Exhibit 3.21

Delaware	PAGE 1
The First State

     I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY THE ATTACHED ARE TRUE AND CORRECT COPIES OF ALL DOCUMENTS ON FILE OF “ASHLAND PHYSICIAN SERVICES, LLC” AS RECEIVED AND FILED IN THIS OFFICE.

     THE FOLLOWING DOCUMENTS HAVE BEEN CERTIFIED:

     CERTIFICATE OF FORMATION, FILED THE SIXTEENTH DAY OF AUGUST, A.D. 2004, AT 2:01 O’CLOCK P.M.

     CERTIFICATE OF AMENDMENT, FILED THE THIRTEENTH DAY OF JULY, A.D. 2005, AT 12:53 O’CLOCK P.M.

     AND I DO HEREBY FURTHER CERTIFY THAT THE AFORESAID CERTIFICATES ARE THE ONLY CERTIFICATES ON RECORD OF THE AFORESAID LIMITED LIABILITY COMPANY, “ASHLAND PHYSICIAN SERVICES, LLC”.

3842873     8100H		/s/ Jeffrey W. Bullock
110292115 You may verify this certificate online at corp. delaware.gov/authver.shtml		Jeffrey W. Bullock, Secretary of State AUTHENICTION: 8619756 DATE: 03-14-11

State of Delaware
Secretary of State
Division of Corporations
Delivered 02:05 PM 08/16/2004
FILED 02:01 PM 08/16/2004
SRV 040597770 — 3842873 FILE

STATE of DELAWARE
LIMITED LIABILITY COMPANY
CERTIFICATE of FORMATION

•	First: The name of the limited liability company is Ashland Physician Services, LLC
•	Second: The address of its registered office in the State of Delaware is 9 East Loockerman Street, Suite 1B in the City of Dover The name of its Registered agent at such address is National Registered Agents, Inc.
•	Third: (Use this paragraph only if the company is to have a specific effective date of dissolution) “ The latest date on which the limited liability company is to dissolve is N/A.”
•	Fourth: (Insert any other matters the members determine to include herein.) The formation of the limited liability company shall be effective upon filing with the Delaware Secretary of State.
In Witness Whereof, the undersigned have executed this Certificate of Formation of Ashland Physician Services, LLC this 13th day of August, 2004.

BY:	/s/ Faye S. Edwards
	Authorized Person(s)
NAME:	Faye S. Edwards
	Type or Print

State of Delaware
Secretary of State
Division of Corporations
Delivered 01:30 PM 07/13/2005
FILED 12:53 PM 07/13/2005
SRV 050578946 — 3842873 FILE

CERTIFICATE OF AMENDMENT

OF

ASHLAND PHYSICIAN SERVICES, LLC

     1. The name of the limited liability company is ASHLAND PHYSICIAN SERVICES, LLC.

     2. The Certificate of Formation of the limited liability company is hereby amended as follows:

          Article Second should be removed in its entirety and replaced with the following:

Second: The address of its registered office in the State of Delaware is: Corporation Trust Center, 1209 Orange Street, Wilmington, New Castle County Delaware 19801. The name of its registered agent at such address is The Corporation Trust Company.

     IN WITNESS WHEREOF, the undersigned has executed this Certificate of Amendment of ASHLAND PHYSICIAN SERVICES, LLC this 1^st day of July, 2005.

ASHLAND PHYSICIAN SERVICES, LLC
By:	/s/ Mary Kim E. Shipp
	Mary Kim E. Shipp