Document:

Ex1018

		

			Exhibit 10.18

		

		
			AMENDMENT NO. 5
TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT
		

		
			This AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT (this “Amendment”) is dated as of December 3, 2019 and is entered into by and among GENESIS HEALTHCARE, INC., a Delaware corporation (“Genesis Healthcare”), GENESIS HEALTHCARE LLC, a Delaware limited liability company (“Genesis Holdings”), FC-GEN OPERATIONS INVESTMENT, LLC, a Delaware limited liability company (“LLC Parent”), Genesis Healthcare’s direct and indirect subsidiaries listed on Annex I-A hereto (together with Genesis Healthcare, Genesis Holdings and LLC Parent, collectively, “Borrowers”), MIDCAP FUNDING IV TRUST, a Delaware statutory trust, as administrative agent (successor-by-assignment to Healthcare Financial Solutions, LLC, in such capacity, the “Administrative Agent”), and the Lenders party hereto and is made with reference to (i) that certain Fourth Amended and Restated Credit Agreement, dated as of March 6, 2018 (as amended or modified prior to the date hereof, and as further amended, amended and restated, supplemented or otherwise modified prior to the date hereof, the “Credit Agreement”), by and among Genesis Healthcare, certain Subsidiaries of Genesis Healthcare from time to time party thereto, the lenders from time to time party thereto and the Administrative Agent and (ii) that certain Third Amended and Restated Security, Guarantee and Collateral Agreement, dated as of March 6, 2018 (as amended or modified prior to the date hereof, and as further amended, amended and restated, supplemented or otherwise modified prior to the date hereof, the “Security Agreement”), made by Genesis Healthcare, the other entities party thereto as Borrowers (as such term is defined therein), the parties thereto as Guarantors (as such term is defined therein) and each other Person (as such term is defined therein) becoming party thereto pursuant to Section 8.14 therein in favor of Administrative Agent for the Secured Parties.  Unless otherwise stated, capitalized terms used herein without definition shall have the same meanings herein as set forth in the Credit Agreement.
		

		
			RECITALS
		

		
			WHEREAS,  Borrowers have requested, and Administrative Agent and the Lenders have agreed, to amend the Credit Agreement and the Security Agreement as set forth in this Amendment.
		

		
			NOW, THEREFORE, in consideration of the premises and the agreements, provisions and covenants herein contained, the parties hereto agree as follows:
		

			
	
			
				 SECTION I.
			AMENDMENTS TO CREDIT AGREEMENT Subject to the terms and conditions of this Amendment, including, without limitation, the conditions to effectiveness set forth in Section III below, the Credit Agreement is amended as follows.

			
	
			
				 1.1
			New Defined Terms.  The following definition shall be added under Section 1.1 of the Credit Agreement in alphabetical order:

		
			“Investment Threshold Date” shall mean September 12, 2019. 
		

		
			

		 

			

					

						 

					

					

						 

					

					

						 

				

		

			 

		

		

			
	
			
				 1.2
			Amended Defined Terms. The definition of “Termination Fee” set forth in Section 1.1 of the Credit Agreement is hereby deleted in its entirety and restated to read as follows:

		
			“Termination Fee” means, as applicable:
		

			
	
			
				 (a)
			the fee payable upon prepayment of the Revolving Credit Facility pursuant to Sections 2.7, 2.8 and 9.2 in an amount equal to (i) if such prepayment is made prior to the second anniversary of the Closing Date, 2.0% of the portion of the Revolving Credit Commitment terminated and (ii) on or after the second anniversary of the Closing Date, 1.5% of the Revolving Credit Commitment terminated; and 

			
	
			
				 (b)
			the fee payable upon prepayment of the Closing Date Term Loan pursuant to Sections 2.7, 2.8 and 9.2 in an amount equal to (i) if such prepayment is made prior to the second anniversary of the Closing Date, 2.0% of Closing Date Term Loan prepaid and (ii) on or after the second anniversary of the Closing Date, 1.5% of the Closing Date Term Loan prepaid; 

		
			provided, that following a refinancing of the Obligations in connection with which MCF serves as the administrative agent and a lender, MCF’s Pro Rata Share of the Termination Fee shall be waived.”
		

			
	
			
				 1.3
			Minimum Liquidity.  Section 5.6 of the Credit Agreement is hereby deleted in its entirety and restated to read as follows:

		
			“5.6Minimum Liquidity.  Permit the Liquidity of Ultimate Parent its Subsidiaries (other than Non-Borrower Subsidiaries but including HUD Sub-Facility Entities) on a Consolidated Basis, as of the last day of each calendar month to be less than $55,000,000.”
		

			
	
			
				 1.4
			Liens; Put and Call Arrangements.  Section 8.2(w) of the Credit Agreement is hereby deleted in its entirety and restated to read as follows:

		
			“(w) in the case of any Investments in joint ventures permitted under Section 8.4(t) hereof, any put and call arrangements related to its Equity Interests and Equity Equivalents set forth in its Constituent Documents or any related joint venture or similar agreement;”
		

			
	
			
				 1.5
			Liens; Joint Ventures.  Section 8.2(y) of the Credit Agreement is hereby deleted in its entirety and restated to read as follows:

		
			“(y)Liens in the Equity Interests or Equity Equivalents of a joint venture granted in connection with the pledge or transfer of the Equity Interests or Equity Equivalents of a joint venture permitted under Section 8.4(t) hereof;”
		

			
	
			
				 1.6
			Investments.  Section 8.4(t) of the Credit Agreement is hereby deleted in its entirety and restated to read as follows:

		
			

		 

			

					

						 

					

					

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			“(t)so long as no Default or Event of Default shall have occurred and be continuing at the time thereof or would result therefrom, Investments in joint ventures in an amount not to exceed $100,000,000 at any time outstanding, provided (i) such Investments were in existence as of, and including, the Investment Threshold Date or (ii) such Investments are made in connection with that certain joint venture transaction with New Generation Health, LLC and known as Bold Quail Holdings LLC.”
		

			
	
			
				 SECTION II.
			AMENDMENT TO SECURITY AGREEMENT

		
			Excluded Assets.  Subject to the terms and conditions of this Amendment, including, without limitation, the conditions to effectiveness set forth in Section III below, clause (vii) of the definition of “Excluded Assets” set forth in the proviso of Section 3.1 of the Security Agreement is hereby deleted in its entirety and restated to read as follows:
		

		
			(vii)interests in partnerships, joint ventures and Subsidiaries whose Equity Interests are not all owned by a Grantor, Investments in which are permitted pursuant to Section 8.4(t) of the Credit Agreement, which interests cannot be pledged without the consent of one or more third parties except to the extent the prohibition is with respect to a tenant or any other entity under a Material Master Lease or its Subsidiaries in a Material Master Lease (unless otherwise restricted or limited by the Master Lease Intercreditor Agreements and any other intercreditor agreement entered into pursuant to Section 7.16 of the Credit Agreement) or is ineffective under the applicable anti-assignment provisions under 9-406, 9-407, 9-408 or 9-409 of the UCC or other Requirement of Law; provided that the Borrowers shall use commercially reasonable efforts to obtain any required consent from the applicable third party;
		

			
	
			
				 SECTION III.
			CONDITIONS TO EFFECTIVENESS

		
			This Amendment shall become effective as of the date hereof only upon Administrative Agent’s receipt of this fully executed Amendment which shall be originals, facsimiles or “pdf” or similar electronic format (followed promptly by originals) unless otherwise specified, properly executed by a Responsible Officer of the signing Loan Party and each Lender whose consent is required hereunder.  
		

			
	
			
				 SECTION IV.
			Costs, Fees and Expenses.  

		
			Borrowers shall be responsible for the payment of all reasonable costs, fees and expenses of Agent’s counsel incurred in connection with the preparation of this Amendment and any related documents.  If Administrative Agent uses in-house counsel for any of these purposes, Borrowers shall be responsible for reasonable charges for such work commensurate with the fees that would otherwise be charged by outside legal counsel selected by Administrative Agent for the work performed; provided that, in accordance with Section 11.3 of the Credit Agreement, the rate charged for such work performed by in-house counsel shall not exceed $450.00 per hour, and Borrowers shall not be liable for in-house legal fees for the same matters on which outside legal counsel has been engaged.  All such costs, fees and expenses shall be paid with proceeds of Revolving Loans.
		

		
			

		 

			

					

						 

					

					

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				 SECTION V.
			Confirmation of Representations and Warranties; Liens; No Default. 

		
			Each Loan Party that is party hereto hereby confirms that (i) all of the representations and warranties set forth in the Loan Documents to which it is a party continue to be true and correct in all material respects as of the date hereof as if made on the date hereof and as if fully set forth herein, except to the extent (A) such representations and warranties by their terms expressly relate only to a prior date (in which case such representations and warranties shall be true and correct in all material respects as of such prior date) or (B) any such representation or warranty is no longer true, correct or complete due to the occurrence of one or more events that are permitted to occur (or are not otherwise prohibited) under the Loan Documents, (ii) there are no continuing Defaults or Events of Default that have not been waived or cured, (iii) subject to the terms and conditions of the Loan Documents, Administrative Agent has and shall continue to have valid, enforceable and perfected Liens on the Collateral with the priority set forth in the Intercreditor Agreement, for the benefit of the Secured Parties, pursuant to the Loan Documents or otherwise granted to or held by Administrative Agent, for the benefit of the Secured Parties, subject only to Permitted Liens, and (iv) the agreements and obligations of Borrowers and each other Loan Party contained in the Loan Documents and in this Amendment constitute the legal, valid and binding obligations of Borrowers and each other Loan Party, enforceable against Borrowers and each other Loan Party in accordance with their respective terms, except to the extent limited by general principles of equity and by bankruptcy, insolvency, fraudulent conveyance, or other similar laws affecting creditors’ rights generally.
		

			
	
			
				 SECTION VI.
			REAFFIRMATION OF LOAN DOCUMENTS

			
	
			
				 6.1
			By executing and delivering this Amendment, each Loan Party hereby (i) reaffirms, ratifies and confirms its Obligations under the Loan Documents, each as may be amended hereby, (ii) agrees that this Amendment shall be a “Loan Document” under the Credit Agreement and (iii) hereby expressly agrees that the Credit Agreement, the Security Agreement and each other Loan Document shall remain in full force and effect as modified by this Amendment. Each Lender executing this Amendment hereby declines the issuance of one or more Notes evidencing its Commitment.

			
	
			
				 6.2
			Without limiting the generality of the foregoing, each Loan Party hereby confirms its pledges, grants of security interests and other obligations, as applicable, under and subject to the terms of each of the Loan Documents to which it is party, and agrees that, notwithstanding the effectiveness of this Amendment or any of the transactions contemplated thereby, such pledges, grants of security interests and other obligations, and the terms of each of the Loan Documents to which it is a party, as supplemented, amended, amended and restated or otherwise modified in connection with this Amendment and the transactions contemplated hereby, are not impaired or affected in any manner whatsoever and shall continue to be in full force and effect and shall continue to secure all the Obligations.

			
	
			
				 SECTION VII.
			RELEASE OF ADMINISTRATIVE AGENT AND LENDERS

		
			As of the date of this Amendment, each Loan Party (a) agrees that, to its knowledge, Administrative Agent and each Lender has fully complied with its obligations under each Loan 

		 

			

					

						 

					

					

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Document required to be performed prior to the date hereof, (b) agrees that no Loan Party has any defenses to the validity, enforceability or binding effect of any Loan Document and (c) fully and irrevocably releases any claims of any nature whatsoever that it may now have against Administrative Agent, and each Lender and relating in any way to this Amendment, the Loan Documents or the transactions contemplated hereby or thereby.
		

			
	
			
				 SECTION VIII.
			MISCELLANEOUS

			
	
			
				 8.1
			Effect on Other Loan Documents.  Except as expressly set forth in this Amendment, the Credit Agreement, the Security Agreement and all other Loan Documents shall remain unchanged and in full force and effect. This Amendment shall be limited precisely and expressly as drafted and shall not be construed as consent to the amendment, restatement, modification, supplementation or waiver of any other terms or provisions of the Credit Agreement, the Security Agreement or any other Loan Document.

			
	
			
				 8.2
			Headings.  Section headings herein and in the other Loan Documents are included for convenience of reference only and shall not affect the interpretation of this Amendment or any other Loan Document.

			
	
			
				 8.3
			Loan Document.  This Amendment shall constitute a “Loan Document” under the terms of the Credit Agreement.

			
	
			
				 8.4
			Costs and Expenses. The payment of all fees, costs and expenses incurred by Administrative Agent in connection with the preparation and negotiation of this Amendment shall be governed by Section 11.3 of the Credit Agreement.

			
	
			
				 8.5
			Successors/Assigns. This Amendment shall bind, and the rights hereunder shall inure to, the respective successors and assigns of the parties hereto, subject to the provisions of the Loan Documents.

			
	
			
				 8.6
			Applicable Law; Miscellaneous.  THIS AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK WITHOUT REGARD TO PRINCIPLES OF CONFLICTS OF LAW THAT WOULD RESULT IN THE APPLICATION OF ANY LAW OTHER THAN THE LAW OF THE STATE OF NEW YORK.  The provisions of Sections 11.13, 11.14 and 11.15 of the Credit Agreement are incorporated by reference herein and made a part hereof.

			
	
			
				 8.7
			Counterparts.  This Amendment may be executed in any number of counterparts and by different parties in separate counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement. Signature pages may be detached from multiple separate counterparts and attached to a single counterpart. Delivery of an executed signature page of this Amendment by facsimile transmission or Electronic Transmission shall be as effective as delivery of a manually executed counterpart hereof. Any party delivering an executed counterpart of this Amendment by facsimile transmission or Electronic Transmission shall also deliver an original executed counterpart of this Amendment but the failure to deliver an original executed counterpart shall not affect the validity, enforceability or binding effect of this Amendment.

		
			

		 

			

					

						 

					

					

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				 8.8
			Further Assurances.  Each of the Loan Parties shall execute and deliver such additional documents and take such additional actions as may be reasonably requested by Administrative Agent to effectuate the purposes of this Amendment.

		
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						BORROWERS:

					
					
						GENESIS HEALTHCARE, INC., a Delaware corporation

By:
  /s/ Michael S. Sherman
Michael S. Sherman
     Senior Vice President, Secretary and Assistant Treasurer

				
	
					
						 

					
					
						FC-GEN OPERATIONS INVESTMENT, LLC, a Delaware limited liability company

By:
  /s/ Michael S. Sherman
Michael S. Sherman
Senior Vice President, Secretary and Assistant Treasurer

				
	
					
						 

					
					
						GENESIS HEALTHCARE LLC, a Delaware limited liability company

By:
  /s/ Michael S. Sherman
Michael S. Sherman
Senior Vice President, Secretary and Assistant Treasurer

				
	
					
						 

					
					
						EACH OF THE ENTITIES LISTED ON ANNEX I-A ATTACHED HERETO:

					
						By: FC-GEN Operations Investments, LLC, its authorized agent

By:
  /s/ Michael S. Sherman
Michael S. Sherman
Senior Vice President, Secretary and Assistant Treasurer

				

		
			 
		

		
			 
		

		

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						

					
						 

					
					
						 

					
						 

					
						 

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						 

					
						 

					
						 

					
						By:_/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						 

					
						 

				
	
					
						ADMINISTRATIVE AGENT:

					
					
						MIDCAP FUNDING IV TRUST, a Delaware statutory trust

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						

					
						By:_/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						 

				
	
					
						    

					
					
						 

				

		
			 
		

		
			
		

		

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						

					
						 

					
					
						 

					
						 

					
						 

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						 

					
						 

					
						By:/s/ Maurice Amsellem 
Maurice Amsellem

					
						Authorized Signatory

					
						 

					
						 

				
	
					
						LENDERS:

					
					
						MIDCAP FUNDING V TRUST, a Delaware statutory trust

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						By:/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						

				
	
					
						 

					
					
						MIDCAP FUNDING IV TRUST, a Delaware statutory trust

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						By:/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						 

				
	
					
						 

					
					
						MIDCAP FUNDING XVI TRUST, a Delaware statutory trust

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						By:/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						 

				

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						

					
						 

					
					
						MIDCAP FUNDING XXX TRUST, a Delaware statutory trust

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						By:/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						 

				
	
					
						LENDERS:

					
					
						MCO 2 LIMITED PARTNERSHIP

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						By:/s/ Maurice Amsellem

					
						Maurice Amsellem

					
						Authorized Signatory

					
						 

				

		
			 
		

		
			
		

		

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						

					
						 

					
					
						 

					
						Its:  Advisor

					
						 

					
						By:  ACC Management GP, LLC

Its”  General Partner

					
						By: /s/ Joseph D. Glatt

Joseph D. Glatt

					
						Authorized Signatory

					
						 

					
						 

				
	
					
						LENDERS:

					
					
						APOLLO INVESTMENT CORPORATION

					
						 

					
						By:  Apollo Investment Management, L.P.

Its:  Advisor

					
						 

					
						By:  ACC Management GP, LLC
Its”  General Partner

					
						By: /s/ Joseph D. Glatt
Joseph D. Glatt

					
						Authorized Signatory

					
						 

				
	
					
						 

					
					
						Tranquilidade Diversified Income ICAV, an Umbrella Irish Collective Asset-Management Vehicle with Segregated Liability between its Sub-Funds, acting in respect of its Sub-Fund, Tranquilidade Loan Origination Fund

					
						 

					
						By:  Apollo Management International LLP,

					
						Its:  Portfolio Manager

					
						 

					
						By:  AMI (Holdings), LLC
Its:  Member

					
						 

					
						By: /s/ Joseph D. Glatt

					
						Joseph D. Glatt

					
						Vice President

					
						

				
	
					
						 

					
					
						AMISSIMA DIVERSIFIED INCOME ICAV,

					
						an Umbrella Irish Collective Asset-Management Vehicle with Segregated Liability between its Sub-Funds, acting in respect of its Sub-Fund, Amissima Loan Origination Fund

					
						 

					
						By:  Apollo Management International LLP

					
						Its:  Portfolio Manager

					
						 

					
						By:  AMI (Holdings), LLC

Its:  Member

					
						 

					
						By: /s/ Joseph D. Glatt

					
						Joseph D. Glatt

					
						Vice President

				

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						

					
						LENDERS:

					
					
						APOLLO CREDIT FUNDS ICAV, an Umbrella Irish Collective Asset Management Vehicle with Segregated Liability between its Sub-Funds, acting in respect of its Sub-Fund, Apollo Helius Loan Fund

					
						 

					
						By:  ACF Europe Management, LLC
Its:  Portfolio Manager

					
						 

					
						By:  Apollo Capital Management, L.P.

Its:  Sole Member

					
						 

					
						By:  Apollo Capital Management GP, LLC
Its:  General Partner

					
						 

					
						By: /s/ Joseph D. Glatt

					
						Joseph D. Glatt

					
						Vice President

					
						 

				
	
					
						 

					
					
						BCSSS INVESTMENTS 2 S.À R.L.

					
						 

					
						By:  Apollo Capital Management, L.P.

					
						Its:  Investment Manager

					
						 

					
						By:  Apollo Capital Management GP, LLC

					
						Its:  General Partner

					
						 

					
						By: /s/ Joseph D. Glatt

					
						Joseph D. Glatt

					
						Authorized Signatory

					
						 

				

		
			 
		

		
			 
		

		

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

		

			 

		

	
					
						

					
						

					
					
						 

					
						pollo Insurance Solutions Group LLC

Its  Investment Adviser

					
						 

					
						 

					
						 

					
						    Name: Matt O’Mara

					
						    Title: Partner

					
						 

					
						 

				
	
					
						LENDERS:

					
					
						AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY

					
						 

					
						By:  Apollo Insurance Solutions Group LLC

Its  Investment Adviser

					
						 

					
						 

					
						By: /s/ Matt O’Mara

					
						    Name: Matt O’Mara

					
						    Title: Partner

					
						 

				
	
					
						 

					
					
						MIDLAND NATIONAL LIFE INSURANCE COMPANY

					
						By:  Athene Asset Management LLC

Its  Investment Adviser

					
						 

					
						 

					
						 

					
						By: /s/ Matt O’Mara

					
						     Name: Matt O’Mara

					
						     Title: Partner

					
						 

				

		
			 
		

		
			 
		

		

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

		

			 

		

	
					
						

					
						 

					
					
						MidCap Financial Services Capital Management,
LLC 
Its:Collateral Manager

					
						 /s/ Hilary Moore
Authorized Signatory

					
						 

				

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						LENDERS:

					
					
						WOODMONT 2017-1 TRUST

					
						By:MidCap Financial Services Capital Management,
LLC 
Its:Collateral Manager

					
						By: /s/ Hilary Moore

					
						Authorized Signatory

					
						 

				
	
					
						 

					
					
						WOODMONT 2017-2 TRUST

					
						By:MidCap Financial Services Capital Management,
LLC
Its:Collateral Manager

					
						By: /s/ Hilary Moore

					
						Authorized Signatory

				
	
					
						 

					
					
						WOODMONT 2017-3 LP 

					
						By:MidCap Financial Services Capital Management, LLC
Its:Collateral Manager

					
						By: /s/ Hilary Moore

					
						Authorized Signatory

				
	
					
						 

					
					
						WOODMONT 2018-4 TRUST

					
						By:MidCap Financial Services Capital Management,
LLC
Its:Collateral Manager

					
						By: /s/ Hilary Moore

					
						Authorized Signatory

				

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

	
					
						

					
						LENDERS:

					
					
						WOODMONT 2018-5 TRUST

					
						By:MidCap Financial Services Capital Management, LLC
Its:Collateral Manager

					
						By: /s/ Hilary Moore

					
						Authorized Signatory

				

		
			 
		

		
			 
		

		
			

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

		

			 

		

		

		
			 
		

			
					
						 

					
					
						 

					
						 /s/ Gregg Bresner
Gregg Bresner
President and Chief Information Officer 

					
						 

					
						 

				
	
					
						LENDERS:

					
					
						33RD STREET FUNDING LLC

					
						 

					
						By: /s/ Gregg Bresner

					
						Gregg Bresner

					
						President and Chief Information Officer 

					
						 

				
	
					
						 

					
					
						34TH STREET FUNDING LLC

					
						 

					
						By: /s/ Gregg Bresner

					
						Gregg Bresner

					
						President and Chief Information Officer

					
						 

				
	
					
						 

					
					
						CION SOF Funding, LLC

					
						 

					
						By:

					
						Gregg Bresner

					
						President and Chief Information Officer

					
						 

				

		
			 
		

		
			 
		

		
			

		 

			

					

						 

					

					

						 

					

					

						SIGNATURE PAGE TO AMENDMENT NO. 5 TO FOURTH AMENDED AND RESTATED CREDIT AGREEMENT AND AMENDMENT TO SECURITY AGREEMENT

				

		

			 

		

		

		
			ANNEX I-A
		

		
			borrowers
		

			
					
						 

				
	
					
						Name

				
	
					
						1 Emerson Drive North Operations LLC

				
	
					
						1 Emerson Drive South Operations LLC

				
	
					
						1 Glen Hill Road Operations LLC

				
	
					
						1 Magnolia Drive Operations LLC

				
	
					
						10 Woodland Drive Operations LLC

				
	
					
						100 Chambers Street Operations LLC

				
	
					
						100 Edella Road Operations LLC

				
	
					
						100 St. Claire Drive Operations LLC

				
	
					
						1000 Association Drive Operations LLC

				
	
					
						1000 Lincoln Drive Operations LLC

				
	
					
						1000 Orwigsburg Manor Drive Operations LLC

				
	
					
						1000 Schuylkill Manor Road Operations LLC

				
	
					
						101 13th Street Operations LLC

				
	
					
						101 Mills Place Operations LLC

				
	
					
						1020 South Main Street Operations LLC

				
	
					
						1080 Silver Lake Boulevard Operations LLC

				
	
					
						1104 Welsh Road Operations LLC

				
	
					
						1113 North Easton Road Operations LLC

				
	
					
						1145 Poquonnock Road Operations LLC

				
	
					
						115 East Melrose Avenue Operations LLC

				
	
					
						115 Sunset Road Operations LLC

				
	
					
						1165 Easton Avenue Operations LLC

				
	
					
						120 Murray Street Operations LLC

				
	
					
						1201 Rural Avenue Operations LLC

				
	
					
						1240 Pinebrook Road, LLC

				
	
					
						1245 Church Road Operations LLC

				
	
					
						1248 Hospital Drive Operations LLC

				
	
					
						125 Holly Road Operations LLC

				
	
					
						128 East State Street Associates, LLC

				
	
					
						1350 E. Lookout Drive Operations LLC

				
	
					
						1351 Old Freehold Road Operations LLC

				
	
					
						140 Prescott Street Operations LLC

				
	
					
						1405 S. Monroe Street Operations LLC

				
	
					
						1420 South Black Horse Pike Operations LLC

				
	
					
						144 Magnolia Drive Operations LLC

				
	
					
						1501 SE 24th Road, LLC

				
	
					
						1515 Lamberts Mill Road Operations LLC

				
	
					
						1526 Lombard Street SNF Operations LLC

				
	
					
						1539 Country Club Road Operations LLC

				
	
					
						1543 Country Club Road Manor Operations LLC

				

		 

			

					

						 

					

					

						Annex I-A - 1

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

        Name

      

    
	
					
						

					
						15810 South 42nd Street Operations LLC

				
	
					
						16 Fusting Avenue Operations LLC

				
	
					
						161 Bakers Ridge Road Operations LLC

				
	
					
						1631 Ritter Drive Operations LLC

				
	
					
						1650 Galisteo Street Operations LLC

				
	
					
						1660 Hospital Drive Operations LLC

				
	
					
						1680 Spring Creek Road Operations LLC

				
	
					
						1700 Pine Street Operations LLC

				
	
					
						1700 Wynwood Drive Operations LLC

				
	
					
						1718 Spring Creek Road Operations LLC

				
	
					
						1775 Huntington Lane, LLC

				
	
					
						1801 Turnpike Street Operations LLC

				
	
					
						1801 Wentworth Road Operations LLC

				
	
					
						184 Bethlehem Pike Operations LLC

				
	
					
						191 Hackett Hill Road Operations LLC

				
	
					
						1980 Sunset Point Road, LLC

				
	
					
						2 Deer Park Drive Operations LLC

				
	
					
						20 Summit Street Operations LLC

				
	
					
						200 Marter Avenue Operations LLC

				
	
					
						200 Reynolds Avenue Operations LLC

				
	
					
						200 South Ritchie Avenue Operations LLC

				
	
					
						201 New Road Operations LLC

				
	
					
						201 Wood Street Operations LLC

				
	
					
						2015 East West Highway Operations LLC

				
	
					
						205 Armstrong Avenue Operations LLC

				
	
					
						215 West Brown Road Operations LLC

				
	
					
						2101 Fairland Road Operations LLC

				
	
					
						22 South Street Operations LLC

				
	
					
						22 Tuck Road Operations LLC

				
	
					
						2240 White Horse Mercerville Road Operations LLC

				
	
					
						225 Evergreen Road Operations LLC

				
	
					
						227 Evergreen Road Operations LLC

				
	
					
						227 Pleasant Street Operations LLC

				
	
					
						23 Fair Street Operations LLC

				
	
					
						2305 Rancocas Road Operations LLC

				
	
					
						239 Pleasant Street Operations LLC

				
	
					
						24 Truckhouse Road Operations LLC

				
	
					
						255 West Brown Road Operations LLC

				
	
					
						2507 Chestnut Street Operations LLC

				
	
					
						2600 Highlands Boulevard, North, LLC

				
	
					
						2601 Evesham Road Operations LLC

				
	
					
						261 Terhune Drive Operations LLC

				
	
					
						262 Toll Gate Road Operations LLC

				

		 

			

					

						 

					

					

						Annex I-A - 2

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

        Name

      

    
	
					
						

					
						279 Cabot Street Operations LLC

				
	
					
						290 Hanover Street Operations LLC

				
	
					
						290 Red School Lane Operations LLC

				
	
					
						2900 Twelfth Street North, LLC

				
	
					
						292 Applegarth Road Operations LLC

				
	
					
						298 Main Street Operations LLC

				
	
					
						3 Park Drive Operations LLC

				
	
					
						30 Princeton Boulevard Operations LLC

				
	
					
						30 West Avenue Operations LLC

				
	
					
						300 Courtright Street Operations LLC

				
	
					
						300 Pearl Street Operations LLC

				
	
					
						3000 Balfour Circle Operations LLC

				
	
					
						3001 Evesham Road Operations LLC

				
	
					
						315 Upper Riverdale Road LLC

				
	
					
						32 Hospital Hill Road Operations LLC

				
	
					
						3227 Bel Pre Road Operations LLC

				
	
					
						329 Exempla Circle Operations LLC

				
	
					
						330 Franklin Turnpike Operations LLC

				
	
					
						333 Grand Avenue Operations LLC

				
	
					
						333 Green End Avenue Operations LLC

				
	
					
						336 South West End Avenue Operations LLC

				
	
					
						3485 Davisville Road Operations LLC

				
	
					
						35 Marc Drive Operations LLC

				
	
					
						35 Milkshake Lane Operations LLC

				
	
					
						350 Haws Lane Operations LLC

				
	
					
						3514 Fowler Avenue Operations LLC

				
	
					
						3720 Church Rock Street Operations LLC

				
	
					
						3809 Bayshore Road Operations LLC

				
	
					
						3865 Tampa Road, LLC

				
	
					
						390 Red School Lane Operations LLC

				
	
					
						4 Hazel Avenue Operations LLC

				
	
					
						40 Parkhurst Road Operations LLC

				
	
					
						400 29th Street Northeast Operations LLC

				
	
					
						400 Groton Road Operations LLC

				
	
					
						400 Vision Drive Operations LLC

				
	
					
						419 Harding Street Operations LLC

				
	
					
						4140 Old Washington Highway Operations LLC

				
	
					
						422 23rd Street Operations LLC

				
	
					
						44 Keystone Drive Operations LLC

				
	
					
						440 North River Street Operations LLC

				
	
					
						450 East Philadelphia Avenue Operations LLC

				
	
					
						455 Brayton Avenue Operations LLC

				
	
					
						4602 Northgate Court, LLC

				

		 

			

					

						 

					

					

						Annex I-A - 3

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

        Name

      

    
	
					
						

					
						462 Main Street Operations LLC

				
	
					
						464 Main Street Operations LLC

				
	
					
						475 Jack Martin Boulevard Operations LLC

				
	
					
						4755 South 48th Street Operations LLC

				
	
					
						4901 North Main Street Operations LLC

				
	
					
						4927 Voorhees Road, LLC

				
	
					
						50 Mulberry Tree Street Operations LLC

				
	
					
						500 East Philadelphia Avenue Operations LLC

				
	
					
						5101 North Park Drive Operations LLC

				
	
					
						515 Brightfield Road Operations LLC

				
	
					
						525 Glenburn Avenue Operations LLC

				
	
					
						530 Macoby Street Operations LLC

				
	
					
						536 Ridge Road Operations LLC

				
	
					
						54 Sharp Street Operations LLC

				
	
					
						5485 Perkiomen Avenue Operations LLC

				
	
					
						549 Baltimore Pike Operations LLC

				
	
					
						55 Cooper Street Operations LLC

				
	
					
						55 Kondracki Lane Operations LLC

				
	
					
						5501 Perkiomen Avenue Operations LLC

				
	
					
						56 Hamilton Avenue Operations LLC

				
	
					
						56 West Frederick Street Operations LLC

				
	
					
						59 Harrington Court Operations LLC

				
	
					
						590 North Poplar Fork Road Operations LLC

				
	
					
						600 Paoli Pointe Drive Operations LLC

				
	
					
						6000 Bellona Avenue Operations LLC

				
	
					
						61 Cooper Street Operations LLC

				
	
					
						610 Dutchman’s Lane Operations LLC

				
	
					
						610 Townbank Road Operations LLC

				
	
					
						613 Hammonds Lane Operations LLC

				
	
					
						625 State Highway 34 Operations LLC

				
	
					
						63 Country Village Road Operations LLC

				
	
					
						642 Metacom Avenue Operations LLC

				
	
					
						65 Cooper Street Operations LLC

				
	
					
						650 Edison Avenue Operations LLC

				
	
					
						70 Gill Avenue Operations LLC

				
	
					
						700 Toll House Avenue Operations LLC

				
	
					
						700 Town Bank Road Operations LLC

				
	
					
						715 East King Street Operations LLC

				
	
					
						72 Salmon Brook Drive Operations LLC

				
	
					
						7232 German Hill Road Operations LLC

				
	
					
						735 Putnam Pike Operations LLC

				
	
					
						7395 W. Eastman Place Operations LLC

				
	
					
						740 Oak Hill Road Operations LLC

				

		 

			

					

						 

					

					

						Annex I-A - 4

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						75 Hickle Street Operations LLC

				
	
					
						7520 Surratts Road Operations LLC

				
	
					
						7525 Carroll Avenue Operations LLC

				
	
					
						77 Madison Avenue Operations LLC

				
	
					
						7700 York Road Operations LLC

				
	
					
						777 Lafayette Road Operations LLC

				
	
					
						78 Opal Street LLC

				
	
					
						8 Rose Street Operations LLC

				
	
					
						800 West Miner Street Operations LLC

				
	
					
						803 Hacienda Lane Operations LLC

				
	
					
						8015 Lawndale Street Operations LLC

				
	
					
						810 South Broom Street Operations LLC

				
	
					
						8100 Washington Lane Operations LLC

				
	
					
						825 SUMMIT STREET OPERATIONS LLC

				
	
					
						84 Cold Hill Road Operations LLC

				
	
					
						840 Lee Road Operations LLC

				
	
					
						841 Merrimack Street Operations LLC

				
	
					
						843 Wilbur Avenue Operations LLC

				
	
					
						845 Paddock Avenue Operations LLC

				
	
					
						850 Paper Mill Road Operations LLC

				
	
					
						867 York Road Operations LLC

				
	
					
						8710 Emge Road Operations LLC

				
	
					
						8720 Emge Road Operations LLC

				
	
					
						89 Morton Street Operations LLC

				
	
					
						899 Cecil Avenue Operations LLC

				
	
					
						905 Penllyn Pike Operations LLC

				
	
					
						91 Country Village Road Operations LLC

				
	
					
						9101 Second Avenue Operations LLC

				
	
					
						920 South Main Street Operations LLC

				
	
					
						93 Main Street SNF Operations LLC

				
	
					
						932 Broadway Operations LLC

				
	
					
						9701 Medical Center Drive Operations LLC

				
	
					
						9738 Westover Hills Boulevard Operations LLC

				
	
					
						98 Hospitality Drive Operations LLC

				
	
					
						9940 West Union Hills Drive Operations LLC

				
	
					
						Alexandria Care Center, LLC

				
	
					
						Alta Care Center, LLC

				
	
					
						Anaheim Terrace Care Center, LLC

				
	
					
						Bay Crest Care Center, LLC

				
	
					
						Belen Meadows Healthcare and Rehabilitation Center, LLC

				
	
					
						Belmont Nursing Center, LLC

				
	
					
						Brier Oak on Sunset, LLC

				
	
					
						CareerStaff Unlimited, LLC

				

		 

			

					

						 

					

					

						Annex I-A - 5

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						Clairmont Longview Property, LLC

				
	
					
						Clairmont Longview, LLC

				
	
					
						Clovis Healthcare and Rehabilitation Center, LLC

				
	
					
						Colonial Tyler Care Center, LLC

				
	
					
						Courtyard JV LLC

				
	
					
						Crestview Nursing, LLC

				
	
					
						Diane Drive Operations LLC

				
	
					
						Dracut JV LLC

				
	
					
						Elmcrest Care Center, LLC

				
	
					
						FC-GEN Hospice Holdings, LLC

				
	
					
						Five Ninety Six Sheldon Road Operations LLC

				
	
					
						Flatonia Oak Manor, LLC

				
	
					
						Florida Holdings I, LLC

				
	
					
						Florida Holdings II, LLC

				
	
					
						Florida Holdings III, LLC

				
	
					
						Fort Worth Center of Rehabilitation, LLC

				
	
					
						Forty Six Nichols Street Operations LLC

				
	
					
						Forty Six Nichols Street Property, LLC

				
	
					
						Fountain Care Center, LLC

				
	
					
						Fountain View Subacute and Nursing Center, LLC

				
	
					
						Franklin Woods JV LLC

				
	
					
						GEN Operations I, LLC

				
	
					
						GEN Operations II, LLC

				
	
					
						Genesis Administrative Services LLC

				
	
					
						Genesis Bayview JV Holdings, LLC

				
	
					
						Genesis CO Holdings LLC

				
	
					
						Genesis CT Holdings LLC

				
	
					
						Genesis DE Holdings LLC

				
	
					
						Genesis Dynasty Operations LLC

				
	
					
						Genesis Eldercare Network Services, LLC

				
	
					
						Genesis ElderCare Physician Services, LLC

				
	
					
						Genesis Eldercare Rehabilitation Services, LLC

				
	
					
						Genesis Health Ventures of New Garden, LLC

				
	
					
						Genesis Holdings LLC

				
	
					
						Genesis IP LLC

				
	
					
						Genesis LGO Operations LLC

				
	
					
						Genesis MA Holdings LLC

				
	
					
						Genesis MD Holdings LLC

				
	
					
						Genesis NH Holdings LLC

				
	
					
						Genesis NJ Holdings LLC

				
	
					
						Genesis OMG Operations LLC

				
	
					
						Genesis Operations II LLC

				
	
					
						Genesis Operations III LLC

				

		 

			

					

						 

					

					

						Annex I-A - 6

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						Genesis Operations IV LLC

				
	
					
						Genesis Operations LLC

				
	
					
						Genesis Operations V LLC

				
	
					
						Genesis Operations VI LLC

				
	
					
						Genesis PA Holdings LLC

				
	
					
						Genesis Partnership LLC

				
	
					
						Genesis ProStep, LLC

				
	
					
						Genesis RI Holdings LLC

				
	
					
						Genesis Staffing Services LLC

				
	
					
						Genesis TX Holdings LLC

				
	
					
						Genesis VA Holdings LLC

				
	
					
						Genesis VT Holdings LLC

				
	
					
						Genesis WV Holdings LLC

				
	
					
						GHC Burlington Woods Dialysis JV LLC

				
	
					
						GHC Dialysis JV LLC

				
	
					
						GHC Holdings II LLC

				
	
					
						GHC Holdings LLC

				
	
					
						GHC JV Holdings LLC

				
	
					
						GHC Matawan Dialysis JV LLC

				
	
					
						GHC Payroll LLC

				
	
					
						GHC Randallstown Dialysis JV LLC

				
	
					
						GHC SelectCare LLC

				
	
					
						GHC TX Operations LLC

				
	
					
						GHC Windsor Dialysis JV LLC

				
	
					
						Granite Ledges JV LLC

				
	
					
						Grant Manor LLC

				
	
					
						Great Falls Health Care Company, L.L.C.

				
	
					
						GRS JV LLC

				
	
					
						Guadalupe Seguin Property, LLC

				
	
					
						Guadalupe Valley Nursing Center, LLC

				
	
					
						Hallettsville Rehabilitation and Nursing Center, LLC

				
	
					
						Hallmark Investment Group, LLC

				
	
					
						Hallmark Rehabilitation GP, LLC

				
	
					
						Harborside Connecticut Limited Partnership

				
	
					
						Harborside Danbury Limited Partnership

				
	
					
						Harborside Health I LLC

				
	
					
						Harborside Healthcare Advisors Limited Partnership

				
	
					
						Harborside Healthcare Limited Partnership

				
	
					
						Harborside Healthcare, LLC

				
	
					
						Harborside Massachusetts Limited Partnership

				
	
					
						Harborside New Hampshire Limited Partnership

				
	
					
						Harborside North Toledo Limited Partnership

				
	
					
						Harborside of Cleveland Limited Partnership

				

		 

			

					

						 

					

					

						Annex I-A - 7

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						Harborside of Dayton Limited Partnership

				
	
					
						Harborside of Ohio Limited Partnership

				
	
					
						Harborside Point Place, LLC

				
	
					
						Harborside Rehabilitation Limited Partnership

				
	
					
						Harborside Rhode Island Limited Partnership

				
	
					
						Harborside Swanton, LLC

				
	
					
						Harborside Sylvania, LLC

				
	
					
						Harborside Toledo Business LLC

				
	
					
						Harborside Toledo Limited Partnership

				
	
					
						Harborside Troy, LLC

				
	
					
						HBR Bardwell LLC

				
	
					
						HBR Barkely Drive, LLC

				
	
					
						Hbr Danbury, LLC

				
	
					
						HBR Elizabethtown, LLC

				
	
					
						HBR Kentucky, LLC

				
	
					
						HBR Madisonville, LLC

				
	
					
						HBR Owensboro, LLC

				
	
					
						HBR Paducah, LLC

				
	
					
						Hbr Stamford, LLC

				
	
					
						Hbr Trumbull, LLC

				
	
					
						HBR Woodburn, LLC

				
	
					
						HC 63 Operations LLC

				
	
					
						HHCI Limited Partnership

				
	
					
						Hospitality Lubbock Property, LLC

				
	
					
						Hospitality Nursing and Rehabilitation Center, LLC

				
	
					
						Huntington Place Limited Partnership

				
	
					
						Kansas City Transitional Care Center, LLC

				
	
					
						Kennett Center, L.P.

				
	
					
						KHI LLC

				
	
					
						Klondike Manor LLC

				
	
					
						Leisure Years Nursing, LLC

				
	
					
						Lincoln Highway JV LLC

				
	
					
						Lincoln Highway Operations LLC

				
	
					
						Live Oak Nursing Center, LLC

				
	
					
						Magnolia JV LLC

				
	
					
						Marietta Healthcare, LLC

				
	
					
						Maryland Harborside, LLC

				
	
					
						Massachusetts Holdings I, LLC

				
	
					
						Montebello Care Center, LLC

				
	
					
						Monument La Grange Property, LLC

				
	
					
						Monument Rehabilitation and Nursing Center, LLC

				
	
					
						MS Exton Holdings, LLC

				
	
					
						MS Exton, LLC

				

		 

			

					

						 

					

					

						Annex I-A - 8

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						Oakland Manor Nursing Center, LLC

				
	
					
						Odd Lot LLC

				
	
					
						Ohio Holdings I, LLC

				
	
					
						Owenton Manor Nursing, LLC

				
	
					
						PDDTSE LLC

				
	
					
						Peak Medical Assisted Living, LLC

				
	
					
						Peak Medical Colorado No. 2, LLC

				
	
					
						Peak Medical Colorado No. 3, LLC

				
	
					
						Peak Medical Idaho Operations, LLC

				
	
					
						Peak Medical Las Cruces No. 2, LLC

				
	
					
						Peak Medical Las Cruces, LLC

				
	
					
						Peak Medical Montana Operations, LLC

				
	
					
						Peak Medical New Mexico No. 3, LLC

				
	
					
						Peak Medical of Boise, LLC

				
	
					
						Peak Medical of Colorado, LLC

				
	
					
						Peak Medical of Idaho, LLC

				
	
					
						Peak Medical of Utah, LLC

				
	
					
						Peak Medical Roswell, LLC

				
	
					
						Peak Medical, LLC

				
	
					
						Pine Tree Villa LLC

				
	
					
						PM Oxygen Services, LLC

				
	
					
						PROCARE ONE NURSES, LLC

				
	
					
						Property Resource Holdings, LLC

				
	
					
						Regency Health Services, LLC

				
	
					
						Regency Nursing, LLC

				
	
					
						Respiratory Health Services LLC

				
	
					
						Rio Hondo Subacute and Nursing Center, LLC

				
	
					
						Riverside Retirement Limited Partnership

				
	
					
						Romney Health Care Center Limited Partnership

				
	
					
						Route 92 Operations LLC

				
	
					
						Royalwood Care Center, LLC

				
	
					
						Saddle Shop Road Operations LLC

				
	
					
						Salisbury JV LLC

				
	
					
						Sharon Care Center, LLC

				
	
					
						SHG Partnership, LLC

				
	
					
						SHG Resources, LLC

				
	
					
						Skies Healthcare and Rehabilitation Center, LLC

				
	
					
						Skiles Avenue and Sterling Drive Urban Renewal Operations LLC

				
	
					
						Skilled Healthcare, LLC

				
	
					
						Southwood Austin Property, LLC

				
	
					
						Southwood Care Center, LLC

				
	
					
						SR-73 AND LAKESIDE AVENUE OPERATIONS LLC

				
	
					
						St. Anthony Healthcare and Rehabilitation Center, LLC

				

		 

			

					

						 

					

					

						Annex I-A - 9

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						St. Catherine Healthcare and Rehabilitation Center, LLC

				
	
					
						St. Elizabeth Healthcare and Rehabilitation Center, LLC

				
	
					
						St. John Healthcare and Rehabilitation Center, LLC

				
	
					
						St. Theresa Healthcare and Rehabilitation Center, LLC

				
	
					
						State Street Associates, L.P.

				
	
					
						State Street Kennett Square, LLC

				
	
					
						Stillwell Road Operations LLC

				
	
					
						Summit Care Parent, LLC

				
	
					
						Summit Care, LLC

				
	
					
						Sun Healthcare Group, Inc.

				
	
					
						SunBridge Beckley Health Care LLC

				
	
					
						SunBridge Braswell Enterprises, LLC

				
	
					
						SunBridge Brittany Rehabilitation Center, LLC

				
	
					
						SunBridge Care Enterprises West, LLC

				
	
					
						SunBridge Care Enterprises, LLC

				
	
					
						SunBridge Carmichael Rehabilitation Center, LLC

				
	
					
						SunBridge Circleville Health Care LLC

				
	
					
						SunBridge Clipper Home of Portsmouth, LLC

				
	
					
						SunBridge Clipper Home of Rochester, LLC

				
	
					
						SunBridge Dunbar Health Care LLC

				
	
					
						SunBridge Gardendale Health Care Center, LLC

				
	
					
						SunBridge Glenville Health Care, LLC

				
	
					
						SunBridge Hallmark Health Services, LLC

				
	
					
						SunBridge Harbor View Rehabilitation Center, LLC

				
	
					
						SunBridge Healthcare, LLC

				
	
					
						SunBridge Marion Health Care LLC

				
	
					
						SunBridge Meadowbrook Rehabilitation Center, LLC

				
	
					
						SunBridge Mountain Care Management, LLC

				
	
					
						SunBridge Nursing Home, LLC

				
	
					
						SunBridge Paradise Rehabilitation Center, LLC

				
	
					
						SunBridge Putnam Health Care LLC

				
	
					
						SunBridge Regency - North Carolina, LLC

				
	
					
						SunBridge Regency - Tennessee, LLC

				
	
					
						SunBridge Retirement Care Associates, LLC

				
	
					
						SunBridge Salem Health Care LLC

				
	
					
						SunBridge Shandin Hills Rehabilitation Center, LLC

				
	
					
						SunBridge Stockton Rehabilitation Center, LLC

				
	
					
						SunBridge Summers Landing, LLC

				
	
					
						SunDance Rehabilitation Agency, LLC

				
	
					
						SunDance Rehabilitation Holdco, Inc.

				
	
					
						SunDance Rehabilitation, LLC

				
	
					
						SunMark of New Mexico, LLC

				
	
					
						The Clairmont Tyler, LLC

				

		 

			

					

						 

					

					

						Annex I-A - 10

					

					

						 

				

		

			 

		

	

      

         

      

    
	

      

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						The Earlwood, LLC

				
	
					
						The Heights of Summerlin, LLC

				
	
					
						The Rehabilitation Center of Albuquerque, LLC

				
	
					
						The Rehabilitation Center of Omaha, LLC

				
	
					
						Three Mile Curve Operations LLC

				
	
					
						Town and Country Boerne Property, LLC

				
	
					
						Town and Country Manor, LLC

				
	
					
						Vintage Park At San Martin, LLC

				
	
					
						Wakefield Healthcare, LLC

				
	
					
						Westfield Healthcare, LLC

				
	
					
						Woodland Care Center, LLC

				
	
					
						Woodspoint LLC

				

		
			 
		

		
			 
		

		 

			

					

						 

					

					

						Annex I-A - 11EXHIBIT 4.2

 

DESCRIPTION OF THE REGISTRANT’S SECURITIES 

REGISTERED PURSUANT TO SECTION 12 OF THE 

SECURITIES EXCHANGE ACT OF 1934 

 

As of December 31, 2019, Harvard Bioscience, Inc. had one class
of securities registered under Section 12 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”),
being our common stock, $0.01 par value. The following description of our common stock is a summary and does not purport to be
complete. It is subject to and qualified in its entirety by reference to our Second Amended and Restated Certificate of Incorporation
(as amended, the “Charter”) and our Amended and Restated By-laws (as amended, the “Bylaws”), each of which
are incorporated by reference as an exhibit to the Annual Report on Form 10-K of which this Exhibit 4.2 is a part. We encourage
you to read our Charter, our Bylaws and the applicable provisions of Delaware law for additional information.

 

Authorized Capital Stock 

 

Our authorized capital stock consists of 80,000,000 shares of common stock, par value
$0.01 per share, and 5,000,000 shares of undesignated preferred stock, par value $0.01 per share. 

 

Common Stock 

 

Voting Rights. Holders of our common stock are entitled to one vote for each share
held of record on all matters submitted to a vote of shareholders; provided, that, except as otherwise required by law, holders
of common stock are not entitled to vote on any amendment to the Charter that changes the powers, preferences, rights or other
terms of one or more series of undesignated preferred stock if the holders of the affected series are entitled to vote, separately
or together, with the holders of one or more other such series, on such amendment pursuant to the Charter or Delaware General Corporation
Law.

 

Classified Board of Directors. Our Charter provides that our Board of Directors
(the “Board”) shall be divided into three classes, each consisting as nearly as reasonably may be possible of one-third
of the total number of directors constituting the entire Board, with each class’s term expiring on a staggered basis. Newly-created
directorships and vacancies on our Board may only be filled by a majority of the members of the incumbent board then in office,
though less than a quorum, and not by our stockholders. Directors may be removed from office only for cause by the affirmative
vote of the holders of at least seventy-five percent (75%) of the outstanding shares entitled to be cast on the election of directors
by the then-outstanding shares of all classes and series of capital stock, voting together as a single class.

 

Liquidation. In the event of our liquidation, dissolution or winding up, after
the satisfaction in full of the liquidation preferences of holders of any preferred stock, holders of common stock are entitled
to ratable distribution of the remaining assets available for distribution to stockholders.

 

Dividend Rights. Holders of common stock are entitled to receive proportionately
any such dividends declared by our Board, out of legally available funds for dividends, subject to any preferences that may be
applicable to any shares of preferred stock that may be outstanding at that time.

 

Rights and Preferences. Holders of common stock have no preemptive, redemption
or conversion rights and are not subject to future calls or assessments. No sinking fund provisions apply to our common stock.
The rights, preferences and privileges of holders of common stock are subject to, and may be adversely affected by, the rights
of the holders of shares of any series of preferred stock that we may designate and issue in the future.

 

Fully Paid and Nonassessable. All outstanding shares are fully-paid and non-assessable.

 

Listing 

 

Our common stock is listed on the NASDAQ Global Market under the symbol “HBIO.”

 

     

    

    

 

Anti-takeover Effects of Our Certificate of Incorporation and Bylaws and Delaware
Law

 

Provisions of our Certificate of Incorporation and Bylaws

 

Certain provisions of the Delaware General Corporation Law and of our Charter and Bylaws
could have the effect of delaying, deferring or discouraging another party from acquiring control of us. These provisions, which
are summarized below, are expected to discourage certain types of coercive takeover practices and inadequate takeover bids and,
as a consequence, they might also inhibit temporary fluctuations in the market price of our common stock that often result from
actual or rumored hostile takeover attempts. These provisions are also designed in part to encourage anyone seeking to acquire
control of us to first negotiate with our Board. These provisions might also have the effect of preventing changes in our management.
It is possible that these provisions could make it more difficult to accomplish transactions that stockholders might otherwise
deem to be in their best interests. However, we believe that the advantages gained by protecting our ability to negotiate with
any unsolicited and potentially unfriendly acquirer outweigh the disadvantages of discouraging such proposals, including those
priced above the then-current market value of our common stock, because, among other reasons, the negotiation of such proposals
could improve their terms.

 

Our Charter, our Bylaws and Delaware law contain provisions that could discourage, delay
or prevent a third party from acquiring us, even if doing so may be beneficial to our stockholders. In addition, these provisions
could limit the price investors would be willing to pay in the future for shares of our common stock. The following are examples
of such provisions in our Charter and Bylaws:

 

	 	•	only our Board, pursuant to a resolution adopted by a majority of our directors, may call special meetings of our stockholders;

 

	 	•	stockholders may not act by written consent and stockholder action must take place at the annual or special meeting of our stockholders;

 

	 	•	stockholder proposals and nominations of candidates for election as directors other than nominations made by or at the direction of our Board or a committee of our Board to be brought before any meeting of our stockholders must comply with advance notice procedures;

 

	 	•	our Board is classified into three classes, each consisting as nearly as reasonably may be possible of one-third of the total number of directors constituting the entire Board;

 

	 	•	our Board will fix the exact number of directors to comprise our Board;

 

	 	•	subject to any rights that holders of any series of our undesignated preferred stock may have to elect directors and to fill vacancies on our Board, newly-created directorships and vacancies on our Board may only be filled by a majority of the members of the incumbent board then in office, even if less than a quorum is present, and not by our stockholders;

 

	 	•	a director may be removed from office only for cause by the affirmative vote of holders of shares representing at least seventy-five percent (75%) of the votes entitled to be cast on such matter by the then-outstanding shares of all classes and series of our capital stock, voting together as a single class;
	 	 	 
	 	•	our Charter and Bylaws do not provide for cumulative voting in the election of directors;
	 	 	 
	 	•	our Bylaws may be further amended by either (i) the affirmative vote of at least a majority of our entire Board or (ii) the affirmative vote of the holders of at least seventy-five percent (75%) of the combined voting power of the outstanding shares of all classes and series of our capital stock entitled to vote on such amendment, voting together as a single class; and

 

	 	•	our Board is authorized to issue, without further action by our stockholders, up to 5,000,000 shares of undesignated preferred stock with rights and preferences, including voting rights, designated from time to time by our Board.

 

     

    

    

 

Additionally, as required by the Delaware General Corporation Law, any amendment of our
Charter must first be approved by a majority of our Board and, as required by our Charter, thereafter be approved by a majority
of the outstanding shares entitled to vote on the amendment, and a majority of the outstanding shares of each class entitled to
vote thereon, voting together as a single class, except that the amendment of the provisions relating to stockholder action, directors,
limitation of liability, the amendment of our Bylaws and Charter and forum must be approved by not less than seventy-five percent
(75%) of the outstanding shares entitled to vote on the amendment, and not less than seventy-five percent (75%) of the outstanding
shares of each class entitled to vote thereon as a class. Our Bylaws may be amended by either (i) a vote of at least a majority
of our entire Board or (ii) a vote of the holders of at least seventy-five percent (75%) of the combined voting power of the outstanding
shares of all classes and series of our capital stock entitled to vote on such amendment, voting together as a single class.

 

Delaware Anti-Takeover Law

 

We are subject to the provisions of Section 203 of the Delaware General Corporation
Law. In general, Section 203 prohibits a publicly-held Delaware corporation from engaging in a “business combination”
with an “interested stockholder” for a three-year period following the time that this stockholder becomes an interested
stockholder, unless the business combination is approved in a prescribed manner. A “business combination” includes,
among other things, a merger, asset or stock sale or other transaction resulting in a financial benefit to the interested stockholder.
An “interested stockholder” is a person who, together with affiliates and associates, owns, or did own within three
years prior to the determination of interested stockholder status, fifteen percent (15%) or more of the corporation’s voting
stock. Under Section 203, a business combination between a corporation and an interested stockholder is prohibited unless
it satisfies one of the following conditions:

 

	 	•	before the stockholder became interested, the Board approved either the business combination or the transaction which resulted in the stockholder becoming an interested stockholder;

 

	 	•	upon consummation of the transaction which resulted in the stockholder becoming an interested stockholder, the interested stockholder owned at least eight-five percent (85%) of the voting stock of the corporation outstanding at the time the transaction commenced, excluding for purposes of determining the voting stock outstanding, shares owned by persons who are directors and also officers, and employee stock plans, in some instances; or

 

	 	•	at or after the time the stockholder became interested, the business combination was approved by the Board of the corporation and authorized at an annual or special meeting of the stockholders by the affirmative vote of at least two-thirds of the outstanding voting stock which is not owned by the interested stockholder.

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