Document:

Lease Agreement

 Exhibit 10.3 
  
 LEASE 
  
 THIS LEASE, made this 1st day of April, 2003, by and between BROWN, NOLTEMEYER COMPANY, hereinafter called “Lessor”, and HEALTH ESSENTIALS SOLUTIONS, INC., hereinafter called
“Lessee”. 
  
 WITNESSETH: 
  
 That Lessor, in consideration of the covenants and agreements to be performed by Lessee and
upon the terms and conditions hereinafter set out, does hereby lease unto Lessee 4,842 square feet better known as Suite 320, on the second floor of Lessor’s building in St. Matthews, Jefferson County, Kentucky, at 7410 New
LaGrange Road. Such space is to be used and occupied by Lessee as a business office and for no other purpose. Norwood II at 7410 New LaGrange Road and the space referenced therein are hereinafter called “Building” and
“leased premises”, respectively. 
  
 TO HAVE AND TO HOLD the leased
premises unto Lessee for the term of 60 months beginning April 1, 2003 and ending March 31, 2008, unless sooner terminated, as hereinafter provided, on the following terms and conditions. 
  

	1.	Rent. Lessee shall pay Lessor as rent for the leased premises during said term of this Lease the sum of $5,043.75 per month, in advance, on the first day of each month
without any setoff or counterclaim whatsoever, such rent and other charges to be payable to Brown, Noltemeyer Company at 122 N. Peterson Avenue, Louisville, Kentucky 40206, or to such other party or at such other place as the Lessor may from
time to time designate in writing. Should this Lease commence on a day other than the first day of a calendar month, the rent for such partial month shall be appropriately pro-rated at a rate of $162.70 per day. 

  

	2.	Deposit. Upon signing this Agreement, Lessee will pay to Lessor the amount of $5,043.75 for the security deposit. The security deposit will be held by the Lessor until
surrender of the leased premises at the expiration of this Lease. Upon surrender, the security deposit will be returned to the Lessee, provided that all required payments due have been paid and that said premises are in good repair, normal wear
accepted. 

  

	3.	Condition of Premises. No representations, except those as are contained herein, have been made to the Lessee respecting the conditions of said premises. The taking
possession of said premises by the Lessee shall be conclusive evidence as against the Lessee that said premises were in good and satisfactory condition when premises of the same were so taken; and the Lessee will, at the termination of this Lease,
by lapse of time or otherwise, return said premises to Lessor in as good condition as when received, loss by fire and ordinary wear accepted. If required during the term of the Lease, the Lessor shall have all walls within the suite, that are
painted, repainted with Lessor’s building standard paint, color selected by Lessee. Said painting does not include the ceiling area, including floor joists, metal decking, duct work, or other fixtures. 

  
 Lessor will complete the following improvements, at their sole cost and
expense, upon the signing of the Lease Agreement and prior to the commencement date so stated herein. 
  

	 	i.	Lessor will construct the improvements per the attached floor plan (Exhibit A). 

  

	 	ii.	Prepare walls for paint and paint walls with lessor’s standard paint, color selection by lessee from lessor’s standard samples. 

  

	 	iii.	Remove existing carpet and or tile, prepare floor for carpet and or tile and install new lessor’s standard glue direct carpet and or tile, color selection by lessee from
lessor’s standard samples. Remove existing base molding and install new lessor’s standard vinyl base molding, color selection by lessee from lessor’s standard samples. 

  

	4.	Lessee’s Duties. Lessee shall take good care of the leased premises, and, at Lessee’s expense, make repairs to the Building, or any part thereof, needed because of
Lessee’s or Lessee’s agents, servants, or employees conduct, and should Lessee fail to do so promptly, Lessor may, at its option, make such repairs and Lessee shall pay the cost thereof to Lessor on demand. Lessee shall indemnify the
Lessor and save it harmless from and against any and all claims, actions, damages, liabilities, and expenses (including, but not limited to, reasonable attorney’s fees and costs) in connection with loss of life, personal injury, or damage to
property occurring in or arising out of use or condition of the leased premises or any activity therein (except for claims, actions, damages, liabilities, or expenses arising from the negligence of the Lessor) or arising wholly or in part from any
act or omission of the Lessee, Lessee’s agents, servants, or employees. Lessee shall, at termination of this Lease by lapse of time or otherwise, deliver up the leased premises to Lessor in as good condition as at commencement of Lessee’s
occupancy, ordinary wear and such damage that Lessee is not obligated to repair accepted. 

  

	5.	 Assigning, Subletting and Alterations. Lessee shall not, without Lessor’s prior written consent, and such consent shall not be unreasonably withheld,
assign this lease, or allow 

  

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the same to be assigned by operation of law or otherwise, or sublet the leased premises or any part thereof, or use or permit same to be used for any purpose
except as above specified, or make or allow alterations therein or additions thereto. 

  

	6.	Lessor’s Right of Entry. Lessor shall have the right to enter the leased premises during normal business hours upon reasonable prior written notice to Lessee, except for
emergency purposes, provided such entrance shall not unreasonably interfere or inconvenience the Lessee, for the purpose of examining the leased premises, and making repairs or improvements either to the leased premises or to utility lines or other
facilities of the building or to install such lines or facilities. Lessee shall, upon discovery of any defect in or injury to the leased premises, or any need of repairs, promptly report the same to Lessor, in writing, specifying such defects. There
shall be no allowance to Lessee or diminution of rent and no liability on the part of the Lessor by reason of inconvenience, annoyance or injury to business arising from the making of any repairs, alterations, additions, or improvements in or to any
portion of the building or the leased premises, or in and to the fixtures, appurtenances, and equipment thereof. All of such repairs, decorations, alterations, changes, additions and improvements shall be done during ordinary business hours, or if
any such work is at the request of the Lessee, be done during any other hours, the Lessee shall pay for all overtime. 

  

	7.	Lessee’s Additions and Fixtures. All additions, fixtures, or improvements placed on or made to the leased premises by Lessee, excluding personal property, furniture,
trade fixtures, and other moveable property not attached to the building, shall at once become the property of Lessor and be surrendered to Lessor upon termination of this Lease. However, Lessee agrees to remove such additions, fixtures, or
improvements as Lessor may request, and restore the leased premises to their original condition and repair any damage resulting from the removal of such additions, fixtures or improvements. 

  

	8.	Personal Property. All of Lessee’s personal property not removed from the leased premises when Lessee leaves the premises on termination of this Lease shall thereupon be
conclusively presumed to have been abandoned by Lessee and forthwith become Lessor’s property. 

  

	9.	Holding Over. Should Lessee hold the leased premises after termination of this lease, by lapse of time or otherwise, the Lessee will be a Lessee from month to month at a
rental rate equivalent to one and one half times the monthly rental rate for the last full month of the lease term most recently expiring and under the same terms and conditions in force at the expiration of the Lease. No receipt of money by Lessor
from Lessee after termination of the Lease shall reinstate or extend this Lease, or affect any prior notice given Lessor to Lessee, and no extension of this Lease shall be valid unless in writing, signed by Lessor and Lessee.

  

	10.	 Rules and Regulations. Lessee shall comply with the rules and regulations made a part hereof, as well as all reasonable changes therein and additions thereto
that may from time to time be made by Lessor for the operation and protection of the building and the 

  

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protection and welfare of Lessor’s lessees and invitees. Changes and additions to the rules and regulations shall become effective and a part of this
Lease upon delivery of a copy thereof to Lessee. 

  

	11.	Additional Rent. In addition to the Rent provided for in Paragraph 1 above, the Lessee agrees to pay to the Lessor additional rent for each Lease Year subsequent to the
initial full year of this Lease representing the Lessee’s pro rata share in any increase in the operational expenses of the Building attributable to such Lease Year. The Lessee’s share of any increase in operational expenses for any Lease
Year (subsequent to the initial full year of this Lease) shall be calculated as follows: first, as of the first and each subsequent anniversary date(s) of this Lease, the annual operational expenses of the Building for the preceding fiscal year
ending 12/31 shall be calculated and from this amount shall be subtracted the annual operational expenses of the Building for the fiscal year ending December 31. In this manner, the total increase in operational expenses of the Building for the
appropriate calendar year of this Lease shall be determined. The base year of the Lease referenced within this document shall be 2003. Second, such increase shall be divided by 34,751 square feet to arrive at the amount of the increase in
operational expenses per square foot of the Building and then the amount of such increase per square foot of the Building shall be multiplied by the number of square feet occupied by the Lessee pursuant to the terms of this Lease to determine the
amount, if any, of additional rent payable by the Lessee for the next Lease Year of the Lease. If the calculations show an increase in operating expenses as compared with the base year, Lessee shall pay to Lessor within thirty (30) days following
Lessor’s notice, a sum equal to the Lessee’s share of the increase in such expense prorated for such Lease Year. For purposes of this paragraph, the operational expenses of the Building for any fiscal year shall be defined as all
expenditures with respect to the Building for such fiscal year other than expenditures for mortgage payments, capital expenditures, depreciation, tenant finish for other lessees, leasing commissions, advertising expenses and executive salaries.

  

	12.	 Government Regulations. Lessee shall comply with all valid laws, ordinances, rules and regulations of all governmental authorities pertaining to use and
occupancy of the leased premises. Lessee will not use or permit upon said premises anything that will invalidate any policies now or hereafter carried on said building or that will increase the rate of insurance on said demised premises, or on the
building of which said demised premises are a part. Lessee will pay all extra insurance premiums on the said building which may be caused by the use which said Lessee shall make of said demised premises, and Lessee will not use or permit upon said
demised premises anything that might be dangerous to life or limb. The Lessee will not in any manner deface or injure said building or any part thereof, or overload the floors of said demised premises, it being mutually agreed that in no event shall
any weight placed upon the said floors exceed Seventy-Five (75) pounds per square foot of floor space covered; Lessee will not permit any objectionable noise or odor to escape or be emitted from said premises, or do anything or permit anything to be
done upon said premises in any way tending to create a nuisance, or tending to disturb any other Lessee in said building, or the occupants of neighboring property, or tending to 

  

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injure the reputation of the said building; and the Lessee will comply with all governmental, health and police requirements and said regulations respecting
said premises and will not use the said premises for lodging or sleeping purposes. 

  

	13.	Default. In the event of any failure of the Lessee to pay any rent or other charges herein set forth within Ten (10) days after such rent or charges shall be due, and without
demand therefore; or if Lessee shall underlet said premises, mortgage, pledge or assign this Lease without Lessor’s written consent first obtained, which shall not be unreasonably withheld; or any failure of Lessee to perform any of the
covenants, conditions and agreements contained herein to be performed or observed by Lessee, or any of the rules and regulations printed herein, or any reasonable additions thereto, or any modification thereof and such failure by Lessee is not cured
within thirty (30) days after written notice of such failure has been delivered to Lessee; or if Lessee shall become bankrupt or insolvent or file any debtor proceedings or take or have taken against Lessee in any court pursuant to any statute,
either of the United States or any state, a petition in bankruptcy or insolvency, or for reorganizations or for the appointment of a receiver or trustee for all or a portion of Lessee’s property; or if Lessee shall make an assignment for the
benefit of creditors or petitions for or enters into an arrangement; or if Lessee shall abandon said premises or suffer this Lease to be taken under any writ of execution; then Lessor, in addition to all other rights and remedies provided in law or
equity, shall have the immediate right of re-entry and the right to remove all persons and property from the leased premises, without service of notice or resort to legal process, and may either: (1) relet the leased premises or any part thereof
upon such terms and conditions and at such rent as Lessor, in its sole discretion, may deem advisable, and apply such rent received to the payment of any indebtedness other than rent due hereunder from Lessee, to the payment of any costs and
expenses of such reletting, including brokerage fees, attorneys’ fees, and costs of alterations and repairs; to the payment of rent due and unpaid hereunder; and the remaining rent, if any, shall be held by Lessor and applied in the payment of
future rent as the same may become due and payable hereunder; and if such rent received from such reletting be less than that due and owing during that month from Lessee, Lessee shall be responsible for and pay any deficiency to Lessor; or (2)
terminate this Lease and recover from Lessee all damages it may incur by reason of such default, including the cost of recovering the leased premises, reasonable attorneys’ fees, and including the worth at the time of such determination of the
excess, if any, of the amount of reasonable rental value of the leased premises for the remainder of the stated term, all of which shall be immediately due and payable from Lessee to Lessor. 

  

	14.	 Liability of Lessor. The Lessor shall not be liable for any damage either to person or property, sustained by the Lessee or by other persons, due to the
building or any part thereof or any appurtenances thereof becoming out of repair, or due to the happening of any accident in or about said building, or due to any act or neglect of any Lessee or occupant of said building, or any other person, unless
such damage shall result from the negligence of Lessor, its employees, agents, or representatives. This provision shall apply especially (but not exclusively) to damage caused by water, snow, frost, steam, 

  

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sewage, illuminating gas or odors, or by the bursting or leaking pipes or plumbing works, and shall apply equally whether such damage be caused by the act or
neglect of other Lessees, occupants of said building, or of any other person, except Lessor, its employees, agents, or representatives and whether such damage be caused or occasioned by anything or circumstance above mentioned or referred to, or any
other thing or circumstance, whether of a like nature or of a wholly different nature. The Lessee further agrees that all personal property upon the demised premises shall be at the risk of the Lessee only and that the Lessor shall not be liable for
any damage thereto or theft thereof. 

  

	15.	Fire and Casualty. In the event the leased premises or the Building shall be partially damaged by fire or other casualty, the same, except as hereinafter provided, shall be
repaired as speedily as possible by and at the expense of the Lessor, but the rent shall not be abated unless the leased premises are partially untenable, in which event the rent shall be abated on a pro rata square footage basis; but in case the
damage should be so extensive as to render the leased premises untenable, then the rent shall cease until such time as the premises and the means of access to them shall be put in repair by and at the expense of the Lessor. In case of the total
destruction of said Building hereby leased, by fire or otherwise, or so much thereof that the Lessor shall desire to raze said building (whether or not the demised premises be affected), or in the event of the total destruction of the leased
premises the rent shall be paid up to the time of such destruction, and then and from thenceforth this Lease shall cease and come to an end. 

  

	16.	Insurance. The Lessee, during the demised term or any renewal thereof, shall maintain, at its expense, public liability and property damage insurance written by a company or
companies licensed in Kentucky and acceptable to Lessor, naming Lessor as an additional insured. The liability policy shall be one which shall afford protection in the minimum sum of ($1,000,000.00) in the event of injury or death to a single person
and in the minimum sum of ($1,000,000.00) in the event of any one accident and for property damage in the minimum sum of ($1,000,000.00). Lessee shall furnish to Lessor certificates evidencing that such insurance is in effect continuously during the
demised term or any renewal thereof. The certificate shall require thirty (30) days written notice from the insurer to Lessor of any cancellation or reduction in coverage. 

  

	17.	Condemnation. Should the leased premises or the building or the parking areas be taken, appropriated, or condemned for public purposes, in whole or in such substantial part
as to render the building unsuitable for Lessor’s purposes or the leased premises unsuitable for Lessee’s purposes, then the term of the Lease shall, at the option of the Lessor in the first instance and at the option of the Lessee in the
second instance, forthwith terminate as of the date of possession by the appropriating authority, and Lessor shall receive the entire award from such taking, but Lessee shall have the right to seek a separate award from the condemning authority, but
not from Lessor, and only after Lessor has received its award from the condemning authority and provided Lessee’s award does not diminish Lessor’s award. 

  

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	18.	Subordination. Lessee agrees that its rights under this Lease are subordinated to the lien of any mortgage or mortgages to any bank, insurance company, or any lending
institution now or hereinafter enforced against the land, any building of which the leased premises are a part or upon any building hereinafter placed upon the land of which the leased premises are a part, and to all advances made or hereafter to be
made upon the security thereof, provided that Lessee reserves the right to defend any foreclosure action initiated by any such entity as long as Lessee is not in default under this Lease. This section shall be self-operative, and no further
instrument of subordination shall be required by any mortgages. 

  

	19.	Limitations. This Lease does not grant any rights to light and air over property, except public streets adjoining the land on which said building is situated.

  

	20.	Utilities and Services. The Lessor shall pay all water, sewer, gas, and electrical bills rendered against or charged to said premises, provided, however, that should
Lessee’s occupancy of said premises necessitate increased electrical service; then and in such event said electrical service above normal service shall be paid for by Lessee. Lessee covenants and agrees that in the event additional electrical
service outlets shall be required for the performance of Lessee’s business as declared under the Lease, then and in such event Lessee agrees to pay for the installation, maintenance, and repair of said service for additional monthly billing
caused by said installations. The Lessor shall pay five (5) day (s) per week janitorial service excluding Saturdays, Sundays and legal holidays. 

  

	21.	Waiver. No provision of this Lease shall be altered, waived, amended or extended, except in writing signed by both parties. Lessor shall not be considered to have waived any
of the rights, covenants or conditions unless evidenced by its written waiver; and the waiver of one default or right shall not constitute the waiver of any other. The acceptance of rent shall not be construed to be a waiver of any breach or
condition of this Lease. 

  

	22.	Quiet Enjoyment. Lessor covenants with the Lessee that the Lessee, having performed its covenants and agreements herein set forth, shall have quiet and peaceable possession
of the leased premises on the terms and conditions herein provided. 

  

	23.	Successors. The provisions of this Lease shall be binding upon and inure to the benefit of the Lessor and Lessee, respectively and their respective successors, assigns,
heirs, executors and administrators. The Lessee agrees to become the Lessee of the Lessor’s successor in interest under the same terms and conditions of its tenancy hereunder. 

  

	24.	Paragraph Descriptions. The descriptions as to the contents of particular paragraphs herein are intended only for convenience and are in no way to be construed as a part of
this Lease, or as a limitation on the scope of the particular paragraphs to which they refer. 

  

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	25.	Lessor’s Right to Cure Default. If the Lessee shall default in the observance or performance of any of the terms or covenants on its part to be observed or performed
contained in this Lease, Lessor, without being under any obligation to do so and without thereby waiving such default may remedy such default for the account and at the expense of Lessee, and Lessee shall pay to the Lessor any expenditures or
obligations incurred for the payment of money in connection therewith, with interest at twelve percent (12%) and costs. 

  

	26.	Subrogation. Lessor and Lessee each hereby releases the other, and their respective employees, agents, and contractors, from any claims which either may have against the
other, or its employees, agents, and contractors, for loss or damage to the building and improvements on the leased premises or to the contents thereof and any personal property stored or placed thereon by either of them, caused by any of the perils
enumerated in standard fire and extended coverage insurance policies, whether such loss or damage caused was by the negligence by either of them, or their respective employees, agents, or contractors, or by others, and whether or not such insurance
on the building and improvements, contents and personal property was in force at the time of the loss or damage. Lessor and Lessee each agree to take any necessary action to make this release effective and binding upon their respective insurance
carriers so that such carriers specifically waive any right of subrogation that such carriers might otherwise have against either of the parties hereto or their employees or contractors. 

  

	27.	Notices. All notices required under this Lease shall be deemed to be properly sent if in writing and delivered personally, or sent by registered or certified mail, return
receipt requested, to the party of whom it is intended. When the Lessor, the same shall be sent to Lessor addressed to Lessor, Brown, Noltemeyer Company, 122 North Peterson Avenue, Louisville, Kentucky 40206 or any subsequent address which
the Lessor may give Lessee in writing, and when to the Lessee the same shall be sent to the Lessee addressed at 7410 New LaGrange Road, Suite 320, Louisville, Kentucky 40222 or to any subsequent address which the Lessee may give Lessor notice
of in writing. Date of service of a notice served by mail shall be the date on which such notice is deposited in the United States Postal Service sent by registered or certified mail, return receipt requested, postage prepaid.

  

	28.	 Late Charges. All rents and charges are due on the first of each month without notice. On the eleventh day, any rents due and unpaid shall be considered late
and there will be a late charge assessed for late payment of rents, said charge to be twenty five ($25.00) per month or five percent (5%) of the monthly rent, which ever is greater. The late charges assessed will be due and payable at the time the
regular rent is remitted. In the event all rent due, including late charges, remains unpaid for a period of 31 consecutive days, Lessor shall have the option of extending the delinquent period or giving notice to the Lessee to vacate premises. In
the event the Lessor shall decide to extend said delinquent period said extension shall be in writing and delivered to Lessee. Failure to receive said extension notice shall be deemed automatic notice of Lessor’s intent to have Lessee 

  

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vacate premises occupied under this Lease and no additional notice shall be deemed necessary. In the event Lessee shall have, in the opinion of Lessor,
vacated the leased premises without paying all rents and charges due, including but not limited to any and all charged due until expiration of said Lease the Lessor may then enter the premises after the said period of 31 days and either change the
existing lock or remove the former Lessee’s belongings and hold them for value against unpaid rent and charges due under this Lease. In addition, the Lessor shall have the duty to notify the former occupant in writing at the Lessee’s last
known address, that such belongings are being held and will be offered for sale after 30 days and that any proceeds therefrom shall be used to reduce any rents and charges due. In the event that after such sale and after deducting for related
expenses in connection with said sale, there exist, excess funds over the amounts due regarding said lease, any excess funds shall be held for Lessee in escrow and said Lessee notified that such funds are available. In the event proceeds are
insufficient to cover amounts due under this Lease, Lessor reserves the right to proceed under law, to collect any additional amounts due including any and all expense in connection with such procedures under law. 

  

	29.	Force Majeure. Notwithstanding anything to the contrary contained herein, whenever a period of time is herein prescribed for action to be taken by Lessor or Lessee, neither
Lessor or Lessee shall be liable or responsible for, and there shall be excluded from the computation for any such period of time, any delays due to strike, riots, acts of God, shortage of labor or materials, war, governmental laws, regulations or
restrictions, or any other causes of any kind whatsoever which are beyond the control of Lessor or; Lessee, as the case may be. 

  

	30.	Guaranty of Lease. In consideration of this lease between the Lessor and Lessee, and in addition to all covenants and agreements contained herein, the Lessee agrees to
guaranty the lease and signifies as such by endorsing the Guaranty of Lease attached hereto. 

  

	31.	Hazardous Substances. Lessee covenants and warrants that it will not engage in or permit any person or entity to engage in any transportation, storage, placement, handling,
treatment, discharge, generation, production, or disposal (collectively, ‘Treatment’) of any hazardous substance on or which affects the premises, the Building of which it is a part, or the underlying real estate ground and ground water in
violation of any application law, statute, ordinance, rule, or regulation. 

  
 Lessee hereby agrees it will indemnify defend, save and hold harmless Lessor and Lessor’s employees, agents, and their respective heirs, successors, and assigns (collectively, the ‘Lessee’s
Indemnities’) against and from, and to reimburse the Lessee’s Indemnities with respect to, any and all damages, claims, liabilities, losses, costs, and expenses (including without limitation, all attorney’s fees and expenses, court
costs, administrative costs, and costs of appeals), incurred by or asserted against the Lessee’s Indemnities by reason or arising out of the breach of any representation or undertaking of Lessee under this Paragraph 30 of this Lease.

  

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 Lessor warrants that to the best of its knowledge, information, and belief the premises, the building of
which it is a part, and the underlying real estate ground and ground water do not contain any, nor are they affected by any, such waste, nor has it received notification from any agency that the premises, the building of which it is a part and the
underlying real estate ground and ground water has been targeted for a Superfund clean up. 
  
 Lessor agrees to indemnify, defend, save, and hold harmless Lessee, its directors, officers, shareholders, employees, attorneys, insurers, agents, and their respective heirs, successors, and assigns (collectively, the
‘Lessor’s Indemnities) from and against, and to reimburse the Lessor’s Indemnities with respect to, any and all claims, liabilities, damages, losses, and expenses (including, but not limited to, all attorneys, fees, consulting fees,
administrative costs, court costs, and costs of appeals) incurred by or asserted against the Lessor’s Indemnities by reason of, arising out of, or resulting from the presence or suspected presence of any waste on the premises, the building of
which it is a part, or the underlying real estate ground and ground water. 
  
 As used herein, ‘Hazardous Substance’ shall have the same meaning as that term or the term ‘Hazardous Materials’ or the term ‘Hazardous Waste’ is defined by any law, statute, ordinance,
rule, or regulatory authority, and including, but not limited to, petroleum products, radioactive wastes, polychlorinated biphenyls, and asbestos (collectively, ‘waste’), but will not include body fluids received for medical testing,
provided Lessee’s storage and disposal of fluids complies with KRS chapter 24 and all applicable regulations promulgated thereunder. 
  
 The provision, covenants, and warranties in this Paragraph 31 will survive the termination, cancellation, modification, rescission, or expiration of this
Lease. 
  

	32.	Option to Renew. Lessee, not being in default, shall have the right to extend the term of this Lease for one (1) extension period of five (5) years, such extended period to
be at the then fair market rental rate and to begin immediately upon the expiration of the next preceding term. All the terms, covenants, and provisions of this Lease, excluding the rate of rent paid by Lessee to Lessor, shall apply to the extended
term. If Lessee elects to exercise the aforesaid option, it shall do so by giving Lessor notice in writing of its intention to do so not later than ninety (90) days prior to the expiration of the then current term of this Lease.

  

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 IN WITNESS THEREOF, the parties have executed this instrument, in duplicate, on the day and year first above written.

  

			
	BROWN, NOLTEMEYER COMPANY
		
	 By:
	 	/s/    KYLE J.
NOLTEMEYER        
	 	 	 Kyle J. Noltemeyer
 Property Manager

  

			
	HEALTH ESSENTIALS SOLUTIONS, INC.
		
	 By:
	 	/s/    MICHAEL R. BARR        

  

 - 11 -Amended and Restated 1999 Employee Stock Option Plan

 Exhibit 10.4 
  
 FEBRUARY 26, 2003 
  
 AMENDED AND RESTATED 
 HEALTHESSENTIALS SOLUTIONS, INC.  
  
 1999 EMPLOYEE STOCK OPTION PLAN 
  
 1.
PURPOSE. The purpose of this Plan is to strengthen the Company by providing an additional means of retaining and attracting competent management personnel and by providing to participating officers, directors and other key employees of
the Company added incentive for high levels of performance and for unusual efforts to increase the earnings of the Company through the opportunity for stock ownership offered by the Plan. 
  
 2. DEFINITIONS. For purposes of this Plan, capitalized words and phrases shall have the following meanings:

  
 A. Board. The word
“Board” means the Company’s Board of Directors. 
  
 B. Change in Control. A “Change in Control” occurs if the Company or any Significant Subsidiary of the Company, merges or consolidates, and is not the surviving corporation in such merger or
consolidation (or, if it is the surviving corporation, there has been a change in the control of more than [fifty percent (50%)] of the outstanding voting stock of the Company or such Significant Subsidiary), or if all or substantially all of
the Company’s or any Significant Subsidiary’s assets are acquired by another corporation, person or entity, or if [fifty percent (50%)] or more of the Company’s outstanding voting stock is acquired by a person, corporation or
other entity which is not now a shareholder of the Company. A Significant Subsidiary of the Company shall mean any subsidiary of the Company which, as of the last day of the fiscal year immediately preceding such Change in Control, constituted
[fifty percent (50%)] or more of the assets of the Company or contributed more than [fifty percent (50%)] to the net income of the Company during such fiscal year. 
  
 C. Code. The word “Code” means the Internal Revenue Code of 1986, as amended.

  
 D. Common Stock. The term
“Common Stock” means the Company’s Common Stock, $.001 par value per share, or the common stock or securities of a Successor that have been substituted therefor pursuant to Section 8 hereof. 
  
 E. Company. The word “Company” means
HealthEssentials Solutions, Inc. a Delaware corporation, with its principal place of business at 9721 Ormsby Station Road, Louisville, Kentucky 40223. 
  
 F. Date of Grant. The term “Date of Grant” means the effective date on which an Option is awarded to an Optionee,
as set forth in the Option Agreement executed 

  

 
pursuant to Section 7 by the Optionee and by a member of the Compensation Committee on behalf of the Company. 
  
 G. Disability. The word “Disability”
means, as defined by and to be construed in accordance with Code Section 22(e)(3), any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous
period of not less than twelve (12) months, and which renders Optionee unable to engage in any substantial gainful activity. Optionee shall not be considered to have a Disability unless Optionee furnishes proof of the existence thereof in such form
and manner, and at such time, as the Compensation Committee may require. 
  
 H. Exchange Act. The term “Exchange Act” means the Securities Exchange Act of 1934, as amended from time to time. 
  
 I. Family Group. The term “Family Group” means with respect to each Optionee, such
Optionee’s spouse and descendants (whether natural or adopted) and any trust solely for the benefit of such Optionee and/or such Optionee’s spouse, their respective ancestors and/or descendants (whether natural or adopted). 
  
 J. ISO. The acronym “ISO” means an
option to purchase Common Stock which at the time the option is granted qualifies as an incentive stock option within the meaning of Code Section 422. 
  
 K. NSO. The acronym “NSO” means a nonstatutory stock option to purchase Common Stock which at the time the option
is granted does not qualify as an ISO. 
  
 L.
Option. The word “Option” means an ISO or NSO. 
  
 M. Option Agreement. The term “Option Agreement” means an agreement between the Company and an Optionee with respect to one or more Options. 
  
 N. Option Price. The term “Option
Price” means the price to be paid for Common Stock upon the exercise of an Option granted under the Plan, in accordance with Section 7.A hereof. 
  
 O. Optionee. The word “Optionee” means an employee to whom Options have been granted under the Plan. 

 
 P. Optionee Representative. The term
“Optionee Representative” means the personal representative of the Optionee’s estate, and after final settlement of the Optionee’s estate, the successor or successors entitled thereto by law. 
  
 Q. Plan. The word “Plan” means the
Amended and Restated HealthEssentials Solutions, Inc. 1999 Stock Option Plan, as set forth herein, and as amended from time to time. 
  

 2 

 R. Compensation Committee. The term “Compensation Committee”
means the committee appointed by the Board to administer the Plan, pursuant to Section 4 hereof. 
  
 S. Subsidiary. The word “Subsidiary” means, as defined in Code Section 424(f), any corporation (other than the
Company) in an unbroken chain of corporations beginning with the Company if, at the time of the granting of an Option under the Plan, each of the corporations other than the last corporation in the unbroken chain owns stock possessing fifty percent
(50%) or more of the total combined voting power of all classes of stock of one of the other corporations in such chain. 
  
 T. Successor. The word “Successor” means the entity surviving a merger or consolidation with the Company, or the
entity that acquires all or substantially all of the Company’s assets or [fifty percent (50%)] or more of the Company’s outstanding voting stock (whether by merger, purchase or otherwise). 
  
 U. Ten Percent Shareholder. The term “Ten
Percent Shareholder” means an employee who, at the time an Option is granted, owns, or is deemed within the meaning of Section 422(b)(6) of the Code to own, stock possessing more than ten percent (10%) of the total combined voting power of all
classes of stock of the Company (or of its Subsidiary or parent (within the meaning of Section 424(e) of the Code)). 
  
 3. STOCK SUBJECT TO PLAN. Subject to adjustment as provided in Section 8 hereof, the aggregate number of shares of Common Stock which
may be issued under the Plan shall not exceed 10,392,306 shares. Authorized and unissued shares shall be delivered under the Plan. If any Option expires or terminates for any reason, the shares of Common Stock subject thereto shall again
become available under the Plan to the extent permitted by law. 
  
 4. ADMINISTRATION. The Compensation Committee shall have full power and authority to construe, interpret and administer the Plan and may from time to time adopt such rules and regulations for carrying out the Plan as it may
deem proper and in the Company’s best interests. The decision of a majority of the members of the Compensation Committee shall constitute the decision of the Compensation Committee and the Compensation Committee may act either at a meeting at
which a majority of the members of the Compensation Committee are present, or by a writing signed by all of the members of the Compensation Committee. The interpretation of any provisions of the Plan by the Compensation Committee shall be final,
conclusive, and binding upon all persons and the officers of the Company shall place into effect and shall cause the Company to perform its obligations under the Plan in accordance with the determinations of the Compensation Committee in
administering the Plan. 
  
 5. GRANT OF OPTIONS.

  
 A. Compensation Committee’s
Authority. Subject to the terms, provisions and conditions of the Plan, the Compensation Committee shall have exclusive jurisdiction: (i) to select the employees to whom Options shall be granted; (ii) to authorize the granting of ISOs, NSOs
or a combination of ISOs and NSOs to employees; (iii) to determine the number of shares 

  

 3 

 
of Common Stock subject to each Option; (iv) to determine the time or times when Options will be granted, the manner in which each Option shall be
exercisable, and the duration of the exercise period; (v) to determine the time or times when Options shall vest; (vi) to fix such other provisions of the Option Agreement as it may deem necessary or desirable consistent with the terms of the Plan;
and (vii) to determine all other questions relating to the administration of the Plan. 
  
 B. $100,000 ISO Exercisability Limitation. Notwithstanding Section 5.A hereof, the maximum aggregate fair market
value of Common Stock (determined as of the date the Option is granted) with respect to which ISOs will first become exercisable by an Optionee in any calendar year under all ISO plans of the Company and its Subsidiaries shall not exceed $100,000.
Any portion of an Option granted under the Plan in excess of the foregoing limit shall constitute a NSO. 
  
 6. ELIGIBILITY. Key employees of the Company and its Subsidiaries, including officers and directors who are also employees of the Company or
a Subsidiary, are eligible to receive ISOs and NSOs under the Plan. Key employees to whom Options may be granted under the Plan will be those selected by the Compensation Committee from time to time who, in the sole discretion of the Compensation
Committee, have contributed in the past or who may be expected to contribute materially in the future to the successful performance of the Company and its Subsidiaries. 
  
 7. TERMS OF OPTIONS. Each Option granted under the Plan shall be evidenced by an Option Agreement
substantially in the form attached hereto as Exhibit A (each, an “Option Agreement”) signed by the Optionee and by a member of the Compensation Committee on behalf of the Company. The Option Agreement shall constitute a
binding contract between the Company and the Optionee, and every Optionee, upon acceptance of such Option Agreement, shall be bound by the terms and restrictions of the Plan and of the Option Agreement. Such agreement shall be subject to the
following express terms and conditions and to such other terms and conditions that are not inconsistent with the Plan as the Compensation Committee may deem appropriate. 
  
 A. Option Price. The Option Price per share of Common Stock shall be determined by the
Compensation Committee at the time an Option is granted. The Option Price for ISOs shall be not less than: (i) the fair market value of Common Stock on the Date of Grant, or (ii) in the case of an ISO granted to a Ten Percent Shareholder, one
hundred ten percent (110%) of the fair market value of Common Stock on the Date of Grant. The fair market value of Common Stock shall be determined by: 
  
 (i) if the Common Stock is traded on the over-the-counter market, the closing high bid quotation for the Common Stock in the
over-the-counter market as reported by the National Association of Securities Dealers Automated Quotation System, on the business day immediately preceding the Date of Grant; 
  

 4 

 (ii) if the Common Stock is listed on a national securities exchange, the average of the
closing prices of the Common Stock on the Composite Tape for the ten (10) consecutive trading days immediately preceding such given date; and 
  
 (iii) if the Common Stock is neither traded on the over-the-counter market nor listed on a national securities exchange, such value as the
Compensation Committee, in good faith, shall determine. 
  
 B. Option Period. Subject to Section 7.C hereof, each Option Agreement shall specify the period for which the Option thereunder is granted and shall provide that the Option shall expire at the end
of such period. The Compensation Committee may extend such period provided that, in the case of an ISO, such extension shall not in any way disqualify the Option as an ISO without the Optionee’s consent. In no case shall such period, including
any such extensions, exceed ten (10) years from the Date of Grant, provided, however, that in the case of an ISO granted to a Ten Percent Stockholder, such period, including extensions, shall not exceed five (5) years from the Date of Grant.

  
 C. Lapse of ISO. An ISO shall
expire and no longer be exercisable at the earliest of the following times: 
  
 (i) ten (10) years from the Date of Grant; 
  
 (ii) five (5) years after the Date of Grant, if Optionee is a Ten Percent Shareholder on the Date of Grant; 
  
 (iii) three (3) months after termination of employment with the Company or a Subsidiary for reasons other than Disability, discharge for
cause, or death occurring less than three (3) months after termination of employment; 
  
 (iv) one (1) year after termination of employment with the Company or a Subsidiary because of Optionee’s Disability; 
  
 (v) one (1) year after the date of death if an Optionee dies
(A) while employed by the Company or a Subsidiary, or (B) within three (3) months after ceasing to be an employee of the Company or a Subsidiary; or 
  
 (vi) immediately upon termination of employment through discharge for cause, as determined by the Compensation Committee in its sole
discretion. 
  
 D. Exercise Period.
Except to the extent provided otherwise by Section 7.H hereof, each stock Option granted under Section 5 hereof shall be exercisable in accordance with the Option Agreement. 
  
 E. Leaves of Absence. The Compensation Committee may, in its discretion, treat all or any
portion of any period during which an Optionee is on military or on an approved 

  

 5 

 
leave of absence from the Company or a Subsidiary as a period of employment of the Optionee by the Company or Subsidiary for purposes of accrual of the
Optionee’s rights under the Plan. Notwithstanding the foregoing, if a leave of absence exceeds ninety (90) days and reemployment is not guaranteed by contract or statute, the Optionee’s employment by the Company or a Subsidiary for the
purposes of the Plan shall be deemed to have terminated on the 91st day of the leave. 
  
 F. Manner of Exercise. To exercise an Option, the Optionee shall deliver to the Company: (i) seven (7) days’ prior
written notice specifying the number of shares as to which the Option is being exercised and, if determined by counsel for the Company to be necessary, representing that such shares are being acquired for investment purposes only and not for purpose
of resale or distribution; (ii) an executed Shareholders’ Agreement in the form attached hereto as Exhibit B; (iii) an executed Noncompetition Agreement in a form satisfactory to the Compensation Committee; and (iv) payment by the
Optionee, or a broker-dealer (as provided in Section 7.G hereof), for such shares of the Option Price for the number of shares with respect to which the Option is exercised. On or before the expiration of the seven (7) day notice period, and
provided that all conditions precedent contained in the Plan are satisfied, the Company shall, without transfer or issuance tax or other incidental expenses to Optionee, deliver to Optionee, at the offices of the Company, or at such other place as
may be mutually acceptable, or, at the election of the Company, by certified mail addressed to Optionee at Optionee’s address as shown in the records of the Company, a certificate or certificates for the Common Stock. Options are exercisable
only in whole shares, and fractional share interests shall be treated in the manner described in the Option Agreement. If Optionee fails to accept delivery of the Common Stock, the Optionee’s rights to exercise the applicable portion of the
Option shall terminate. 
  
 G. Payment for
Shares. Except as otherwise provided in this Section 7, the Option Price for the Common Stock shall be paid in full when the Option is exercised. Subject to such rules as the Committee may impose and the terms of the Option Agreement,
the Option Price may be paid in whole or in part in (i) cash, (ii) certified or cashier’s check, (iii) whole shares of Common Stock owned by the Optionee evidenced by negotiable certificates, (iv) such other consideration as shall constitute
lawful consideration for the issuance of Common Stock and be approved by the Committee (including without limitation, the delivery of a copy of irrevocable instructions from the Optionee to a broker registered under the Securities Exchange Act of
1934, reasonably acceptable to the Committee, to sell certain of the Option Shares purchased upon exercise of the Option, or to pledge said shares as collateral for a loan, and to promptly deliver to the Corporation the amount of sale or loan
proceeds necessary to pay such purchase price), or (v) by a combination of such methods of payment. If payment of the Option Price is made in Common Stock, the value of the Common Stock used for payment of the Option Price shall be the fair market
value of the Common Stock, determined in accordance with Section 7.A hereof, on the business day preceding the day written notice of exercise is delivered to the Company. 
  
 H. Acceleration. Notwithstanding the provisions of Sections 7.B or Section 7.D
hereof to the contrary, if there is a Change in Control, the exercise dates of all outstanding 

  

 6 

 
Options shall accelerate so that each Option outstanding may be exercised on or after the date of the Change in Control. 
  
 I. ISOs. Each Option Agreement which provides
for the grant of an ISO shall contain such terms and provisions as the Compensation Committee deems necessary or desirable to qualify such Option as an ISO within the meaning of Code Section 422. 
  
 J. Transferability of Options. During
Optionee’s lifetime, the Option shall be exercisable only by Optionee, and neither the Option nor any right hereunder shall be transferable except (i) among such Optionee’s Family Group, (ii) by will, or (iii) by the laws of descent and
distribution. The Option may not be subject to execution or other similar process. If Optionee attempts to alienate, assign, pledge, hypothecate or otherwise dispose of the Option or any of Optionee’s rights hereunder, except as provided
herein, or in the event of any levy, attachment, execution or similar process upon the rights or interests hereby conferred, the Company may, in its sole and absolute discretion, terminate the Option by notice to Optionee and it shall thereupon
become null and void. 
  
 8. ADJUSTMENT OF SHARES.
In the event of capital adjustment after the effective date of the Plan in the Common Stock of the Company by reason of any reorganization, recapitalization, stock split, stock dividend, combination or exchange of shares, merger or consolidation, or
any other change (after the effective date of the Plan) in the nature or number of shares of Common Stock of the Company, a proportionate adjustment shall be made in the maximum number and kind of shares which may be delivered under the Plan, and in
the Option Price under and the number and kind of shares of Common Stock covered by outstanding Options granted under the Plan. By virtue of such a capital adjustment, the price of any share under Option shall be adjusted so that there will be no
change in the aggregate purchase price payable upon exercise of any such Option. Such determination by the Compensation Committee shall be conclusive. 
  
 Without limiting the generality of the foregoing, if (i) there is a Change in Control of the Company, and (ii) as a result of the transactions
contemplated by the Change in Control, a Successor will acquire all or substantially all of the assets or [fifty percent (50%)] of more of the Company’s outstanding voting stock, then the kind of shares of common stock which shall be
subject to the Plan and to each outstanding Option shall automatically be converted into and replaced by shares of common stock, or such other class of equity securities having rights and preferences no less favorable than common stock of the
Successor, and the number of shares subject to the Options and the purchase price per share upon exercise of the Options shall be correspondingly adjusted, so that, by virtue of such Change in Control of the Company, each Optionee shall have the
right to purchase (A) that number of shares of the Successor which, as of the date of the Change in Control, have a fair market value equal to the fair market value of the shares of the Company theretofore subject to an Option, (B) for a purchase
price per share which, when multiplied by the number of shares of the Successor subject to the Option, shall equal the aggregate exercise price at which the Optionee could have acquired shares of the Company under such Option. 
  

 7 

 The granting of an Option pursuant to this Plan shall not affect in any way the right and power of the
Company to make adjustments, reorganizations, reclassifications, or changes of its capital or business structure or to merge, consolidate, dissolve, liquidate, sell or transfer all or any part of its business or assets; provided, however, that the
Company shall not, and shall not permit its Subsidiaries to, recommend or agree or consent to a transaction or series of transactions which would result in a Change of Control of the Company unless and until the person or persons acquiring or
succeeding to assets or capital stock of the Company or its Subsidiaries as a result of such transaction or transactions agrees to be bound by the terms of the Plan so far as it pertains to Options theretofore granted and agrees to assume and
perform the obligations of the Company and its Successor under the Plan. 
  
 9. COMPLIANCE WITH OTHER LAWS AND REGULATIONS. Upon the exercise of an Option at a time when there is not in effect a registration statement under the Securities Act of 1933, as amended, and any
applicable state securities laws (the “Securities Laws”) relating to the shares of Common Stock issuable upon exercise thereof and available for delivery a prospectus meeting the requirements of the Securities Laws, the shares of Common
Stock may be issued only if the Optionee or Optionee Representative represents and warrants in writing to the Company that the shares being purchased are being acquired for investment and not with a view to the distribution thereof. The shares of
the Common Stock shall contain such legends or other restricture endorsements as counsel for the Company shall deem necessary or proper. No shares of Common Stock shall be purchased upon the exercise of any Option unless and until there shall have
been satisfied any applicable requirements of the Securities and Exchange Commission or other regulatory agencies having jurisdiction and of any exchanges upon which stock of the Company may be listed. 
  
 10. NO RIGHTS AS SHAREHOLDER. No Optionee or Optionee’s
Representative shall have any rights as a shareholder with respect to Common Stock subject to Optionee’s Option before the date of issuance to the Optionee of a certificate or certificates for such shares. 
  
 11. NO RIGHTS TO CONTINUED EMPLOYMENT. The Plan and any Option
granted under the Plan shall not confer upon any Optionee any right with respect to continuance of employment by the Company or any Subsidiary, nor shall it interfere in any way with the right of the Company or any Subsidiary by which an Optionee is
employed to terminate Optionee’s employment at any time. 
  
 12. TERMINATION. The Amended Plan shall terminate on February 26, 2013, ten (10) years from the earlier of the date it was adopted by the Board or approved by the shareholders of the Company, and may be terminated at any
earlier time by the Compensation Committee. No Option shall be granted after termination of the Plan. Termination of the Plan, however, shall not affect the validity of any Option theretofore granted under the Plan. 
  
 13. AMENDMENT. The Board shall have the right, at any time, to
amend, suspend or terminate the Plan in any respect that it may deem to be in the best interests of the Company, except that, without approval by shareholders of the Company holding not less than a majority of the votes represented and entitled to
be voted at a duly held meeting of the Company’s 

  

 8 

 
shareholders, no amendment shall be made if shareholder approval is necessary to qualify the Plan under the Securities and Exchange Commission Rule 16b-3. No
amendment of the Plan, however, may, without the consent of the Optionee or Optionee Representative, make any changes in any outstanding Option theretofore granted under the Plan which would adversely affect the rights of such Optionee or Optionee
Representative. 
  
 14. TAX WITHHOLDING. Upon the
exercise of any Option granted under the Plan, or upon the disposition of any Common Stock acquired by the exercise of an ISO granted under the Plan within two (2) years from the Date of Grant or one (1) year after such Common Stock is transferred
to the Optionee, the Company shall have the right to require Optionee to remit to the Company an amount sufficient to satisfy all federal, state and local withholding tax requirement, or, alternatively, the Company shall have the right to retain
Common Stock otherwise payable to the Optionee pursuant to exercise of an Option in an amount sufficient to satisfy such withholding requirements, before the delivery to the Optionee of any certificate(s) for shares of Common Stock. 
  
 15. GOVERNING LAW. This Plan and the Option Agreements entered
into under the Plan shall be governed by, and construed in accordance with, the laws of the Commonwealth of Kentucky. 
  
 16. EFFECTIVE DATE. The effective date of this Amended Plan shall be February 26, 2003. The Plan was adopted by the Board on February
    , 1999, and approved by stockholders of the Company holding not less than a majority of the shares represented and entitled to vote on February     , 1999. 
  

			
	 HEALTHESSENTIALS SOLUTIONS, INC.

		
	 By:
	 	/s/    MICHAEL R. BARR        
	 	 	 Michael R. Barr,
 Chief Executive Officer

  

 9

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