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                                                               EXHIBIT 10.15.2.4

               AMENDMENT TO CHANGE-IN-CONTROL SEVERANCE AGREEMENT

     This Amendment to the Change-In-Control Severance Agreement ("Agreement")
made as of May 1,1998 between Ventas, Inc., a Delaware corporation (the
"Company"), and T. Richard Riney (the "Employee") is made as of September 30,
1999.

                                   WITNESSETH:

     WHEREAS, the Employee and the Company entered into the Agreement;

     WHEREAS, the Board of Directors of the Company have determined that it is
in the best interests of the Company to enter into this Amendment to the
Agreement.

     NOW, THEREFORE, the Company and Employee agree as follows:

     1.   The following is added as Section 4A. Tax Payment to the Agreement:

          "4A. Tax Payment. For purposes of determining the amount of payments
          pursuant to Sections 4 and 8 in this Agreement, the Employee shall be
          deemed to pay federal income taxes at the highest marginal rate of
          federal income taxation in the calendar year in which the payment is
          to be made and state and local income taxes at the highest marginal
          rates of taxation in the state and locality of the Employee's
          residence or the Employee's place of business, whichever is higher, on
          the date the payment is to be made. Without limitation on any other
          provision of this Agreement, all such payments involving the
          calculation of taxes shall be made no later than two (2) days after
          the receipt by the Company of written advice from a professional tax
          advisor selected by the Employee that taxes are payable. The expense
          incurred in obtaining such advice shall be paid by the Company.
          Without limitation on any other provisions of this Agreement, the
          Company shall indemnify Employee for all taxes with respect to the
          amounts for which payments described in the first sentence of this
          Section are required to be made pursuant to this Agreement and all
          other costs including interest and penalties with respect to the
          payment of such taxes. To the extent any of the payments pursuant to
          this Section are treated as taxable to the Employee, the Company shall
          pay Employee an additional amount such that the net amount retained by
          the Employee after deduction or payment of all federal, state, local
          and other taxes with respect to amounts pursuant to this Section shall
          be equal to the full amount of the payments required by this Section."

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     2.   The following sentence is added at the end of Section 8
Disputes to the Agreement:

          "To the extent any of the payments within this Section are treated as
          taxable to the Employee, the Company shall pay Employee an additional
          amount such that the net amount retained by Employee after deduction
          or payment of all federal, state, local and other taxes with respect
          to amounts under this Section shall be equal to the full amount of the
          payments required by this Section."

     3.   In all other respects, the Agreement shall continue in full force and
effect.

                                      VENTAS, INC.


                                      By: /s/ Debra A. Cafaro
                                         ------------------------------------
                                            Debra A. Cafaro, President and Chief
                                            Executive Officer


                                      EMPLOYEE


                                      By: /s/ T. Richard Riney
                                         ------------------------------------
                                            T. Richard Riney