Exhibit 5.1

 

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August 20, 2026

 

  

Norton Rose Fulbright US LLP

1301 Avenue of the Americas

New York, New York 10019-6022

United States

 

Tel +1 212 318 3000

Fax +1 212 318 3400

nortonrosefulbright.com

Universal Health Services, Inc.

Universal Corporate Center

367 South Gulph Road

P.O. Box 61558

King of Prussia, Pennsylvania 19406-0958

Ladies and Gentlemen:

We have acted as counsel to Universal Health Services, Inc., a Delaware corporation (the “Company”), the subsidiaries of the Company listed on Schedule I hereto (the “DE Guarantors”) and the subsidiaries of the Company listed on Schedule II hereto (the “Non-DE Guarantors” and, collectively with the DE Guarantors, the “Guarantors”), with respect to certain legal matters in connection with the Company’s proposed issuance of $600,000,000 aggregate principal amount of 5.500% Senior Secured Notes due 2031 and $500,000,000 aggregate principal amount of 6.000% Senior Secured Notes due 2036 (collectively, the “Notes”), and the issuance of the related guarantees of the Notes by the Guarantors (the “Guarantees”), as contemplated by the Company’s and the Guarantors’ registration pursuant to a shelf registration statement on Form S-3 (File No. 333-282135) (the “ Original Registration Statement”), as amended by Post-Effective Amendment No. 1 thereto (“Post Effective Amendment No. 1”) (such Original Registration Statement, as amended by Post-Effective Amendment No. 1 and as may be amended from time to time, the “Registration Statement”) filed with the Securities and Exchange Commission (the “Commission”) under the Securities Act of 1933, as amended (the “Securities Act”). The Original Registration Statement and Post Effective Amendment No. 1 have been filed with the Commission and each became effective upon their respective filing. The Company’s prospectus dated September 16, 2024 was filed with the Commission as part of the Registration Statement (the “Base Prospectus”) and the Company’s prospectus supplement dated August 11, 2026 relating to the Notes and the Guarantees has been filed with the Commission pursuant to Rule 424(b) under the Securities Act (the “Prospectus Supplement”).

The Company and Guarantors entered into an Underwriting Agreement (the “Underwriting Agreement”), dated August 11, 2026, with J.P. Morgan Securities LLC, BofA Securities, Inc., Truist Securities, Inc., US Bancorp Investments, Inc. and Wells Fargo Securities, LLC, as representatives of the underwriters named therein (the “Underwriters”), relating to the issuance and sale by the Company to the Underwriters of the Notes, which shall be issued pursuant to an Indenture dated as of September 26, 2024 (as supplemented prior to the date hereof, the “Base Indenture”) and a Third Supplemental Indenture dated as of August 20, 2026 (the “Supplemental Indenture” and, together with the Base Indenture, the “Indenture”) among the Company, the Guarantors, U.S. Bank Trust Company, National Association, as trustee (the “Trustee”), and JPMorgan Chase Bank, N.A., as collateral agent (the “Collateral Agent”).

 

Norton Rose Fulbright US LLP is a limited liability partnership registered under the laws of Texas.

Norton Rose Fulbright US LLP, Norton Rose Fulbright LLP and Norton Rose Fulbright Canada LLP are separate legal entities and all of them are members of Norton Rose Fulbright Verein, a Swiss verein. Norton Rose Fulbright Verein helps coordinate the activities of the members but does not itself provide legal services to clients. Details of each entity, with certain regulatory information, are available at nortonrosefulbright.com.


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In connection with this opinion, we have (i) investigated such questions of law, (ii) examined originals or certified, conformed, electronic or reproduction copies of such agreements, instruments, documents and records of the Company and the Guarantors, such certificates of public officials and such other documents and (iii) received such information from officers and representatives of the Company, the Guarantors and others, in each case as we have deemed necessary or appropriate for the purposes of this opinion. We have examined, among other documents, the following:

 

  (a)

the Restated Certificate of Incorporation and bylaws of the Company,

 

  (b)

the organizational documents of the DE Guarantors,

 

  (c)

the Registration Statement,

 

  (d)

the Base Prospectus and the Prospectus Supplement,

 

  (e)

the Underwriting Agreement,

 

  (f)

the Base Indenture and the Supplemental Indenture,

 

  (g)

the Notes in global form as executed by the Company and authenticated by the Trustee, and

 

  (h)

the form of Officers’ Certificates to be delivered pursuant to Section 13.03 of the Base Indenture.

The documents referred to in items (a) through (h) above, inclusive, are referred to herein collectively as the “Documents.”

In all such examinations, we have assumed the legal capacity of all natural persons, the genuineness of all signatures, the authenticity of original and certified documents and the conformity to original or certified documents of all copies submitted to us as certified, conformed, electronic or reproduction copies. As to various questions of fact relevant to the opinions expressed herein, we have relied upon, and assume the accuracy of, the statements, representations and warranties contained in the Documents, certificates and oral or written statements and other information of or from public officials, officers or other appropriate representatives of the Company, the Guarantors and others and assume compliance on the part of all parties to the Documents with their respective covenants and agreements contained therein.

All assumptions and statements of reliance herein have been made without any independent investigation or verification on our part and we express no opinion with respect to the subject matter or accuracy of such assumptions or items relied upon.

To the extent it may be relevant to the opinions expressed herein, we have assumed that (i) all of the parties to the Documents (other than the Company and the DE Guarantors) are validly existing and in good standing under the laws of their respective jurisdictions of organization; (ii) the parties to the Documents (other than the Company and the DE Guarantors) have the power and authority to (a) execute and deliver the Documents, (b) perform their obligations thereunder and (c) consummate the transactions contemplated thereby; (iii) each of the Documents has been duly authorized, executed and delivered by each of the parties thereto (other than the Company and


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the DE Guarantors), (iv) each of the Documents constitutes a valid and binding obligation of all of the parties thereto (other than as expressly addressed below as to the Company and the Guarantors), enforceable against such parties in accordance with their respective terms; (v) all of the parties to the Documents will comply with all of their obligations under the Documents and all laws applicable thereto; (vi) the Notes have been duly authenticated and delivered by the Trustee in accordance with the terms of the Indenture; and (vii) the opinion letter dated the date hereof of Matthew D. Klein, Senior Vice President and General Counsel to the Company, regarding this issuance of the Notes and the Guarantees is accurate.

Based on the foregoing, and subject to the assumptions, qualifications, limitations, and exceptions set forth herein, we are of the opinion that:

 

1.

The Notes are legally issued and constitute valid and legally binding obligations of the Company, enforceable against the Company in accordance with their terms.

 

2.

The Guarantees constitute valid and legally binding obligations of the Guarantors, enforceable against the Guarantors in accordance with their terms.

The foregoing opinions regarding the enforceability of the Notes and the Guarantees (collectively, the “Opinion Documents”) are subject to the following:

 

(i)

The enforceability of the Opinion Documents may be limited or affected by (a) bankruptcy, insolvency, reorganization, moratorium, liquidation, rearrangement, probate, conservatorship, fraudulent transfer, fraudulent conveyance and other similar laws (including court decisions) now or hereafter in effect and affecting the rights and remedies of creditors generally or providing for the relief of debtors generally, (b) the refusal of a particular court to grant (i) equitable remedies, including, without limiting the generality of the foregoing, specific performance and injunctive relief, or (ii) a particular remedy sought under any Opinion Document as opposed to another remedy provided for therein or another remedy available at law, admiralty or in equity, (c) general principles of equity (regardless of whether such remedies are sought in a proceeding in equity, admiralty or at law), and (d) judicial discretion.

 

(ii)

In rendering the foregoing opinions, we express no opinion as to (a) the availability of certain equitable remedies, including specific performance; (b) provisions in the Opinion Documents that purport to (i) restrict access to legal or equitable remedies, (ii) establish property classifications, presumptions or evidentiary standards, or (iii) waive or affect rights or defenses of any party that may not be waived or affected under applicable law, (c) provisions in the Opinion Documents relating to severability clauses, (d) provisions in the Opinion Documents relating to indemnities and rights of contribution to the extent prohibited by public policy or which might require indemnification or contribution for losses or expenses caused by negligence, gross negligence, willful misconduct, fraud or illegality of a party otherwise entitled to indemnification or contribution, and (e) the effect of any provision of the Opinion Documents which is intended to permit modification thereof only by means of an agreement signed in writing by the parties thereto.

 

(iii)

We note that the enforceability of specific provisions of the Opinion Documents may be subject to standards of reasonableness, care and diligence and “good faith” limitations and obligations such as those provided in Sections 1-302(b), 1-303, 1-304 and 1-309 of the New York Uniform Commercial Code and applicable principles of common law and judicial decisions.


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(iv)

We have assumed that the Trustee and the Collateral Agent will enforce and perform each Opinion Document in compliance with the provisions thereof and all requirements of applicable law.

 

(v)

In connection with any provisions of the Opinion Documents whereby the Company or any Guarantor submits to the jurisdiction of the United States District Court for the Southern District of New York, we note the limitations of 28 U.S.C. §§ 1331 and 1332 on Federal court jurisdiction, and we also note that such submissions cannot supersede such court’s discretion in determining whether to transfer an action from one Federal court to another under 28 U.S.C. § 1404(a).

 

(vi)

With respect to the valid existence and good standing of the Company and the DE Guarantors, we have relied solely upon certificates of public officials in the State of Delaware, without further investigation.

The opinions expressed herein are limited to the laws of the State of New York and to the extent relevant to the opinions expressed herein, the General Corporation Law of the State of Delaware, the Limited Liability Company Act of the State of Delaware and the Revised Uniform Limited Partnership Act of the state of Delaware, each as currently in effect, and no opinion is expressed with respect to any other laws or any effect that such other laws may have on the opinions expressed herein. This opinion letter is limited to the matters stated herein, and no opinion is implied or may be inferred beyond the matters expressly stated herein. This letter is given only as of the date hereof, and we undertake no responsibility to update or supplement this letter after such time.

We hereby consent to the filing of this opinion as an exhibit to the Company’s Current Report on Form 8-K to be filed with the Commission on the date hereof and to the reference to this firm under the caption “Legal Matters” in the Base Prospectus and the Prospectus Supplement. In giving this consent, we do not hereby admit that we are in the category of persons whose consent is required under Section 7 of the Securities Act or the rules and regulations of the Securities and Exchange Commission.

 

Very truly yours,

 

/s/ Norton Rose Fulbright US LLP

 

Norton Rose Fulbright US LLP


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SCHEDULE I

DE GUARANTORS

 

Entity

  

Jurisdiction of
incorporation

or organization

Ascend Health Corporation    Delaware
Atlantic Shores Hospital, LLC    Delaware
Beach 77 LP    Delaware
Behavioral Health Management, LLC    Delaware
Behavioral Health Realty, LLC    Delaware
Behavioral Healthcare LLC    Delaware
BHC Holdings, Inc.    Delaware
BHC Mesilla Valley Hospital, LLC    Delaware
BHC Northwest Psychiatric Hospital, LLC    Delaware
Brentwood Acquisition—Shreveport, Inc.    Delaware
Calvary Center, Inc.    Delaware
CAT Realty, LLC    Delaware
CAT Seattle, LLC    Delaware
Cedar Springs Hospital, Inc.    Delaware
Coral Shores Behavioral Health, LLC    Delaware
Cumberland Hospital, LLC    Delaware
Cumberland Hospital Partners, LLC    Delaware
DHP 2131 K St, LLC    Delaware
Diamond Grove Center, LLC    Delaware
DVH Hospital Alliance LLC    Delaware
Emerald Coast Behavioral Hospital, LLC    Delaware
Fort Duncan Medical Center, L.P.    Delaware
FRN, Inc.    Delaware
Frontline Behavioral Health, Inc.    Delaware
Frontline Hospital, LLC    Delaware
Frontline Residential Treatment Center, LLC    Delaware
HHC Delaware, Inc.    Delaware
HHC Pennsylvania, LLC    Delaware
Hickory Trail Hospital, L.P.    Delaware
Horizon Health Corporation    Delaware
Horizon Health Hospital Services, LLC    Delaware
Independence Physician Management, LLC    Delaware
Keys Group Holdings LLC    Delaware
Keystone/CCS Partners LLC    Delaware
KMI Acquisition, LLC    Delaware
Laurel Oaks Behavioral Health Center, Inc.    Delaware
Liberty Point Behavioral Healthcare, LLC    Delaware
Manatee Memorial Hospital, L.P.    Delaware
McAllen Hospitals, L.P.    Delaware
McAllen Medical Center, Inc.    Delaware
Merion Building Management, Inc.    Delaware
Ocala Behavioral Health, LLC    Delaware
Palmetto Behavioral Health Holdings, LLC    Delaware


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Entity

  

Jurisdiction of
incorporation

or organization

Pasteur Healthcare Properties, LLC

   Delaware

Pendleton Methodist Hospital, L.L.C.

   Delaware

Premier Behavioral Solutions of Florida, Inc.

   Delaware

Premier Behavioral Solutions, Inc.

   Delaware

Psychiatric Realty, LLC

   Delaware

Psychiatric Solutions Hospitals, LLC

   Delaware

Psychiatric Solutions, Inc.

   Delaware

Ramsay Managed Care, LLC

   Delaware

Ramsay Youth Services of Georgia, Inc.

   Delaware

Riveredge Hospital Holdings, Inc.

   Delaware

RR Recovery, LLC

   Delaware

Salt Lake Behavioral Health, LLC

   Delaware

Salt Lake Psychiatric Realty, LLC

   Delaware

Shadow Mountain Behavioral Health System, LLC

   Delaware

Springfield Hospital, Inc.

   Delaware

Stonington Behavioral Health, Inc.

   Delaware

TBD Acquisition II, LLC

   Delaware

TBD Acquisition, LLC

   Delaware

TBJ Behavioral Center, LLC

   Delaware

Texas Hospital Holdings, Inc.

   Delaware

Toledo Holding Co., LLC

   Delaware

Two Rivers Psychiatric Hospital, Inc.

   Delaware

UBH of Oregon, LLC

   Delaware

UBH of Phoenix Realty, LLC

   Delaware

UBH of Phoenix, LLC

   Delaware

UHP LP

   Delaware

UHS Capitol Acquisition, LLC

   Delaware

UHS Children’s Services, Inc.

   Delaware

UHS Funding, LLC

   Delaware

UHS Kentucky Holdings, L.L.C.

   Delaware

UHS Midwest Behavioral Health, LLC

   Delaware

UHS of Anchor, L.P.

   Delaware

UHS of Benton, LLC

   Delaware

UHS of Bowling Green, LLC

   Delaware

UHS of Centennial Peaks, L.L.C.

   Delaware

UHS of Cornerstone Holdings, Inc.

   Delaware

UHS of Cornerstone, Inc.

   Delaware

UHS of D.C., Inc.

   Delaware

UHS of Delaware, Inc.

   Delaware

UHS of Denver, Inc.

   Delaware

UHS of Dover, L.L.C.

   Delaware

UHS of Doylestown, L.L.C.

   Delaware

UHS of Fairmount, Inc.

   Delaware

UHS of Georgia Holdings, Inc.

   Delaware

UHS of Georgia, Inc.

   Delaware

UHS of Greenville, LLC

   Delaware

UHS of Kansas City, LLC

   Delaware


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Entity

  

Jurisdiction of
incorporation

or organization

UHS of Lakeside, LLC

   Delaware

UHS of Laurel Heights, L.P.

   Delaware

UHS of Madera, Inc.

   Delaware

UHS of Parkwood, Inc.

   Delaware

UHS of Peachford, L.P.

   Delaware

UHS of Phoenix, LLC

   Delaware

UHS of Provo Canyon, Inc.

   Delaware

UHS of Puerto Rico, Inc.

   Delaware

UHS of Ridge, LLC

   Delaware

UHS of Rockford, LLC

   Delaware

UHS of Salt Lake City, L.L.C.

   Delaware

UHS of Savannah, L.L.C.

   Delaware

UHS of Spring Mountain, Inc.

   Delaware

UHS of Springwoods, L.L.C.

   Delaware

UHS of Summitridge, L.L.C.

   Delaware

UHS of Texoma, Inc.

   Delaware

UHS of Timpanogos, Inc.

   Delaware

UHS of Tucson, LLC

   Delaware

UHS of Wyoming, Inc.

   Delaware

UHS Sahara, Inc.

   Delaware

UHS Sub III, LLC

   Delaware

UHS-Corona, Inc.

   Delaware

Universal Health Services of Palmdale, Inc.

   Delaware

University Behavioral Health of El Paso, LLC

   Delaware

Valle Vista, LLC

   Delaware

Valley Health System LLC

   Delaware

Wekiva Springs Center, LLC

   Delaware

Willow Springs, LLC

   Delaware

Windmoor Healthcare of Pinellas Park, Inc.

   Delaware

Wisconsin Avenue Psychiatric Center, Inc.

   Delaware


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SCHEDULE II

NON-DE GUARANTOR

 

Entity

  

Jurisdiction of
incorporation or
organization

ABS Lincs KY, LLC

   Virginia

ABS Lincs SC, Inc.

   South Carolina

Aiken Regional Medical Centers, LLC

   South Carolina

Alliance Health Center, Inc.

   Mississippi

Alternative Behavioral Services, Inc.

   Virginia

AZ Holding 4, LLC

   Arizona

Benchmark Behavioral Health System, Inc.

   Utah

BHC Alhambra Hospital, Inc.

   Tennessee

BHC Belmont Pines Hospital, Inc.

   Tennessee

BHC Fairfax Hospital, Inc.

   Tennessee

BHC Fox Run Hospital, Inc.

   Tennessee

BHC Fremont Hospital, Inc.

   Tennessee

BHC Health Services of Nevada, Inc.

   Nevada

BHC Heritage Oaks Hospital, Inc.

   Tennessee

BHC Intermountain Hospital, Inc.

   Tennessee

BHC Montevista Hospital, Inc.

   Nevada

BHC of Indiana, General Partnership

   Tennessee

BHC Pinnacle Pointe Hospital, LLC

   Tennessee

BHC Properties, LLC

   Tennessee

BHC Sierra Vista Hospital, Inc.

   Tennessee

BHC Streamwood Hospital, Inc.

   Tennessee

Bloomington Meadows, General Partnership

   Tennessee

Brentwood Acquisition, Inc.

   Tennessee

Brynn Marr Hospital, Inc.

   North Carolina

Canyon Ridge Hospital, Inc.

   California

CCS/Lansing, Inc.

   Michigan

Children’s Comprehensive Services, Inc.

   Tennessee

Columbus Hospital Partners, LLC

   Tennessee

Del Amo Hospital, Inc.

   California

District Hospital Partners, L.P.

   District of Columbia

Fannin Management Services, LLC

   Texas

First Hospital Corporation of Virginia Beach

   Virginia

Forest View Psychiatric Hospital, Inc.

   Michigan

Fort Lauderdale Hospital, Inc.

   Florida

Garfield Park Hospital, LLC

   Illinois

Great Plains Hospital, Inc.

   Missouri

Gulf Coast Treatment Center, Inc.

   Florida

Gulph Mills Associates, LLC

   Pennsylvania

H. C. Corporation

   Alabama

H.C. Partnership

   Alabama

Harbor Point Behavioral Health Center, Inc.

   Virginia

Havenwyck Hospital Inc.

   Michigan

HHC Augusta, Inc.

   Georgia


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Entity

  

Jurisdiction of
incorporation or
organization

HHC Indiana, Inc.

   Indiana

HHC Ohio, Inc.

   Ohio

HHC Poplar Springs, LLC

   Virginia

HHC River Park, Inc.

   West Virginia

HHC South Carolina, Inc.

   South Carolina

HHC St. Simons, Inc.

   Georgia

Holly Hill Hospital, LLC

   Tennessee

Horizon Health Austin, Inc.

   Texas

Horizon Mental Health Management, LLC

   Texas

HSA Hill Crest Corporation

   Alabama

Hughes Center, LLC

   Virginia

Keystone Continuum, LLC

   Tennessee

Keystone Education and Youth Services, LLC

   Tennessee

Keystone Marion, LLC

   Virginia

Keystone Memphis, LLC

   Tennessee

Keystone Newport News, LLC

   Virginia

Keystone NPS LLC

   California

Keystone Richland Center LLC

   Ohio

Keystone WSNC, L.L.C.

   North Carolina

Kids Behavioral Health of Utah, Inc.

   Utah

Kingwood Pines Hospital, LLC

   Texas

La Amistad Residential Treatment Center, LLC

   Florida

Lancaster Hospital Corporation

   California

Lebanon Hospital Partners, LLC

   Tennessee

Mayhill Behavioral Health, LLC

   Texas

Meridell Achievement Center, Inc.

   Texas

Michigan Psychiatric Services, Inc.

   Michigan

Millwood Hospital, L.P.

   Texas

Milwaukee Behavioral Health, LLC

   Wisconsin

Neuro Institute of Austin, L.P.

   Texas

North Spring Behavioral Healthcare, Inc.

   Tennessee

Northern Indiana Partners, LLC

   Tennessee

Northwest Texas Healthcare System, Inc.

   Texas

Oak Plains Academy of Tennessee, Inc.

   Tennessee

Palmetto Behavioral Health System, L.L.C.

   South Carolina

Palmetto Lowcountry Behavioral Health, L.L.C.

   South Carolina

Palm Point Behavioral Health, LLC

   Florida

Park Healthcare Company

   Tennessee

Pennsylvania Clinical Schools, Inc.

   Pennsylvania

PSJ Acquisition, LLC

   North Dakota

Psychiatric Solutions of Virginia, Inc.

   Tennessee

Ridge Outpatient Counseling, L.L.C.

   Kentucky

River Oaks, Inc.

   Louisiana

Riverside Medical Clinic Patient Services, L.L.C.

   California

Rolling Hills Hospital, LLC

   Tennessee

Samson Properties, LLC

   Florida

Schick Shadel of Florida, LLC

   Florida


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Entity

  

Jurisdiction of
incorporation or
organization

SHC-KPH, LP

   Texas

Southeastern Hospital Corporation

   Tennessee

SP Behavioral, LLC

   Florida

Sparks Family Hospital, Inc.

   Nevada

Summit Oaks Hospital, Inc.

   New Jersey

Sunstone Behavioral Health, LLC

   Tennessee

Temecula Valley Hospital, Inc.

   California

Temple Behavioral Healthcare Hospital, Inc.

   Texas

Tennessee Clinical Schools, LLC

   Tennessee

Texas Cypress Creek Hospital, L.P.

   Texas

Texas Laurel Ridge Hospital, L.P.

   Texas

Texas Oaks Psychiatric Hospital, L.P.

   Texas

Texas San Marcos Treatment Center, L.P.

   Texas

Texas West Oaks Hospital, L.P.

   Texas

The Arbour, Inc.

   Massachusetts

The Bridgeway, LLC

   Arkansas

The National Deaf Academy, LLC

   Florida

Three Rivers Behavioral Health, LLC

   South Carolina

Three Rivers Healthcare Group, LLC

   South Carolina

Turning Point Care Center, LLC

   Georgia

UHS East End Corporation

   District of Columbia

UHS East End Sub, LLC

   District of Columbia

UHS Holding Company, Inc.

   Nevada

UHS of Fuller, Inc.

   Massachusetts

UHS of Hampton, Inc.

   New Jersey

UHS of Hartgrove, Inc

   Illinois

UHS of Lancaster, LLC

   Pennsylvania

UHS of New Orleans, LLC

   Louisiana

UHS of Oklahoma, LLC

   Oklahoma

UHS of Pennsylvania, Inc.

   Pennsylvania

UHS of River Parishes, Inc.

   Louisiana

UHS of Timberlawn, Inc.

   Texas

UHS of Westwood Pembroke, Inc.

   Massachusetts

UHS Oklahoma City LLC

   Oklahoma

UHSD, L.L.C.

   Nevada

UHSL, L.L.C.

   Nevada

United Healthcare of Hardin, Inc.

   Tennessee

Universal Health Services of Rancho Springs, Inc.

   California

University Behavioral, LLC

   Florida

Valle Vista Hospital Partners, LLC

   Tennessee

Valley Hospital Medical Center, Inc.

   Nevada

Wellington Regional Medical Center, LLC

   Florida

Wellstone Regional Hospital Acquisition, LLC

   Indiana

Windmoor Healthcare Inc.

   Florida

Zeus Endeavors, LLC

   Florida