Exhibit
10.19  THIRD
AMENDMENT TO
AMENDED AND RESTATED MASTER LEASE AGREEMENT
(LEASE NO. 1)  THIS
THIRD AMENDMENT TO AMENDED AND RESTATED MASTER LEASE AGREEMENT (LEASE NO. 1)(this Amendment) is made and
entered into as of December 10, 2009 by and among each of the parties
identified on the signature pages hereof as a landlord (collectively, Landlord)
and FIVE STAR QUALITY CARE TRUST, a Maryland business trust (Tenant).  WI T N E S S E T H:  WHEREAS, pursuant to the terms of that certain
Amended and Restated Master Lease Agreement (Lease No. 1), dated as of August 4,
2009, as amended by that certain Partial Termination of and First Amendment to
Amended and Restated Master Lease Agreement (Lease No. 1), dated as of October 1,
2009, and that certain Second Amendment to Amended and Restated Master Lease
Agreement (Lease No. 1), dated as of November 17, 2009 (as so
amended, Amended Lease No. 1), Landlord leases to Tenant, and
Tenant leases from Landlord, the Leased Property (this and other capitalized terms
used but not otherwise defined herein having the meanings given such terms in
Amended Lease No. 1), all as more particularly described in Amended Lease No. 1;
and  WHEREAS, on or about the date hereof, SNH/LTA
Properties GA LLC has acquired certain real property and related improvements known as Eastside Gardens and located at 2078
Scenic Highway North, Snellville, Georgia 30078, as more particularly
described on Exhibit A-60 attached hereto (the Eastside Gardens
Property); and  WHEREAS,SNH/LTA Properties GA LLC, the other
entities comprising Landlord and Tenant wish to amend Amended Lease No. 1
to include the Eastside Gardens Property;  NOW,
THEREFORE, in
consideration of the mutual covenants herein contained and other good and
valuable consideration, the mutual receipt and legal sufficiency of which are
hereby acknowledged, Landlord and Tenant hereby agree that, effective as of the
date hereof, Amended Lease No. 1 is hereby amended as follows:  1.Definition of Minimum Rent. 
The defined term Minimum Rent set forth in Section 1.68 of
Amended Lease No. 1 is hereby deleted in its entirety and replaced with
the following:


Minimum
Rentshall mean the sum of Fifty-Two Million Seven
Hundred Twenty-Two Thousand Three Hundred Twenty-Three and 49/100s Dollars
($52,722,323.49) per annum.  2.Leased Property.  Section 2.1
of Amended Lease No. 1 is hereby amended by deleting subsection (a) therefrom
in its entirety and replacing it with the following:  (a)those certain tracts, pieces and parcels
of land as more particularly described on Exhibits A-1 through A-60
attached hereto and made a part hereof (the Land).  3.Schedule 1.  Schedule 1 to
Amended Lease No. 1 is hereby deleted in its entirety and replaced with Schedule
1 attached hereto.  4.Exhibit A.  Exhibit A
to Amended Lease No. 1 is hereby amended by adding Exhibit A-60
attached hereto immediately following Exhibit A-59 to Amended Lease No. 1.  5.Ratification. 
As amended hereby, Amended Lease No. 1 is hereby ratified and
confirmed.  [Remainder of page intentionally left blank;signature pages follow]  2


IN WITNESS WHEREOF, the parties have executed
this Amendment as a sealed instrument as of the date above first written.  LANDLORD:SNH SOMERFORD PROPERTIES TRUSTBy:
  /s/ Richard A. DoyleRichard A. DoyleTreasurerSPTMNR PROPERTIES TRUSTBy:
  /s/ Richard A. DoyleRichard A. DoyleTreasurerSNH/LTA PROPERTIES TRUSTBy:
  /s/ Richard A. DoyleRichard A. DoyleTreasurerSPTIHS PROPERTIES TRUSTBy:
  /s/ Richard A. DoyleRichard A. DoyleTreasurerSNH CHS PROPERTIES TRUSTBy:
  /s/ Richard A. DoyleRichard A. DoyleTreasurer  -Signature Page to Third
Amendment-


SNH/LTA PROPERTIES GA LLCBy:
  /s/ Richard A. DoyleRichard A. DoyleTreasurerTENANT:FIVE STAR QUALITY CARE TRUSTBy:
  /s/ Francis R. Murphy
  IIIFrancis R. Murphy IIITreasurer  -Signature Page to Third
Amendment-


EXHIBIT
A-60  Eastside
Gardens
2078 Scenic Highway North
Snellville, Georgia 30078  Certain attachments to the Exhibits to this agreement have been
omitted. The Company agrees to furnish supplementally copies of any of the
omitted attachments to the Exhibits to the Securities and Exchange Commission
upon request.


SCHEDULE 1  PROPERTY-SPECIFIC INFORMATION  Exhibit
  
  Property Address
  
  Base Gross
  Revenues(Calendar
  Year)
  
  Base Gross
  Revenues(Dollar Amount)
  
  Commencement
  Date
  
  Interest
  RateA-1
  
  La
  Mesa Healthcare Center
  2470 South Arizona Avenue
  Yuma, AZ 85364
  
  2005
  
  $
  6,333,157
  
  12/31/2001
  
  10
  %A-2
  
  SunQuest
  Village of Yuma
  265 East 24thStreet
  Yuma, AZ 85364
  
  2005
  
  $
  543,595
  
  12/31/2001
  
  10
  %A-3
  
  Somerford
  Place - Encinitas
  1350 South El Camino Real
  Encinitas, CA 92024
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-4
  
  Somerford
  Place - Fresno
  6075 North Marks Avenue
  Fresno, CA 93711
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-5
  
  Lancaster
  Healthcare Center
  1642 West Avenue J
  Lancaster, CA 93534
  
  2005
  
  $
  6,698,648
  
  12/31/2001
  
  10
  %A-6
  
  Somerford
  Place - Redlands
  1319 Brookside Avenue
  Redlands, CA 92373
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-7
  
  Somerford
  Place - Roseville
  110 Sterling Court
  Roseville,
  CA 95661
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-8
  
  Leisure
  Pointe
  1371 Parkside Drive
  San Bernardino, CA 92404
  
  2007
  
  $
  1,936,220
  
  09/01/2006
  
  8.25
  %A-9
  
  Van Nuys Health Care Center
  6835 Hazeltine Street
  Van Nuys, CA 91405
  
  2005
  
  $
  3,626,353
  
  12/31/2001
  
  10
  %A-10
  
  Mantey
  Heights Rehabilitation & Care Center
  2825 Patterson Road
  Grand Junction, CO 81506
  
  2005
  
  $
  5,564,949
  
  12/31/2001
  
  10
  %A-11
  
  Cherrelyn
  Healthcare Center
  5555 South Elati Street
  Littleton, CO 80120
  
  2005
  
  $
  12,574,200
  
  12/31/2001
  
  10
  %


Exhibit
  
  Property Address
  
  Base Gross
  Revenues(Calendar
  Year)
  
  Base Gross
  Revenues(Dollar Amount)
  
  Commencement
  Date
  
  Interest
  RateA-12
  
  Somerford House and Somerford Place - Newark I & II
  501 South Harmony Road
  and
  4175 Ogletown Road
  Newark, DE 19713
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-13
  
  Tuscany
  Villa Of Naples
  (aka Buena Vida)
  8901 Tamiami Trail East
  Naples, FL 34113
  
  2008
  
  $
  2,157,675
  
  09/01/2006
  
  8.25
  %A-14
  
  College
  Park Healthcare Center
  1765 Temple Avenue
  College Park, GA 30337
  
  2005
  
  $
  4,130,893
  
  12/31/2001
  
  10
  %A-15
  
  Morningside
  of Columbus
  7100 South Stadium Drive
  Columbus, GA 31909
  
  2006
  
  $
  1,381,462
  
  11/19/2004
  
  9
  %A-16
  
  Morningside of Dalton
  2470 Dug Gap Road
  Dalton, GA 30720
  
  2006
  
  $
  1,196,357
  
  11/19/2004
  
  9
  %A-17
  
  Morningside
  of Evans
  353 North Belair Road
  Evans, GA 30809
  
  2006
  
  $
  1,433,421
  
  11/19/2004
  
  9
  %A-18
  
  Vacant
  Land Adjacent to Morningside of Macon
  6191 Peake Road
  Macon, GA 31220
  
  2006
  
  N/A
  
  11/19/2004
  
  9
  %A-19
  
  Intentionally
  Deleted.A-20
  
  Union
  Park Health Services
  2401 East 8thStreet
  Des Moines, IA 50316
  
  2005
  
  $
  4,404,678
  
  12/31/2001
  
  10
  %A-21
  
  Park Place
  114 East Green Street
  Glenwood, IA 51534
  
  2005
  
  $
  8,109,512
  
  12/31/2001
  
  10
  %A-22
  
  Prairie
  Ridge Care & Rehabilitation
  608 Prairie Street
  Mediapolis, IA 52637
  
  2005
  
  $
  3,234,505
  
  12/31/2001
  
  10
  %A-23
  
  Ashwood
  Place
  102 Leonardwood
  Frankfort, KY 40601
  
  2007
  
  $
  1,769,726
  
  09/01/2006
  
  8.25
  %A-24
  
  Somerford
  Place - Annapolis
  2717 Riva Road
  Annapolis, MD 21401
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-25
  
  Somerford
  Place - Columbia
  8220 Snowden River Parkway
  Columbia, MD 21045
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-26
  
  Somerford
  Place - Frederick
  2100 Whittier Drive
  Frederick, MD 21702
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %


Exhibit
  
  Property Address
  
  Base Gross
  Revenues(Calendar
  Year)
  
  Base Gross
  Revenues(Dollar Amount)
  
  Commencement
  Date
  
  Interest
  RateA-27
  
  Somerford
  Place - Hagerstown
  10114 & 10116 Sharpsburg Pike
  Hagerstown, MD 21740
  
  2009
  
  N/A
  
  03/31/2008
  
  8
  %A-28
  
  The
  Wellstead of Rogers
  20500 and 20600
  South Diamond Lake Road
  Rogers, MN 55374
  
  2009
  
  N/A
  
  03/01/2008
  
  8
  %A-29
  
  Arbor
  View Healthcare & Rehabilitation
  (aka Beverly Manor)
  1317 North 36th St
  St. Joseph, MO 64506
  
  2005
  
  $
  4,339,882
  
  12/31/2001
  
  10
  %A-30
  
  Hermitage
  Gardens of Oxford
  1488 Belk Boulevard
  Oxford, MS 38655
  
  2007
  
  $
  1,816,315
  
  10/01/2006
  
  8.25
  %A-31
  
  Hermitage
  Gardens of Southaven
  108 Clarington Drive
  Southaven, MS 38671
  
  2007
  
  $
  1,527,068
  
  10/01/2006
  
  8.25
  %A-32
  
  Ashland
  Care Center
  1700 Furnace Street
  Ashland, NE 68003
  
  2005
  
  $
  4,513,891
  
  12/31/2001
  
  10
  %A-33
  
  Blue Hill Care Center
  414 North Wilson Street
  Blue Hill, NE 68930
  
  2005
  
  $
  2,284,065
  
  12/31/2001
  
  10
  %A-34
  
  Central City Care Center
  2720 South 17thAvenue
  Central City, NE 68462
  
  2005
  
  $
  2,005,732
  
  12/31/2001
  
  10
  %A-35
  
  Rose
  Brook Care Center
  106 5thStreet
  Edgar, NE 68935
  
  2005
  
  $
  1,862,074
  
  12/31/2001
  
  10
  %A-36
  
  Gretna
  Community Living Center
  700 South Highway 6
  Gretna, NE 68028
  
  2005
  
  $
  3,380,356
  
  12/31/2001
  
  10
  %A-37
  
  Sutherland
  Care Center
  333 Maple Street
  Sutherland, NE 69165
  
  2005
  
  $
  2,537,340
  
  12/31/2001
  
  10
  %A-38
  
  Waverly Care Center
  11041 North 137thStreet
  Waverly, NE 68462
  
  2005
  
  $
  3,066,135
  
  12/31/2001
  
  10
  %A-39
  
  Rolling Hills Manor
  600 Newport Drive
  Baldwin, PA 15234
  
  2006
  
  $
  1,791,274
  
  10/31/2005
  
  9
  %A-40
  
  Ridgepointe
  5301 Brownsville Road
  Pittsburgh, PA 15236
  
  2006
  
  $
  1,944,499
  
  10/31/2005
  
  9
  %A-41
  
  Mount
  Vernon of South Park
  1400 Riggs Road
  South Park, PA 15129
  
  2006
  
  $
  2,718,057
  
  10/31/2005
  
  9
  %A-42
  
  Morningside
  of Gallatin
  1085 Hartsville Pike
  Gallatin, TN 37066
  
  2006
  
  $
  1,343,801
  
  11/19/2004
  
  9
  %


Exhibit
  
  Property Address
  
  Base Gross
  Revenues(Calendar
  Year)
  
  Base Gross
  Revenues(Dollar Amount)
  
  Commencement
  Date
  
  Interest
  RateA-43
  
  Walking
  Horse Meadows
  207 Uffelman Drive
  Clarksville,
  TN 37043
  
  2007
  
  $
  1,471,410
  
  01/01/2007
  
  8.25
  %A-44
  
  Morningside
  of Belmont
  1710 Magnolia Boulevard
  Nashville, TN 37212
  
  2006
  
  $
  3,131,648
  
  06/03/2005
  
  9
  %A-45
  
  Dominion Village at Chesapeake
  2856 Forehand Drive
  Chesapeake, VA 23323
  
  2005
  
  $
  1,416,951
  
  05/30/2003
  
  10
  %A-46
  
  Dominion Village at Williamsburg
  4132 Longhill Road
  Williamsburg, VA 23188
  
  2005
  
  $
  1,692,753
  
  05/30/2003
  
  10
  %A-47
  
  Heartfields
  at Richmond
  500 North Allen Avenue
  Richmond, VA 23220
  
  2005
  
  $
  1,917,765
  
  10/25/2002
  
  10
  %A-48
  
  Brookfield
  Rehabilitation and Specialty Care (aka Woodland Healthcare Center)
  18741 West Bluemound Road
  Brookfield, WI 53045
  
  2005
  
  $
  13,028,846
  
  12/31/2001
  
  10
  %A-49
  
  Meadowmere
  - Southport Assisted Living
  8350 and 8351 Sheridan Road
  Kenosha, WI 53143
  
  2009
  
  N/A
  
  01/04/2008
  
  8
  %A-50
  
  Meadowmere
  - Madison Assisted Living
  5601 Burke Road
  Madison, WI 53718
  
  2009
  
  N/A
  
  01/04/2008
  
  8
  %A-51
  
  Sunny
  Hill Health Care Center
  4325 Nakoma Road
  Madison, WI 53711
  
  2005
  
  $
  3,237,633
  
  12/31/2001
  
  10
  %A-52
  
  Mitchell
  Manor Senior Living
  5301 West Lincoln Avenue
  West Allis, WI 53219
  
  2009
  
  N/A
  
  01/04/2008
  
  8
  %A-53
  
  Laramie
  Care Center
  503 South 18thStreet
  Laramie, WY 82070
  
  2005
  
  $
  4,473,949
  
  12/31/2001
  
  10
  %A-54
  
  Haven
  in Highland Creek
  5920 McChesney Drive
  Charlotte, NC 28269
  Laurels in Highland Creek
  6101 Clark Creek Parkway
  Charlotte, NC 28269
  
  2010
  
  N/A
  
  11/17/2009
  
  8.75
  %


Exhibit
  
  Property Address
  
  Base Gross
  Revenues(Calendar
  Year)
  
  Base Gross
  Revenues(Dollar Amount)
  
  Commencement
  Date
  
  Interest
  RateA-55
  
  Haven
  in the Village at Carolina Place
  13150 Dorman Road
  Pineville, NC 28134
  Laurels in the Village at Carolina Place
  13180 Dorman Road
  Pineville, NC 28134
  
  2010
  
  N/A
  
  11/17/2009
  
  8.75
  %A-56
  
  Haven
  in the Summit
  3 Summit Terrace
  Columbia, SC 29229
  
  2010
  
  N/A
  
  11/17/2009
  
  8.75
  %A-57
  
  Haven
  in the Village at Chanticleer
  355 Berkmans Lane
  Greenville, SC 29605
  
  2010
  
  N/A
  
  11/17/2009
  
  8.75
  %A-58
  
  Haven
  in the Texas Hill Country
  747 Alpine Drive
  Kerrville, TX 78028
  
  2010
  
  N/A
  
  11/17/2009
  
  8.75
  %A-59
  
  Haven
  in Stone Oak
  511 Knights Cross Drive
  San Antonio, TX 78258
  Laurels in Stone Oak
  575 Knights Cross Drive
  San Antonio, TX 78258
  
  2010
  
  N/A
  
  11/17/2009
  
  8.75
  %A-60
  
  Eastside Gardens
  2078 Scenic Highway North
  Snellville, Georgia 30078
  
  2010
  
  N/A
  
  12/10/2009
  
  8.75
  %