Document:

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                                                                   Exhibit 10.27

                                 AMENDMENT NO. 4
                                     TO THE
                        KINDRED & AFFILIATES 401(k) PLAN

     This is Amendment No. 4 to the Kindred & Affiliates 401(k) Plan (the
"Plan") as last amended and restated as of March 1, 2000.

                                    RECITALS

A.   Kindred Healthcare, Inc. (the "Company") maintains the Plan and has
     reserved the right in Section 9.1 of the Plan to amend the Plan from time
     to time in its discretion.

B.   The Company wishes to amend the Plan to provide for automatic correction of
     any failures of a discrimination test applicable to the matching
     contribution formula under the Plan.

                                    AMENDMENT

     1.   Section 3.2 of the Plan is hereby amended effective January 1, 1997 by
the addition of the following new subsection (e) at the end thereof:

          (e)  Each Matching Contribution level under Section 3.2(d) above must
               benefit a group of Participants that satisfies Code Section
               410(b) minimum coverage requirements (without regard to the
               average benefit percentage test of Treasury Regulation Section
               1.410(b)-5) for each Plan Year, as required by Treasury
               Regulation Section 1.401(a)(4)-4. If the Administrator determines
               that such minimum coverage requirement of Section 410(b) of the
               Code is not initially satisfied for one of the Matching
               Contribution levels for a Plan Year, the following rules shall
               apply:

               (i)  the Administrator shall establish a list of Non-Highly
                    Compensated Employee Participants who do not have the
                    necessary completed Years of Service to be eligible for the
                    level of Matching Contribution that does not meet the
                    coverage requirement;

               (ii) the Administrator shall designate the Non-Highly Compensated
                    Employee Participant from among the group identified in (i)
                    above with the highest number of Years of Service as of
                    March 31 of the Plan Year as eligible for that Matching
                    Contribution level (if more than one Participant meets that
                    condition, only the Participant with the earliest hire date
                    shall be considered so eligible), and

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               (iii) if the minimum coverage requirement is still not satisfied,
                     step (ii) is repeated so that the Participant with the next
                     highest number of Years of Service (or earliest hire date)
                     shall be designated as eligible for that level of Matching
                     Contribution, and so on until the minimum coverage
                     requirement is satisfied.

     IN WITNESS WHEREOF, the Employer has caused this Amendment No. 4 to be
executed this 18th day of December, 2002.

                                        KINDRED HEALTHCARE, INC.

                                        By /s/ Richard E. Chapman
                                           -------------------------------------

                                        Title: CIO,CAO & SVP
                                               ---------------------------------

                                        2<PAGE>

                                                                   Exhibit 10.28

                                 AMENDMENT NO. 5
                                     TO THE
                        KINDRED & AFFILIATES 401(k) PLAN

     This is Amendment No. 5 to the Kindred & Affiliates 401(k) Plan (the
"Plan") as last amended and restated as of March 1, 2000.

                                    RECITALS

A.   Kindred Healthcare, Inc. (the "Company") maintains the Plan and has
     reserved the right in Section 9.1 of the Plan to amend the Plan from time
     to time in its discretion.

B.   The Company wishes to amend the Plan to

                                    AMENDMENT

     1.   Section 1.9 of the Plan is hereby amended to read in its entirety as
     follows:

          Compensation means, for any Plan Year or portion thereof during which
          an Employee is eligible to participate in this Plan (which shall not
          include compensation payable for periods after employment terminates,
          such as severance pay, but shall include vacation time earned but no
          yet paid as of that last date at work), total compensation paid to an
          Employee by the Employer that is includable in the Participant's gross
          income, including bonuses, commissions and overtime, but excluding (i)
          reimbursements or other expense allowance, (ii) fringe benefits (cash
          and noncash), (iii) moving expenses, (iv) deferred compensation, (v)
          welfare benefits, and (vi) amounts realized from the exercise of a
          nonqualified stock option (or the lifting of restrictions on
          restricted stock) or the sale or exchange of stock acquired under a
          qualified stock option. Despite the exclusions in the preceding
          sentence, Compensation shall include any amounts deducted pursuant to
          Code Sections 125 (flexible benefit plans), 402(a)(8) (salary
          redirection), 402(h)(1)(B) (simplified employee plans), 403(b), and
          132(f)(4) (effective January 1, 1998). Effective for Plan Years
          beginning on or after January 1, 1989, Compensation shall be limited
          to such amount as determined pursuant to Code Section 401(a)(17). For
          Plan Years beginning on or after January 1, 1994, Compensation shall
          be limited to $150,000, or such higher amount determined by the
          Commissioner of Internal Revenue pursuant to Section 401(a)(17) of the
          Code.

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     2.   Section 1.21 of the Plan is hereby amended to read in its entirety as
     follows:

          Highly Compensated Employee means any Employee of the Employer who (i)
          was a five percent owner of the Company during the current Plan Year
          or the preceding Plan Year, or (ii) during the preceding Plan Year,
          received Compensation from the Company in excess of $80,000 (as such
          amount may be adjusted from time to time by the Secretary of the
          Treasury) and was in the top-paid group of employees for such Plan
          Year.

     3.   Section 4.5(b) of the Plan is hereby amended to read as follows:

          25% of the Participant's compensation (as defined in Section 415(c)(3)
          of the Code), including compensation under Section 132(f) of the Code
          effective January 1, 1998.

     4.   Section 4.7 and 11.3 of the Plan are hereby amended effective March 1,
     2000 by the addition of the following language at the beginning of each
     section to reflect the repeal of Section 415(e):

          "This section shall no longer apply effective January 1, 2000."

     5.   Section 5.10(b) of the Plan is hereby amended which shall read in its
     entirety as follows:

          For purposes of this Section an eligible rollover distribution is
          described in IRC Section 402(c)(4), which the participant can elect to
          roll over to another plan pursuant to IRS Section 401(a)(31), excludes
          hardship withdrawals (effective January 1, 1999) as defined in IRC
          401(k)(2)(B)(i)(IV) which are attributable to the participant's
          elective contributions under Treasury Regulation Section
          1.401(k)-1(d)(2)(ii).

     IN WITNESS WHEREOF, the Employer has caused this Amendment No. 5 to be
executed this 18th day of December, 2002.

                                            KINDRED HEALTHCARE, INC.

                                            By Richard E. Chapman
                                               ---------------------------------

                                            Title: CIO, CAO & SVP
                                                   -----------------------------

                                        2<PAGE>

                                                                   EXHIBIT 10.29

                             AMENDMENT NO. 6 TO THE
                        KINDRED & AFFILIATES 401(k) PLAN

     This is an Amendment to the Kindred & Affiliates 401(k) Plan as most
recently amended and restated effective March 1, 2000 (the "Plan").

                                    Recitals

A.   Kindred Healthcare, Inc. (the "Employer") maintains the Plan and has
     reserved the right to amend the Plan from time to time in its discretion.

B.   This amendment of the Plan is adopted to reflect certain provisions of the
     Economic Growth and Tax Relief Reconciliation Act of 2001 ("EGTRRA"). This
     amendment is intended as good faith compliance with the requirements of
     EGTRRA and is to be construed in accordance with EGTRRA and guidance issued
     thereunder. Except as otherwise provided, this amendment shall be effective
     as of the first day of the first Plan year beginning after December 31,
     2001.

C.   This Amendment to the Plan is also adopted to reflect the model amendments
     in Revenue Procedure 2002-29 which provides that qualified retirement plans
     generally must be amended by the end of the first Plan year beginning on or
     after January 1, 2003 to the extent necessary to comply with final and
     temporary regulations under section 401(a)(9) of the Internal Revenue Code,
     relating to required minimum distributions.

D.   This amendment shall supersede the provisions of the Plan to the extent
     those provisions are inconsistent with the provisions of this amendment.

                                   Amendments

                   Section 1-- MODIFICATION OF TOP-HEAVY RULES

     1.1  Effective Date. This section shall apply for purposes of determining
whether the Plan is a top-heavy plan under section 416(g) of the Code for Plan
Years beginning after December 31, 2001, and whether the Plan satisfies the
minimum benefits requirements of section 416(c) of the Code for such years. This
section amends Section 11 of the Plan.

     1.2  Key Employee. Key Employee means any employee or former employee
(including any deceased employee) who at any time during the Plan Year that
includes the Determination Date was an officer of any member of the Employer
Group having annual compensation greater than $130,000 (as adjusted under
Section 416(i)(1) of the Code for Plan Years beginning after December 31, 2002),
a 5-percent owner of any member of the Employer Group, or a 1-percent owner of
any member of the Employer Group having annual compensation of more than
$150,000. For this purpose, annual compensation means compensation within the

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meaning of Section 415(c)(3) of the Code. The determination of who is a Key
Employee will be made in accordance with Section 416(i)(1) of the Code and the
applicable regulations and other guidance of general applicability issued
thereunder.

     1.3. Determination of Present Values and Amounts. This section 1.3 shall
apply for purposes of determining the present value of accrued benefits and the
amounts of account balances of employees as of the Determination Date.

          1.3.1  Distributions During Year Ending On The Determination Date. The
present values of accrued benefits and the amounts of account balances of an
employee as of the Determination Date shall be increased by the distributions
made with respect to the employee under the Plan and any Plan aggregated with
the Plan under Section 416(g)(2) of the Code during the 1-year period ending on
the Determination Date. The preceding sentence shall also apply to distributions
under a terminated Plan which, had it not been terminated, would have been
aggregated with the Plan under Section 416(g)(2)(A)(i) of the Code. In the case
of a distribution made for a reason other than separation from service, death,
or disability, this provision shall be applied by substituting "5-year period"
for "1-year period."

          1.3.2  Employees Not Performing Services During Year Ending On The
Determination Date. The accrued benefits and accounts of any individual who has
not performed services for the employer during the 1-year period ending on the
Determination Date shall not be taken into account.

     1.4  Minimum Benefits -- Matching Contributions. Matching Contributions
shall be taken into account for purposes of satisfying the minimum contribution
requirements of Section 416(c)(2) of the Code and the Plan. The preceding
sentence shall apply with respect to Matching Contributions under the Plan or,
if the Plan provides that the minimum contribution requirement shall be met in
another Plan, such other Plan. Matching Contributions that are used to satisfy
the minimum contribution requirements shall still be treated as Matching
Contributions for purposes of the actual contribution percentage test and other
requirements of Section 401(m) of the Code.

                    Section 2 - LIMITATIONS ON CONTRIBUTIONS

     2.1  Effective Date. This section shall be effective for limitation years
beginning after December 31, 2001.

     2.2  Maximum Annual Addition. Except to the extent permitted under Section
7 of this Amendment and Section 414(v) of the Code, if applicable, the annual
addition that may be contributed or allocated to a Participant's Account under
the Plan for any Limitation Year shall not exceed the lesser of:

          (a)  $40,000, as adjusted for increases in the cost-of-living under
               Section 415(d) of the Code, or

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          (b)  100 percent of the Participant's compensation, within the meaning
               of Section 415(c)(3) of the Code, for the Limitation Year. The
               compensation limit referred to in this (b) shall not apply to any
               contribution for medical benefits after separation from service
               (within the meaning of Section 401(h) or Section 419A(f)(2) of
               the Code) which is otherwise treated as an annual addition.

               Section 3 -- DIRECT ROLLOVERS OF PLAN DISTRIBUTIONS

     3.1  Effective Date. This Section shall apply to distributions made after
December 31, 2001.

     3.2  Modification Of Definition Of Eligible Retirement Plan. For purposes
of the direct rollover provisions in Section 5.10 of the Plan, an Eligible
Retirement Plan shall also mean an annuity contract described in Section 403(b)
of the Code and an eligible Plan under Section 457(b) of the Code which is
maintained by a state, political subdivision of a state, or any agency or
instrumentality of a state or political subdivision of a state and which agrees
to separately account for amounts transferred into such Plan from this Plan. The
definition of Eligible Retirement Plan shall also apply in the case of a
distribution to a surviving spouse, or to a spouse or former spouse who is the
alternate payee under a qualified domestic relation order, as defined in Section
414(p) of the Code.

     3.3  Modification Of Definition Of Eligible Rollover Distribution To
Exclude Hardship Distributions. For purposes of the direct rollover provisions
in Section 5.10 of the Plan, any amount that is distributed on account of
hardship shall not be an eligible rollover distribution and the distributee may
not elect to have any portion of such a distribution paid directly to an
Eligible Retirement Plan.

     3.4  Modification Of Definition Of Eligible Rollover Distribution To
Include After-Tax Employee Contributions. For purposes of the direct rollover
provisions in Section 5.10 of the Plan, a portion of a distribution shall not
fail to be an eligible rollover distribution merely because the portion consists
of after-tax employee contributions which are not includible in gross income.
However, such portion may be transferred only to an individual retirement
account or annuity described in Section 408(a) or (b) of the Code, or to a
qualified defined contribution Plan described in Section 401(a) or 403(a) of the
Code that agrees to separately account for amounts so transferred, including
separately accounting for the portion of such distribution which is includible
in gross income and the portion of such distribution which is not so includible.

                     Section 4 -- ROLLOVERS FROM OTHER PLANS

     The Plan will accept Rollover Contributions and/or direct rollovers of
distributions made after December 31, 2001, from the types of Plans specified
below beginning January 1, 2003 (i) a qualified plan described in Section 401(a)
or 403(a) of the Code, excluding after-tax employee contributions; (ii) an
annuity contract described in Section 403(b) of the Code, excluding after-tax
employee contributions; (iii) an eligible plan under Section 457(b) of the Code
which is

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maintained by a state, political subdivision of a state, or any agency or
instrumentality of a state or political subdivision of a state, and (iv) the
portion of a distribution from an individual retirement account or annuity
described in Section 408(a) or 408(b) of the Code that is eligible to be rolled
over and would otherwise be includible in gross income.

           Section 5 -- ROLLOVERS DISREGARDED IN INVOLUNTARY CASH-OUTS

Effective for distributions made after December 31, 2002, for purposes of
Section 5.7(a) of the Plan, the value of a Participant's Nonforfeitable Account
Balance shall be determined without regard to that portion of the Account
Balance that is attributable to Rollover Contributions (and earnings allocable
thereto) within the meaning of Sections 402(c), 403(a)(4), 403(b)(8),
408(d)(3)(A)(ii), and 457(e)(16) of the Code. If the value of the Participant's
Nonforfeitable Account Balance as so determined is $5,000 or less, the Plan
Administrator may distribute the Participant's entire Nonforfeitable Account
Balance without consent in accordance with the Plan's terms.

                    Section 6 -- REPEAL OF MULTIPLE USE TEST

The multiple use test described in Treasury Regulation Section 1.401(m)-2 and
Section 3.2(i) of the Plan shall not apply for Plan Years beginning after
December 31, 2001.

                       Section 7 -- CATCH-UP CONTRIBUTIONS

     The following provision shall apply to contributions made after January 1,
2003. All Employees who are eligible to make Elective Deferrals under this Plan
and who have attained age 50 before the close of the Plan Year shall be eligible
to make catch-up contributions in accordance with, and subject to the
limitations of, Section 414(v) of the Code. Such catch-up contributions shall
not be taken into account for purposes of the provisions of the Plan
implementing the required limitations of Sections 402(g) and 415 of the Code.
The Plan shall not be treated as failing to satisfy the provisions of the Plan
implementing the requirements of Section 401(k)(3), 401(k)(11), 401(k)(12),
410(b), or 416 of the Code, as applicable, by reason of the making of such
catch-up contributions.

                   Section 8 -- INCREASE IN COMPENSATION LIMIT

     The annual compensation of each Participant taken into account in
determining allocations for any Plan Year beginning after December 31, 2001,
shall not exceed $200,000, as adjusted for cost-of-living increases in
accordance with Section 401(a)(17)(B) of the Code. Annual compensation means
compensation during the Plan Year or such other consecutive 12-month period over
which compensation is otherwise determined under the Plan (the determination
period). The cost-of-living adjustment in effect for a calendar year applies to
annual compensation for the determination period that begins with or within such
calendar year.

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             Section 9 - INCREASE IN ALLOWABLE PERCENTAGE DEFERRALS

     Section 3.1(a) and (c) of the Plan previously limited Elective
Contributions in two ways: based on whole percentages of pay between 1% and 16%,
and, to the extent that contributions from the Employer plus Elective
Contributions were, in the Administrator's judgement, likely to exceed the
deduction limits of Sections 401(k), 402(g) or 415 of the Code. With the
effectiveness of EGTRRA, the contribution and deduction limits have changed,
thereby allowing the Administrator to change its policy and the Employer to
amend the Plan accordingly, to allow all Employees to make Elective
Contributions, without such a low percentage limit. Therefore, effective January
1, 2003, all Participants shall be allowed the opportunity to make Elective
Contributions and Section 3.1(a) of the Plan is hereby amended so that as
amended, it reads as follows:

               (a)  Salary Redirection each payroll period must equal an
                    whole percentage from 1% to 30% of a Participant's
                    Compensation. Salary Redirection shall begin, be
                    increased or revoked as soon as practicable after a
                    Participant has entered into or changed his salary
                    reduction agreement via IVR. In the event a
                    Participant does not so elect when initially
                    eligible, he may subsequently elect to have Salary
                    Redirection made on his behalf at any time effective
                    for as soon as practicable after the Participant has
                    entered into a salary reduction agreement via IVR.

            Section 10 -- VESTING OF EMPLOYER MATCHING CONTRIBUTIONS

     13.1 Applicability. This Section shall apply to Participants with Accrued
Benefits derived from Matching or Profit Sharing Contributions (other than Prior
Plan Employer Contributions from the Hillhaven Corporation Deferred Savings Plan
as provided in Section 5.5(d) of the Plan) whether or not the Participant
completes an Hour of Service under the Plan in a Plan Year beginning after
December 31, 2001.

     13.2 Vesting Schedule. A Participant's Accrued Benefit derived Matching or
Profit Sharing Contributions (other than Prior Plan Employer Contributions from
the Hillhaven Corporation Deferred Savings Plan as provided in Section 5.5(d) of
the Plan) vest according to the following schedule:

                 Years of Vesting Service           Nonforfeitable Percentage
                 ------------------------           -------------------------
                            2                                     20
                            3                                     40
                            4                                     60
                            5                                     80
                            6                                    100

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                 Section 11 - MINIMUM DISTRIBUTION REQUIREMENTS

     11.1. General Rules

           11.1.1 Effective Date. This Amendment applies for purposes of
determining required minimum distributions for distribution calendar years
beginning with the 2003 calendar year. It shall only apply if and to the extent
the Plan provides for payment of a minimum required distribution amount on or
after the Required Beginning Date, rather than payment of a greater portion or
all of the Participant's Account Balance upon attainment of the Required
Beginning Date.

           11.1.2 Coordination with Minimum Distribution Requirements Previously
in Effect. If this Amendment specifies an effective date that is earlier than
calendar years beginning with the 2003 calendar year, required minimum
distributions for 2002 under this Amendment will be determined as follows. If
the total amount of 2002 required minimum distributions under the Plan made to
the distributee prior to the effective date of this Amendment equals or exceeds
the required minimum distributions determined under this Amendment, then no
additional distributions will be required to be made for 2002 on or after such
date to the distributee. If the total amount of 2002 required minimum
distributions under the Plan made to the distributee prior to the effective date
of this Amendment is less than the amount determined under this Amendment, then
required minimum distributions for 2002 on and after such date will be
determined so that the total amount of required minimum distributions for 2002
made to the distributee will be the amount determined under this Amendment.

           11.1.3 Precedence. The requirements of this Amendment will take
precedence over any inconsistent provisions of the Plan.

           11.1.4 Requirements of Treasury Regulations Incorporated. All
distributions required under this Amendment will be determined and made in
accordance with the Treasury regulations under section 401(a)(9) of the Internal
Revenue Code.

           11.1.5 TEFRA Section 242(b)(2) Elections. Notwithstanding the other
provisions of this Amendment, distributions may be made under a designation made
before January 1, 1984, in accordance with section 242(b)(2) of the Tax Equity
and Fiscal Responsibility Act (TEFRA) and the provisions of the Plan that relate
to section 242(b)(2) of TEFRA.

     11.2. Time and Manner of Distribution

           11.2.1 Required Beginning Date. The Participant's entire interest
will be distributed, or begin to be distributed, to the Participant no later
than the Participant's required beginning date.

           11.2.2 Death of Participant Before Distributions Begin. If the
Participant dies before distributions begin, the Participant's entire interest
will be distributed, or begin to be distributed, no later than as follows:

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                  (a) If the Participant's surviving spouse is the Participant's
           sole designated beneficiary, then, except as provided in this
           Amendment, distributions to the surviving spouse will begin by
           December 31 of the calendar year immediately following the calendar
           year in which the Participant died, or by December 31 of the calendar
           year in which the Participant would have attained age 70 1/2, if
           later.

                  (b) If the Participant's surviving spouse is not the
           Participant's sole designated beneficiary, then, except as provided
           in this Amendment, distributions to the designated beneficiary will
           begin by December 31 of the calendar year immediately following the
           calendar year in which the Participant died.

                  (c) If there is no designated beneficiary as of September 30
           of the year following the year of the Participant's death, the
           Participant's entire interest will be distributed by December 31 of
           the calendar year containing the fifth anniversary of the
           Participant's death.

                  (d) If the Participant's surviving spouse is the Participant's
           sole designated beneficiary and the surviving spouse dies after the
           Participant but before distributions to the surviving spouse begin,
           this section 11.2.2, other than section 11.2.2(a), will apply as if
           the surviving spouse were the Participant.

For purposes of this section 11.2.2 and section 11.4 , unless section 11.2.2(d)
applies, distributions are considered to begin on the Participant's required
beginning date. If section 11.2.2(d) applies, distributions are considered to
begin on the date distributions are required to begin to the surviving spouse
under section 11.2.2(a). If distributions under an annuity purchased from an
insurance company irrevocably commence to the Participant before the
Participant's required beginning date (or to the Participant's surviving spouse
before the date distributions are required to begin to the surviving spouse
under section 11.2.2(a)), the date distributions are considered to begin is the
date distributions actually commence.

           11.2.3 Forms of Distribution. Unless the Participant's interest is
distributed in the form of an annuity purchased from an insurance company or in
a single sum on or before the required beginning date, as of the first
distribution calendar year distributions will be made in accordance with
sections 11.3 and 11.4 of this Amendment. If the Participant's interest is
distributed in the form of an annuity purchased from an insurance company,
distributions thereunder will be made in accordance with the requirements of
section 401(a)(9) of the Code and the Treasury regulations.

     11.3. Required Minimum Distributions During Participant's Lifetime

           11.3.1 Amount of Required Minimum Distribution For Each Distribution
Calendar Year. During the Participant's lifetime, the minimum amount that will
be distributed for each distribution calendar year is the lesser of:

                  (a) the quotient obtained by dividing the Participant's
           account balance by the distribution period in the Uniform Lifetime
           Table set forth in section 1.401(a)(9)-9

                                        7

<PAGE>

           of the Treasury regulations, using the Participant's age as of the
           Participant's birthday in the distribution calendar year; or

                  (b) if the Participant's sole designated beneficiary for the
           distribution calendar year is the Participant's spouse, the quotient
           obtained by dividing the Participant's account balance by the number
           in the Joint and Last Survivor Table set forth in section
           1.401(a)(9)-9 of the Treasury regulations, using the Participant's
           and spouse's attained ages as of the Participant's and spouse's
           birthdays in the distribution calendar year.

           11.3.2 Lifetime Required Minimum Distributions Continue Through Year
of Participant's Death. Required minimum distributions will be determined under
this section 11.3 beginning with the first distribution calendar year and up to
and including the distribution calendar year that includes the Participant's
date of death.

     11.4. Required Minimum Distributions After Participant's Death

           11.4.1 Death On or After Date Distributions Begin.

                  (a) Participant Survived by Designated Beneficiary. If the
Participant dies on or after the date distributions begin and there is a
designated beneficiary, the minimum amount that will be distributed for each
distribution calendar year after the year of the Participant's death is the
quotient obtained by dividing the Participant's account balance by the longer of
the remaining life expectancy of the Participant or the remaining life
expectancy of the Participant's designated beneficiary, determined as follows:

                      (1) The Participant's remaining life expectancy is
           calculated using the age of the Participant in the year of death,
           reduced by one for each subsequent year.

                      (2) If the Participant's surviving spouse is the
           Participant's sole designated beneficiary, the remaining life
           expectancy of the surviving spouse is calculated for each
           distribution calendar year after the year of the Participant's death
           using the surviving spouse's age as of the spouse's birthday in that
           year. For distribution calendar years after the year of the surviving
           spouse's death, the remaining life expectancy of the surviving spouse
           is calculated using the age of the surviving spouse as of the
           spouse's birthday in the calendar year of the spouse's death, reduced
           by one for each subsequent calendar year.

                      (3) If the Participant's surviving spouse is not the
           Participant's sole designated beneficiary, the designated
           beneficiary's remaining life expectancy is calculated using the age
           of the beneficiary in the year following the year of the
           Participant's death, reduced by one for each subsequent year.

                  (b) No Designated Beneficiary. If the Participant dies on or
after the date distributions begin and there is no designated beneficiary as of
September 30 of the year

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<PAGE>

after the year of the Participant's death, the minimum amount that will be
distributed for each distribution calendar year after the year of the
Participant's death is the quotient obtained by dividing the Participant's
account balance by the Participant's remaining life expectancy calculated using
the age of the Participant in the year of death, reduced by one for each
subsequent year.

           11.4.2 Death Before Date Distributions Begin.

                  (a) Participant Survived by Designated Beneficiary. Except as
provided in this Amendment, if the Participant dies before the date
distributions begin and there is a designated beneficiary, the minimum amount
that will be distributed for each distribution calendar year after the year of
the Participant's death is the quotient obtained by dividing the Participant's
account balance by the remaining life expectancy of the Participant's designated
beneficiary, determined as provided in section 11.4.1.

                  (b) No Designated Beneficiary. If the Participant dies before
the date distributions begin and there is no designated beneficiary as of
September 30 of the year following the year of the Participant's death,
distribution of the Participant's entire interest will be completed by December
31 of the calendar year containing the fifth anniversary of the Participant's
death.

                  (c) Death of Surviving Spouse Before Distributions to
Surviving Spouse Are Required to Begin. If the Participant dies before the date
distributions begin, the Participant's surviving spouse is the Participant's
sole designated beneficiary, and the surviving spouse dies before distributions
are required to begin to the surviving spouse under section 11.2.2(a), this
section 11.4.2 will apply as if the surviving spouse were the Participant.

     11.5. Definitions.

           11.5.1 Designated Beneficiary. The individual who is designated as
the beneficiary under section 2.4 of the Plan and is the designated beneficiary
under section 401(a)(9) of the Internal Revenue Code and section 1.401(a)(9)-1,
Q&A-4, of the Treasury regulations.

           11.5.2 Distribution Calendar Year. A calendar year for which a
minimum distribution is required. For distributions beginning before the
Participant's death, the first distribution calendar year is the calendar year
immediately preceding the calendar year which contains the Participant's
required beginning date. For distributions beginning after the Participant's
death, the first distribution calendar year is the calendar year in which
distributions are required to begin under section 11.2.2. The required minimum
distribution for the Participant's first distribution calendar year will be made
on or before the Participant's required beginning date. The required minimum
distribution for other distribution calendar years, including the required
minimum distribution for the distribution calendar year in which the
Participant's required beginning date occurs, will be made on or before December
31 of that distribution calendar year.

                                        9

<PAGE>

           11.5.3 Life Expectancy. Life expectancy as computed by use of the
Single Life Table in section 1.401(a)(9)-9 of the Treasury regulations.

           11.5.4 Participant's Account Balance. The account balance as of the
last valuation date in the calendar year immediately preceding the distribution
calendar year (valuation calendar year) increased by the amount of any
contributions made and allocated or forfeitures allocated to the account balance
as of dates in the valuation calendar year after the valuation date and
decreased by distributions made in the valuation calendar year after the
valuation date. The account balance for the valuation calendar year includes any
amounts rolled over or transferred to the Plan either in the valuation calendar
year or in the distribution calendar year if distributed or transferred in the
valuation calendar year.

           11.5.5 Required Beginning Date. The date specified in section 5.6(c)
of the Plan.

     11.6. Optional Change. The following provision applies rather than any
conflicting provisions in this Amendment:

           11.6.1 Election to Apply 5-Year Rule to Distributions to Designated
Beneficiaries. If the Participant dies before distributions begin and there is a
designated beneficiary, distribution to the designated beneficiary is not
required to begin by the date specified in section 11.2.2 of this Amendment, but
the Participant's entire interest will be distributed to the designated
beneficiary by December 31 of the calendar year containing the fifth anniversary
of the Participant's death. If the Participant's surviving spouse is the
Participant's sole designated beneficiary and the surviving spouse dies after
the Participant but before distributions to either the Participant or the
surviving spouse begin, this election will apply as if the surviving spouse were
the Participant. This election will apply to all distributions.

     IN WITNESS WHEREOF, the Employer has signed this Amendment on the date set
forth below.

                                      KINDRED HEALTHCARE, INC.

                                      By: /s/ Richard E. Chapman
                                          -------------------------------------

                                      Title: CIO, CAO & SVP
                                             ----------------------------------

                                      Date: 12-18-2002
                                            -----------------------------------

                                       10

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