June 10, 2008
VIA U.S. MAIL AND EMAIL
Integrated Healthcare Holdings, Inc.
1301 North Tustin Avenue
Santa Ana, California 92705
Attn: Bruce Mogel, CEO
Re: Amendment No. 1 to $50 Million Revolving Credit Agreement dated October 9, 2007
Reference is made to the $50 Million Revolving Credit Agreement dated October 9, 2007 ("Credit Agreement")
by and between Borrowers and Lender. Capitalized terms not otherwise defined herein shall have the same
meaning as set forth in the Credit Agreement.
Due to the general decline in economic conditions and other factors, Borrowers have requested that Lender
reduce the Minimum Fixed Charge Coverage Ratio set forth in Annex A to the Credit Agreement. Lender has
considered Borrower's request and is prepared to amend the Credit Agreement on the following terms and
1. Effective January 1, 2008 and ending June 30, 2009 ("Reduction Period"), the Minimum Fixed Charge
Coverage Ratio set forth in Annex A to the Credit Agreement shall be reduced from 1.0 to
0.4 ("Reduced Coverage Ratio").
2. The reduction of the Minimum Fixed Charge Coverage Ratio for the Reduction Period shall not be deemed to
be nor constitute a waiver of Borrower's rights, duties or obligations under the Credit Agreement, and shall not
operate or be construed as a waiver by Lender of any current or future Default or Event of Default, whether of a
like or different nature.
2100 South State College Blvd, Anaheim, California 92806 o (800) 824-3700 o (714) 935-3100 o FAX (714)
935-3114 Internet: http://www.medlcalcapital.com
The reduction of the Minimum Fixed Charge Coverage Ratio shall be limited solely to the express terms and
provisions set forth in this amendment. By making a reduction in the Minimum Fixed Charge Coverage Ratio,
Lender does not waive any breach of any representation or warranty of Borrowers under any Loan Document,
and all of Lender's claims and rights resulting from any such breach or misrepresentation