Document:

Second Amendment to Guaranty

 EXHIBIT 10.1.2 
  
 THIS SECOND AMENDMENT TO GUARANTY (this “Second Amendment”) is made and entered into this
30th day of September, 2003, by and between VENTAS REALTY, LIMITED PARTNERSHIP, a Delaware limited partnership
(together with its successors and assigns, the “Lender”) and TRANS HEALTHCARE, INC., a Delaware corporation (“Parent”), and the subsidiaries of Parent listed on Schedule A hereto (along with Parent, each a
“Guarantor” and collectively, the “Guarantors”) and shall be deemed effective as of November 1, 2002 (the “Effective Date”). 
  
 RECITALS 
  
 WHEREAS, Guarantors previously executed that certain Guaranty dated as of November 1, 2002 for the benefit of Lender (the “Original
Guaranty”); 
  
 WHEREAS, Lender and Guarantors
amended the Original Guaranty pursuant to that certain Re-sizing and First Amendment to Loan Documents by and among Ventas TRS, LLC, Mortgage Borrowers (as defined in the Guaranty), and Guarantors dated as of December 27, 2002 (the portions of such
agreement that amend the Guaranty hereafter being referred to as the “Resizing”) and that certain First Amendment to Guaranty by and between Lender and Guarantors dated as of April 28, 2003, and effective as of the Effective Date
(the “First Amendment” and together with the Resizing and the Original Guaranty, the “Guaranty”); 
  
 WHEREAS, initially capitalized terms used but not defined herein shall have the meaning ascribed to such term in the Guaranty; and 
  
 WHEREAS, at the request of Guarantor, the parties desire to amend the
Guaranty on the terms hereinafter set forth; 
  
 NOW,
THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are acknowledged hereby, the parties hereto, intending to be legally bound, agree to incorporate the foregoing recitals as if the same were more particularly
set forth in the body of this Second Amendment and further agree as follows: 
  
 1. Certain Definitions. 
  
 1.1. The following definition is added to Article 1 of the Guaranty: 
  
 “Rent Expense” shall mean rent expense computed under and in accordance with GAAP, exclusive of any non-cash adjustment under GAAP for
the straight lining of rent. 
  
 1.2. The following
definition is added to Article 1 of the Guaranty: 
  
 “Modified Consolidated Adjusted Leverage Ratio” shall mean, at any date, for Parent and its Consolidated Subsidiaries determined on a consolidated basis, the ratio of the sum of (i) Debt (excluding (A) reimbursement
obligations in connection with any undrawn letters of credit to the extent included in Debt and 

 
(B) Subordinated Debt for which Lender has entered into a written subordination agreement) and (ii) (a) Rent Expense for the Trailing Four Quarter Period
ending on such date multiplied by eight (8) to (b) Consolidated EBITDAR for the Trailing Four Quarter Period ending on such date plus (1) for the first Fiscal Quarter of the 2003 calendar year, $1,000,000; (2) for the second Fiscal Quarter of the
2003 calendar year, $750,000 (but not including the amount set forth in (b)(1) above); (3) for the third Fiscal Quarter of the 2003 calendar year, $500,000 (but not including the amounts set forth in (b)(1) and (b)(2) above) and (4) for the fourth
Fiscal Quarter of the 2003 calendar year, $250,000 (but not including the amounts set forth in (b)(1), (b)(2) and (b)(3) above). 
  
 1.3. The definition of “Consolidated Adjusted Leverage Ratio” is hereby deleted in its entirety and replaced with the following
definition: 
  
 “Consolidated Adjusted Leverage
Ratio” shall mean, at any date, for Parent and its Consolidated Subsidiaries determined on a consolidated basis, the ratio of the sum of (i) Debt (excluding reimbursement obligations in connection with any undrawn letters of credit to the
extent included in Debt) and (ii) (a) Rent Expense for the Trailing Four Quarter Period ending on such date multiplied by eight (8) to (b) Consolidated EBITDAR for the Trailing Four Quarter Period ending on such date plus (1) for the first Fiscal
Quarter of the 2003 calendar year, $1,000,000; (2) for the second Fiscal Quarter of the 2003 calendar year, $750,000 (but not including the amount set forth in (b)(1) above); (3) for the third Fiscal Quarter of the 2003 calendar year, $500,000 (but
not including the amounts set forth in (b)(1) and (b)(2) above) and (4) for the fourth Fiscal Quarter of the 2003 calendar year, $250,000 (but not including the amounts set forth in (b)(1), (b)(2) and (b)(3) above). 
  
 1.4. The following definition is added to Article 1 of the Guaranty:

  
 “Original Consolidated Adjusted Leverage
Ratio” shall mean, at any date, for Parent and its Consolidated Subsidiaries determined on a consolidated basis, the ratio of the sum of (i) Debt (excluding reimbursement obligations in connection with any undrawn letters of credit to the
extent included in Debt) and (ii) Rent Expense for the Trailing Four Quarter Period ending on such date multiplied by eight (8) to Consolidated EBITDAR for the Trailing Four Quarter Period ending on such date. 
  
 1.5. The following definition is added to Article 1 of the Guaranty:

  
 “CapitalSource Financing” shall mean,
collectively, those certain financings (and any refinancings, refundings, renewals or extensions thereof to the extent permitted under the terms hereof and under the terms of that certain Subordination Agreement dated as of the date hereof GTCR Fund
VI, L.P., GTCR VI Executive Fund, L.P., GTCR Associates VI and Lender) (i) in the 

  

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maximum principal amount of $12,000,000 pursuant to that certain Revolving Credit and Security Agreement dated as of December 31, 2002 between CapitalSource
Finance, LLC (“CapitalSource”) and Trans Lessees and certain Mezzanine Borrowers (“CapitalSource Borrowers”); and (ii) in the maximum principal amount of $8,000,000 pursuant to that certain Revolving Credit and
Security Agreement dated as of December 31, 2002 between certain affiliates of CapitalSource Borrowers and CapitalSource. 
  
 1.6. Clause (vii) of the definition of “Debt” in Article 1 of the Guaranty is hereby deleted in its entirety and replaced with the
following: 
  
 (vii) any obligations of Parent and its
Consolidated Subsidiaries with respect to redemption, repayment or other repurchase of any Equity Interest or the principal amount of any Subordinated Debt (regardless of whether interest or principal is then-currently payable with respect thereto);

  
 1.7. The definition of “Fixed Charge Coverage
Ratio” is hereby deleted in its entirety and replaced with the following definition: 
  
 “Fixed Charge Coverage Ratio” shall mean, for Parent and its Consolidated Subsidiaries on a consolidated basis, (I) (A) Consolidated EBITDAR for such period plus (B) (1) for the first Fiscal Quarter
of the 2003 calendar year, $1,000,000; (2) for the second Fiscal Quarter of the 2003 calendar year, $750,000 (but not including the amount set forth in (B)(1) above); (3) for the third Fiscal Quarter of the 2003 calendar year, $500,000 (but not
including the amounts set forth in (B)(1) and (B)(2) above) and (4) for the fourth Fiscal Quarter of the 2003 calendar year, $250,000 (but not including the amounts set forth in (B)(1), (B)(2) and (B)(3) above), divided by (II) the sum of (i)
scheduled principal payments on Debt of Parent and its Consolidated Subsidiaries required to be made during such period (regardless of whether actually paid) and amortization of discount or premium related to any such Debt for such period, whether
expensed or capitalized (including any payments made pursuant to the P&S Agreement), (ii) Cash Interest Expense for such period, (iii) Rent Expense for such period and (iv) dividends or distributions to the extent paid on or in respect of any
preferred equity of Parent for such period notwithstanding the prohibition on payment of same. The applicable period of determination shall be the Trailing Four Quarter Period. 
  
 1.8. The definition of “Consolidated Net Income” in Article 1 of the Guaranty is hereby deleted in
its entirety and replaced with the following: 
  
 “Consolidated Net Income” shall mean, for any period, the net income or loss of Parent and its Consolidated Subsidiaries during such period determined on a consolidated basis for such period taken as a single accounting
period in accordance with GAAP; provided that there shall be excluded from such 

  

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determination of net income or loss (i) adjustments for straight-line rent accounting, (ii) the income or loss of any Person (other than the Consolidated
Subsidiaries) in which Parent or any of its Consolidated Subsidiaries has an equity investment or comparable interest, except to the extent of the amount of dividends or other distributions actually received by Parent or any Loan Party in cash on a
non-contingent basis, without any obligation to return such dividend or distribution by the Parent or any Loan Party (net of any payments by Parent to a Non-Guarantor Subsidiary pursuant to Section 7.3 hereof), (iii) income or loss of a Person
accrued prior to the date it becomes a Consolidated Subsidiary or is merged or consolidated with or such Person’s assets are acquired by Parent or any of its Consolidated Subsidiaries and (iv) any after tax gains or losses attributable to sales
of non-current assets out of the ordinary course of business and write-downs of non-current assets in anticipation of losses to the extent they have decreased net income. The applicable period of determination shall be the Trailing Four Quarter
Period. 
  
 1.9. The definition of “Trailing Four
Quarter Period” in Article 1 of the Guaranty is hereby deleted in its entirety and replaced with the following: 
  
 “Trailing Four Quarter Period” shall mean the period of four consecutive full fiscal quarters of the Parent and its Consolidated
Subsidiaries ended on such date (or, in the case of any such date which is earlier than December 31, 2003, for the period from January 1, 2003 to and including such date multiplied by a fraction the numerator of which is 365 and denominator of which
is the number of days in such period). 
  
 2. Certain
Ratios. 
  
 2.1. Section 6.1(a) of the Guaranty is
hereby deleted in its entirety and replace with the following Section 6.1(a): 
  
 (a) At each Quarterly Measurement Date from and after March 31, 2003, the Fixed Charge Coverage Ratio will not be less than the ratio set forth below opposite such Quarterly Measurement Date (or any Quarterly
Measurement Date which falls during the period set forth below): 
  

	 Period

	  	Ratio

	 January 1, 2003 through December 31, 2003
	  	1.6:1
	 January 1, 2004 through December 31, 2004
	  	1.65:1
	 January 1, 2005 and thereafter
	  	1.7:1

  

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 2.2. Section 6.2 of the Guaranty is hereby deleted in its entirety and replaced with the following
Section 6.2: 
  
 Section 6.2 Leverage Ratio. 
  
 (a) Consolidated Adjusted Leverage Ratio. At each Quarterly
Measurement Date from and after March 31, 2003, the Consolidated Adjusted Leverage Ratio will not exceed the ratio set forth below opposite such Quarterly Measurement Date (or any Quarterly Measurement Date which falls during the period set forth
below): 
  

	 Period

	  	Ratio

	 January 1, 2003 through June 30, 2003
	  	5.40:1
	 July 1, 2003 through December 31, 2003
	  	5.20:1
	 January 1, 2004 through June 30, 2004
	  	5.15:1
	 July 1, 2004 through December 31, 2004
	  	5.05:1
	 January 1, 2005 through March 31, 2005
	  	5:00:1
	 April 1, 2005 through September 30, 2005
	  	4.95:1
	 October 1, 2005 and thereafter
	  	4.90:1

  
 (b) Modified
Consolidated Adjusted Leverage Ratio. At each Quarterly Measurement Date from and after March 31, 2003, the Modified Consolidated Adjusted Leverage Ratio will not exceed the ratio set forth below opposite such Quarterly Measurement Date (or any
Quarterly Measurement Date which falls during the period set forth below): 
  

	 Period

	  	Ratio

	 January 1, 2003 through June 30, 2003
	  	5.20:1
	 July 1, 2003 through December 31, 2003
	  	5.10:1
	 January 1, 2004 through June 30, 2004
	  	5.00:1
	 July 1, 2004 through December 31, 2004
	  	4.90:1
	 January 1, 2005 through June 30, 2005
	  	4:80:1
	 July 1, 2005 and thereafter
	  	4.75:1

  
 (c) For purposes of
calculating the foregoing ratios, Asset Dispositions or Acquisitions which have occurred during such period shall be included on a Pro Forma Basis. 
  

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 3. Borrowing Prohibition. Each Guarantor hereby covenants with Lender that such
Guarantor shall not incur any debt of any kind or nature whatsoever except (i) any unfunded commitments under the CapitalSource Financing or (ii) if incurring such debt would not (a) cause such Guarantor to violate any other applicable term or
condition of the Guaranty or (b) cause the Original Consolidated Adjusted Leverage Ratio to exceed the ratio set forth below opposite such Quarterly Measurement Date (or any Quarterly Measurement Date which falls during the periods set forth below):

  

	 Period

	  	Ratio

	 July 1, 2003 through December 31, 2003
	  	5.0:1
	 January 1, 2004 through December 31, 2004
	  	4.9:1
	 January 1, 2005 and thereafter
	  	4.8:1

  
 4.
Financial Reporting. Delivery of the quarterly and annual financial statements contemplated by Sections 5.1(a), 5.1(b) and 5.1(c) of the Guaranty shall be reported using the template being delivered by Lender to Guarantors as of
the date hereof, a hard copy of which is attached hereto as Exhibit A, and shall be accompanied by a checklist in the form attached hereto as Exhibit B, completed by Guarantors; provided, however, that the use of such
template and such checklist shall not excuse Guarantors from any financial reporting requirement under the Guaranty or any Mezzanine Loan Document. 
  
 5. Delivery Requirements. This Second Amendment shall not be effective until such time as all of the following conditions shall have
been satisfied or waived, as determined by Lender. Lender’s execution and delivery of this Second Amendment shall constitute Lender’s agreement that such conditions have been satisfied, subject to any written agreement between Lender and
Guarantors to the contrary. 
  
 5.1. Amendment
Documents. Lender shall have received a duly executed copy of each of this Second Amendment, the Second Amendment to Mezzanine Loan Agreement and the Second Amendment to Master Lease Agreement (collectively, the “Amendment
Documents”), all of which documents shall be held in escrow pending Lender’s review and approval (in Lender’s sole discretion) of Borrower’s financial reports for the second fiscal quarter of the 2003 calendar year. All of
the Delivery Requirements in each Amendment Document shall have been satisfied as set forth in such Amendment Document. 
  
 5.2. Legal Opinions. Lender shall have received legal opinions in form and substance satisfactory to Lender. 
  
 5.3. Expenses. Guarantors shall have paid all costs and
expenses incurred by Lender as of such date, including, without limitation, the transaction costs specified in Section 8 hereof, a summary of which has been provided to Guarantors by Lender on or prior to the date hereof. 
  
 5.4. Financial Information. Lender shall have received
financial information relating to Guarantors that is satisfactory to Lender including, without limitation, (i) financial projections for calendar years 2004 and 2005; (ii) all quarterly financial information for the second fiscal quarter of the 2003
calendar year required to be delivered by Guarantors to Lender; and (iii) a complete financial package, satisfactory to Lender, related to the “Properties” as defined in the Mortgage Loan Agreement. 
  

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 5.5. No Material Adverse Change. There shall not have occurred a material adverse
change with respect to the property, business, operations or prospects of the Guarantors or the Property, as determined by Lender. 
  
 5.6. Additional Matters. Lender shall have received such other certificates, opinions, documents and instruments as may have been
requested by Lender. All corporate and other proceedings, all other documents and all legal matters entered into or delivered in connection with the transactions contemplated by this Second Amendment shall be satisfactory in form and substance to
Lender. 
  
 6. Certification. From and after
the date hereof, any and all financial or other information delivered by Guarantors, or any of them, to Lender (regardless of whether such information is required to be delivered pursuant to the Guaranty) shall be accompanied by a then executed
certificate in the form attached as Exhibit C attached hereto. 
  
 7. Representations and Warranties of Guarantors. Without limiting in any way any representation or warranty in the Guaranty, each Guarantor represents and warrants that as of the date hereof: 
  
 7.1. Organization. Guarantor (i) is a duly organized and
validly existing entity as set forth on the attached Schedule A in good standing in the State of its organization as set forth on the attached Schedule A, (ii) has the requisite power and authority to carry on its business as now being conducted and
(iii) has the requisite power to execute and deliver, and perform its obligations under, this Second Amendment. 
  
 7.2. Authorization. The execution and delivery by Guarantor of this Second Amendment and Guarantor’s performance of its
obligations hereunder (i) have been duly authorized by all requisite action on the part of Guarantor, (ii) will not violate any provision of any applicable legal requirements, any order, writ, decree, injunction or demand of any court or other
governmental authority, any organizational document of Guarantor or any indenture or agreement or other instrument to which Guarantor is a party or by which Guarantor is bound and (iii) will not be in conflict with, result in a breach of, or
constitute (with due notice or lapse of time or both) a default under, or result in the creation or imposition of any lien of any nature whatsoever upon any of the property or assets of Guarantor pursuant to, any indenture or agreement or
instrument. Except for those obtained or filed on or prior to the date hereof, Guarantor is not required to obtain any consent, approval or authorization from, or to file any declaration or statement with, any governmental authority or other agency
in connection with or as a condition to the execution, delivery or performance of this Second Amendment. This Second Amendment has been duly authorized, executed and delivered by Guarantor. 
  
 7.3. Full and Accurate Disclosure. No statement of fact
made by or on behalf of Guarantor in this Second Amendment or in any other document or certificate delivered to Lender by Guarantor contains any untrue statement of a material fact or omits to state any material fact necessary to makes statements
contained herein or therein not misleading, including, without limitation, all of the financial information delivered by any 

  

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Guarantor or Affiliate of Guarantor prior or simultaneous to the execution of this Second Amendment, all of which Guarantor hereby acknowledges were relied
upon by Lender in executing this Second Amendment. There is no fact presently known to Guarantor which has not been disclosed to Lender which materially adversely affects, nor as far as Guarantor can foresee, might materially adversely affect the
business, operations or condition (financial or otherwise) of Guarantor. 
  
 7.4. Enforceability. This Second Amendment is a legal, valid and binding obligation of Guarantor, enforceable against Guarantor in accordance with its terms, subject to bankruptcy, insolvency and
other limitations on creditors’ rights generally and to equitable principles. 
  
 7.5. No Defaults or Modifications. To Guarantor’s actual knowledge, no Event of Default or monetary default under the Guaranty, the Note, the Mezzanine Loan Agreement, any of the other
Mezzanine Loan Documents or any document that was executed in connection with the CapitalSource Financing (the “CapitalSource Financing Documents”), has occurred or with the passage of time, giving of notice or both will exist.
There has been no modification to, or waiver by CapitalSource of, any CapitalSource Financing Documents. 
  
 7.6. No Offsets or Defenses. Through the date of this Second Amendment, and to Guarantor’s knowledge, Guarantor neither has nor
claims any offset, defense, claim, right of set-off or counterclaim against Lender under, arising out of or in connection with this Second Amendment, the Guaranty, the Note, or any of the other Mezzanine Loan Documents. In addition, Guarantor
covenants and agrees with Lender that if any offset, defense, claim, right of set-off or counterclaim exists about which Guarantor has knowledge as of the date of this Second Amendment, Guarantor hereby irrevocably and expressly waives the right to
assert such matter. 
  
 7.7. Reliance on
Representations and Warranties. Each Guarantor hereby agrees all representations, warranties, covenants and agreements made in this Second Amendment shall be deemed to have been relied upon by Lender notwithstanding any investigation
heretofore or hereafter made by Lender. 
  
 8.
Transactions Costs. Each Guarantor agrees to pay on the date hereof all costs and expenses incurred by Lender in connection with this Second Amendment, including, without limitation, all legal fees of Lender’s counsel and
travel costs. Each Guarantor shall pay its respective costs and expenses incurred in connection with this Second Amendment. 
  
 9. Meetings and Reviews. At any time during normal business hours, and with five (5) business days notice if prior to an Event of
Default, Guarantor shall permit, and make appropriate arrangements for, Lender and/or Lender’s representatives to discuss the affairs, operations, finances, accounts, business and/or operational and financial condition of Mezzanine Borrowers,
Trans Lessees, Guarantors and their respective Affiliates (the “Review Parties”) with, and be advised as to the same by, senior officers of the Review Parties (and such Review Parties’ independent accountants and other
financial advisors as would be 

  

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relevant to the topic(s) of the particular meeting), and to review, and make abstracts from and copies of, the books, accounts and records of the Review
Parties relative to any of the Property, all as Lender may deem appropriate for the purpose of verifying any report(s) delivered by Guarantor under the Guaranty or for otherwise ascertaining compliance with this Guaranty, or the business,
operational or financial condition of the Review Parties and/or any of the Property 
  
 10. Modifications. This Second Amendment may not be amended, modified or otherwise changed in any manner except by a writing executed by all of the parties hereto. 
  
 11. Severability. In case any provision of this Second
Amendment shall be invalid, illegal, or unenforceable, such provision shall be deemed to have been modified to the extent necessary to make it valid, legal, and enforceable. The validity, legality, and enforceability of the remaining provisions
shall not in any way be affected or impaired thereby. 
  
 12.
Further Assurances. Each Guarantor shall execute and deliver such further instruments and perform such further acts as may be reasonably requested by Lender from time to time to confirm the provisions of this Second Amendment, the
Guaranty and the Mezzanine Loan Documents, to carry out more effectively the purposes of this Second Amendment and the Mezzanine Loan Documents, or to confirm the priority of any lien created by any of the Mezzanine Loan Documents. 
  
 13. Successors and Assigns. This Second Amendment
applies to, inures to the benefit of, and binds all parties hereof, their heirs, legatees, devisees, administrators, executors, and permitted successors and assigns. 
  
 14. Governing Law. This Second Amendment shall be governed by, and construed in accordance with, the
laws of the State of New York, without giving effect to the conflict of laws provisions of said State. 
  
 15. Entire Agreement. This Second Amendment constitutes all of the agreements among the parties relating to the matters set forth
herein and supersedes all other prior or concurrent oral or written letters, agreements and understandings with respect to the matters set forth herein. 
  
 16. Full Force and Effect. The Guaranty and the Mezzanine Loan Documents remain in full force and effect. None of the
representations, warranties or covenants contained herein shall in no way limit in any way any representation, warranty or covenant contained in the Guaranty or any Mezzanine Loan Document. This Second Amendment shall constitute a “Mezzanine
Loan Document” as defined in the Guaranty. 
  
 17.
Amendment Controlling. This Second Amendment is considered by to be an integral part of the Guaranty. If there is any conflict between the terms of the Guaranty and this Second Amendment, the terms of this Second Amendment shall
control. Except as expressly amended herein, all other terms, agreements, and conditions of the Guaranty shall remain unmodified and in full force and effect. 
  

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 18. Counterparts/Fax Signatures. This Second Amendment may be executed in two or
more counterparts, any one of which need not contain the signatures of more than one party, but all such counterparts when taken together will constitute one in the same agreement. Confirmation of the execution of this Second Amendment by telex or
by telecopy or telefax of a facsimile page(s) executed by the parties shall be binding upon the parties hereto. 
  
 [Signature Page to Follow] 
  

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 IN WITNESS WHEREOF, the parties have caused this Second Amendment to Guaranty to be executed as of the
date first above written. 
  

	 LENDER:
  
 VENTAS REALTY, LIMITED PARTNERSHIP,
 a Delaware limited partnership

			
	 	 	By:	 	VENTAS, INC., a Delaware corporation
				
	 	 	 	 	 	 	 
	 	 	 	 	By:	 	/s/    T. Richard Riney        
	 	 	 	 	 	

	 	 	 	 	Name:	 	     T. Richard Riney        
	 	 	 	 	 	

	 	 	 	 	Title:	 	Executive Vice President and General Counsel
	 	 	 	 	 	

  

	 GUARANTOR:
  
 TRANS HEALTHCARE, INC.,
 a
Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 TRANS HEALTHCARE OF OHIO, INC.,
 a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THI OF OHIO ALFS, INC.,
 a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

	 THI PROPERTIES, INC.,
 a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THI SERVICES CORP.,
 a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THI SPECIALTY HOSPITALS OF OHIO, INC.,

a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 TRANS HEALTH MANAGEMENT, INC.,
 a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THI OF MARYLAND, INC.,
 a Delaware corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

	 PHYSICAL THERAPY PLUS, INC.,
 a Pennsylvania corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 DALE J. CORDIAL, PT, INC.,
 a Pennsylvania corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 DALE J. CORDIAL, PT, INC., NUMBER 4,
 a Pennsylvania corporation

		
	By:	 	 /s/    Anthony F. Misitano        

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THE PT GROUP OF PENN HILLS,
 a Pennsylvania general partnership

		
	By:	 	 TRANS HEALTHCARE, INC.,
 a Delaware corporation,
 its Partner

			
	 	 	By:	 	 /s/    Anthony F. Misitano        

	 	 	 	

	 	 	 	 	 Name: Anthony F. Misitano
 Title: President

	 THE PT GROUP PHYSICAL THERAPY FOR WOMEN,
 a Pennsylvania general partnership

		
	By:	 	 DALE J. CORDIAL, PT, INC.,
 a Pennsylvania corporation,
 its Partner

			
	 	 	By:	 	 /s/    Anthony F. Misitano        

	 	 	 	

	 	 	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THE PT GROUP OF MOON TOWNSHIP,
 a Pennsylvania general partnership

		
	By:	 	 DALE J. CORDIAL, PT, INC., NUMBER 4,
 a Pennsylvania corporation,
 its Partner

			
	 	 	By:	 	 /s/    Anthony F. Misitano        

	 	 	 	

	 	 	 	 	 Name: Anthony F. Misitano
 Title: President

  

	 THI THERAPY CONCEPTS, LLC,
 a Delaware limited liability company

		
	By:	 	 /s/    Jeffrey A. Barnhill        

	 	

	 	 	 Name: Jeffrey A. Barnhill
 Title: Vice-President

  

	 THI SERVICES OF MARYLAND, LLC,
 a Delaware limited liability company

		
	By:	 	 /s/    Jeffrey A. Barnhill        

	 	

	 	 	 Name: Jeffrey A. Barnhill
 Title: Vice-President

 Schedule A 
  

(GUARANTORS) 
  

	 GUARANTOR

	 	 TYPE OF ENTITY

		
	 1. Trans Healthcare, Inc.
	 	a Delaware corporation
		
	 2. Trans Healthcare of Ohio, Inc.
	 	a Delaware corporation
		
	 3. THI of Ohio ALFs, Inc.
	 	a Delaware corporation
		
	 4. THI Properties, Inc.
	 	a Delaware corporation
		
	 5. THI Services Corp.
	 	a Delaware corporation
		
	 6. THI Specialty Hospitals of Ohio, Inc.
	 	a Delaware corporation
		
	 7. Trans Health Management, Inc.
	 	a Delaware corporation
		
	 8. THI of Maryland, Inc.
	 	a Delaware corporation
		
	 9. THI Therapy Concepts, LLC
	 	a Maryland limited liability company
		
	 10. THI Services of Maryland, LLC
	 	a Maryland limited liability company
		
	 11. Physical Therapy Plus, Inc.
	 	a Pennsylvania corporation
		
	 12. Dale J. Cordial, PT, Inc.
	 	a Pennsylvania corporation
		
	 13. Dale J. Cordial, PT, Inc., Number 4
	 	a Pennsylvania corporation
		
	 14. The pt Group of Penn Hills
	 	a Pennsylvania general partnership
		
	 15. The pt Group Physical Therapy for Women
	 	a Pennsylvania general partnership
		
	 16. The pt Group of Moon Township
	 	a Pennsylvania general partnershipSecond Amendment to Master Lease Agreement

 EXHIBIT 10.1.3 
  
 THIS SECOND AMENDMENT TO MASTER LEASE AGREEMENT (this “Second Amendment”) is made and entered into
this 30th day of September, 2003, by and between VENTAS REALTY, LIMITED PARTNERSHIP, a Delaware limited partnership (“Landlord”) and THI OF OHIO AT CHARDON, LLC, THI OF OHIO AT GREENBRIAR NORTH, LLC, TRANS HEALTHCARE OF OHIO, INC.,
THI OF OHIO ALFS AT THE COMMONS, LLC, THI OF MARYLAND AT SOUTH RIVER, LLC, MILLENNIUM HEALTH AND REHABILITATION CENTER OF FORESTVILLE, LLC, AND MILLENNIUM HEALTH AND REHABILITATION CENTER OF ELLICOTT CITY, LLC (collectively,
“Tenant”) and shall be deemed effective, as to Section 1, 2 and 3, as of November 1, 2002 and as to the remaining Sections, as of date hereof (the “Effective Date”). 
  
 RECITALS 
  
 WHEREAS, Tenant and Landlord are parties to that certain Master Lease
Agreement dated as of November 1, 2002 (the “Original Lease”); 
  
 WHEREAS, Tenant and Landlord amended the Original Lease pursuant to that certain First Amendment to Master Lease Agreement by and between Tenant and Landlord dated as of April 28, 2003, and effective as of the
Effective Date (the “First Amendment” and together with the Original Lease, the “Lease”); 
  
 WHEREAS, initially capitalized terms used but not defined herein shall the meaning ascribed to such term in the Lease; and 
  
 WHEREAS, at the request of Tenant, the parties desire to amend the
Lease on the terms hereinafter set forth; 
  
 NOW,
THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are acknowledged hereby, the parties hereto, intending to be legally bound, agree to incorporate the foregoing recitals as if the same were more particularly
set forth in the body of this Second Amendment and further agree as follows: 
  
 1. Portfolio Coverage Ratio and Coverage Ratio. 
  
 1.1. The following definition is added to Section 2 of the Lease: 
  
 “Rent Expense” shall mean lease payments computed under and in accordance with GAAP, exclusive of any
non-cash adjustment under GAAP for the straight lining of rent 

 1.2. The definition of “Portfolio Coverage Ratio” is hereby deleted in its
entirety and replaced with the following definition: 
  
 “Portfolio Coverage Ratio” shall mean the ratio of (i) the Cash Flow for all of the Facilities for the applicable period; to (ii) Fixed Rent and all other debt service and Rent Expense relating to such Facilities,
excepting, however, any interest payment under any Approved Accounts Receivable Financing or any other corporate financing approved in writing by Landlord in Landlord’s sole discretion, in any event to the extent actually incurred, or
allocated, as to a Facility, for the applicable period. 
  
 1.3. The following definition is added to Section 2 of the Lease: 
  
 “Approved Accounts Receivable Financing” shall mean, collectively, those certain financings (i) in the maximum principal amount of $12,000,000 pursuant to that certain Revolving Credit and Security
Agreement dated as of December 31, 2002 between CapitalSource Finance, LLC (“CapitalSource”) and Tenants and certain Borrowers (“CapitalSource Borrowers”); and (ii) in the maximum principal amount of $8,000,000
pursuant to that certain Revolving Credit and Security Agreement dated as of December 31, 2002 between certain affiliates of CapitalSource Borrowers and CapitalSource. 
  
 1.4. The definition of “Coverage Ratio” is hereby deleted in its entirety and replaced with the
following definition: 
  
 “Coverage Ratio” shall
mean the ratio of (i) Cash Flow of any Facility for the applicable period; to (ii) the Fixed Rent payments allocated to such Facility and all other debt service and Rent Expense relating to such Facility for the applicable period, excepting,
however, any interest payment under any Approved Accounts Receivable Financing or any other corporate financing approved in writing by Landlord in Landlord’s sole discretion, in any event to the extent actually incurred, or allocated, as to a
Facility, for the applicable period. 
  
 1.5. Section
8.2.6.1 of the Lease is hereby deleted in its entirety and replace with the following Section 8.2.6.3 
  
 8.2.6.1 Coverage Ratio. Tenant shall maintain for each fiscal quarter a Coverage Ratio with respect to each Facility (other than St. Agnes
identified on Schedule 1 to the Lease (“St. Agnes”), The Commons at Greenbriar identified on Schedule 1 to the Lease (“Greenbriar Commons”) and Greenbriar Quality Care identified on Schedule 1
to the Lease (“Greenbriar Quality”)) of not less than 1.00 to 1.00. Tenant shall maintain for each fiscal quarter from and after (and including) the third fiscal quarter in calendar year 2003 a Coverage Ratio (a) with respect to
each of St. Agnes of not less than 1.00 to 1.00 and (b) with respect to Greenbriar Commons and Greenbriar Quality collectively of not less than 1.00 to 1.00. 
  

 - 2 - 

 1.6. Section 8.2.6.3 of the Lease is hereby deleted in its entirety and replaced with the
following Section 8.2.6.3: 
  
 8.2.6.3 Portfolio Coverage
Ratio. Tenant shall maintain for each fiscal quarter a Portfolio Coverage Ratio of (i) 1.20 to 1.00 for each fiscal quarter in calendar year 2003 and (ii) 1.25 to 1.00 for each fiscal quarter thereafter. 
  
 2. Minimum Occupancy. 
  
 2.1. Section 8.2.6.4 of the Lease is hereby deleted in its entirety
and replaced with the following Section 8.2.6.4: 
  
 8.2.6.4
Occupancy. 
  
 8.2.6.4.1 Minimum
Occupancy. Tenant shall maintain a minimum occupancy rate in the applicable Facility (other than Greenbriar Commons and the Greenbriar Hospital Facility identified on Schedule 1 to the Lease (“Greenbriar Hospital”))
of seventy-five percent (75%) by patients for which full reimbursement is provided in accordance with the terms of the applicable Facility Providers. Tenant shall maintain a minimum occupancy rate from and after (and including) the third fiscal
quarter in calendar year 2003 (i) in the Greenbriar Commons of fifty percent (50%); and (ii) in the Greenbriar Hospital of thirty-five percent (35%), in the case of any of clause (i) or (ii), by patients for which full reimbursement is
provided in accordance with the terms of the applicable Facility Providers 
  
 8.2.6.4.2 Portfolio Minimum Occupancy. Tenant shall maintain an aggregate minimum occupancy rate in all of the Facilities for each quarter of eighty percent (80%) by patients for which full reimbursement
is provided in accordance with the terms of the applicable Facility Provider Agreements. 
  
 3. Events of Default. Section 17.1.2 of the Lease is hereby is hereby deleted in its entirety and replaced with the following Section 17.1.2: 
  
 17.1.2 Certain Covenant Defaults. 
  
 17.1.2.1 Tenant fails to observe or perform any term,
covenant or agreement on its part to be performed or observed pursuant to Section 3.4.3, Section 8.1.17, Section 8.2.1, Section 8.2.6.2, Section 8.2.6.3, Section 8.2.6.4.2, Section 8.3, Section
14.2, Section 14.5, Section 12, item (f) of Section 13, or Section 14.1. 
  

 - 3 - 

 17.1.2.2 Tenant fails to observe or perform the covenants on its part to be
performed or observed pursuant to Section 8.2.6.1; provided, however, that it shall not be an Event of Default if no more than two (2) Facilities fail to meet the Coverage Ratio required thereby so long as such Facility or
Facilities has or have not failed to maintain the Coverage Ratio required thereby for the four immediately preceding fiscal quarters. 
  
 17.1.2.3 Tenant fails to observe or perform the covenant on its part to be performed pursuant to Section 8.2.6.4.1;
provided, however, that it shall not be an Event of Default if no more than two (2) Facilities fails to meet the minimum occupancy rate required thereby so long as such Facility or Facilities has or have not failed to maintain the
minimum occupancy rate required thereby for the four immediately preceding fiscal quarters. 
  
 4. Monthly Census Information. As soon as available, and in any event within fifteen (15) Business Days after the end of each calendar month, Tenant shall furnish to Landlord, in hard copy and
electronic format, the Census Information, which shall be accompanied by, in hard copy and electronic format, a then-current occupancy report for each Facility and such other information as Landlord shall reasonably request. 
  
 5. Financial Reporting. Delivery of the quarterly and
annual financial statements contemplated by Sections 25.2 and 25.3 of the Lease shall be reported using the template being delivered by Landlord to Tenant as of the date hereof, a hard copy of which is attached hereto as Exhibit A, and shall
be accompanied by a checklist in the form attached hereto as Exhibit B, completed by Tenant; provided, however, that the use of such template and such checklist shall not excuse Tenant from any financial reporting requirement
under the Lease Documents. Section 25.4 of the Lease is hereby amended by deleting the words “debt to equity ratio” from clause (ii). 
  
 6. Monthly Financial Reporting. As soon as available, and in any event within ten (10) Business Days after the end of each
calendar month, Tenant shall furnish to Landlord, in hard copy and electronic format, a report on the accounts receivable financing of each Tenant specifying the income from such accounts receivable, the disposition of such income and amounts
borrowed under such accounts receivable financing, together with such other information as Landlord shall require. 
  
 7. Delivery Requirements. This Second Amendment shall not be effective until such time as all of the following conditions shall have
been satisfied or waived, as determined by Landlord. Landlord’s execution and delivery of this Second Amendment shall constitute Landlord’s agreement that such conditions have been satisfied, subject to any written agreement between
Landlord and Tenant to the contrary. 
  

 - 4 - 

 7.1. Amendment Documents. Landlord shall have received a duly executed copy of each
of this Second Amendment, the Second Amendment to Mezzanine Loan Agreement and the Second Amendment to Guaranty (collectively, the “Amendment Documents”), all of which documents shall be held in escrow pending Landlord’s review
and approval (in Landlord’s sole discretion) of Tenant’s financial reports for the second fiscal quarter of the 2003 calendar year. All of the Delivery Requirements in each Amendment Document shall have been satisfied as set forth in such
Amendment Document. 
  
 7.2. Legal
Opinions. Landlord shall have received legal opinions in form and substance satisfactory to Landlord. 
  
 7.3. Expenses. Tenant shall have paid all costs and expenses incurred by Landlord as of such date, including, without limitation, the
transaction costs specified in Section 10 hereof, a summary of which has been provided to Tenant by Landlord on or prior to the date hereof 
  
 7.4. Financial Information. Landlord shall have received financial information relating to Tenant that is satisfactory to Landlord
including, without limitation, (i) financial projections for calendar years 2004 and 2005; (ii) all quarterly financial information for the second fiscal quarter of the 2003 calendar year required to be delivered by Tenant to Landlord; and (iii) a
complete financial package, satisfactory to Landlord, related to the properties encumbered by the Primary Loan. 
  
 7.5. Other Lease Payments. Tenant’s demonstration to Landlord’s satisfaction that other lease payments on the Facilities
are related to adjustments for the new rent allocations and that LIBOR interest is related to the interest payable to GTCR Fund VI, L.P. that is allocated to each Facility. 
  
 7.6. No Material Adverse Change. There shall not have occurred a material adverse change with respect
to the property, business, operations or prospects of the Tenant or the Facilities, as determined by Landlord. 
  
 7.7. Additional Matters. Landlord shall have received such other certificates, opinions, documents and instruments as may have been
requested by Landlord. All corporate and other proceedings, all other documents and all legal matters entered into or delivered in connection with the transactions contemplated by this Second Amendment shall be satisfactory in form and substance to
Landlord. 
  
 8. Certification. From and
after the date hereof, any and all financial or other information delivered by Tenant, or any of them, to Landlord (regardless of whether such information is required to be delivered pursuant to the Lease) shall be accompanied by a then executed
certificate in the form attached as Exhibit C attached hereto. 
  

 - 5 - 

 9. Representations and Warranties of Tenants. Without limiting in any way any
representation or warranty in the Lease or any document executed in connection therewith (collectively, the “Lease Documents”), each Tenant represents and warrants that as of the date hereof: 
  
 9.1. Organization. Tenant (i) is a duly organized and
validly existing limited liability company in good standing under the laws of the State of Delaware, (ii) has the requisite power and authority to carry on its business as now being conducted and (iii) has the requisite power to execute and deliver,
and perform its obligations under, this Agreement. 
  
 9.2.
Authorization. The execution and delivery by Tenant of this Agreement and Tenant’s performance of its obligations hereunder (i) have been duly authorized by all requisite action on the part of Tenant, (ii) will not violate any
provision of any applicable legal requirements, any order, writ, decree, injunction or demand of any court or other governmental authority, any organizational document of Tenant or any indenture or agreement or other instrument to which Tenant is a
party or by which Tenant is bound and (iii) will not be in conflict with, result in a breach of, or constitute (with due notice or lapse of time or both) a default under, or result in the creation or imposition of any lien of any nature whatsoever
upon any of the property or assets of Tenant pursuant to, any indenture or agreement or instrument. Except for those obtained or filed on or prior to the date hereof, Tenant is not required to obtain any consent, approval or authorization from, or
to file any declaration or statement with, any governmental authority or other agency in connection with or as a condition to the execution, delivery or performance of this Second Amendment. This Second Amendment has been duly authorized, executed
and delivered by Tenant. 
  
 9.3. Full and Accurate
Disclosure. No statement of fact made by or on behalf of Tenant in this Second Amendment or in any other document or certificate delivered to Landlord by Tenant contains any untrue statement of a material fact or omits to state any material
fact necessary to makes statements contained herein or therein not misleading, including, without limitation, all of the financial information delivered by any Tenant or Affiliate of Tenant prior or simultaneous to the execution of this Second
Amendment, all of which Tenant hereby acknowledges were relied upon by Lender in executing this Second Amendment. There is no fact presently known to Tenant which has not been disclosed to Landlord which materially adversely affects, nor as far as
Tenant can foresee, might materially adversely affect the business, operations or condition (financial or otherwise) of Tenant. 
  
 9.4. Enforceability. This Second Amendment is a legal, valid and binding obligation of Tenant, enforceable against Tenant in
accordance with its terms, subject to bankruptcy, insolvency and other limitations on creditors’ rights generally and to equitable principles. 
  

 - 6 - 

 9.5. No Defaults. To Tenant’s actual knowledge, no Event of Default or monetary
default under the Lease or under any of the other Lease Documents has occurred or with the passage of time, giving of notice or both will exist. 
  
 9.6. No Offsets or Defenses. Through the date of this Second Amendment, and to Tenant’s knowledge, Tenant neither has nor claims
any offset, defense, claim, right of set-off or counterclaim against Landlord under, arising out of or in connection with this Second Amendment, the Lease or any of the other Lease Documents. In addition, Tenant covenants and agrees with Landlord
that if any offset, defense, claim, right of set-off or counterclaim exists about which Tenant has knowledge as of the date of this Second Amendment, Tenant hereby irrevocably and expressly waives the right to assert such matter. 
  
 9.7. Damage or Injury. Since the Closing Date, no
Facility has been materially injured or damaged by fire or other casualty. 
  
 9.8. Change. Since the Closing Date, no material adverse change with respect to any Facility or Tenant has occurred. 
  
 9.9. Representation and Warranties in Lease Agreement. All of the representations and warranties made
by the Tenants in the Lease remain true and correct as if made on the date hereof, except those representations and warranties as to which the facts or circumstances causing such representations and warranties to not be true and correct would not
have a material adverse effect. 
  
 9.10. Survival of
Representations and Warranties. Without in any way limiting any provision of any Lease Document which provides for a longer period of survival, Tenant hereby agrees that (i) all representations and warranties made by Tenant in this Second
Amendment shall continue for so long as any amount remains owing under the Second Amendment, and (ii) all representations, warranties, covenants and agreements made in this Second Amendment shall be deemed to have been relied upon by Landlord
notwithstanding any investigation heretofore or hereafter made by Landlord. 
  
 10. Transactions Costs. Each Tenant agrees to pay on the date hereof all costs and expenses incurred by Landlord in connection with this Second Amendment, including, without limitation, all legal
fees of Landlord’s counsel and travel costs. Each Tenant shall pay its respective costs and expenses incurred in connection with this Second Amendment. 
  
 11. Modifications. This Second Amendment may not be amended, modified or otherwise changed in any manner except by a writing executed
by all of the parties hereto. 
  
 12.
Severability. In case any provision of this Second Amendment shall be invalid, illegal, or unenforceable, such provision shall be deemed to have been modified to the extent necessary to make it valid, legal, and enforceable. The
validity, legality, and enforceability of the remaining provisions shall not in any way be affected or impaired thereby. 
  

 - 7 - 

 13. Further Assurances. Each Tenant shall execute and deliver such further
instruments and perform such further acts as may be reasonably requested by Landlord from time to time to confirm the provisions of this Second Amendment and the Lease Documents to carry out more effectively the purposes of this Second Amendment and
the Lease Documents, or to confirm the priority of any lien created by any of the Lease Documents. 
  
 14. Successors and Assigns. This Second Amendment applies to, inures to the benefit of, and binds all parties hereof, their heirs,
legatees, devisees, administrators, executors, and permitted successors and assigns. 
  
 15. Governing Law. This Second Amendment shall be governed by, and construed in accordance with, the laws of the State of New York, without giving effect to the conflict of laws provisions of said
State. 
  
 16. Entire Agreement. This Second
Amendment constitutes all of the agreements among the parties relating to the matters set forth herein and supersedes all other prior or concurrent oral or written letters, agreements and understandings with respect to the matters set forth herein.

  
 17. Full Force and Effect. The Lease
Documents remain in full force and effect. None of the representations, warranties or covenants contained herein shall in no way limit in any way any representation, warranty or covenant contained in any Lease Document. This Second Amendment shall
constitute a “Lease Document” as defined herein. 
  
 18. Second Amendment Controlling. This Second Amendment is considered by the parties to the Lease to be an integral part of such Lease. If there is any conflict between the terms of the Lease and this Second Amendment,
the terms of this Second Amendment shall control. Except as expressly amended herein, all other terms, agreements, and conditions of the Lease shall remain unmodified and in full force and effect. 
  
 19. Counterparts/Fax Signatures. This Second Amendment
may be executed in two or more counterparts, any one of which need not contain the signatures of more than one party, but all such counterparts when taken together will constitute one in the same agreement. Confirmation of the execution of this
Second Amendment by telex or by telecopy or telefax of a facsimile page(s) executed by the parties shall be binding upon the parties hereto. 
  
 [Signature Page to Follow] 
  

 - 8 - 

 IN WITNESS WHEREOF, the parties have caused this Second Amendment to Master Lease Agreement to be
executed as of the date first above written. 
  

	 	 	 LANDLORD:

		
	Witness:	 	 VENTAS REALTY, LIMITED PARTNERSHIP,
 a Delaware limited partnership

			
	 /s/    Kimberly S. Tobin
	 	 By:
	 	 VENTAS, INC., a Delaware corporation

	
	 	 	 	 
	 Name:
	 	Kimberly S. Tobin	 	 	 	 	 	 	 	 
	 	
	 	 	 	 	 	 	 	 
				
	 	 	 	 	By:	 	 /s/    T. Richard Riney

	 	 	 	 	 	

	 /s/    Jill Jones
	 	 	 	Name:	 	T. Richard Riney
	
	 	 	 	 	

	 Name:
	 	Jill Jones	 	 	 	Title:	 	Executive Vice President and General Counsel
	 	
	 	 	 	 	

		
	 	 	TENANT:
		
	 Witness:
	 	THI OF OHIO AT CHARDON, LLC
		
	/s/    Robin K. Partridge	 	THI OF OHIO AT GREENBRIAR NORTH, LLC
	
	 	 
	Name:	 	Robin K. Partridge	 	 	 	 	 	 	 	 
	 	
	 	 	 	 	 	 	 	 
	 	 	TRANS HEALTHCARE OF OHIO, INC.
		
	/s/    Vonnie L. Cromwell	 	THI OF OHIO ALFs AT THE COMMONS, LLC
	
	 	 
	Name:	 	Vonnie L. Cromwell	 	 	 	 	 	 	 	 
	 	
	 	 	 	 	 	 	 	 
	 	 	THI OF MARYLAND AT SOUTH RIVER, LLC
		
	 	 	MILLENNIUM HEALTH AND REHABILITATION CENTER OF FORESTVILLE, LLC
		
	 	 	MILLENNIUM HEALTH AND REHABILITATION CENTER OF ELLICOTT CITY, LLC
	 	 	 	 	 
				
	 	 	 	 	By:	 	/s/    Anthony F. Misitano
	 	 	 	 	 	

	 	 	 	 	Name:	 	Anthony F. Misitano
	 	 	 	 	 	

	 	 	 	 	Title:	 	President
	 	 	 	 	 	

 GUARANTOR HEREBY AGREES AND CONSENTS TO THIS SECOND AMENDMENT TO MASTER LEASE AGREEMENT: 
  

	GUARANTOR:
	
	TRANS HEALTHCARE, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	TRANS HEALTHCARE OF OHIO, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	THI OF OHIO ALFS, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	THI PROPERTIES, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

	THI SERVICES CORP.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	THI SPECIALTY HOSPITALS OF OHIO, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	TRANS HEALTH MANAGEMENT, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	THI OF MARYLAND, INC.,
a Delaware corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	PHYSICAL THERAPY PLUS, INC.,
a Pennsylvania corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

	DALE J. CORDIAL, PT, INC.,
a Pennsylvania corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	DALE J. CORDIAL, PT, INC., NUMBER 4,
a Pennsylvania corporation
		
	By:	 	 /s/    Anthony F. Misitano

	 	

	 	 	 Name: Anthony F. Misitano
 Title: President

  

	THE PT GROUP OF PENN HILLS,
a Pennsylvania general partnership
		
	By:	 	TRANS HEALTHCARE, INC.,
a Delaware corporation,
its Partner
			
	 	 	By:	 	 /s/    Anthony F. Misitano

	 	 	 	

	 	 	 	 	 Name: Anthony F. Misitano
 Title: President

  
  

	THE PT GROUP PHYSICAL THERAPY FOR WOMEN,
a Pennsylvania general
partnership
		
	By:	 	 DALE J. CORDIAL, PT, INC.,
 a Pennsylvania corporation,
 its Partner

			
	 	 	By:	 	 /s/    Anthony F. Misitano

	 	 	 	

	 	 	 	 	 Name: Anthony F. Misitano
 Title: President

	THE PT GROUP OF MOON TOWNSHIP,
a Pennsylvania general partnership
		
	By:	 	DALE J. CORDIAL, PT, INC., NUMBER 4,
a Pennsylvania corporation,
its Partner
			
	 	 	By:	 	 /s/    Anthony F. Misitano

	 	 	 	

	 	 	 	 	 Name: Anthony F. Misitano
 Title:   President

  

	THI THERAPY CONCEPTS, LLC,
a Delaware limited liability company
		
	By:	 	 /s/    Jeffrey A. Barnhill

	 	

	 	 	Name: Jeffrey A. Barnhill
Title:   Vice-President

  

	THI SERVICES OF MARYLAND, LLC,
a Delaware limited liability company
		
	By:	 	 /s/    Jeffrey A. Barnhill

	 	

	 	 	Name: Jeffrey A. Barnhill
Title:   Vice-President

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