) an "investment company" or a company "controlled" by an
         investment company within the meaning of the Investment Company Act of
         1940, as amended, or (ii) a "holding company" or a "subsidiary company"
         of a holding company, or an "affiliate" thereof within the meaning of
         the Public Utility Holding Company Act of 1935, as amended.

                  (t) Each certificate signed by any officer of the Company and
         delivered to the Initial Purchasers or the Initial Purchasers' Counsel
         shall be deemed to be a representation and warranty by the Company to
         each Initial Purchaser as to the matters covered thereby.

                  (u) The Company has delivered to the Initial Purchasers a true
         and correct copy of each of the Operative Documents that have been
         executed and delivered prior to the date of this Agreement and each
         other Operative Document in the form substantially as it will be
         executed and delivered on or prior to the Closing Date, together with
         all related agreements and all schedules and exhibits thereto, and
         there have been no amendments, alterations, modifications or waivers of
         any of the provisions of any of the Operative Documents since their
         date of execution or from the form in which it has been delivered to
         the Initial Purchasers; there exists as of the date hereof (after
         giving effect to the transactions contemplated by the Operative
         Documents) no event or condition that would constitute a default or an
         event of default (in each case as defined in each of the Operative
         Documents) under any of the Operative Documents which would reasonably
         be expected to result in a Material Adverse Effect.

                  (v) Each of the Preliminary Offering Memorandum and the
         Offering Memorandum, as of its date, contains all the information
         specified in, and meeting the requirements of, Rule 144A(d)(4) under
         the Act.

                  (w) When the Securities are issued and delivered pursuant to
         this Agreement, the Securities will not be of the same class (within
         the meaning of Rule 144A under the Act) as any security of the Company
         that is listed on a national securities exchange registered under
         Section 6 of the Exchange Act or that is quoted in the United States
         automated inter-dealer quotation system.

                  (x) No form of general solicitation or general advertising (as
         defined in Regulation D under the Act) was used by the Company, or any
         of its representatives (other than the Initial Purchasers, as to whom
         the Company makes no representation) in connection with the offer and
         sale of the Securities contemplated hereby, including, but not limited
         to, articles, notices or other communications published in any
         newspaper, magazine, or similar medium or broadcast over television or
         radio, or any seminar or meeting whose attendees have been invited by
         any general solicitation or general advertising. No securities of the
         same class as the Securities have been issued and sold by the Company
         within the six-month period immediately prior to the date hereof.

                  (y) Prior to the effectiveness of any Registration Statement,
         the Indentures are not required to be qualified under the TIA.

                  (z) Neither the Company, nor any of its respective affiliates
         or any person acting on its or their behalf (other than the Initial
         Purchasers, as to whom the Company makes no representation) has engaged
         or will engage in any directed selling efforts within the meaning of
         Regulation S under the Act ("Regulation S") with respect to the
         Securities.

                  (aa) The Securities offered and sold in reliance of Regulation
         S have been and will be offered and sold only in offshore transactions,
         assuming the accuracy of the Initial Purchasers' representations and
         warranties and agreements set forth in Section 6 hereof.

                  (bb) The sale of the Securities pursuant to Regulation S is
         not part of a plan or scheme to evade the registration provisions of
         the Act.

                                     - 10 -



                  (cc) No registration of the Securities under the Act is
         required for the sale of the Securities to the Initial Purchasers as
         contemplated hereby or for the Exempt Resales assuming the accuracy of
         the Initial Purchasers' representations and warranties and agreements
         set forth in Section 6 hereof.

                  6. INITIAL PURCHASERS' REPRESENTATIONS AND WARRANTIES. Each
Initial Purchaser, severally and not jointly, represents and warrants to, and
agrees with, the Company:

                  (a) Such Initial Purchaser is a QIB with such knowledge and
         experience in financial and business matters as is necessary in order
         to evaluate the merits and risks of an investment in the Securities.

                  (b) Such Initial Purchaser (A) is not acquiring the Securities
         with a view to any distribution thereof or with any present intention
         of offering or selling any of the Securities in a transaction that
         would violate the Act or the securities laws of any state of the United
         States or any other applicable jurisdiction and (B) will be reoffering
         and reselling the Securities only to (x) QIBs in reliance on the
         exemption from the registration requirements of the Act provided by
         Rule 144A and (y) in offshore transactions in reliance upon
         Regulation S.

                  (c) Such Initial Purchaser agrees that no form of general
         solicitation or general advertising (within the meaning of Regulation D
         under the Act) has been or will be used by such Initial Purchaser or
         any of its representatives in connection with the offer and sale of the
         Securities pursuant hereto, including, but not limited to, articles,
         notices or other communications published in any newspaper, magazine or
         similar medium or broadcast over television or radio, or any seminar or
         meeting whose attendees have been invited by any general solicitation
         or general advertising.

                  (d) Such Initial Purchaser agrees that, in connection with
         Exempt Resales, such Initial Purchaser will solicit offers to buy the
         Securities only from, and will offer to sell the Securities only to,
         Eligible Purchasers. Each Initial Purchaser further agrees that it will
         offer to sell the Securities only to, and will solicit offers to buy
         the Securities only from (A) Eligible Purchasers that such Initial
         Purchaser reasonably believes are QIBs and (B) Regulation S Purchasers,
         in each case, that agree that (x) the Securities purchased by them may
         be resold, pledged, or otherwise transferred within the time period
         referred to under Rule 144(k) (taking into account the provisions of
         Rule 144(d) under the Act, if applicable) under the Act, as in effect
         on the date of the transfer of such Securities, only (I) to the Company
         or any of its subsidiaries, (II) to a person whom the seller reasonably
         believes is a QIB purchasing for its own account or for the account of
         a QIB in a transaction meeting the requirements of Rule 144A under the
         Act, (III) in an offshore transaction (as defined in Rule 902 under the
         Act) meeting the requirements of Rule 903 and Rule 904 of the Act, (IV)
         in a transaction meeting the requirements of Rule 144 under the Act,
         (V) in accordance with another exemption from the registration
         requirements of the Act (and based upon an opinion of counsel
         acceptable to the Company) or (VI) pursuant to an effective
         registration statement and, in each case, in accordance with the
         applicable securities laws of any state of the United States or any
         other applicable jurisdiction and (y) they will deliver to each person
         to whom such Securities or an interest therein is transferred a notice
         substantially to the effect of the foregoing.

                  (e) Such Initial Purchaser and its affiliates or any person
         acting on its behalf have not engaged and will not engage in any
         directed selling efforts within the meaning of Regulation S with
         respect to the Securities.

                  (f) The Securities offered and sold by such Initial Purchaser
         pursuant hereto in reliance on Regulation S have been and will be
         offered and sold only in offshore transactions.

                  (g) The sale of the Securities offered and sold by such
         Initial Purchaser pursuant hereto in reliance on Regulation S is not
         part of a plan or scheme to evade the registration provisions of the
         Act.
                                     - 11 -



                  (h) Such Initial Purchaser further represents and agrees that
         (i) it has not offered or sold and will not offer or sell any
         Securities to persons in the United Kingdom prior to the expiration of
         the period of six months from the issue date of the Securities, except
         to persons whose ordinary activities involve them in acquiring,
         holding, managing or disposing of investments (as principal or agent)
         for the purposes of their business or otherwise in circumstances that
         have not resulted and will not result in an offer to the public in the
         United Kingdom within the meaning of the Public Offers of Securities
         Regulations 1995, (ii) it has complied and will comply with all
         applicable provisions of the Financial Services Act 1986 with respect
         to anything done by it in relation to the Securities in, from or 
         otherwise involving the United Kingdom and (iii) it has only issued or
         passed on and will only issue or pass on in the United Kingdom any
         document received by it in connection with the issuance of the
         Securities to a person who is of a kind described in Article 11(3) of
         the Financial Services Act of 1986 (Investment Advertisements)
         (Exemptions) Order 1996 or is a person to whom the document may 
         otherwise lawfully be issued or passed on.

                  (i) Such Initial Purchaser agrees that it will not offer, sell
         or deliver any of the Securities in any jurisdiction outside the United
         States except under circumstances that will result in compliance with
         the applicable laws thereof, and that it will take at its own expense
         whatever action is required to permit its purchase and resale of the
         Securities in such jurisdictions. Such Initial Purchaser understands
         that no action has been taken to permit a public offering in any
         jurisdiction outside the United States where action would be required
         for such purpose.

                  Each Initial Purchaser acknowledges that the Company, for
purposes of the opinions to be delivered to each Initial Purchaser pursuant to
Section 8 hereof, counsel to the Company and counsel to the Initial Purchasers
will rely upon the accuracy and truth of the foregoing representations and each
Initial Purchaser hereby consents to such reliance.

                  7.       INDEMNIFICATION.

                  (a) The Company agrees to indemnify and hold harmless (i) each
of the Initial Purchasers and their respective affiliates, (ii) each person, if
any, who controls (within the meaning of Section 15 of the Act or Section 20 of
the Exchange Act) any of the Initial Purchasers or any of their respective
affiliates (any of the persons referred to in this clause (ii) being hereinafter
referred to as a "Controlling Person"), and (iii) each of the respective
officers, directors, partners, employees, representatives and agents of any of
the Initial Purchasers or any Controlling Person, and each of their respective
officers, directors, partners, employees, representatives and agents (any person
referred to in clause (i), (ii) or (iii) of this Section 7(a) may hereinafter be
referred to as an "Indemnified Person") to the fullest extent lawful, from and
against any and all losses, claims, damages, judgments, actions, costs,
assessments, expenses and other liabilities (collectively, "Liabilities"),
including without limitation and as incurred, reimbursement of all reasonable
costs of investigating, preparing, pursuing or defending any claim or action, or
any investigation or proceeding by any foreign, Federal, state or local
authority, regulatory body, administrative agency, court or other governmental
or quasi-governmental body, commenced or threatened, including the reasonable
fees and expenses of counsel to any Indemnified Person, to the extent such
Liabilities are directly or indirectly caused by, related to, based upon or
arising out of, or in connection with, any untrue statement or alleged untrue
statement of a material fact contained in the Offering Memorandum (or any
supplement or amendment thereto), the Preliminary Offering Memorandum or any
Rule 144A Information provided by the Company to any holder or prospective
purchaser of Securities pursuant to Section 4(i), or any omission or alleged
omission to state therein a material fact required to be stated therein or
necessary to make the statements therein not misleading, except insofar as such
Liabilities are caused by any such untrue statement or omission or alleged
untrue statement or omission that is (x) made in reliance upon and in conformity
with information relating to any of the Initial Purchasers furnished in writing
to the Company by or on behalf of an Initial Purchaser through DLJ expressly for
use in the Offering Memorandum (or any amendment or supplement thereto), the
Preliminary Offering Memorandum or any Rule 144A Information provided by the
Company to any holder or prospective purchaser of Securities pursuant to Section
4(g), or (y) with respect to the Initial Purchaser from whom the person
asserting the Liabilities purchased Securities, made in any Preliminary Offering
Memorandum if a copy of the Offering Memorandum

                                     - 12 -



(as amended or supplemented, if the Company shall have furnished the Initial 
Purchasers with such amendments or supplements thereto on a timely basis) was 
not delivered by or on behalf of such Initial Purchaser to the person 
asserting the Liabilities, if required by law to have been so delivered by 
the Initial Purchaser seeking indemnification, at or prior to the written 
confirmation of the sale of the Securities, and it shall be determined by a 
court of competent jurisdiction or binding mediation or arbitration tribunal, 
in a judgment or determination not subject to appeal or review, that the 
Offering Memorandum (as so amended or supplemented) would have corrected such 
untrue statement or omission in all material respects. The foregoing 
indemnity shall be in addition to any liability that the Company might 
otherwise have to any of the Initial Purchasers and such other Indemnified 
Persons. The Company shall notify you promptly after becoming aware of the 
institution, threat or assertion of any claim, proceeding (including any 
governmental investigation) or litigation in connection with the matters 
addressed by this Agreement which involves the Company or an Indemnified 
Person.

                  (b) In case any action or proceeding (for all purposes of this
Section 7, including any governmental or quasi-governmental investigation) shall
be brought or asserted against any of the Indemnified Persons with respect to
which indemnity under this Section 7 may be sought against the Company, such
Indemnified Person promptly shall notify the Company in writing and the Company
shall assume the defense thereof, including the employment of counsel reasonably
satisfactory to such Indemnified Person and payment of all reasonable fees and
expenses; PROVIDED, that the delay or failure to give such notice shall not
relieve the Company from any liability that it may have on account of the
indemnity under this Section 7, except to the extent that such delay or omission
materially adversely affects the ability of the Company to defend or assume the
defense of such action or proceeding. Upon receiving such notice, the Company
shall be entitled to participate in any such action or proceeding and/or to
assume, at its sole expense, the defense thereof, with counsel reasonably
satisfactory to such Indemnified Person (who shall not, except with the consent
of the Indemnified Person to be represented, be counsel to the Company or any of
the Subsidiaries) and, after written notice from the Company to such Indemnified
Person of its election so to assume the defense thereof promptly after receipt
of the notice from the Indemnified Person of such action or proceeding, the
Company shall not be liable to such Indemnified Person hereunder for legal
expenses of other counsel subsequently incurred by such Indemnified Person in
connection with the defense thereof, other than reasonable costs of
investigation, unless (i) the Company agrees in writing to pay such fees and
expenses, or (ii) the Company fails promptly to assume such defense or fails to
employ counsel reasonably satisfactory to such Indemnified Person, or (iii) the
named parties to any such action or proceeding (including any impleaded parties)
include both such Indemnified Person and the Company or an affiliate of the
Company, and that Indemnified Person shall have been advised in writing by
counsel, with a copy of such writing to the Company, that either (x) there may
be one or more legal defenses available to such Indemnified Person that are
different from or additional to those available to the Company or such affiliate
or (y) a conflict may exist between such Indemnified Person and the Company or
such affiliate. In the event of any of clause (i), (ii) and (iii) of the
immediately preceding sentence, the Company shall not have the right to assume
the defense thereof on behalf of the Indemnified Person and such Indemnified
Person shall have the right to employ its own counsel (who shall be reasonably
acceptable to the Company and shall not, except with the Company's consent, be
counsel to the Company) in any such action and the reasonable fees and expenses
of such counsel shall be paid, as incurred, by the Company, subject to repayment
to the Company if it is ultimately determined that an Indemnified Person is not
entitled to indemnification hereunder, it being understood, however, that the
Company shall not, in connection with any one such action or proceeding or
separate but substantially similar or related actions in the same jurisdiction
arising out of the same general allegations or circumstances, be liable for the
fees and expenses of more than one separate firm of attorneys (in addition to
any local counsel) for all of the Indemnified Persons, which firm shall be
designated in writing by DLJ. The Company shall not be liable for any settlement
of any such action or proceeding effected without the Company's written consent,
which consent may not be unreasonably withheld, but if settled with the written
consent of the Company, the Company agrees to indemnify and hold harmless any
Indemnified Person from and against any loss or liability incurred in such
settlement. The Company shall not, without the prior written consent of each
Indemnified Person, which consent shall not be unreasonably withheld settle,
compromise or consent to the entry of any judgment in or otherwise seek to
terminate any pending or threatened action, claim, suit, investigation or other
proceeding in respect of which any Indemnified Person is or could have been a
party and indemnification or contribution could have been sought hereunder

                                     - 13 -

by such Indemnified Person, unless such settlement, compromise, consent or 
termination includes an unconditional release of each Indemnified Person from 
all liability on claims that are the subject matter of such proceeding.

                  (c) Each of the Initial Purchasers agrees, severally and 
not jointly, to indemnify and hold harmless the Company, its directors, its 
officers, and any person controlling (within the meaning of Section 15 of the 
Act or Section 20 of the Exchange Act) the Company, to the same extent as the 
foregoing indemnity from the Company to each of the Indemnified Persons, but 
only with respect to claims and actions based on information relating to such 
Initial Purchaser furnished in writing by or on behalf of such Initial 
Purchaser through DLJ expressly for use in the Offering Memorandum, the 
Preliminary Offering Memorandum or any Rule 144A Information provided by the 
Company to any holder or prospective purchaser of Securities pursuant to 
Section 4(g), as applicable. In case any action shall be brought against the 
Company, any of its directors, any such officer, or any such controlling 
person based on the Offering Memorandum, the Preliminary Offering Memorandum 
or any Rule 144A Information provided by the Company to any holder or 
prospective purchaser of Securities pursuant to Section 4(g) in respect of 
which indemnity is sought against any Initial Purchaser pursuant to the 
foregoing sentence, the Initial Purchaser shall have the rights and duties 
given to the Company (except that if an Initial Purchaser shall have assumed 
the defense thereof, the Company shall not be required to do so, but may 
employ separate counsel therein and participate in the defense thereof, but 
the fees and expenses of such counsel shall be at the expense of the 
Company), and the Company, its directors, any such officers, and each such 
controlling person shall have the rights and duties given to the Indemnified 
Person by Section 7(b) above.

                  (d) If the indemnification provided for in this Section 7 
is finally determined by a court of competent jurisdiction to be unavailable 
to an Indemnified Person in respect of any Liabilities referred to herein, 
then the Company, in lieu of indemnifying such Indemnified Person, shall 
contribute to the amount paid or payable by such Indemnified Person as a 
result of such Liabilities: (i) in such proportion as is appropriate to 
reflect the relative benefits received by the Company on the one hand and the 
Indemnified Person on the other hand from the offering of the Securities, or 
(ii) if the allocation provided by clause (i), above, is not permitted by 
applicable law, in such proportion as is appropriate to reflect not only the 
relative benefits referred to in clause (i), above, but also the relative 
fault of the Company and the Indemnified Person in connection with the 
actions, statements or omissions that resulted in such Liabilities, as well 
as any other relevant equitable considerations. The relative benefits 
received by the Company, on the one hand, and any of the Initial Purchasers 
(and its related Indemnified Persons), on the other hand, shall be deemed to 
be in the same proportion as the total proceeds from the offering (net of 
Initial Purchaser's discounts and commissions but before deducting expenses) 
received by the Company bear to the total Initial Purchaser's discounts and 
commissions received by such Initial Purchaser, in each case as set forth in 
the Offering Memorandum. The relative fault of the Company and the Initial 
Purchaser shall be determined by reference to, among other things, whether 
the untrue or alleged untrue statement of a material fact or the omission or 
alleged omission to state a material fact related to information supplied by 
the Company or the Initial Purchaser and the parties' relative intent, 
knowledge, access to information and opportunity to correct or prevent such 
statement or omission. The indemnity and contribution obligations of the 
Company set forth herein shall be in addition to any liability or obligation 
the Company may otherwise have to any Indemnified Person.

                  The Company and the Initial Purchasers agree that it would 
not be just and equitable if contribution pursuant to this Section 7(d) were 
determined by PRO RATA allocation (even if the Initial Purchasers were 
treated as one entity for such purpose) or by any other method of allocation 
that does not take account of the equitable considerations referred to in the 
immediately preceding paragraph. The amount paid or payable by an Indemnified 
Party as a result of the Liabilities referred to in the immediately preceding 
paragraph shall be deemed to include, subject to the limitations set forth 
above, any reasonable legal or other expenses reasonably incurred by such 
Indemnified Party in connection with investigating or defending any such 
action or claim. Notwithstanding the provisions of this Section 7, none of 
the Initial Purchasers (or any of their related Indemnified Persons referred 
to in Section 7 above) shall be required to contribute, in the aggregate, any 
amount in excess of the amount by which the total underwriting discount 
applicable to the Securities purchased by such underwriter exceeds the amount 
of any damages or liabilities which such Initial Purchaser (and its related 
Indemnified Persons referred to in Section 7 above) has otherwise been 
required to pay or incur by reason of such untrue or alleged untrue statement 
or omission or alleged omission or other indemnified action

                                     - 14 -


or proceeding. Notwithstanding anything to the contrary contained herein, no 
person guilty of fraudulent misrepresentation (within the meaning of Section 
11(f) of the Act) shall be entitled to contribution from any person who was 
not guilty of such fraudulent misrepresentation. The Initial Purchasers' 
obligations to contribute pursuant to this Section 7(d) are several in 
proportion to the respective aggregate principal amount of Securities 
purchased by each of the underwriters hereunder and not joint.

                  8. CONDITIONS OF INITIAL PURCHASERS' OBLIGATIONS. The
respective obligations of the several Initial Purchasers to purchase any
Securities under this Agreement are subject to the satisfaction or waiver by the
several underwriters of each of the following conditions on the Closing Date:

                  (a) All the representations and warranties of the Company
         contained or incorporated by reference in this Agreement shall be true
         and correct on the Closing Date after giving effect to the transactions
         contemplated by the Operative Documents, with the same force and effect
         as if made on and as of the Closing Date, unless another date is
         specified therein. The Company and its Subsidiaries shall have
         performed or complied with all of their obligations and agreements
         herein contained and required to be performed or complied with by them
         at or prior to the Closing Date.

                  (b) No action shall have been taken and no statute, rule,
         regulation or order shall have been enacted, adopted or issued by any
         governmental agency, body or official which would, as of the Closing
         Date, prevent the issuance of the Securities; and no injunction,
         restraining order or order of any nature by any Federal or state court
         shall have been issued as of the Closing Date which would prevent the
         issuance of the Securities. Subsequent to the execution and delivery of
         this Agreement and prior to the Closing Date, there shall not have been
         any downgrading, nor shall any notice have been given of any intended
         or potential downgrading or of any review for a possible change that
         does not indicate the direction of the possible change, in the rating
         accorded any of the Company's securities by any "nationally recognized
         statistical rating organization," as such term is defined for purposes
         of Rule 436(g)(2) of the Act.

                  (c) (i) Since the earlier of the date hereof or the dates as
         of which information is given in the Offering Memorandum, there shall
         not have been any Material Adverse Change, (ii) since the date of the
         latest balance sheet included in the Offering Memorandum, there shall
         not have been any material adverse change, or development involving a
         prospective material adverse change, in the capital stock or debt, of
         the Company and the Subsidiaries, taken as a whole, and (iii) none of
         the Company or any of the Subsidiaries shall have any liability or
         obligation, direct or contingent, that is material to the Company and
         the Subsidiaries, taken as a whole, and which is not disclosed in the
         Offering Memorandum as of the date hereof.

                  (d) You shall have received a certificate of the Company,
         dated the Closing Date, executed on behalf of the Company, by an
         executive officer and a financial officer of the Company satisfactory
         to you confirming, as of the Closing Date, the matters set forth in
         paragraphs (a), (b), (c) and (j) of this Section 8.

                  (e) On the Closing Date, you shall have received:

                           (l) an opinion (reasonably satisfactory to you and
                  your counsel), dated the Closing Date, of Skadden, Arps,
                  Slate, Meagher & Flom LLP, counsel for the Company ("Skadden,
                  Arps"), to the effect that:

                                    (i) each document filed pursuant to the
                           Exchange Act and incorporated by reference in the
                           Offering Memorandum, at the time it was filed or last
                           amended, complied as to form in all material respects
                           to the applicable requirements of the Exchange Act
                           (except for financial statements, the notes thereto
                           and related schedules and other financial data
                           included or incorporated by reference therein or
                           omitted therefrom, as to which no opinion need be
                           expressed);

                                     - 15 -



                                (ii) the Securities have been duly authorized
                           and executed by the Company and, when authenticated
                           in accordance with the terms of the Indentures and
                           delivered to and paid for by the Initial Purchasers
                           in accordance with the terms of this Agreement, will
                           be valid and binding obligations of the Company,
                           enforceable against the Company in accordance with
                           their respective terms and entitled to the benefits
                           of the respective Indenture under which they are
                           being issued, except to the extent that the 
                           enforceability thereof may be limited by 
                           (a) bankruptcy, insolvency, fraudulent transfer, 
                           reorganization, moratorium and other similar laws in
                           effect as of the date of the opinion or thereafter 
                           relating to or affecting creditors' rights generally 
                           and (b) general principles of equity (regardless of 
                           whether enforcement is sought in a proceeding at law
                           or in equity) and except that such counsel need
                           express no opinion as to the enforceability or effect
                           of the waiver of rights under any usury laws pursuant
                           to each of the Indentures;

                               (iii) each of the Indentures has been duly
                           authorized, executed and delivered by the Company
                           and, assuming due authorization, execution and
                           delivery thereof by the applicable Trustee, is a
                           valid and binding agreement of the Company,
                           enforceable against the Company in accordance with
                           its terms, except to the extent that the
                           enforceability thereof may be limited by (a)
                           bankruptcy, insolvency, fraudulent transfer,
                           reorganization, moratorium and other similar laws in
                           effect as of the date of the opinion or thereafter
                           relating to or affecting creditors' rights generally
                           and (b) general principles of equity (regardless of
                           whether enforcement is sought in a proceeding at law
                           or in equity) and except that such counsel need
                           express no opinion as to the enforceability or effect
                           of the waiver of rights under any usury laws pursuant
                           to each of the Indentures;

                                (iv) the Securities and the Indentures conform
                           in all material respects to the descriptions thereof
                           contained in the Offering Memorandum;

                                 (v) the Company is a corporation existing and
                           in good standing under the laws of its jurisdiction
                           of organization;

                                (vi) the Company is not an "investment company"
                           within the meaning of the Investment Company Act of
                           1940, as amended;

                               (vii) no consent, approval, authorization or
                           other order of, or filing with, any Federal or New
                           York executive, legislative, judicial, administrative
                           or regulatory body, including, without limitation,
                           the Commission (each, a "Governmental Authority"), is
                           legally required under any laws, rules and
                           regulations of the State of New York and the United
                           States of America that, in the experience of such
                           counsel, are normally applicable to transactions of
                           the type contemplated by this Agreement and the
                           Indentures (provided that no opinion need be
                           expressed as to the "blue sky" or state securities
                           laws of any jurisdiction) (collectively, the
                           "Applicable Laws") for the issuance or sale to the
                           Initial Purchasers of the Securities as contemplated
                           by this Agreement;

                              (viii) the execution and delivery by the Company
                           of this Agreement and the Indentures and the issuance
                           and sale of the Securities to you as contemplated
                           thereby and the performance of its obligations
                           pursuant to this Agreement and the Indentures (a)
                           will not conflict with or result in a breach of
                           violation of any of the terms or provisions of, or
                           constitute a default under the charter or bylaws of
                           the Company; and (b) will not conflict with or
                           violate any Applicable Law or any order or decree of
                           any Governmental Authorities by which the Company or
                           any of its Subsidiaries is bound, the existence of
                           which is actually

                                     -16-


                           known to such counsel or has been specifically
                           disclosed to such counsel in writing by the Company;

                                (ix) the Registration Rights Agreement has been
                           duly authorized, executed and delivered by the
                           Company and is a valid and binding agreement of the
                           Company enforceable against the Company in accordance
                           with its terms, except as (x) the enforceability
                           thereof may be limited by bankruptcy, insolvency or 
                           similar laws affecting creditors' rights generally
                           and (y) rights of acceleration and the availability 
                           of equitable remedies may be limited by equitable 
                           principles of general applicability;

                                 (x) the Indentures comply as to form in all
                           material respects with the requirements of the TIA,
                           and the rules and regulations of the Commission
                           applicable to an indenture that is qualified
                           thereunder. It is not necessary in connection with
                           the offer, sale and delivery of the Securities to the
                           Initial Purchasers in the manner contemplated by this
                           Agreement or in connection with the Exempt Resales to
                           qualify the Indentures under the TIA;

                                (xi) no registration under the Act of the
                           Securities is required for the sale of the Securities
                           to the Initial Purchasers as contemplated by this
                           Agreement or for the Exempt Resales assuming that (i)
                           each Initial Purchaser is a QIB or a Regulation S
                           Purchaser, (ii) the accuracy of, and compliance with,
                           the Initial Purchasers' representations and
                           agreements contained in Section 6 of this Agreement
                           and (iii) the accuracy of the representations of the
                           Company set forth in Sections 4(h) and 5(y), (aa) and
                           (bb) of this Agreement.

                           (2) In giving their opinion required by subsection
                  (e)(l) of this Section 8, such counsel may state that such
                  opinions are limited to matters governed by the Federal laws
                  of the United States of America and the laws of the State of
                  New York.

                           In addition, such counsel shall state that such
                  counsel has participated in conferences with officers and
                  other representatives of the Company, representatives of the
                  independent public accountants for the Company, your
                  representatives and your counsel at which the contents of the
                  Offering Memorandum and related matters were discussed and,
                  although such counsel is not passing upon, and does not assume
                  any responsibility for, the accuracy, completeness or fairness
                  of the statements contained in the Offering Memorandum, on the
                  basis of the foregoing, no fact has come to the attention of
                  such counsel that leads it to believe that, as of the date of
                  the Offering Memorandum or as of the Closing Date, the
                  Offering Memorandum contained an untrue statement of a
                  material fact or omitted to state a material fact required to
                  be stated therein or necessary to make the statements therein
                  not misleading, except that such counsel need not express any
                  opinion or belief with respect to the financial statements,
                  schedules and other financial data included or incorporated by
                  reference in or excluded from the Offering Memorandum.

                           In rendering the foregoing opinions, Skadden, Arps
                  may rely as to matters of Nevada law on the opinion of
                  Woodburn and Wedge, Nevada counsel to the Company, or such
                  other counsel as is reasonably satisfactory to the Initial
                  Purchasers' Counsel.

                           (3) an opinion (satisfactory to you and Initial
                  Purchasers' Counsel), dated the Closing Date, of Scott M.
                  Brown, Esq., Senior Vice President and General Counsel of the
                  Company, or Richard B. Silver, Vice President and Associate
                  General Counsel of the Company, to the effect that:

                                 (i) the descriptions in the Offering Memorandum
                           of statutes, legal and governmental proceedings,
                           contracts and other documents and regulatory matters,
                           including, without limitation, those described in the
                           Offering Memorandum under the captions "Risk

                                                     - 17 -



                           Factors--Limits on Reimbursement," "--Extensive
                           Regulation," "--Health care Reform Legislation" and
                           in the Company's Annual Report on Form 10-K for the
                           fiscal year ended May 31, 1997 (the "Form 10-K")
                           under the captions "Medicare, Medicaid and Other
                           Revenues" and "Healthcare Reform, Regulation and
                           Licensing" and in the Company's Form 10-K and
                           Quarterly Report on Form 10-Q for the quarter ended
                           February 28, 1997 under the caption "Legal 
                           Proceedings" insofar as such statements constitute
                           summaries of legal matters, documents or proceedings
                           referred to therein are accurate in all material 
                           respects and such counsel does not know of any
                           contracts or documents of a character required to be 
                           described in the Offering Memorandum and not 
                           described therein; it being understood that such
                           counsel need express no opinion as to the financial
                           statements, notes or schedules or other financial
                           data included or incorporated by reference therein;

                                (ii) each of the Company and its Significant
                           Subsidiaries has such Authorizations from all
                           regulatory or governmental officials, bodies and
                           tribunals as are necessary to own, lease and operate
                           its respective properties and to conduct its business
                           in the manner described in the Offering Memorandum,
                           except as could not reasonably be expected to have,
                           singly or in the aggregate, a material adverse effect
                           on the business, financial condition or results of
                           operations of the Company and its Subsidiaries, taken
                           as a whole;

                               (iii) to the best of such counsel's knowledge,
                           there is no current, pending or threatened action,
                           suit or proceeding before any court or governmental
                           agency, authority or body or any arbitrator involving
                           the Company or any of its Subsidiaries or to which
                           any of their respective property is subject of a
                           character required to be disclosed in the Offering
                           Memorandum which is not adequately disclosed in the
                           Offering Memorandum;

                                (iv) except as otherwise disclosed in the
                           Offering Memorandum, all of the issued and
                           outstanding shares of capital stock of, or other
                           ownership interests in, each Significant Subsidiary
                           of the Company that is owned directly or indirectly
                           by the Company have been duly and validly authorized
                           and issued, and, except as otherwise described in the
                           Offering Memorandum, the shares of capital stock of,
                           or other ownership interests in, each of its
                           Significant Subsidiaries are owned of record,
                           directly or through subsidiaries, by the Company, are
                           fully paid and nonassessable, and to the best
                           knowledge of such counsel are owned free and clear of
                           any material, consensual Lien;

                                 (v) the Company and each of its Significant
                           Subsidiaries is a duly organized corporation, has the
                           requisite corporate power and authority to own, lease
                           and operate its properties and to conduct its
                           business as described in the Offering Memorandum,
                           and, to the extent each is a party thereto, to
                           execute, deliver and perform its obligations pursuant
                           to the Indentures and this Agreement, and is duly
                           qualified as a foreign corporation and in good
                           standing in each jurisdiction where the ownership,
                           leasing or operation of property or the conduct of
                           its business requires such qualification, except
                           where the failure so to be qualified could not
                           reasonably be expected to have, singly or in the
                           aggregate, a Material Adverse Effect; and

                                (vi) the execution and delivery by the Company
                           of this Agreement and the Indentures and the issuance
                           and sale of the Securities to you as contemplated
                           thereby and the performance of its obligations
                           pursuant to this Agreement and the Indentures will
                           not conflict with or result in a breach or violation
                           of any of the terms or provisions of, or constitute a
                           default (with the passage of time or otherwise)
                           under, or result in the imposition of a Lien on any
                           properties of the Company or any of its Subsidiaries
                           or an acceleration of indebtedness pursuant to any of
                           the agreements listed on a schedule attached to such

                                                     - 18 -



                           counsel's opinion, where, in any such instance, such
                           breach, default, Lien, acceleration of indebtedness
                           or conflict could have, singly or in the aggregate, a
                           material adverse effect or a prospective material
                           adverse effect on the business, financial condition
                           or results of operations of the Company and its
                           Subsidiaries, taken as a whole.

                           (4) In giving their opinion required by subsection
                  (e)(3) of this Section 8, such counsel shall state that no
                  fact has come to the attention of such counsel that leads it
                  to believe that the descriptions of statutes, legal and
                  governmental proceedings, contracts and other documents and
                  regulatory matters described in the Offering Memorandum under
                  the captions set forth in subsection (e)(3)(i) of this Section
                  8 contained an untrue statement of a material fact or omitted
                  to state a material fact required to be stated therein or
                  necessary to make the statements therein, in light of the
                  circumstances under which they were made, not misleading.

                           (5) an opinion (satisfactory to you and Initial
                  Purchasers' Counsel), dated the Closing Date, of Woodburn and
                  Wedge, special Nevada counsel to the Company, to the effect
                  that:

                                 (i) the Company has the corporate power and
                           authority to execute, deliver and perform this
                           Agreement and the Company has the corporate power and
                           authority to authorize, issue and sell the Securities
                           as contemplated by this Agreement;

                                (ii) this Agreement has been duly authorized,
                           executed and delivered by the Company, and the
                           Securities and the Indentures have been duly
                           authorized, executed and delivered by the Company;

                               (iii) the Company is a duly organized and validly
                           existing corporation in good standing under the laws
                           of the State of Nevada and has the requisite
                           corporate power and authority to own, lease and
                           operate its properties and to conduct its business as
                           described in the Offering Memorandum, and to execute
                           and deliver, and perform its obligations pursuant to,
                           the Indentures, the Securities and this Agreement;

                                (iv) no consent, approval, authorization, or
                           order of any Nevada governmental agency or body is
                           required, for the consummation by the Company of the
                           transactions contemplated by this Agreement in
                           connection with the issuance and sale of the
                           Securities;

                                 (v) the execution and delivery by the Company
                           of this Agreement and the Indentures, the issuance
                           and sale of the Securities to you as contemplated by
                           this Agreement and the performance of its obligations
                           pursuant to this Agreement, the Securities and the
                           Indentures will not conflict with or result in a
                           breach or violation of any of the terms or provision
                           of, or constitute a default under, (a) any of the
                           charter or bylaws of the Company, or (b) any existing
                           applicable statute, rule or regulation or any order
                           of any Nevada court or governmental agency or body
                           having jurisdiction over the Company or any of its
                           properties; provided that the opinion expressed in
                           clause (b) is limited to those statutes, rules or
                           regulations which, in the experience of such counsel,
                           are normally applicable to transactions of the type
                           contemplated by this Agreement in connection with the
                           issuance and sale of the Securities; and

                                (vi) in any action or proceeding arising out of
                           or relating to this Agreement or the Indentures in
                           any court of the State of Nevada or in any federal
                           court sitting in the state of Nevada, such court
                           would recognize and give effect to the provisions of
                           Section 11 of this Agreement and Section 9.10 of the
                           Indentures wherein the parties thereto agreed, to the

                                                     - 19 -



                           extent therein stated, that each such document shall
                           be governed by and construed in accordance with the
                           internal laws of the State of New York.

                  (f) You shall have received an opinion, dated the Closing
         Date, of Sullivan & Cromwell, counsel for the Initial Purchasers, in
         form and substance reasonably satisfactory to you.

                  (g) You shall have received complete sets of all closing
         documents, including without limitation all opinions, required to be
         delivered under any of the other Operative Documents.

                  (h) You shall have received letters on and as of the date
         hereof as well as on and as of the Closing Date, in the latter case
         constituting an affirmation of the statements set forth in the earlier
         letters, in form and substance satisfactory to you, from KPMG Peat
         Marwick LLP, independent public accountants to the Company, with
         respect to the financial statements and certain financial information
         contained or incorporated by reference in the Offering Memorandum as
         you shall reasonably require.

                  (i) All corporate proceedings and other legal matters incident
         to the authorization, form and validity of this Agreement and the
         Offering Memorandum and all other legal matters relating to this
         Agreement and the transactions contemplated hereby shall be reasonably
         satisfactory to Sullivan & Cromwell.

                  (j) There shall have been no amendments, alterations,
         modifications, or waivers of any provisions of the Operative Documents
         since the date of the execution and delivery thereof by the parties
         thereto other than those which are disclosed in the Offering Memorandum
         or any supplement thereto or which under the Act are not required to be
         disclosed in the Offering Memorandum or any supplement thereto and
         which have been disclosed to the Initial Purchasers prior to the date
         hereof.

                  (k) On or before the Closing Date, the Initial Purchasers and
         Sullivan & Cromwell, counsel for the Initial Purchasers, shall have
         received such further documents, opinions, certificates and schedules
         or instruments relating to the business, corporate, legal and financial
         affairs of the Company and the Subsidiaries as they shall have
         reasonably requested prior to the date of this Agreement.

                  9. EFFECTIVE DATE OF AGREEMENT, DEFAULT AND TERMINATION. This
Agreement shall become effective upon the execution and delivery of this
Agreement by the parties hereto.

                  This Agreement may be terminated at any time on or prior to
the Closing Date by you by notice to the Company if any of the following has
occurred: (i) subsequent to the date of this Agreement, any Material Adverse
Change which, in your judgment, impairs the investment quality of the
Securities, (ii) any outbreak or escalation of hostilities or other national or
international calamity or crisis or material adverse change in the financial
markets of the United States or elsewhere, or any other substantial national or
international calamity or emergency if the effect of such outbreak, escalation,
calamity, crisis or emergency would, in your judgment make it impracticable or
inadvisable to market the Securities or to enforce contracts for the sale of the
Securities, (iii) any suspension or limitation of trading generally in
securities, or in any securities of the Company on the New York or American
Stock Exchanges, or the National Association of Securities Dealers Automated
Quotation National Market, or the over-the-counter markets or any setting of
minimum prices for trading on such exchanges or markets, (iv) any declaration of
a general banking moratorium by either Federal or New York authorities, (v) the
taking of any action by any Federal or state government or agency in respect of
its monetary or fiscal affairs that in your judgment has a material adverse
effect on the financial markets in the United States, and would, in your
judgment, make it impracticable or inadvisable to market the Securities or to
enforce contracts for the sale of the Securities, (vi) any securities of the
Company or any of its Subsidiaries shall have been downgraded or placed on any
"watch list" for possible downgrading or reviewed for a possible change that
does not indicate the direction of the possible change by any "nationally
recognized statistical rating organization," as such term is defined for
purposes of Rule 436(g)(2) of the Act, or (vii) the enactment, publication,
decree or other
                                     
                                     - 20 -



promulgation of any Federal or state statute, regulation, or rule or order of 
any court or other governmental authority which in your judgment could 
reasonably be expected to have a Material Adverse Effect.

                  If this Agreement shall be terminated by you pursuant to 
clause (i), (vi) or, in the case of a statute, regulation, rule or order 
specifically addressing the Company, and not affecting the general hospital 
industry generally, (vii) of the second paragraph of this Section 9 or 
because of the failure or refusal on the part of the Company to comply with 
the terms or to fulfill any of the conditions of this Agreement, the Company 
agrees to reimburse you for all reasonable out-of-pocket expenses (including 
the reasonable fees and disbursements of counsel) incurred by you. 
Notwithstanding any termination of this Agreement, the Company shall be 
liable for all expenses which it has agreed to pay pursuant to Section 4(d) 
hereof. If this Agreement is terminated pursuant to this Section 9, such 
termination shall be without liability of any Initial Purchaser to the 
Company or any of its Subsidiaries.

                  If on the Closing Date any Initial Purchaser shall fail or 
refuse to purchase the securities which it has agreed to purchase hereunder 
on such date, and the aggregate principal amount of such Securities that such 
defaulting Initial Purchaser or Initial Purchasers, as the case may be, 
agreed but failed or refused to purchase does not exceed 20% of the total 
principal amount of such Securities to be purchased on such date by all 
Initial Purchasers, each non-defaulting Initial Purchaser shall be obligated 
severally, in the proportion which the amount of Securities set forth 
opposite its name in Schedule I and Schedule II, respectively, hereto bears 
to the aggregate principal amount of Securities which all the non-defaulting 
Initial Purchasers, as the case may be, have agreed to purchase, or in such 
other proportion as you (at your option) may specify, to purchase the 
Securities that such defaulting Initial Purchaser or Initial Purchasers, as 
the case may be, agreed but failed or refused to purchase on such date; 
PROVIDED that in no event shall the aggregate principal amount of Securities 
that any Initial Purchaser has agreed to purchase pursuant to Section 2 
hereof be increased pursuant to this Section 9 by an amount in excess of 
one-ninth of such principal amount of Securities without the written consent 
of such Initial Purchaser. If, on the Closing Date any of the Initial 
Purchasers shall fail or refuse to purchase the Securities, as the case may 
be, and the total principal amount of Securities with respect to which such 
default occurs exceeds 20% of the total amount of Securities to be purchased 
on such date by all Initial Purchasers and arrangements satisfactory to you 
and the Company for the purchase of such Securities are not made within 48 
hours after such default, this Agreement shall terminate without liability on 
the part of the non-defaulting Initial Purchaser and the Company, except as 
otherwise provided in this Section 9. In any such case that does not result 
in termination of this Agreement, either the non-defaulting Initial Purchaser 
or the Company may postpone the Closing Date for not longer than seven (7) 
days, in order that the required changes, if any, in the Offering Memorandum 
or any other documents or arrangements may be effected. Any action taken 
under this paragraph shall not relieve a defaulting Initial Purchaser from 
liability in respect of any default of any such Initial Purchaser under this 
Agreement.

                  10. NOTICES. Notices given pursuant to any provision of this
Agreement shall be addressed as follows: (a) if to the Company, to it at 3820
State Street, Santa Barbara, California 93105, Attention: Chief Financial
Officer, with copies to Attention: General Counsel and to Skadden, Arps, Slate,
Meagher & Flom, 300 South Grand Avenue, Suite 3400, Los Angeles, California
90071, Attention: Thomas C. Janson, Jr. and (b) if to any Initial Purchaser, to
Donaldson, Lufkin & Jenrette Securities Corporation, 277 Park Avenue, New York,
New York 10172, Attention: Syndicate Department, and, in each case, with a copy
to Sullivan & Cromwell, 444 South Flower Street, Suite 1200, Los Angeles,
California 90071, Attention: Alison S. Ressler, or in any case to such other
address as the person to be notified may have required in writing.

                  11. GOVERNING LAW.  THIS AGREEMENT SHALL BE GOVERNED BY AND 
CONSTRUED IN ACCORDANCE WITH THE INTERNAL LAWS OF THE STATE OF NEW YORK AS 
APPLIED TO CONTRACTS MADE AND PERFORMED ENTIRELY WITHIN THE STATE OF NEW 
YORK, WITHOUT REGARD TO PRINCIPLES OF CONFLICTS OF LAW. THE COMPANY HEREBY 
IRREVOCABLY SUBMITS TO THE EXCLUSIVE JURISDICTION OF THE FEDERAL AND NEW YORK 
STATE COURTS LOCATED IN THE CITY OF NEW YORK IN CONNECTION WITH ANY SUIT, 
ACTION OR PROCEEDING RELATED TO THIS AGREEMENT OR ANY OF THE MATTERS 
CONTEMPLATED HEREBY, IRREVOCABLY WAIVES ANY DEFENSE OF LACK OF PERSONAL 
JURISDICTION AND IRREVOCABLY AGREES THAT ALL CLAIMS IN

                                                  - 21 -




RESPECT OF ANY SUCH SUIT, ACTION OR PROCEEDING MAY BE HEARD AND DETERMINED IN 
ANY SUCH COURT. THE COMPANY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT IT MAY 
EFFECTIVELY DO SO UNDER APPLICABLE LAW, ANY OBJECTION WHICH IT MAY NOW OR 
HEREAFTER HAVE TO THE LAYING OF VENUE OF ANY SUCH SUIT, ACTION OR PROCEEDING 
BROUGHT IN ANY SUCH COURT AND ANY CLAIM THAT ANY SUCH SUIT, ACTION OR 
PROCEEDING BROUGHT IN ANY SUCH COURT HAS BEEN BROUGHT IN AN INCONVENIENT 
FORUM.

                  12. SEVERABILITY.  Any determination that any provision of 
this Agreement may be, or is, unenforceable shall not affect the 
enforceability of the remainder of this Agreement.

                  13. SUCCESSORS. Except as otherwise provided, this Agreement
has been and is made solely for the benefit of and shall be binding upon the
Company, the Initial Purchasers, any Indemnified Person referred to herein and
their respective successors and assigns, all as and to the extent provided in
this Agreement, and no other person shall acquire or have any right under or by
virtue of this Agreement. The terms "successors and assigns" shall not include a
purchaser of any of the Securities from any of the Initial Purchasers merely
because of such purchase.

                  14. CERTAIN DEFINITIONS. For purposes of this Agreement, 
(a) "business day" means any day on which the NYSE is open for trading and 
(b) "subsidiary" has the meaning set forth in Rule 405 under the Act.

                  15. COUNTERPARTS. This Agreement may be executed in one or 
more counterparts and, if executed in one or more counterparts, the executed 
counterparts shall each be deemed to be an original, not all such 
counterparts shall together constitute one and the same instrument.

                  16. HEADINGS.  The headings herein are inserted for 
convenience of reference only and are not intended to be part of, or to 
affect the meaning or interpretation of, this Agreement.

                  17. SURVIVAL. The indemnities and contribution provisions 
and the other agreements, representations and warranties of the Company, its 
officers and directors and of the Initial Purchasers set forth in or made 
pursuant to this Agreement shall remain operative and in full force and 
effect, and will survive delivery of and payment for the Securities, 
regardless of (i) any investigation, or statement as to the results thereof, 
made by or on behalf of any of the Initial Purchasers or by or on behalf of 
the Company, the officers or directors of the Company or any controlling 
person of the Company, (ii) acceptance of the Securities and payment for them 
hereunder and (iii) termination of this Agreement.

                                     - 22 -



     This Agreement may be signed in various counterparts which together 
shall constitute one and the same instrument. Please confirm that the 
foregoing correctly sets forth the agreement among the Company and you.

                                         Very truly yours,

                                         TENET HEALTHCARE CORPORATION

                                         By: /s/ STEPHEN D. FARBER
                                            ---------------------------------
                                            Name:    Stephen D. Farber
                                            Title:   Vice President

The foregoing Purchase Agreement 
is hereby confirmed and accepted as of 
the date first above written.

DONALDSON, LUFKIN & JENRETTE
  SECURITIES CORPORATION

By: /s/ DAVID L. DENNIS
   -------------------------------------
   Name:     David L. Dennis
   Title:    Managing Director

MERRILL LYNCH, PIERCE, FENNER & SMITH INCORPORATED

By: /s/ JAMES F. FLAHERTY III
   -------------------------------------
   Name:     James F. Flaherty III
   Title:    Managing Director Investment Banking


                                       
                                    - 23 -



J.P. MORGAN SECURITIES INC.

By: /s/ DAVID H. DEMING
   --------------------------------------
   Name:     David H. Deming
   Title:    Managing Director

MORGAN STANLEY & CO. INCORPORATED

By: /s/ CHARLES DITLOFF
   ---------------------------------------
   Name:     Charles Ditloff
   Title:    Principal

SALOMON BROTHERS INC

By: /s/ GRAEME A. GILFILLAN
   ---------------------------------------
   Name:     Graeme A. Gilfillan
   Title:    Managing Director


DEUTSCHE MORGAN GRENFELL INC.

By: /s/ STEVE WARDEN
   ---------------------------------------
   Name:     Steve Warden
   Title:    Managing Director


By: /s/ LAIN STEWART
   ---------------------------------------
   Name:     Lain Stewart
   Title:    Vice President


                                       
                                    - 24 -



BANCAMERICA ROBERTSON STEPHENS

By: /s/ JOHN MULRY
   ---------------------------------------
   Name:     John Mulry
   Title:    Managing Director





                                    - 25 -




                                  SCHEDULE I



                                                                               PRINCIPAL          PERCENTAGE
INITIAL PURCHASER                                                                AMOUNT            OF TOTAL
                                                                                            
 
Donaldson, Lufkin & Jenrette Securities Corporation ...................       $175,000,000          50.0%

Merrill Lynch, Pierce, Fenner & Smith Incorporated.....................       $ 52,500,000          15.0%

J.P. Morgan Securities Inc.............................................       $ 35,000,000          10.0%

Morgan Stanley & Co. Incorporated......................................       $ 26,250,000           7.5%

Salomon Brothers Inc ..................................................       $ 26,250,000           7.5%

Deutsche Morgan Grenfell Inc...........................................       $ 17,500,000           5.0%

BancAmerica Robertson Stephens.........................................       $ 17,500,000           5.0%
                                                                           ------------------    ------------------
                  Total................................................       $300,000,000          100.0%
                                                                           ==================    ==================





                                       I-1



                                   SCHEDULE II




                                                                                PRINCIPAL           PERCENTAGE
INITIAL PURCHASER                                                                AMOUNT              OF TOTAL

                                                                                              
Donaldson, Lufkin & Jenrette Securities Corporation....................         $500,000,000            50.0%

Merrill Lynch, Pierce, Fenner & Smith Incorporated.....................         $150,000,000            15.0%

J.P. Morgan Securities Inc.............................................         $100,000,000            10.0%

Morgan Stanley & Co. Incorporated......................................         $100,000,000            10.0%

Salomon Brothers Inc...................................................         $100,000,000            10.0%

Deutsche Morgan Grenfell Inc...........................................         $ 50,000,000             5.0%
                                                                           ------------------      ------------------
                   Total...............................................        $1,000,000,000          100.0%
                                                                           ==================      ==================




                                      III-1




                                    EXHIBIT A

                      FORM OF REGISTRATION RIGHTS AGREEMENT








                                      III-2