Document:

First Amendment to Master Lease Agreement dated as of July 25, 2007

 EXHIBIT 10.61 
 FIRST AMENDMENT TO MASTER LEASE AGREEMENT 
 THIS FIRST AMENDMENT TO MASTER LEASE AGREEMENT
(“Amendment”) is dated as of July 25, 2007 (“Amendment Effective Date”) among HCRI MASSACHUSETTS PROPERTIES TRUST, a Massachusetts business trust organized under the laws of the Commonwealth of Massachusetts
(“HCN-MA” and a “Landlord”), having its principal office located at One SeaGate, Suite 1500, P. 0. Box 1475, Toledo, Ohio 43603-1475, HCRI MASSACHUSETTS PROPERTIES TRUST II, a Massachusetts business trust organized under
the laws of the Commonwealth of Massachusetts (“HCN-MA II” and a “Landlord”), having its principal office located at One SeaGate, Suite 1500, P. O. Box 1475, Toledo, Ohio 43603-1475, and KINDRED HOSPITALS EAST, L.L.C, a
Delaware limited liability company organized under the laws of the State of Delaware (“Tenant”), having its chief executive office located at 680 South Fourth Avenue, Louisville, Kentucky 40202. 
 R E C I T A L S 
 A. Landlord has leased to Tenant property located in Massachusetts (collectively called “Property”) pursuant to a Master Lease Agreement dated as of February 28, 2006, as amended from time to time
(“Lease”). 
 B. As of the Amendment Effective Date of this Amendment, HCN-MA II is acquiring an unimproved parcel of property
located in Leicester, Massachusetts (“Leicester Unimproved Property”). 
 C. Landlord desires to lease the Leicester Unimproved
Property to Tenant and Tenant desires to lease the Leicester Unimproved Property from Landlord upon the terms set forth in the Lease. 
 D.
Landlord and Tenant desire to amend the Lease to include the Leicester Unimproved Property and to modify certain terms and conditions. 
 NOW, THEREFORE, in consideration of the foregoing recitals and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows. 
 1. Definitions. Any capitalized terms not defined in this Amendment shall have the meaning set forth in the Lease. 
 2. Amended Definitions. The definitions of “Closing Certificate”, “Commitment”, “Option Amount”, and “Rent
Schedule” in §1.4 of the Lease are hereby amended to read in their entireties as follows (added language in italics): 
 “Closing Certificate” means the Closing Certificate of even date from Tenant and Affiliate Subtenant in favor of Landlord and any Closing Certificate executed in connection with an amendment of this Lease. 

 
“Commitment” means the Amended and Restated Term Sheet for the Lease dated February 21, 2006, as amended and the Project Approval Letter
dated November 16, 2006. 
 “Option Amount” means the Investment Amount. 
 “Rent Schedule” means the schedule issued by Landlord to Tenant showing the Base Rent to be paid by Tenant pursuant to the terms of this Lease,
as such schedule is amended from time to time by Landlord. The initial Rent Schedule is attached to this Lease as Schedule 1 or will be attached following Closing if the Rent Schedule cannot be determined until the day of Closing. The Rent
Schedule to be in effect upon the Amendment Effective Date of the First Amendment to Master Lease Agreement is attached as Schedule 1-A. 
 3. Base Rent. Section 2.1 of the Lease is hereby amended to read in its entirety as follows (added language in italics): 
 2.1 Base Rent. Tenant shall pay Landlord base rent (“Base Rent”) in advance in consecutive monthly installments payable on the first day of each month during the Term commencing on the Commencement Date. If the Effective
Date is not the first day of a month, Tenant shall pay Landlord Base Rent on the Effective Date for the partial month, i.e., for the period commencing on the Effective Date and ending on the day before the Commencement Date. The Base Rent payable
for the first Lease Year is as shown on the Rent Schedule, subject to adjustment pursuant to §2.2.2 if applicable. For the second and each subsequent Lease Year of the Initial Term, the Base Rent shall be paid in accordance with the most recent
revised Rent Schedule provided by Landlord pursuant to §2.2, as applicable. The Base Rent for each Renewal Term will be determined in accordance with §12.2. Notwithstanding the foregoing, the Base Rent may also be adjusted if Landlord
makes a payment to acquire additional Leased Property. In such cases, Landlord shall issue, and Tenant shall pay Base Rent according to, a revised Rent Schedule. The increase in Base Rent shall be based on the applicable rate of return to Landlord
as set forth in the Commitment and shall be effective as of the date that Landlord makes the payment to acquire the additional Leased Property. 
  

 2 

 4. Early Option to Purchase. Section 13.7 of the Lease is hereby amended to read in its
entirety as follows (added language in italics): 
 13.7 Early Option to Purchase. Notwithstanding any provision to the contrary
contained in this Article 13, Tenant may exercise the Option to Purchase all of the Leased Property by giving notice of such exercise within 24 months after the Effective Date (“Early Option Period”) subject to the same terms and
conditions of this Article 13 except for §13.3 and except that [i] the required Purchase Notice may be given at any time during the Early Option Period; [ii] the Option Price for the Leased Property shall be $72,225,000.00; [iii] the
purchase of the Leased Property shall close no later than 90 days after Landlord’s receipt of the Purchase Notice; and [iv] no Event of Default shall have occurred and be continuing. The Option to Purchase pursuant to this §13.7 shall be
referred to as the “Early Option”. 
 5. Parking Lot Improvements. Article 15 of the Lease is hereby amended to add a new
Section 15.12 as follows: 
 15.12 Parking Lot Improvements. Tenant shall improve the Land as a parking lot to provide additional
parking for Kindred Hospital Parkview Central Mass. The parking lot shall be constructed according to plans and specifications approved by Landlord (such approval not to be unreasonably withheld), prior to commencement of construction and in
accordance with all applicable legal requirements, including but not limited to requirements of the Massachusetts Wetlands Protection Act. Tenant shall use diligent, commercially reasonable efforts to complete construction of the parking lot on or
before December 31, 2007. 
 6. Amendment Rent Schedule. The Lease is hereby amended to add a new Schedule 1-A in the form of
Schedule 1-A attached hereto and made a part hereof. 
 7. Legal Description. Exhibit A-4 of the Lease is hereby amended to read in
its entirety as set forth on Exhibit A-4 attached hereto and made a part hereof. 
 8. Permitted Exceptions. Exhibit B-4 of the Lease
is hereby amended to read in its entirety as set forth on Exhibit B-4 attached hereto and made a part hereof. 
 9. Affirmation.
Except as specifically modified by this Amendment, the terms and provisions of the Lease are hereby affirmed and shall remain in full force and effect. 
  

 3 

 10. Binding Effect. This Amendment will be binding upon and inure to the benefit of the successors
and permitted assigns of Landlord and Tenant. 
 11. Further Modification. The Lease may be further modified only by writing signed by
Landlord and Tenant. 
 12. Counterparts. This Amendment may be executed in multiple counterparts, each of which shall be deemed an
original hereof, but all of which will constitute one and the same document. 
 13. Consent of Guarantor. This Amendment shall have no
force or effect unless and until each Guarantor has executed the Consent of Guarantor set forth below. 
 [THE REMAINDER OF THIS PAGE IS
INTENTIONALLY LEFT BLANK] 
  

 4 

 IN WITNESS WHEREOF, Landlord and Tenant have executed this Amendment as of the date first set forth
above. 
  

									
	Signed and acknowledged in the presence of:	 	HCRI MASSACHUSETTS PROPERTIES TRUST
				
	 Signature
 Print Name
	 	 /s/ Rita J. Rogge
 Rita J.
Rogge
	 	By:	 	HCRI Massachusetts Properties, Inc., as Trustee, and not individually, and subject to the provisions of the Declaration of Trust of HCRI Massachusetts Properties Trust filed with the
Secretary of the Commonwealth of Massachusetts and the City Clerk of Boston
		 		 		 		 	
	Signature	 	 /s/ Donna J. Lunsford
	 		 		 	
	Print Name	 	Donna J. Lunsford	 		 		 	
					
		 		 		 	By:	 	 /s/ Erin C. Ibele

		 		 		 		 	Erin C. Ibele
		 		 		 		 	Senior Vice President –
		 		 		 		 	Administration and Corporate Secretary
					
		 		 		 	By:	 	 /s/ Michael A. Crabtree

		 		 		 		 	Michael A. Crabtree
		 		 		 		 	Vice President and Treasurer
			
	Signature	 	 /s/ Rita J. Rogge
	 	HCRI MASSACHUSETTS PROPERTIES TRUST II
	Print Name	 	Rita J. Rogge	 		 		 	
				
	 Signature
 Print Name
	 	 /s/ Donna J. Lunsford
 Donna J. Lunsford

	 	By:	 	HCRI Massachusetts Properties, Inc., as Trustee, and not individually, and subject to the provisions of the Declaration of Trust of HCRI Massachusetts Properties Trust II filed with
the Secretary of the Commonwealth of Massachusetts and the City Clerk of Boston
		 		 		 		 	
					
		 		 		 	By:	 	 /s/ Erin C. Ibele

		 		 		 		 	Erin C. Ibele
		 		 		 		 	Senior Vice President –
		 		 		 		 	Administration and Corporate Secretary
					
		 		 		 	By:	 	 /s/ Michael A. Crabtree

		 		 		 		 	Michael A. Crabtree
		 		 		 		 	Vice President and Treasurer

  

 S-1 

							
		 		  	KINDRED HOSPITALS EAST, L.L.C.
				
	 Signature
	 	 /s/ RICHARD MYERS
	  	By:	 	 /s/ Douglas L. Curnutte

	 Print Name
	 	RICHARD MYERS	  		 	Douglas L. Curnutte
		 		  		 	Vice President of Facilities and Real Estate Development
	 Signature
	 	 /s/ Lisa Adams
	  		 	
	 Print Name
	 	Lisa Adams	  		 	

  

					
	STATE OF OHIO	  	)	  	
		  	)	  	SS:
	COUNTY OF LUCAS	  	)	  	

 The foregoing instrument was acknowledged before me this 8 day of August, 2007 by Erin C. Ibele,
the Senior Vice President-Administration and Corporate Secretary, and Michael A. Crabtree, the Vice President and Treasurer of HCRI Massachusetts Properties, Inc., a Delaware corporation, as Trustee, on behalf of and as the free act and deed of HCRI
Massachusetts Properties Trust, a Massachusetts business trust. 
  

			
		  	 /s/ Rita J. Rogge

		  	Notary Public
	My Commission Expires:
                                        
                    	  	[SEAL]
		  	

  

					
	STATE OF OHIO	  	)	  	
		  	)	  	SS:
	COUNTY OF LUCAS	  	)	  	

 The foregoing instrument was acknowledged before me this 8 day of August, 2007 by Erin C. Ibele,
the Senior Vice President-Administration and Corporate Secretary, and Michael A. Crabtree, the Vice President and Treasurer of HCRI Massachusetts Properties, Inc., a Delaware corporation, as Trustee, on behalf of and as the free act and deed of HCRI
Massachusetts Properties Trust II, a Massachusetts business trust. 
  

			
		  	 /s/ Rita J. Rogge

		  	Notary Public
	 My Commission Expires:
                                        
                    
	  	[SEAL]
		  	

  

 S-2 

 COMMONWEALTH OF MASSACHUSETTS 
 State of Kentucky 
 Jefferson County 
 On this 25th day of July, 2007, before me, the undersigned notary public, personally appeared Douglas L. Curnutte, the Vice President of Facilities and Real Estate Development of KINDRED HOSPITALS EAST, L.L.C. and
proved to me through satisfactory evidence of identification, which was a Kentucky Driver’s License, to be the person whose name is signed on this document, and acknowledged to me that he signed it voluntarily in his capacity as Vice President
of Facilities and Real Estate Development, for its stated purpose, as his free act and deed and the free act and deed of KINDRED HOSPITALS EAST, L.L.C. 
  

	
	 /s/ Patricia A. Burkhead

	 Notary Public

	 My commission expires:

 

 
 THIS INSTRUMENT PREPARED BY: 
 Cynthia L. Rerucha, Esq. 
 Shumaker, Loop & Kendrick, LLP 
 1000 Jackson Street 
 Toledo, Ohio 43624 
  

 S-3 

 CONSENT OF GUARANTOR 
 In connection with the Unconditional and Continuing Lease Guaranty (“Guaranty”) made by the undersigned Guarantors in favor of Landlord dated as of February 28, 2006, the undersigned Guarantors hereby
[i] consent to the foregoing First Amendment to Master Lease Agreement (“Amendment”), [ii] affirm the Guaranty which shall remain in full force and effect and secure the Guaranteed Obligations, as defined in the Guaranty, and [iii] waive
any suretyship defenses arising in connection with the Amendment. All capitalized terms not defined herein shall have the meaning set forth in the foregoing Amendment. 
  

			
	KINDRED HEALTHCARE OPERATING, INC.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development
	
	GODDARD NURSING, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development
	
	SPRINGFIELD PARK VIEW HOSPITAL, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development
	
	MEADOWS NURSING, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development

			
	KINDRED BRAINTREE HOSPITAL, L.L.C.
		
	 By:
	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development

  

 2 

 SCHEDULE 1-A: FIRST AMENDMENT RENT SCHEDULE 

 KINDRED HEALTHCARE OPERATING. INC. - MASTER LEASE 
 HEALTH CARE REIT, INC. 
  

						
	 EFFECTIVE DATE
	  	03/01/06	 	 	
			
	 INITIAL TERM COMMENCEMENT DATE
	  	03/01/06	 	 	FINAL
	 INITIAL TERM
	  	15 Yrs	 	 	
	 INITIAL TERM EXPIRATION DATE
	  	02/28/21	 	 	
	 INITIAL INVESTMENT AMOUNT
	  	72,450,000	 	 	
	 AMENDED INVESTMENT AMOUNT EFFECTIVE 7/25/07
	  	72,575,000	 	 	
			
	 RATE OF RETURN
	  	N/A	 	 	
	 (365/360 BASIS)
	  	N/A	 	 	
	 INITIAL RATE OF RETURN
	  	8.75	%	 	
		  	 	 	 	
		
	INCREASER	  	As defined within the Master Lease Agreement

  

																				
	 	  	DATES	  	 	  	 	 	 	 	 	 	  	 	  	 	  	 
	 LEASE YEAR
	  	FROM	  	TO	  	REVENUE
CONDITION MET
(YES/NO)	  	INCREASER
(BP)	 	BEGINNING
RENT RATE
OF RETURN
(ROUNDED)	 	 	PERCENTAGE
RATE
SHORTFALL	  	ADJUSTED
RENT RATE
OF RETURN
(ROUNDED)	  	MONTHLY
RENT
AMOUNT	  	ANNUAL
RENT AMOUNT
	 1
	  	03/01/06	  	02/28/07	  	YES	  	N/A	 	8.75	%	 	N/A	  	N/A	  	528,281.25	  	6,339,375.00
	 2
	  	03/01/07	  	06/30/07	  	TBD	  	2.5%	 	8.97	%	 	N/A	  	N/A	  	541,488.28	  	2,165,953.12
	 2A
	  	07/01/07	  	07/24/07	  	N/A	  	N/A	 	8.97	%	 	N/A	  	N/A	  	419,216.73	  	419,216.73
	 2B
	  	07/25/07	  	07/31/07	  	N/A	  	N/A	 	8.97	%	 	N/A	  	N/A	  	122,499.58	  	122,499.58
	 2C
	  	08/01/07	  	02/29/08	  	TBD	  	N/A	 	8.97	%	 	N/A	  	N/A	  	542,498.13	  	3,797,486.91
	 3
	  	03/01/08	  	02/28/09	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 4
	  	03/01/09	  	02/28/10	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 5
	  	03/01/10	  	02/28/11	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 6
	  	03/01/11	  	02/29/12	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 7
	  	03/01/12	  	02/28/13	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 8
	  	03/01/13	  	02/28/14	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 9
	  	03/01/14	  	02/28/15	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 10
	  	03/01/15	  	02/29/16	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 11
	  	03/01/16	  	02/28/17	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 12
	  	03/01/17	  	02/28/18	  	TSD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 13
	  	03/01/18	  	02/28/19	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 14
	  	03/01/19	  	02/29/20	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56
	 15
	  	03/01/20	  	02/28/21	  	TBD	  	TBD	 	8.97	%	 	TBD	  	TBD	  	542,498.13	  	6,509,977.56

  

					
	 12/12/2007
	  		  	

 EXHIBIT A-4: LEGAL DESCRIPTION 
 Facility Name: The Meadows Rehabilitation and Nursing Center and 
 Kindred Hospital Park
View - Central Mass. 
 Parcel 1: 
 Real property in the
County of Worcester, Commonwealth of Massachusetts, described as follows: 
 A certain piece of land in Leicester, Worcester County, Massachusetts on the
northeasterly side of Huntoon Memorial Highway, also known as State Road 56, depicted as Lot 5-A on a plan entitled, “Plan of Land Prepared for David A. Cooper, et al” dated September 16, 1993 and prepared by Charles L.
Rowley & Associates and recorded with the Worcester County Registry of Deeds in Plan Book 676, Plan No. 81. Said Lot No. 5-A on said Plan is bounded and described as follows: 
 Beginning at a point on the northeasterly sideline of Huntoon Memorial Highway (Route 56) at the most southwesterly corner of the lot to be described: 
 Thence N31°04’36” W along the northeasterly sideline of Huntoon Memorial Highway a distance of 37.12 feet to a point opposite an iron pipe and continuing
in said sideline a distance of 213.40 feet to an iron rod at land of Edwin Buczak; 
 Thence N 78°42’27” E, along land of Buczak and along a
stonewall a distance of 184.66 feet to a corner of stonewalls; 
 Thence N 08°21’20” W along land of said Buczak and along a stonewall a
distance of 209.13 feet to a point at other land of David A. Cooper, et al; 
 Thence in line of land of said Cooper, N 80°02’46” E, a distance
of 356.18 feet to a point at a corner of stonewalls; 
 Thence in line of land of Stephen P. Magnuson and Mary A. Magnuson and in line of land of I. Virginia
Magnuson, S 07°25’20” E along a stone wall, a distance of 364.55 feet to a point; 
 Thence in line of land of I. Virginia Magnuson, S
14°3’28” E, along a stonewall a distance of 48.12 feet to a point opposite an iron pipe and continuing in the same course along said stonewall, a distance of 35.00 feet to a point; 
 Thence in line of remaining land of David A. Cooper, et al, S 80°02’46” W, a distance of 446.87 feet to the POINT OF BEGINNING. 

 Parcel 2: 
 A certain
parcel of land being subdivided from a larger parcel presently owned by David, James, Marjorie and Richard Cooper, located to the east of Huntoon Highway, Mass Highway Route 56, in the Town of Leicester, in Worcester County, Massachusetts more
particularly bounded and described as follows: 
 BEGINNING at an iron pipe located at the southerly corner of the lot herein described, proceed North 04°
41’ 33” West along land owned, by Edwin Buczak, seven and ninety hundredths feet (7.90’) to a point on a stone wall; 
 THENCE proceed
North 09° 33’ 01” West along land owned by Edwin Buczak and land owned by Stephen & Carol Asquith, one hundred thirteen and seventeen hundredths feet (113.17’) to a point on the same stone wall; 
 THENCE proceed North 10° 07’ 25” West along land owned by Stephen & Carol Asquith, one hundred sixteen and thirty one hundredths feet
(116.31’) to a point on the same stone wall; 
 THENCE 30° 34’ 15” East along Lot 2 now or formerly owned by Cooper, forty nine and
thirty seven hundredths feet (49.37’) to a point; 
 THENCE proceed North 80° 15’ 45” East along Lot 2 now or formerly owned by
Cooper, one hundred sixty seven and seventy hundredths feet (167.70’) to a point; 
 THENCE proceed South 09° 44’ 15” East along
remainder of land owned by Cooper, two hundred fifty four and twenty seven hundredths feet (254.27’) to a point; 
 THENCE proceed North 80°
03’ 09” East along remainder of land owned by Cooper, one hundred fifty six and eighteen hundredths feet (156.18’) to a point; 
 THENCE
proceed South 09° 56’ 51” East along remainder of land owned by Cooper, twenty and zero hundredths feet (20.00’) to a point; 
 THENCE proceed South 80° 03’ 09” West by land owned by HCRI Massachusetts Properties Trust II, three
hundred fifty six and eighteen hundredths feet (356.18’) to the point of beginning at the land of Edwin Buczak. 
 Said parcel
containing 57,238 square feet and is shown as Lot #3 on a “Plan of Land” in Leicester, Massachusetts, owned by David, James, Marjorie and Richard Cooper, prepared by Land Planning, Inc., and dated June 29, 2006, and recorded in Plan
Book 847, Plan 58. 
  

 2 

 EXHIBIT B: PENDING LITIGATION 
 None. 

 EXHIBIT B-4: PERMITTED EXCEPTIONS 
 Facility Name: The Meadows Rehabilitation and Nursing Center and 
 Kindred Hospital Park
View – Central Mass. 
  

	1.	The lien of real estate taxes and other governmental charges not yet due and payable and the lien of municipal betterments assessed after the Amendment Effective Date of the
Amendment to Master Lease Agreement. 

  

	2.	Title to and rights of the public and others entitled thereto in and to those portions of the . insured premises lying within the bounds of adjacent streets, roads, and ways.

  

	3.	The following matters as shown on the survey entitled “ALTA/ACSM Land Title Survey Special K The Meadows of Leicester 111 Huntoon Memorial Hwy (Route 56) Rochdale, MA County of
Worcester” drawn by American National llc, dated July 25, 2005, Reference No. 20050110-010 (the “Survey”): a. Small portion of Unit Sign encroaches onto public road right-of-way by 1.20’; b. Building encroaches onto
building setback line by 1.60’. 

  

	4.	Easement to Massachusetts Electric Company, dated July 22, 1994, recorded with said Deeds, Book 16510, Page 55. 

  

	5.	Order of Conditions issued by the Town of Leicester, recorded in Book 15527, Page 186. 

  

	6.	The following matters as shown on the survey entitled “ALTA/ACSM Land Title Survey drawn by Land Planning, Inc., dated September 15, 2006, Job No. G 6615 (the
“Survey”): a. Gravel parking encroachment onto the property next northerly and easterly to the extent shown on said survey. 

  

	7.	First Amendment of Memorandum of Lease between Landlord and Tenant.Second Amendment to Master Lease Agreement

 EXHIBIT 10.62 
 SECOND AMENDMENT TO MASTER LEASE AGREEMENT 
 THIS SECOND AMENDMENT TO MASTER LEASE AGREEMENT
(“Amendment”) is dated as of December 5, 2007 (“Amendment Effective Date”) among HCRI MASSACHUSETTS PROPERTIES TRUST, a Massachusetts business trust organized under the laws of the Commonwealth of Massachusetts
(“HCN-MA” and a “Landlord”), having its principal office located at One SeaGate, Suite 1500, P. 0. Box 1475, Toledo, Ohio 43603-1475, HCRI MASSACHUSETTS PROPERTIES TRUST II, a Massachusetts business trust organized under
the laws of the Commonwealth of Massachusetts (“HCN-MA II” and a “Landlord”), having its principal office located at One SeaGate, Suite 1500, P, O. Box 1475, Toledo, Ohio 43603-1475, and KINDRED HOSPITALS EAST, L.L.C., a
Delaware limited liability company organized under the laws of the State of Delaware (“Tenant”), having its chief executive office located at 680 South Fourth Avenue, Louisville, Kentucky 40202. 
 R E C I T A L S 
 A. Landlord has leased to Tenant property located in Massachusetts (collectively called “Property”) pursuant to a Master Lease Agreement dated as of February 28, 2006, as amended from time to time
(“Lease”). 
 B. Under the Lease, Tenant has an option to purchase the Property prior to the end of the Lease Term. Tenant has
requested that Landlord extend the time during which this option can be exercised by three months. Landlord has agreed to this request subject to the terms and conditions of this Amendment. 
 C. Landlord and Tenant desire to amend the Lease to modify the terms and conditions of the early option. 
 NOW, THEREFORE, in consideration of the foregoing recitals and for other good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereto agree as follows. 
 1. Definitions. Any capitalized terms not defined in this Amendment shall have
the meaning set forth in the Lease. 
 2. Early Option to Purchase. Section 13.7 of the Lease is hereby amended to read in its
entirety as follows (added language in italics): 
 13.7 Early Option to Purchase. Notwithstanding any provision to the contrary
contained in this Article 13, Tenant may exercise the Option to Purchase all of the Leased Property by giving notice of such exercise within 27 months after the Effective Date (“Early Option Period”) subject to the same terms and
conditions of this Article 13 except for §13.3 and except that [i] the required Purchase Notice may be given at any time during the Early Option Period; [ii] the Option Price for the Leased Property shall 

 
be $72,225,000.00; [iii] the purchase of the Leased Property shall close no later than 90 days after Landlord’s receipt of the Purchase Notice; and [iv]
no Event of Default shall have occurred and be continuing. The Option to Purchase pursuant to this §13.7 shall be referred to as the “Early Option”. 
 3. Affirmation. Except as specifically modified by this Amendment, the terms and provisions of the Lease are hereby affirmed and shall remain in full force and effect. 
 4. Binding Effect. This Amendment will be binding upon and inure to the benefit of the successors and permitted assigns of Landlord and Tenant.

 5. Further Modification. The Lease may be further modified only by writing signed by Landlord and Tenant. 
 6. Counterparts. This Amendment may be executed in multiple counterparts, each of which shall be deemed an original hereof, but all of which will
constitute one and the same document. 
 7. Consent of Guarantor. This Amendment shall have no force or effect unless and until each
Guarantor has executed the Consent of Guarantor set forth below. 
 [THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK]

  

 2 

 IN WITNESS WHEREOF, Landlord and Tenant have executed this Amendment as of the date first set forth
above. 
  

									
	Signed and acknowledged in the presence of:	 	HCRI MASSACHUSETTS PROPERTIES TRUST
				
	 Signature
 Print Name
	 	 /s/ Rita J. Rogge
 Rita J.
Rogge
	 	By:	 	HCRI Massachusetts Properties, Inc., as Trustee, and not individually, and subject to the provisions of the Declaration of Trust of HCRI Massachusetts Properties Trust filed with the
Secretary of the Commonwealth of Massachusetts and the City Clerk of Boston
		 		 		 		 	
	Signature	 	 /s/ Donna J. Lunsford
	 		 		 	
	Print Name	 	Donna J. Lunsford	 		 		 	
					
		 		 		 	By:	 	 /s/ Erin C. Ibele

		 		 		 		 	Erin C. Ibele
		 		 		 		 	Senior Vice President –
		 		 		 		 	Administration and Corporate Secretary
					
		 		 		 	By:	 	 /s/ Michael A. Crabtree

		 		 		 		 	Michael A. Crabtree
		 		 		 		 	Vice President and Treasurer
			
	Signature	 	 /s/ Rita J. Rogge
	 	HCRI MASSACHUSETTS PROPERTIES TRUST II
	Print Name	 	Rita J. Rogge	 		 		 	
				
	 Signature
 Print Name
	 	 /s/ Donna J. Lunsford
 Donna J. Lunsford

	 	By:	 	HCRI Massachusetts Properties, Inc., as Trustee, and not individually, and subject to the provisions of the Declaration of Trust of HCRI Massachusetts Properties Trust II filed with
the Secretary of the Commonwealth of Massachusetts and the City Clerk of Boston
		 		 		 		 	
					
		 		 		 	By:	 	 /s/ Erin C. Ibele

		 		 		 		 	Erin C. Ibele
		 		 		 		 	Senior Vice President –
		 		 		 		 	Administration and Corporate Secretary
					
		 		 		 	By:	 	 /s/ Michael A. Crabtree

		 		 		 		 	Michael A. Crabtree
		 		 		 		 	Vice President and Treasurer

  

 S-1 

							
		 		  	KINDRED HOSPITALS EAST, L.L.C.
				
	Signature	 	 /s/ RICHARD MYERS
	  	By:	 	 /s/ Douglas L. Curnutte

	Print Name	 	RICHARD MYERS	  		 	Douglas L. Curnutte
		 		  		 	Vice President of Facilities and Real Estate Development
				
	Signature	 	 /s/ Lisa Adams
	  		 	
	Print Name	 	Lisa Adams	  		 	

  

					
	STATE OF OHIO	  	)	  	
		  	)	  	SS:
	COUNTY OF LUCAS	  	)	  	

 The foregoing instrument was acknowledged before me this 7 day of December, 2007 by Erin C. Ibele,
the Senior Vice President-Administration and Corporate Secretary, and Michael A. Crabtree, the Vice President and Treasurer of HCRI Massachusetts Properties, Inc., a Delaware corporation, as Trustee, on behalf of and as the free act and deed of HCRI
Massachusetts Properties Trust a Massachusetts business trust. 
  

			
		  	 /s/ Rita J. Rogge

		  	Notary Public
		
	 My Commission Expires:
                                        
                    
	  	[SEAL]

  

					
	STATE OF OHIO	  	)	  	
		  	)	  	SS:
	COUNTY OF LUCAS	  	)	  	

 The foregoing instrument was acknowledged before me this 7 day of December, 2007 by Erin C. Ibele,
the Senior Vice President-Administration and Corporate Secretary, and Michael A. Crabtree, the Vice President and Treasurer of HCRI Massachusetts Properties, Inc., a Delaware corporation, as Trustee, on behalf of and as the free act and deed of HCRI
Massachusetts Properties Trust II, a Massachusetts business trust. 
  

			
		  	 /s/ Rita J. Rogge

		  	Notary Public
		
	My Commission Expires:
                                        
                    	  	[SEAL]

  

 S-2 

 COMMONWEALTH OF KENTUCKY 
 Jefferson Co. 
 On this 5th day of December, 2007, before me, the undersigned notary public, personally appeared Douglas L. Curnutte, the Vice President of Facilities and Real Estate Development of KINDRED
HOSPITALS EAST, L.L.C. and proved to me through satisfactory evidence of identification, which was a Kentucky Driver’s License, to be the person whose name is signed on this document, and acknowledged to me that he signed it voluntarily in his
capacity as Vice President of Facilities and Real Estate Development, for its stated purpose, as his free act and deed and the free act and deed of KINDRED HOSPITALS EAST, L.L.C. 
  

	
	 /s/ Jenny McGarry

	Notary Public
	My commission expires: 2/16/2008

 THIS INSTRUMENT PREPARED BY: 
 Cynthia L. Rerucha, Esq. 
 Shumaker, Loop & Kendrick, LLP 
 1000 Jackson Street 
 Toledo, Ohio 43624 
  

 S-3 

 CONSENT OF GUARANTOR 
 In connection with the Unconditional and Continuing Lease Guaranty (“Guaranty”) made by the undersigned Guarantors in favor of Landlord dated as of February 28, 2006, the undersigned Guarantors hereby
[i] consent to the foregoing Second Amendment to Master Lease Agreement (“Amendment”), [ii] affirm the Guaranty which shall remain in full force and effect and secure the Guaranteed Obligations, as defined in the Guaranty, and [iii] waive
any suretyship defenses arising in connection with the Amendment. All capitalized terms not defined herein shall have the meaning set forth in the foregoing Amendment. 
  

			
	KINDRED HEALTHCARE OPERATING, INC.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development
	
	GODDARD NURSING, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development
	
	SPRINGFIELD PARK VIEW HOSPITAL, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development
	
	MEADOWS NURSING, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development

			
	KINDRED BRAINTREE HOSPITAL, L.L.C.
		
	By:	 	 /s/ Douglas L. Curnutte

		 	Douglas L. Curnutte
		 	Vice President of Facilities and Real Estate Development

  

 2

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