PROMISSORY NOTE

Exhibit 10.6 PROMISSORY NOTE

FOR VALUE RECEIVED, RHA STROUD, LLC , an Oklahoma limited liability company, d/b/a Stroud Regional Medical Center (hereinafter referred to as the "Borrower"), unconditionally promises to pay to the order of VALLIANCE BANK ("Lender"), at 1601 N.W. Expressway, Oklahoma City, OK 73118, or at such other place as may be designated in writing by the holder of this promissory note, the principal sum not to exceed THREE MILLION SIX HUNDRED SIXTY-TWO THOUSAND AND 00/100 Dollars ($3,662,000.00), together with interest thereon at the rate hereinafter specified: INTEREST RATE . Interest shall accrue on the outstanding principal balance of this loan at the rate of Wall Street Journal Prime Rate plus two percent (2.00%), adjusted at the end of each calendar quarter. Interest on this Note shall be computed on the basis of a 360 day year. In no event shall the interest rate be less than seven percent (7.0%) per annum. The Wall Street Journal Prime Rate (WSJP) means that annual rate of interest published in the Wall Street Journal and is defined herein as the base rate on corporate loans posted by at least 75% of the nations thirty (30) largest banks or a similar substitute rate determined by the Lender in its sole discretion as most nearly approximating that rate in the case this prime rate is no longer published. Each change in the WSJP shall become effective without notice (which notice is hereby waived) on the date of change. PAYMENT TERMS . Beginning on November 30, 2008, and on the last day of each month thereafter, Borrower shall pay Lender monthly installment payments of principal and interest based upon a sixteen (16) year amortization. On the Maturity Date of November 6, 2024, all accrued interest and unpaid principal shall be due and payable in full. Lender may adjust the monthly payments as needed to provide for payment in full within the stated amortization period. LATE CHARGES : Notwithstanding the grace period, Lender may assess a late charge if a payment is more than 10 days late. The charge will be $100.00 for each late payment. This charge will be paid promptly but only once for each late payment. In no event shall these charges, either before or after maturity, be greater than permitted by law. DEFAULT INTEREST : Any sum not paid when due shall bear interest at a rate of six percent (6%) per annum greater than the per annum interest rate prevailing on this Note at the time the unpaid amount came due, but in no event at a rate less than ten percent (10%) per annum. Of even date herewith the Borrower and Lender have entered into that certain Loan Agreement ("Agreement"). This Promissory Note is defined in the Agreement as the Promissory Note. Unless otherwise defined herein, all words and phrases with their initial letter capitalized shall be afforded the meaning given in the Agreement.

The Lender’s records of advances and repayments will be prima facie evidence of the amount owed by the Borrower to the Lender with respect to this Note, in the absence of manifest error. All payments made upon this Note shall be applied first to the outstanding accrued interest, if any, through the date of payment and the balance, if any, to the principal balance due and owing under this Note. PREPAYMENT : On any installment payment date additional payments may be made to be credited to principal. Borrower agrees to a prepayment premium of five percent (5.0%) of any additional principal amount paid in year one; four percent (4%) in year two three percent (3.0%) in year three; two percent (2.0%) in year four, and one percent (1.0%) in year five. After the fifth year Borrower shall have the right to make any prepayment of principal without a premium cost. Prepayments shall be credited to installments of principal in the inverse order of their maturity. Monthly payments shall not be reduced as a result of any prepayments. To the extent permitted by law, the foregoing prepayment premium shall be payable regardless of whether the loan is prepaid voluntarily or involuntarily. Any prepaid amounts specified in a notice of prepayment, as aforesaid, shall become due and payable at the time provided in said notice. Borrower agrees that if, and as often as, this Note is placed in the hands of an attorn