Schedule 13d

Filed by: MEDCATH CORP
Subject Company: MEDCATH CORPORATION
Filed as of Date: 03/05/2008
View Original Filing on Edgar's
0001169232-08-001235.txt : 20080305
<SEC-HEADER>0001169232-08-001235.hdr.sgml : 20080305
<ACCEPTANCE-DATETIME>20080305140651
ACCESSION NUMBER:		0001169232-08-001235
CONFORMED SUBMISSION TYPE:	SC 13D/A
PUBLIC DOCUMENT COUNT:		3
FILED AS OF DATE:		20080305
DATE AS OF CHANGE:		20080305
GROUP MEMBERS:		DAVID NIERENBERG
GROUP MEMBERS:		NIERENBERG INVESTMENT MANAGEMENT OFFSHORE, INC.
GROUP MEMBERS:		THE D3 FAMILY BULLDOG FUND, L.P.
GROUP MEMBERS:		THE D3 FAMILY CANADIAN FUND, L.P.
GROUP MEMBERS:		THE D3 FAMILY FUND, L.P.
GROUP MEMBERS:		THE DIII OFFSHORE FUND, L.P.

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			NIERENBERG INVESTMENT MANAGEMENT CO
		CENTRAL INDEX KEY:			0001282683
		IRS NUMBER:				911677205

	FILING VALUES:
		FORM TYPE:		SC 13D/A

	MAIL ADDRESS:	
		STREET 1:		19605 NE 8TH ST
		CITY:			CAMAS
		STATE:			WA
		ZIP:			98607

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			MEDCATH CORP
		CENTRAL INDEX KEY:			0001139463
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062]
		IRS NUMBER:				562248952
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			0930

	FILING VALUES:
		FORM TYPE:		SC 13D/A
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	005-62451
		FILM NUMBER:		08667254

	BUSINESS ADDRESS:	
		STREET 1:		10720 SIKES PLACE SUITE 300
		CITY:			CHARLOTTE
		STATE:			NC
		ZIP:			28277
		BUSINESS PHONE:		7047086600

	MAIL ADDRESS:	
		STREET 1:		10720 SIKES PLACE SUITE 300
		CITY:			CHARLOTTE
		STATE:			NC
		ZIP:			28277
</SEC-HEADER>
<DOCUMENT>
<TYPE>SC 13D/A
<SEQUENCE>1
<FILENAME>d73827_sc13d-a.txt
<DESCRIPTION>AMENDMENT NO. 10 TO SCHEDULE 13D
<TEXT>
                                  UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549

                                  SCHEDULE 13D
                    Under the Securities Exchange Act of 1934
                               (Amendment No. 10)

                           MEDCATH CORPORATION (MDTH)
                                (Name of Issuer)

                                  Common Stock
                         (Title of Class of Securities)

                                    58404W109
                                 (CUSIP Number)

                                David Nierenberg
                               The D3 Family Funds
                               19605 NE 8th Street
                                 Camas, WA 98607
                                 (360) 604-8600

                                 With a copy to:

                               Henry Lesser, Esq.
                                DLA Piper US LLP
                             2000 University Avenue
                            East Palo Alto, CA 94303
                                 (650) 833-2000

                  (Name, Address and Telephone Number of Person
                Authorized to Receive Notices and Communications)
                                  March 3, 2008
             (Date of Event which Requires Filing of this Statement)

If the filing person has previously filed a statement on Schedule 13G to report
the acquisition that is the subject of this Schedule 13D and is filing this
schedule because of ss.ss. 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the
following box |_|.

<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      The D3 Family Fund, L.P.
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      WC
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Washington
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         483,096 common shares (2.3%)
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           0
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              483,096
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         0
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 483,096; for all reporting
      persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      PN
- --------------------------------------------------------------------------------


                                       2
<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      The DIII Offshore Fund, L.P.
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      WC
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Bahamas
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         558,166 common shares (2.6%)
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           0
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              558,166
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         0
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 558,166; for all reporting
      persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      PN
- --------------------------------------------------------------------------------


                                       3
<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      The D3 Family Bulldog Fund, L.P.
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      WC
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Washington
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         1,798,863 common shares (8.5%)
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           0
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              1,798,863
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         0
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 1,798,863; for all reporting
      persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      PN
- --------------------------------------------------------------------------------


                                       4
<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      The D3 Family Canadian Fund, L.P.
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      WC
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Washington
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         94,386 common shares (0.4%)
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           0
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              94,386
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         0
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 94,386 shares; for all
      reporting persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      PN
- --------------------------------------------------------------------------------


                                       5
<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      Nierenberg Investment Management Company, Inc.
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      AF
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Washington
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         0
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           2,934,511 common shares (13.8%)
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              0
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         2,934,511
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 2,934,511; for all reporting
      persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      CO
- --------------------------------------------------------------------------------


                                       6
<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      Nierenberg Investment Management Offshore, Inc.
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      AF
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Bahamas
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         0
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           558,166 common shares (2.6%)
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              0
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         558,166
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 558,166; for all reporting
      persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      CO
- --------------------------------------------------------------------------------


                                       7
<PAGE>

- --------------------------------------------------------------------------------
1     NAME OF REPORTING PERSONS

      David Nierenberg
- --------------------------------------------------------------------------------
2     CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
                                                                         (a) |X|
                                                                         (b) |_|
- --------------------------------------------------------------------------------
3     SEC USE ONLY


- --------------------------------------------------------------------------------
4     SOURCE OF FUNDS (See Instructions)

      AF
- --------------------------------------------------------------------------------
5     CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS
      2(d) or 2(e)
                                                                            |_|
- --------------------------------------------------------------------------------
6     CITIZENSHIP OR PLACE OF ORGANIZATION

      Washington
- --------------------------------------------------------------------------------
                  7      SOLE VOTING POWER

                         0
                 ---------------------------------------------------------------
    NUMBER OF     8      SHARED VOTING POWER
     SHARES
  BENEFICIALLY           2,934,511 common shares (13.8%)
    OWNED BY      --------------------------------------------------------------
      EACH        9      SOLE DISPOSITIVE POWER
    REPORTING
     PERSON              0
      WITH        --------------------------------------------------------------
                  10     SHARED DISPOSITIVE POWER

                         2,934,511
- --------------------------------------------------------------------------------
11    AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

      For the reporting person listed on this page, 2,934,511; for all reporting
      persons as a group, 2,934,511 shares (13.8%)
- --------------------------------------------------------------------------------
12    CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
      (See Instructions)
                                                                             |_|
- --------------------------------------------------------------------------------
13    PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

      13.8%
- --------------------------------------------------------------------------------
14    TYPE OF REPORTING PERSON (See Instructions)

      IN
- --------------------------------------------------------------------------------


                                       8
<PAGE>

      This Amendment No.10 to Schedule 13D (this "Amendment") amends the
below-indicated items from the Schedule 13D previously filed by or on behalf of
the undersigned parties (the "Reporting Persons"), as previously amended (the
"Schedule 13D"), by supplementing such Items with the information below:

Item 2.  Identity and Background.

      David Nierenberg is hereby added as a Reporting Person; his business
address is 19605 NE 8th Street, Camas WA 98607; his principal occupation is
President of Nierenberg Investment Management Company, Inc. and Nierenberg
Investment Management Offshore, Inc, two of the other Reporting Persons; during
the past five years he has not been convicted in a criminal proceeding required
to be reported in response to Item 2(d), or a party to a civil proceeding
required to be reported in response to Item 2(e), of Schedule 13D ; and he is a
citizen of the United States of America.

Item 3.  Source and Amount of Funds or Other Consideration.

      The total amount of funds used by the Reporting Persons to pay for the
purchases of Shares reported in Item 5(c) was $3,196,747. The source of funds
for purchases of Shares by each of the Reporting Persons is the working capital
of the applicable Fund.

Item 4.  Purpose of Transaction.

      We have continued buying MedCath shares for investment because we believe
that the shares are extremely undervalued. As set forth in our attached letter,
we urge the Company's board to increase the current $59M repurchase program by
an additional $100M and offer suggestions about how and why to do this.

The previous statements by the Reporting Persons regarding their investment in
MDTH (including those contained in the attached letter) represent solely their
own analyses and judgments, based on publicly-available information and their
own internal evaluation thereof. Those statements are not intended, and should
not be relied on, as investment advice to any other investor or prospective
investor. To the extent those statements reflect assessments of possible future
developments, those assessments are inherently subject to the uncertainties
associated with all assessments of future events; actual developments may
materially differ as a result of circumstances affecting MDTH and/or extrinsic
factors such as developments in the company's industry and the economic
environment. The Reporting Persons reserve the right to change their internal
evaluation of this investment in the future, as well as to increase or decrease
their investment depending on their evaluation, and to discuss the company and
their investment in it with the directors and executive officers of the company
and third parties, without further amending the Schedule 13D except as required
by applicable rules.


                                       9
<PAGE>

Item 5. Interest in Securities of the Issuer.

      (a, b) The Reporting Persons, in the aggregate, beneficially own 2,934,511
common shares, constituting approximately 13.8% of the outstanding Shares. This
percentage is based on number of Shares reported as outstanding as of January
31, 2008 in the Company's Form 10-Q dated February 11, 2008.

      (c) During the past sixty (60) days the following purchases of Shares were
made by the Reporting Persons in open market transactions:

<TABLE>
<CAPTION>
       Fund                               Transaction Date   Shares Bought     Price
       ----                               ----------------   -------------     -----
<S>                                          <C>                    <C>        <C>
       D3 Family Fund, LP                    01/03/2008              5,200     23.96
       D3 Family Bulldog Fund, LP            01/03/2008             18,000     23.96
       D3 Family Canadian Fund, LP           01/03/2008              1,035     23.96
       D3 Family Bulldog Fund, LP            01/04/2008             25,100     23.64
       D3 Family Canadian Fund, LP           01/04/2008              1,287     23.64
       DIII Offshore Fund, LP                02/29/2008              7,900     20.77
       D3 Family Fund, LP                    03/03/2008                900     19.83
       DIII Offshore Fund, LP                03/03/2008             91,200     19.83
</TABLE>

Item 7.  Material to be filed as Exhibits

      Exhibit 1 to this Schedule 13D is a letter to the Chairman of the Board,
President and Chief Executive Officer, and Members of the Board of MedCath Corp.
dated March 5, 2008.

      Exhibit 2 to this Schedule 13D is the Joint Filing Agreement among the
Reporting Persons dated March 5, 2008 pursuant to which all of the Reporting
Persons have authorized the filing of Schedule 13D's and amendments thereto as a
group.


                                       10
<PAGE>

                                    SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, each of the
undersigned certifies that the information set forth in the Statement is true,
complete and correct.

                                  D3 Family Fund, L.P., D3 Family Bulldog Fund,
                                  and D3 Family Canadian Fund, L.P.

                                  By: Nierenberg Investment Management
                                      Company, Inc.

                                  Its: General Partner

March 05, 2008                    By: /s/ David Nierenberg
- --------------------                 -------------------------------------------
                                      David Nierenberg, President


                                  DIII Offshore Fund, L.P.

                                  By: Nierenberg Investment Management
                                       Offshore, Inc.

                                  Its: General Partner

March 05, 2008                    By: /s/ David Nierenberg
- --------------------                  ------------------------------------------
                                      David Nierenberg, President


                                  Nierenberg Investment Management
                                  Company, Inc.

March 05, 2008                    By: /s/ David Nierenberg
- --------------------                 -------------------------------------------
                                      David Nierenberg, President


                                  Nierenberg Investment Management
                                     Offshore, Inc.

March 05, 2008                    By: /s/ David Nierenberg
- --------------------                 -------------------------------------------
                                      David Nierenberg, President


March 05, 2008                    /s/ David Nierenberg
- --------------------              ----------------------------------------------
                                  David Nierenberg


                                       11
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-1
<SEQUENCE>2
<FILENAME>d73827_ex-1.txt
<DESCRIPTION>LETTER TO THE CHAIRMAN OF THE BOARD
<TEXT>
EXHIBIT 1:

                              THE D3 FAMILY FUNDS

March 5, 2008

John T. Casey, Chairman of the Board
O. Edwin French, President and Chief Executive Officer
Members of the Board
MedCath Corp.
10720 Sikes Place
Charlotte, NC 28277

Dear John, Ed, and members of the Board:

As your  largest  shareholders,  which have been  invested  in MedCath  for five
years, we enthusiastically  support your recent decision to invest up to $59M to
repurchase  the  Company's  shares.  At the  prices  which  you  are  paying  to
repurchase the shares, we believe that it is an excellent  investment.  Although
MedCath has the  strongest  balance sheet and the best revenue and profit growth
prospects of any American  hospital  company,  the  Company's  enterprise  value
(equity market  capitalization  plus debt minus cash) relative to its EBITDA was
only half that of its peer group on March 3. We suspect that the principal cause
for this extreme valuation anomaly is recurring market paranoia about a possible
legislative ban on physician referrals to hospitals in which they are investors.

Since this paranoia seems to be distorting the market's judgment, we are writing
you to make several  suggestions  about how MedCath  might exploit the resulting
under-valuation  for the  benefit  of those of us who want to  remain  long term
shareholders of the Company.

We do not believe that the size of your repurchase  program should be limited to
only $59M.  We do  recognize  that the $59M limit  comes from the  covenants  of
MedCath's  existing  debt.  But it is our judgment  that the Company can pay off
that debt  later this year,  thereby  removing  the $59M cap on the size of your
repurchase program. Once you do that, we would urge you to authorize the Company
to  repurchase  another  $100M of MedCath  shares,  provided this can be done at
bargain prices.

We also  would  like to  suggest  a way to fund the debt  pay-off  and the $100M
follow-on share repurchase  which we believe would not impair MedCath's  ability
to outgrow its rivals organically or via acquisition(s) of hospitals. We suggest
that MedCath do a master sale - leaseback of virtually  all of its hospital land
and buildings,  taking full advantage of the following circumstances which we do
not believe are reflected in MedCath's current book value for these assets:  cap
rates today are still relatively  attractive;  MedCath's hospitals rank first or
second in cardiac  market  share in all of its  markets;  we believe that all of
your hospitals are profitable; most of your hospitals are located in Sun Belt or
Western markets which have  attractive  demographic  growth;  your buildings are
relatively  new;  and  we  believe  that  your  land-holdings  have  appreciated
significantly in value. We therefore  believe that the proceeds from such a sale
- - leaseback, combined with MedCath's existing cash, could pay off the debt whose
covenants limit


                                       12
<PAGE>

the Company's repurchase program, and fund the repurchase of an additional $100M
of shares,  while leaving the corporate  balance sheet  sufficiently  liquid and
unencumbered to pursue any reasonable growth opportunities.

We  would  like to  conclude  with an  observation  about  the  market  paranoia
referenced  earlier.  After  five  years  of  being  loyal,  supportive  MedCath
stockholders,  we must  admit  that  we  have  become  tired  of this  recurring
political bogeyman about banning physician ownership.  It doesn't seem to matter
which party  controls the  Congress or who chairs the relevant  committees - the
American  Hospital  Association and its friends on Capitol Hill do not let go of
their  crusade.  Worries about this issue  periodically  crush  MedCath's  share
price, artificially  exacerbating its volatility,  and raising MedCath's cost of
capital.

You know and we know that there are elements of unreal  political  theatre about
this;  the  claims  made by AHA and its  allies  do not  comport  with  economic
reality.  Perhaps this should not surprise,  for as former  Senator Alan Simpson
said,  "Those  who  travel  the high  road in  Washington  need  not fear  heavy
traffic."  We all know that many AHA  hospitals  partner  with their  physicians
whenever they believe it is advantageous to do so. Certainly the  not-for-profit
hospital  of  which  I am  Vice  Chair  does  so.  Why  is it  acceptable  for a
not-for-profit to do this but objectionable  when a for-profit does? Because the
for-profits are better competitors. We know that the principal reason physicians
refer cases to, and  practice  in,  MedCath  hospitals  is not because  they are
investors  in the  hospitals.  Rather,  it is  because,  unlike  most  community
hospitals,  MedCath's hospitals are designed, operated, and governed to maximize
physician  productivity.  Productive time is the only asset doctors can sell. We
therefore do not doubt that, even if Congress were to ban physician  investment,
doctors would still prefer practicing in MedCath's hospitals.

MedCath may have been too  oppositional to  Congressional  efforts to change the
rules of the game.  Maybe this year,  instead,  you should  find the best way to
resolve your differences, to finally put this largely shadow-boxing issue behind
you, once and for all. Wouldn't it be better if all MedCath  management's  time,
and all the Company's  money,  were focused,  not on constant  lobbying,  but on
building the intrinsic value of MedCath's  business?  Wouldn't it be terrific if
you could put an end to this recurring  political paranoia and bear raids on the
stock?  If you finally could reach closure on this issue,  we believe  MedCath's
valuation  could double to eight times cash flow instead of four. (And with your
excellent growth opportunities,  the share price could climb much further.) But,
until then, we urge you to repurchase as many shares as you prudently can! Carpe
diem.

Thanks for considering our views,

Sincerely yours,


David Nierenberg

       Nierenberg Investment Management Company, Inc. 19605 NE 8th Street,
                     Camas, Washington 98607 (360) 604-8600
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-2
<SEQUENCE>3
<FILENAME>d73827_ex-2.txt
<DESCRIPTION>JOINT FILING AGREEMENT (RESTATED)
<TEXT>

EXHIBIT 2:

                        JOINT FILING AGREEMENT (RESTATED)

      WHEREAS, the undersigned (collectively, the "Reporting Persons") from time
to time make filings with the  Securities  and Exchange  Commission  pursuant to
Regulation 13D-G under the Securities Exchange Act of 1934, as amended; and

      WHEREAS,  the Reporting  Persons prefer to make joint filings on behalf of
all Reporting  Persons rather than  individual  filings on behalf of each of the
Reporting Persons;

      NOW,  THEREFORE,  the undersigned hereby agree as follows with each of the
other Reporting Persons:

      1. Each of the Reporting  Persons is  individually  eligible to make joint
filings.

      2. Each of the Reporting  Persons is  responsible  for timely making joint
filings and any amendments thereto.

      3. Each of the Reporting  Persons is responsible for the  completeness and
accuracy of the information concerning such person contained in joint filings.

      4. None of the Reporting  Persons is responsible  for the  completeness or
accuracy of the information  concerning the other Reporting Persons contained in
joint  filings,  unless  such  person  knows or has reason to believe  that such
information is inaccurate.

      5. This Joint Filing Agreement  amends,  restates and supersedes the Joint
Filing  Agreement  (Restated)  dated August 3, 2007 by and among  certain of the
undersigned, but only as to those filings to be made by all Reporting Persons.


                                       13
<PAGE>

      6. The undersigned  agree that each joint filing made on or after the date
hereof will be, and any amendment thereto will be, made on behalf of each of the
Reporting Persons.

                                         D3 Family Fund, L.P., D3 Bulldog Fund,
                                         L.P. and D3 Family Canadian Fund, L.P.


                                         By: Nierenberg Investment Management
                                              Company, Inc.

                                         Its: General Partner

March 5, 2008                            By:
                                            ------------------------------------
                                               David Nierenberg, President


                                         DIII Offshore Fund, L.P.

                                         By: Nierenberg Investment Management
                                              Offshore, Inc.

                                         Its: General Partner

March 5, 2008                            By:
                                            ------------------------------------
                                               David Nierenberg, President


                                         Nierenberg Investment Management
                                              Company, Inc.

March 5, 2008                            By:
                                            ------------------------------------
                                               David Nierenberg, President


                                         Nierenberg Investment Management
                                              Offshore, Inc.

March 5, 2008                            By:
                                            ------------------------------------
                                               David Nierenberg, President

</TEXT>
</DOCUMENT>