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Exhibit 10.20  

$20,000,000.00 

AMENDMENT
NO. 1 TO 

AMENDED
AND RESTATED LOAN AND SECURITY AGREEMENT 

originally
dated as of March 25, 2004 by and among 

THE
ENSIGN GROUP, INC., ENSIGN WHITTIER WEST LLC,

ENSIGN WHITTIER EAST LLC, ENSIGN SANTA ROSA LLC, ENSIGN PANORAMA LLC,

ENSIGN SABINO LLC, ENSIGN SAN DIMAS LLC, ENSIGN MONTGOMERY LLC,

ENSIGN PALM I LLC, ENSIGN SONOMA LLC, ENSIGN CLOVERDALE LLC,

ENSIGN WILLITS LLC, ENSIGN PLEASANTON LLC,

24TH STREET HEALTHCARE ASSOCIATES LLC,

GLENDALE HEALTHCARE ASSOCIATES LLC,

ATLANTIC MEMORIAL HEALTHCARE ASSOCIATES, INC.,

ROSE PARK HEALTHCARE ASSOCIATES, INC.,

LEMON GROVE HEALTH ASSOCIATES LLC,

PRESIDIO HEALTH ASSOCIATES LLC, BELL VILLA CARE ASSOCIATES LLC,

DOWNEY COMMUNITY CARE LLC, COSTA VICTORIA HEALTHCARE LLC,

WEST ESCONDIDO HEALTHCARE LLC, REDBROOK HEALTHCARE ASSOCIATES LLC,

HB HEALTHCARE ASSOCIATES LLC, NORTH MOUNTAIN HEALTHCARE LLC,

PARK WAVERLY HEALTHCARE LLC, SUNLAND HEALTH ASSOCIATES LLC,

VISTA WOODS HEALTH ASSOCIATES LLC, CITY HEIGHTS HEALTH ASSOCIATES LLC,

CLAREMONT FOOTHILLS HEALTH ASSOCIATES LLC,

C STREET HEALTH ASSOCIATES LLC, VICTORIA VENTURA HEALTHCARE LLC

(collectively, "Continuing Borrower") 

RADIANT
HILLS HEALTH ASSOCIATES LLC, HIGHLAND HEALTHCARE LLC,

GATE THREE HEALTHCARE LLC, SOUTHLAND MANAGEMENT LLC,

MANOR PARK HEALTHCARE LLC, NORTHERN OAKS HEALTHCARE, INC.,

SALADO CREEK SENIOR CARE, INC., MCALLEN COMMUNITY HEALTHCARE, INC.,

WELLINGTON HEALTHCARE, INC.

(collectively, "New Borrower") 

ENSIGN
HIGHLAND LLC

("Withdrawing Borrower") 

and

GENREAL
ELECTRIC CAPITAL CORPORATION

("Lender") 

Amended
as of December 3, 2004 

 

AMENDMENT
NO. 1 TO AMENDED AND 

RESTATED
LOAN AND SECURITY AGREEMENT 

        THIS
AMENDMENT NO. 1 TO AMENDED AND RESTATED LOAN AND SECURITY AGREEMENT (this "Amendment") is made as of this 3rd, day of December, 2004, by and among THE ENSIGN GROUP, INC., a
Delaware corporation, ENSIGN HIGHLAND LLC, a Nevada limited liability company, ENSIGN WHITTIER WEST LLC, a Nevada limited liability company, ENSIGN WHITTIER EAST LLC, a Nevada limited liability
company, ENSIGN SANTA ROSA LLC, a Nevada limited liability company, and ENSIGN PANORAMA LLC, a Nevada limited liability company, ENSIGN SABINO LLC, a Nevada limited liability company, ENSIGN SAN DIMAS
LLC, a Nevada limited liability company, ENSIGN MONTGOMERY LLC, a Nevada limited liability company,
ENSIGN CLOVERDALE LLC, a Nevada limited liability company, ENSIGN PALM I LLC, a Nevada limited liability company, ENSIGN SONOMA LLC, a Nevada limited liability company, ENSIGN WILLITS LLC, a Nevada
limited liability company, ENSIGN PLEASANTON LLC, a Nevada limited liability company, 24th STREET HEALTHCARE ASSOCIATES LLC, a Nevada limited liability company, GLENDALE HEALTHCARE ASSOCIATES LLC, a
Nevada limited liability company, ATLANTIC MEMORIAL HEALTHCARE ASSOCIATES, INC., a Nevada corporation, and ROSE PARK HEALTHCARE ASSOCIATES, INC., a Nevada corporation, LEMON GROVE HEALTH
ASSOCIATES LLC, a Nevada limited liability company, PRESIDIO HEALTH ASSOCIATES LLC, a Nevada limited liability company, BELL VILLA CARE ASSOCIATES LLC, a Nevada limited liability company, DOWNEY
COMMUNITY CARE LLC, a Nevada limited liability company, COSTA VICTORIA HEALTHCARE LLC, a Nevada limited liability company, WEST ESCONDIDO HEALTHCARE LLC, a Nevada limited liability company, REDBROOK
HEALTHCARE ASSOCIATES LLC, a Nevada limited liability company, HB HEALTHCARE ASSOCIATES LLC, a Nevada limited liability company, NORTH MOUNTAIN HEALTHCARE LLC, a Nevada limited liability company, PARK
WAVERLY HEALTHCARE LLC, a Nevada limited liability company, SUNLAND HEALTH ASSOCIATES LLC, a Nevada limited liability company, VISTA WOODS HEALTH ASSOCIATES LLC, a Nevada limited liability company,
CITY HEIGHTS HEALTH ASSOCIATES LLC, a Nevada limited liability company, CLAREMONT FOOTHILLS HEALTH ASSOCIATES LLC, a Nevada limited liability company, C STREET HEALTH ASSOCIATES LLC, a Nevada limited
liability company, and VICTORIA VENTURA HEALTHCARE LLC, a Nevada limited liability company (collectively, "Continuing Borrower"), RADIANT HILLS HEALTH ASSOCIATES LLC, a Nevada limited liability
company, HIGHLAND HEALTHCARE LLC, a Nevada limited liability company, GATE THREE HEALTHCARE LLC, a Nevada limited liability company, SOUTHLAND MANAGEMENT LLC, Nevada limited liability company, MANOR
PARK HEALTHCARE LLC, a Nevada limited liability company, NORTHERN OAKS HEALTHCARE, INC., a Nevada corporation, SALADO CREEK SENIOR CARE, INC., a Nevada corporation, McALLEN COMMUNITY
HEALTHCARE, INC., a Nevada corporation, WELLINGTON HEALTHCARE, INC., a Nevada corporation (collectively "New Borrower", and together with Continuing Borrower, "Borrower"), ENSIGN
HIGHLAND LLC, a Nevada limited liability company ("Withdrawing Borrower"), and GENERAL ELECTRIC CAPITAL CORPORATION, a Delaware corporation ("Lender"). 

 
 

RECITALS    

        A.    Pursuant
to that certain Amended and Restated Loan and Security Agreement dated as of March 25, 2004 by and between Continuing Borrower and Lender (as amended,
modified and restated from time to time, the "Loan Agreement"), the parties have established certain financing arrangements that allow funds to be borrowed from Lender in accordance with the terms and
conditions set forth in the Loan Agreement. 

2

 

        B.    Continuing
Borrower and New Borrower have requested that the proceeds of the Loan be made available to New Borrower. 

        C.    The
entity designated above as "Withdrawing Borrower" is not an operating entity and desires to withdraw as a borrower under the Loan Agreement. Lender, Continuing
Borrower, New Borrower and Withdrawing Borrower have agreed that Withdrawing Borrower shall no longer be a party to the Loan Agreement. 

        D.    The
parties now desire to amend the Loan Agreement in accordance with the terms and conditions set forth below. 

NOW,
THEREFORE, in consideration of the premises set forth above, the terms and conditions contained in this Amendment, and other good and valuable consideration, the receipt and sufficiency of which
are hereby acknowledged, the parties have agreed to the following amendments to the Loan Agreement. Capitalized terms used but not defined in this Amendment shall have the meanings that are set forth
in the Loan Agreement. 

        1.     Addition
of New Borrower. Continuing Borrower, New Borrower and Lender agree that, upon satisfaction of the conditions set forth herein, New Borrower shall constitute a
"Borrower" for purposes of, and as defined in, the Loan Agreement and all other Loan Documents. Accordingly, New Borrower hereby agrees to be bound, jointly and severally, by all of the conditions,
covenants, representations, warranties, and other agreements set forth in the Loan Agreement, and hereby agrees to promptly execute all further documentation required by Lender to be executed by New
Borrower, consistent with the terms of the Loan Agreement. 

        2.     Withdrawal
of Withdrawing Borrower. Withdrawing Borrower shall no longer be party to the Loan Agreement or any of the other Loan Documents and will not be bound, by any
of the conditions, covenants, representations, warranties, and other agreements set forth in the Loan Agreement or any of the other Loan Documents. Withdrawing Borrower shall remain an obligated party
under that certain Amended and Restated Loan Agreement dated as of December     , 2004, as amended, among Sky Holdings AZ LLC, Terrace Holdings AZ LLC, Withdrawing Borrower and Valley
Health Holdings LLC, as mortgage borrowers, and Lender, as lender. 

        3.     Amendment
to Section 1.47. Section 1.47 of the Loan Agreement is hereby amended by deleting the existing Section 1.47 in its entirety and by
inserting in lieu thereof the following new Section 1.47: 

Section 1.47.
Real Estate Borrower. "Real Estate Borrower" means, collectively, Sky Holdings AZ LLC, Terrace Holdings AZ LLC, Ensign Highland LLC and Valley Health Holdings LLC, as mortgage
borrowers under that certain Amended and Restated Loan Agreement dated as of December    , 2004, as amended, among such mortgage borrowers and Lender. 

        4.     Amendment
to Section 1.48. Section 1.48 of the Loan Agreement is hereby amended by deleting the existing Section 1.48 in its entirety and by
inserting in lieu thereof the following new Section 1.48: 

Section 1.48.
Real Estate Loan Documents. "Real Estate Loan Documents" shall mean that certain Amended and Restated Loan Agreement dated as of December    , 2004, as amended, among
Sky Holdings AZ LLC, Terrace Holdings AZ LLC, Ensign Highland LLC and Valley Health Holdings LLC, as mortgage borrowers, and Lender, as lender, and all instruments and documents executed in connection
with such loan made pursuant thereto, as such documents and instruments may be amended from time to time. 

        5.     Amendment
to Section 2.1(e). Section 2.1(e) of the Loan Agreement is hereby amended by deleting from the eleventh (11) line thereof, relating to the
condition with respect to annualized Net Operating Income, the words "Two Million Five Hundred Fifty Thousand and No/100 Dollars 

3

 

($2,550,000.00)"
and by inserting in lieu thereof the words "Three Million Five Hundred Thousand and No/100 Dollars ($3,500,000.00)". 

        6.     New
Facilities. The following new facilities (the "New Facility") operated by New Borrower shall be added to the Borrowing Base: 

	North Mountain Medical &

Rehabilitation Center

9155 North 3rd Street

Phoenix, Arizona

(operated by Radiant Hills Health Associates LLC)	 	Highland Manor Health & Rehabilitation Center

4635 North 14th Street

Phoenix, Arizona

(operated by Highland Healthcare LLC)
	

Palm Terrace Rehab & Healthcare Center

24692 Calle Aragon

Laguna Hills, California

(operated by Gate Three Healthcare LLC)	
 	

Southland and Southland Home

11701 Studebaker Road

Norwalk, California

(operated by Southland Management LLC)
	

Park Manor Rehabilitation Center

1710 Plaza Way

Walla Walla, Washington

(operated by Manor Park Healthcare LLC)	
 	

Northern Oaks Living & Rehabilitation

Center

2722 Old Anson Road

Abilene, Texas

(operated by Northern Oaks Healthcare, Inc.)
	

Salado Creek Living & Rehabilitation Center

603 Corinne Drive

San Antonio, Texas

(operated by Salado Creek Senior Care, Inc.)	
 	

The Village Care Center

615 North Ware Road

McAllen, Texas

(operated by McAllen Community Healthcare, Inc.)
	

Wellington Place Living &

Rehabilitation Center

1802 South 31st Street

Temple, Texas

(operated by Wellington Healthcare, Inc.)	
 	

 

        7.     Grant
by New Borrower of Security Interest. Consistent with the intent of the parties, New Borrower hereby grants to Lender a continuing first priority lien on and
security interest in, upon, and to the Collateral, pursuant to and in accordance with the terms of Article III of the Loan Agreement, as follows: 

        (a)   All
of Borrower's now-owned and hereafter acquired or arising Accounts, accounts receivable and rights to payment of every kind and description, and all of
Borrower's contract rights, chattel paper, documents and instruments with respect thereto, and all of Borrower's rights, remedies, security and liens, in, to and in respect of the Accounts, including,
without limitation, rights of stoppage in transit, replevin, repossession and reclamation and other rights and remedies of an unpaid vendor, lienor or secured party, guaranties or other contracts of
suretyship with respect to the Accounts, deposits or other security for the obligation of any Account Debtor, and credit and other insurance; 

        (b)   All
moneys, securities and other property and the proceeds thereof, now or hereafter held or received by, in transit to, in possession of, or under the control of Lender
or a bailee or Affiliate of Lender, from or for Borrower, whether for safekeeping, pledge, custody, transmission, collection or otherwise, and all of Borrower's deposits (general or special),
balances, sums and credits with Lender at any time existing; 

        (c)   All
of Borrower's right, title and interest in, to and in respect of all goods relating to, or which by sale have resulted in, Accounts, including, without limitation,
all goods described in invoices or other documents or instruments with respect to, or otherwise representing or evidencing, any Account, and all returned, reclaimed or repossessed goods; 

        (d)   All
of Borrower's now owned or hereafter acquired deposit accounts into which Accounts are deposited, including the Lockbox Account; 

4

 

        (e)   All
of Borrower's now owned and hereafter acquired or arising general intangibles and other property of every kind and description with respect to, evidencing or
relating to its Accounts, accounts receivable and other rights to payment, including, without limitation, all existing and future customer lists, choses in action, claims, books, records, ledger
cards, contracts, licenses, formulae, tax and other types of refunds, returned and unearned insurance premiums, rights and claims under insurance policies, and computer programs, information,
software, records, and data, as the same relates to the Accounts; 

        (f)    All
of Borrower's other general intangibles (including, without limitation, any proceeds from insurance policies after payment of prior interests), patents, unpatented
inventions, trade secrets, copyrights, contract rights, goodwill, literary rights, rights to performance, rights under licenses, choses-in-action, claims, information contained
in computer media (such as data bases, source and object codes, and information therein), things in action, trademarks and trademarks applied for (together with the goodwill associated therewith) and
derivatives thereof, trade names, including the right to make, use, and vend goods utilizing any of the foregoing, and permits, licenses, certifications, authorizations and approvals, and the rights
of Borrower thereunder, issued by any governmental, regulatory, or private authority, agency, or entity whether now owned or hereafter acquired, together with all cash and non-cash
proceeds and products thereof; 

        (g)   All
of Borrower's now owned or hereafter acquired inventory of every description which is held by Borrower for sale or lease or is furnished by Borrower under any
contract of service or is held by Borrower as raw materials, work in process or materials used or consumed in a business, wherever located, and as the same may now and
hereafter from time to time be constituted, together with all cash and non-cash proceeds and products thereof; 

        (h)   All
of Borrower's now owned or hereafter acquired machinery, equipment, computer equipment, tools, tooling, furniture, fixtures, goods, supplies, materials, work in
process, whether now owned or hereafter acquired, together with all additions, parts, fittings, accessories, special tools, attachments, and accessions now and hereafter affixed thereto and/or used in
connection therewith, all replacements thereof and substitutions therefor, and all cash and non-cash proceeds and products thereof; and 

        (i)    The
proceeds (including, without limitation, insurance proceeds) of all of the foregoing. 

        8.     Confirmation
of Representations and Warranties. Borrower hereby (a) confirms that all of the representations and warranties set forth in Article IV of the
Loan Agreement are true and correct, and (b) specifically represents and warrants to Lender that it has good and marketable title to all of its respective Collateral, free and clear of any lien
or security interest in favor of any other person or entity, except as identified in Schedule 1.38 and Schedule 4.19 to the Loan Agreement, each as updated, and as otherwise permitted
pursuant to the Loan Agreement. 

        9.     Effective
Date. This Amendment shall be effective upon: 

        (a)   Borrower
shall have delivered to Lender, in each case executed by a duly authorized member and/or officer of each Borrower, this Amendment and a Second Amended and
Restated Promissory Note in a form satisfactory to Lender (which shall be considered to be the "Note" referred to in the Loan Agreement); and 

        (b)   Lender
shall have received and approved: 

        (i)    A
duly enacted Resolution or Consent of Member from each New Borrower authorizing the execution, delivery and performance of the Loan Documents and the borrowing of the
Loan under the Loan Documents, as well as the an Incumbency Certificate containing the names and signatures of the officers of the sole member of New Borrower authorized to execute documents on its
behalf in connection with the Loan, all as also certified as of the date of this Amendment by New Borrower's chief financial officer, or equivalent, and such other papers as Lender may reasonably
require; 

        (ii)   copies,
certified as true, correct and complete by the sole member of each New Borrower, of the certificate of organization of each New Borrower, with any amendments to
any of the foregoing, and all other documents necessary for performance of the obligations of New Borrower under this Amendment, the Loan Agreement and the other Loan Documents; 

        (iii)  financing
statement, tax lien and pending litigation search results with respect to each New Borrower and the New Facilities; 

5

 

        (iv)  an
updated Borrowing Base Certificate which includes calculations with respect to each New Borrower and the New Facilities; 

        (v)   complete
copies of the relevant executed purchase agreement, lease agreement, sublease agreement, management agreement, license, permit and Medicare and Medicaid
provider agreements evidencing the New Borrowers' right to own and/or operate (whether by lease, sublease, assignment of lease, management agreement or deed) the New Facilities; 

        (vi)  updated
Schedules to the Loan Agreement, as described below; 

        (vii) landlord
estoppel certificates executed by each landlord for the New Facilities; 

        (viii) a
fully executed Amendment to Four Party Lockbox Agreement; 

        (ix)  an
Amended and Restated Certificate of Validity; 

        (x)   Confirmation
and Assignment Agreement in respect of Accounts generated at the New Facilities, if necessary; 

        (xi)  insurance
certificates for the New Facilities naming Lender as an additional insured; and 

        (xii) such
additional information, documents and certifications as Lender shall reasonably deem necessary. 

Notwithstanding the foregoing, the items listed in clauses (iii), (iv), (v), (vii), (x) and (xi) may be delivered after the effective date of this
Amendment with respect to one or more of the Facilities; provided that Accounts of such Facilities shall not be included within the Borrowing Base until such items are delivered to Lender's
satisfaction. 

        10.   Updated
Schedules. As a condition precedent to Lender's agreement to enter into this Amendment, and in order for this Amendment to be effective, Borrower shall revise,
update and deliver to Lender all Schedules to the Loan Agreement to (a) reflect updated and accurate information with respect to New Borrower, and (b) to update all other information as
necessary to make the Schedules previously delivered correct. Borrower hereby represents and warrants that the information set forth on the attached Schedules is true and correct as of the date of
this Amendment. The attached Schedules are hereby incorporated into the Loan Agreement as if originally set forth therein. 

        11.   Enforceability.
This Amendment constitutes the legal, valid and binding obligation of each Borrower and is enforceable against each such Borrower in accordance with its
terms. 

        12.   Reference
to the Effect on the Loan Agreement. 

        (a)   Upon
the effectiveness of this Amendment, each reference in the Loan Agreement to "this Agreement," "hereunder," "hereof," "herein" or words of similar import shall mean
and be a reference to the Loan Agreement as amended by this Amendment. 

        (b)   Except
as specifically amended above, the Loan Agreement and all other Loan Documents shall remain in full force and effect and are hereby ratified and confirmed. 

        (c)   The
execution, delivery and effectiveness of this Amendment shall not, except as expressly provided in this Amendment, operate as a waiver of any right, power or remedy
of Lender, nor constitute a waiver of any provision of the Loan Agreement or any other documents, instruments and agreements executed or delivered in connection with the Loan Agreement. 

        (d)   This
Amendment (together with any other document executed in connection herewith) is not intended to be, nor shall it be construed as, a novation of the Loan Agreement. 

        13.   Governing
Law. This Amendment shall be governed by and construed in accordance with the laws of the State of Maryland. 

6

 

        14.   Headings.
Section headings in this Amendment are included for convenience of reference only and shall not constitute a part of this Amendment for any other purpose. 

        15.   Counterparts.
This Amendment may be executed in counterparts, and such counterparts taken together shall be deemed to constitute one and the same instrument. 

[SIGNATURES
FOLLOW] 

7

  

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

	 	 	 	LENDER:
	

 	

 	
 	

GE HFS HOLDINGS, INC.

f/k/a Heller Healthcare Finance, Inc.

a Delaware corporation
	

 	

 	
 	

By:	

/s/ Debra Owen

	 	 	 	Name:	DEBRA OWEN
	 	 	 	Title:	DULY AUTHORIZED SIGNATORY
	

ATTEST/WITNESS	
 	

CONTINUING BORROWER

THE ENSIGN GROUP, INC.

a Delaware corporation
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By:	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President
	 	 	 	 	 

8

 

	 	 	 	ENSIGN WHITTIER WEST LLC

ENSIGN WHITTIER EAST LLC

ENSIGN SANTA ROSA LLC

ENSIGN PANORAMA LLC

ENSIGN SAN DIMAS LLC

ENSIGN SABINO LLC

ENSIGN MONTGOMERY LLC

ENSIGN CLOVERDALE LLC

ENSIGN PALM I LLC

ENSIGN SONOMA LLC

ENSIGN WILLITS LLC

ENSIGN PLEASANTON LLC

24th STREET HEALTHCARE ASSOCIATES LLC

GLENDALE HEALTHCARE ASSOCIATES LLC

each, a Nevada limited liability company
	

 	

 	
 	

By:	

The Ensign Group, Inc.

Its Sole Member
	

ATTEST/WITNESS	
 	

 	

 
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By:	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President
	

 	

 	
 	

ATLANTIC MEMORIAL HEALTHCARE ASSOCIATES, INC.

ROSE PARK HEALTHCARE ASSOCIATES, INC.
	ATTEST/WITNESS	 	 	 
	 	 	 	each, a Nevada corporation
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By:	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President
	 	 	 	 	 

9

 

	 	 	 	LEMON GROVE HEALTH ASSOCIATES LLC

PRESIDIO HEALTH ASSOCIATES LLC

BELL VILLA CARE ASSOCIATES LLC

DOWNEY COMMUNITY CARE LLC

COSTA VICTORIA HEALTHCARE LLC

WEST ESCONDIDO HEALTHCARE LLC

REDBROOK HEALTHCARE ASSOCIATES LLC

HB HEALTHCARE ASSOCIATES LLC

NORTH MOUNTAIN HEALTHCARE LLC

PARK WAVERLY HEALTHCARE LLC

SUNLAND HEALTH ASSOCIATES LLC

VISTA WOODS HEALTH ASSOCIATES LLC

CITY HEIGHTS HEALTH ASSOCIATES LLC

CLAREMONT FOOTHILLS HEALTH ASSOCIATES LLC

C STREET HEALTH ASSOCIATES LLC

VICTORIA VENTURA HEALTH CARE LLC

each, a Nevada limited liability company
	

ATTEST/WITNESS	
 	

 	

 
	 	 	 	By:	The Ensign Group, Inc.

Its Sole Member
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By::	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President
	 	 	 	 	 

10

 

	 	 	 	NEW BORROWER:
	

 	

 	
 	

RADIANT HILLS HEALTH ASSOCIATES LLC

HIGHLAND HEALTHCARE LLC

GATE THREE HEALTHCARE LLC

SOUTHLAND MANAGEMENT LLC

MANOR PARK HEALTHCARE LLC
	

 	

 	
 	

each, a Nevada limited liability company
	

ATTEST/WITNESS	
 	

 	

 
	 	 	 	By:	The Ensign Group, Inc.

Its Sole Member
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By:	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President
	

 	

 	
 	

NORTHERN OAKS HEALTHCARE, INC.

SALADO CREEK SENIOR CARE, INC.

MCALLEN COMMUNITY HEALTHCARE, INC.

WELLINGTON HEALTHCARE, INC.
	ATTEST/WITNESS	 	each, a Nevada corporation
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By:	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President
	

 	

 	
 	

WITHDRAWING BORROWER:
	

 	

 	
 	

ENSIGN HIGHLAND LLC

a Nevada limited liability company
	

ATTEST/WITNESS	
 	

By:	

The Ensign Group, Inc.

Its Sole Member
	

By:	

/s/ Alan J. Norman
 Alan J. Norman

Vice President	
 	

By:	

/s/ Christopher R. Christensen
 Christopher R. Christensen

President

11

 
 
 

LIST OF SCHEDULES    

	Schedule 1.39	 	—	 	Permitted Liens
	

Schedule 4.1	
 	

—	
 	

Subsidiaries
	

Schedule 4.5	
 	

—	
 	

Litigation
	

Schedule 4.13	
 	

—	
 	

Non-Compliance with Law
	

Schedule 4.14	
 	

—	
 	

Environmental Matters
	

Schedule 4.15	
 	

—	
 	

Places of Business with patient census
	

Schedule 4.16	
 	

—	
 	

Licenses
	

Schedule 4.17	
 	

—	
 	

Stock Ownership
	

Schedule 4.19	
 	

—	
 	

Borrowings and Guarantees
	

Schedule 4.21	
 	

—	
 	

Trade Names
	

Schedule 4.22	
 	

—	
 	

Joint Ventures
	

Schedule 7.12	
 	

—	
 	

Transactions with Affiliates

12

  

 
 

SCHEDULES TO AMENDMENT NO. 1 TO
  AMENDED & RESTATED LOAN AGREEMENT
  (No. 14)    

	Sched
 
	 	Description
	 	Matters Covered

	1.38	 	Permitted Liens:	 	(i)    Landlord's liens, both statutory and contractual, contained in or created by the various leases, security agreement, pledges and related documentation covering the locations described in
Schedule 4.15, but only to the extent that such liens are contractually subordinated to Lender's liens and security interests pursuant to agreements between Lender and such landlords that are satisfactory to Lender
	

 	
 	

 	
 	

(ii)    (a) The lien of the Deed of Trust and Assignment of Rents by and between Ensign Southland LLC as Trustor and Continental Wingate Associates, Inc. as Beneficiary, affecting the California Property and recorded
January 30, 2001 at Document No. 01-0161647 in the office of the Los Angeles County Recorder, securing indebtedness in the original principal amount of $7,455,100, and (b) the lien of the Leasehold Deed of Trust with Assignment of
Rents as Additional Security by and between Ensign Santa Rosa LLC as Trustor and Berryman Health, Inc. as Beneficiary, affecting the leasehold for Summerfield Convalescent Hospital and recorded September 22, 2000 at Document
No. 2000096596 in the office of the Sonoma County Recorder, securing seller carryback indebtedness in the original principal amount of $252,413.44, as well as the corresponding Security Agreement dated July 1, 2000 covering the same
obligations and assets and the accompanying UCC-1 filed September 11, 2000 at Document No. 0026260342 in the office of the California Secretary of State; and (c) the lien of the Deed of Trust, Assignment of Rents Security Agreement and
Fixture Financing Statement by and between Sky Holdings AZ LLC as Trustor and General Electric Capital Corporation as Agent for the Lenders identified in the corresponding Loan Agreement as Beneficiary, affecting the Desert Sky Facility located at
5125 N. 58th, Avenue, Glendale, Arizona, and recorded March 25, 2004 at Document No. 2004-0305693 in the office of the Maricopa County Recorder, securing indebtedness in the original principal amount of $12,400,000 (to be increased to
$18,400,000 concurrently with the execution of this Amendment); (d) the lien of the Deed of Trust, Assignment of Rents Security Agreement and Fixture Financing Statement by and between Terrace Holdings AZ LLC as Trustor and General Electric
Capital Corporation as Agent for the Lenders identified in the corresponding Loan Agreement as Beneficiary, affecting the Desert Terrace Facility located at 2509 N. 24th Street, Phoenix, Arizona, and recorded March 25, 2004 at Document
No. 2004-0305689 in the office of the Maricopa County Recorder, securing indebtedness in the original principal amount of $12,400,000 (to be increased to $18,400,000 concurrently with the execution of this Amendment); and (e) the lien of
the Deed of Trust, Assignment of Rents Security Agreement and Fixture Financing Statement by and between Ensign Highland LLC as Trustor and General Electric Capital Corporation as Agent for the Lenders identified in the corresponding Loan Agreement
as Beneficiary, affecting the Highland Manor Facility located at 4635 N. 14th Street, Phoenix, Arizona, and recorded March 25, 2004 at Document No. 2004-0305691 in the office of the Maricopa County Recorder, securing indebtedness in the
original principal amount of $12,400,000 (to be increased to $18,400,000 concurrently with the execution of this Amendment); and (f) the lien of the Deed of Trust and Security Agreement by and between The Mary Jane Lindsay Living Trust, Mary
Jane Lindsay, Trustee and Northern Life Insurance Company, affecting the Catalina Facility located at 2611 North Warren Avenue, Tucson, Arizona, as recorded March 31, 1995 in Pima County Recorder Docket No. 10012 at Page 870, as assumed by
Presidio Health Associates LLC by Assignment, Assumption and Amendatory Agreement recorded May 16, 2003 at Pima County Recorder Doc.
No. 03-                    .
	 	 	 	 	 

13

 

	

 	
 	

 	
 	

(iii)    Liens permitted to be created by Sections 6.23 and 7.1(d) of the Loan Agreement.
	

4.1	
 	

Subsidiaries:	
 	

Original Borrower is the sole Member of Ensign Highland LLC, Highland Healthcare LLC, Ensign Whittier East LLC, Ensign Whittier West LLC, Ensign Santa Rosa LLC, Ensign Panorama LLC, Ensign Sabina LLC, Ensign San Dimas LLC (formerly Ensign Arden LLC),
Ensign Montgomery LLC (formerly Ensign Jackson LLC), Ensign Southland LLC, Southland Management LLC, Ensign Bellflower LLC, Ensign Palm I LLC, Ensign Cloverdale LLC, Ensign Sonoma LLC, Ensign Willits LLC, Ensign Pleasanton LLC, Sky Holdings AZ LLC,
Glendale Healthcare Associates LLC, Terrace Holdings AZ LLC, 24th Street Healthcare Associates LLC, Manor Park Healthcare LLC, Moenium Holdings LLC, Brown Road Senior Housing LLC, Greenfields Assisted Living LLC, Lemon Grove Health Associates LLC,
Rillito Holdings LLC, Presidio Health Associates LLC, Bell Villa Care Associates LLC, Downey Community Care LLC, Costa Victoria Healthcare LLC, West Escondido Healthcare LLC, Redbrook Healthcare Associates LLC, HB Healthcare Associates LLC, Adipiscor
LLC, North Mountain Healthcare LLC, Park Waverly Healthcare LLC, Sunland Health Associates LLC, Permunitum LLC, Vista Woods Health Associates LLC, City Heights Health Associates LLC, Claremont Foothills Health Associates LLC, C Street Health
Associates LLC, Victoria Ventura Healthcare LLC, Radiant Hills Health Associates LLC, Valley Health Holdings LLC, and Gate Three Healthcare LLC, and is also the sole shareholder of Atlantic Memorial Healthcare Associates, Inc., Rose Park
Healthcare Associates, Inc., Ensign Facility Services, Inc., Salado Creek Senior Care, Inc., Wellington Healthcare Inc., McAllen Community Healthcare, Inc. and Northern Oaks Healthcare, Inc all of which are currently active
and doing business. Original Borrower is also the sole Member of Ensign Bellflower LLC, Ensign Napa LLC, Mountainview Communitycare LLC, Walnut Grove Campuscare LLC, Ramon Healthcare Associates, Inc., East Escondido Health Associates LLC,
Meadowbrook Health Associates LLC, Long Beach Senior MultiCare LLC, Long Beach Health Associates LLC and Cedar Avenue Holdings LLC, all entities formed by Original Borrower to facilitate concluded, failed, pending or future transactions.
	

4.5	
 	

Pending or Threatened Litigation:	
 	

There is currently no pending or threatened litigation which the Borrower believes would materially threaten Borrower's viability or ability to repay the Obligations; further, all claims pending or threatened against the Borrower are either covered
by insurance or, to the extent they are not, Borrower believes it has accrued adequate reserves in connection therewith.
	 	 	 	 	 

14

 

	

4.8	
 	

Defaults:	
 	

Relating to the representations in Section 4.8 of the Loan Agreement, and without admitting any default, reference is made to Schedule 4.5 above.
	

4.13	
 	

Non-compliance With Law:	
 	

To the best of the actual knowledge of the officers of Borrower, there does not currently exist any material non-compliance with applicable laws.
	

4.14	
 	

Environmental Matters:	
 	

To the best of the actual knowledge of the officers of original Borrower, there are no material adverse environmental matters associated with any of the Texas, Arizona, California or Washington properties.
	

4.15	
 	

Places of Business with patient census:	
 	

See consolidated Schedule 4.15(a)/4.16 and Schedule 4.15(b) at the end of this Exhibit A.
	

4.16	
 	

Licenses:	
 	

The entity which currently holds or possesses the right to use the operating license for each of the facilities is as shown in consolidated Schedule 4.15(a)/4.16.
	

4.17	
 	

Stock Ownership:	
 	

See separate schedule at the end of this Exhibit A.
	

4.19	
 	

Borrowings:	
 	

Other than normal trade creditors, some or all of the entities comprising the Borrower are currently indebted to the following creditors in the following manners and amounts:
	

 	
 	

 	
 	

    a.    General Electric Capital Corporation; $20,000,000 Revolving Credit Facility for working capital.
	

 	
 	

 	
 	

    b.    General Electric Capital Corporation; $12,400,000 Arizona Term Loan secured by Deeds of Trust encumbering (i) Ensign Highland LLC's Highland Manor facility in Phoenix, Arizona, (ii) Sky
Holdings AZ LLC's Desert Sky Health Center & Assisted living in Glendale, Arizona, and (iii) Terrace Holdings AZ LLC's Desert Terrace Nursing & Rehabilitation Center in Phoenix, Arizona. (to be increased to $18,400,000
concurrently with the execution and delivery of the within Amendment to the Original Loan Agreement).
	

 	
 	

 	
 	

    c.    Continental Wingate Associates, Inc.; $7,455,100 HUD-insured Loan secured by a Deed of Trust and Assignment of Rents on Ensign Southland LLC's Southland Care Center & Home facility,
Norwalk, California.
	

 	
 	

 	
 	

    e.    Berryman Health, Inc.; $252,413.44 Carryback Promissory Note secured by Leasehold Deed of Trust and Security Agreement and Financing Statement on Summerfield Convalescent Hospital
Lease.
	

 	
 	

 	
 	

    f.    Reliastar Life Insurance Company, as successor by merger to Northern Life Insurance Company; $2,051,824.69 secured loan balance upon assumption of Deed of Trust and Security Agreement encumbering
Rillito Holdings LLC's Catalina Care Center in Tucson, Arizona.
	

 	
 	

 	
 	

    g.    Larry Santora as Successor Trustee of the Mary Jane Lindsay Living Trust darted July 26, 1993; $331,061.76 Carryback Promissory Note secured by second-position Deed of Trust on Rillito Holdings
LLC's Catalina Care Center in Tucson, Arizona.
	 	 	 	 	 

15

 

	

4.20	
 	

Labor Disputes:	
 	

A union organizing election was held at Sonoma Healthcare Center in May, 2002 at which a majority of the approximately 60 employees classified as Housekeeping, Laundry and CNAs voted to have union representation from SEIU Local 250. On August 30,
 2004, the National Labor Relations Board certified the union. The union has requested bargaining, but bargaining has not yet begun. Due to irregularities in the voting procedures during the election, the certification may be further appealable. In
the meantime, the SEIU has published statements critical of Sonoma Healthcare Center, The Ensign Group and other Ensign affiliates, and has filed two B&P §17200 suits against the facility, and has filed various unfair labor practice charges,
all in an effort to coerce the facility into waiving its appeal rights. One § 17200 suit was settled for a nominal amount, and all ULP charges except one that the facility settled by merely posting a notice were either dropped by the union at
the NLRB's behest or resulted in findings in the facility's favor. Operations at the facility and throughout the company have not been materially disrupted by union issues at any time since the original organizing election.
	

4.22	
 	

Joint Ventures:	
 	

None
	

7.12	
 	

Transactions with Affiliates:	
 	

Lease between Ensign Highland LLC as Landlord and Highland Healthcare LLC as Tenant for Highland Manor; formation and capitalization of Ensign Southland LLC, and the conveyance of Southland Care Center and Home thereto in connection with the
HUD-insured refinancing of that facility; Lease between Ensign Southland LLC as Landlord and Southland Management LLC as Tenant for Southland Care Center & Home; Lease between Terrace Holdings AZ LLC as Landlord and 24th Street Healthcare
Associates LLC as Tenant for Desert Terrace Nursing and Rehabilitation Center; Lease between Sky Holdings AZ LLC as Landlord and Glendale Healthcare Associates LLC as Tenant for Desert Sky Health Center & Assisted Living; Lease between
Rillito Holdings LLC as Landlord and Presidio Health Associates LLC as Tenant for Catalina Care Center; Sublease between Moenium Holdings LLC as Sublandlord and Bell Villa Care Associates LLC as Subtenant for Rose Villa Healthcare Center; Sublease
between Moenium Holdings LLC as Sublandlord and Downey Community Care LLC as Subtenant for Brookfield Healthcare Center; Sublease between Adipiscor LLC as Sublandlord and North Mountain Healthcare LLC as Subtenant for Coronado Care Center; Sublease
between Adipiscor LLC as Sublandlord and Park Waverly Healthcare LLC as Subtenant for Waverly Park Healthcare Center; Sublease between Adipiscor LLC as Sublandlord and Sunland Health Associates LLC as Subtenant for East Mesa Care Center; Sublease
between Permunitum LLC as Sublandlord and Vista Woods Health Associates LLC as Subtenant for Vista Knoll Specialized Care Center; Sublease between Permunitum LLC as Sublandlord and City Heights Health Associates LLC as Subtenant for Arroyo Vista
Healthcare Center; Sublease between Permunitum LLC as Sublandlord and Claremont Foothills Health Associates LLC as Subtenant for Claremont Care Center; Lease between Valley Health Holdings LLC as Landlord and Radiant Hills Health Associates LLC as
Tenant for North Mountain Medical and Rehabilitation Center.
	

 	
 	

 	
 	

---Schedules 4.15(a)/4.16, 4.15(b) and 4.17 follow---

16

 
 
 

Second Amendment & Restatement to Loan and Security Agreement (No. 14)
  Consolidated Schedule 4.15(a)/4.16    

 
  Places of Business with Trade Names, Licensee and Record Owner Data
  (as of November 1, 2004)
  (See separate Schedule 4.15(b) for Census Data)    

	The Ensign Group, Inc.

Ensign Facility Services, Inc.

27101 Puerta Real, Suite 450

Mission Viejo, CA 92691

Record Owner: Mission

Ridge Associates, L.L.C.	 	Royal Court Healthcare

(fka Berryman Health Whittier West)

12385 E. Washington Blvd.

Whittier, CA 90606

Licensee: Ensign Whittier West LLC

Record Owner: Whittier West, L.L.C.
	

Southland Care Center and Home

11701 Studebaker Road

Norwalk, CA 90659

Licensee: Southland Management LLC

Record Owner: Ensign Southland LLC	
 	

Whittier Hills Healthcare Center

(fka Berryman Health Whittier East)

10426 Bogardus Avenue

Whittier CA, 90603

Licensee: Ensign Whittier East LLC

Record Owner: Whittier East, L.L.C.
	

The Village Care Center

615 North Ware Road

McAllen, TX 78501

Licensee: McAllen Community Healthcare, Inc.

Record Owner: James F. Cotter	
 	

Summerfield Healthcare Center

1280 Summerfield Road

Santa Rosa, CA 95405

Licensee: Ensign Santa Rosa LLC

Record Owner: Summerfield Development Co.
	

Wellington Place Healthcare Center

(fka Camlu Care Center Temple)

1802 South 31st Street Temple, TX 76504

Licensee: Wellington Healthcare, Inc.

Record Owner: James F. Cotter	
 	

Salado Creek Living & Rehab Center

(fka Camlu Care Center San Antonio)

603 Corrine

San Antonio, TX 78218

Licensee: Salado Creek Senior Care, Inc.

Record Owner: James F. Cotter
	

Panorama Gardens

9541 Van Nuys Boulevard

Panorama City, CA 91402

Licensee: Ensign Panorama LLC

Record Owner: Vannovi Properties, LLC	
 	

Sabino Canyon Rehab & Care Center

5830 E. Pima Street

Tucson, AZ 85712

Licensee: Ensign Sabino LLC

Record Owner: Tucson-Cal Associates, LLC
	

Northern Oaks Nursing and Rehab Center

2722 Old Anson Road

Abilene, TX 79603

Licensee: Northern Oaks Healthcare, Inc.

Record Owner: James F. Cotter	
 	

Arbor Glen Care & Living Center

(fka Glendora Care & Living Center)

1130 East Arrow Highway

Glendora, CA 91740

Licensee: Ensign San Dimas LLC

Record Owner: Health Care Investors III
	

Park Manor Convalescent Center

1710 Plaza Way

Walla Walla, Washington 99362

Licensee: Manor Park Healthcare LLC

Record Owner: Health Care Property Investors, Inc.	
 	

Park View Gardens at Montgomery

3571 Montgomery Drive

Santa Rosa, CA 95405

Licensee: Ensign Montgomery LLC

Record Owner: Health Care REIT, Inc.
	 	 	 

17

 

	

Highland Manor Health & Rehab Center

4635 N. 14th Street

Phoenix, Arizona 85014

Licensee: Highland Healthcare LLC

Record Owner: Ensign Highland LLC	
 	

Premier Care & Rehabilitation Center

2990 East Ramon Road

Palm Springs, CA 92262

Licensee: Ensign Palm I LLC

Record Owner: Coachella House, Inc.
	

Northbrook Healthcare Center

(fka Willits Healthcare Center)

64 Northbrook Way

Willits, CA 95490

Licensee: Ensign Willits LLC

Record Owner: James F. Cotter	
 	

Cloverdale Healthcare Center

300 Cherry Creek Road

Cloverdale, CA 95425

Licensee: Ensign Cloverdale LLC

Record Owner: James F. Cotter
	

Sonoma Healthcare Center

1250 Broadway

Sonoma, CA 95476

Licensee: Ensign Sonoma LLC

Record Owner: James F. Cotter	
 	

Ukiah Convalescent Hospital

1349 South Dora

Ukiah, CA 95482

Licensee: Berryman Health, Inc.;

Ensign Pleasanton LLC (pending)

Record Owner: Ukiah SNF, LLC
	

Desert Sky Health & Assisted Living Center

5125 N. 58th Avenue

Glendale, AZ 85301

Licensee: Glendale Healthcare Associates LLC

Record Owner: Sky Holdings AZ LLC	
 	

Desert Terrace Nursing and Rehabilitation Center

2409 N. 24th Street

Phoenix, AZ 85008

Licensee: 24th Street Healthcare Associates LLC

Record Owner: Terrace Holdings AZ LLC
	

Atlantic Memorial Healthcare Center

(fka Akin's Post Acute Rehab Hospital)

2750 Atlantic Avenue

Long Beach, CA 90806

Lic'e: Atlantic Memorial Healthcare Associates, Inc.

Record Owner: RMA Land, LLC	
 	

Shoreline Healthcare Center

(fka Eastwood Convalescent Hospital)

4029 East Anaheim Street

Long Beach, CA 90804

Licensee: Rose Park Healthcare Associates, Inc.

Record Owner: Akin Investments, Inc.
	

Catalina Care Center

2611 North Warren Ave.

Tucson, AZ 85719

Licensee: Presidio Health Associates LLC

Record Owner: Presidio Health Associates LLC	
 	

Lemon Grove Care & Rehab Center

8351 Broadway

Lemon Grove, CA 91945

Licensee: Lemon Grove Health Associates LLC

Record Owner: MCS PGCH LLC et al
	

Rose Villa Healthcare Center

9028 Rose Street

Bellflower, CA 90706

Licensee: Bell Villa Care Associates LLC

Record Owner: Healthcare Investors, III	
 	

Brookfield Care & Rehab Center

9300 Telegraph Rd.

Downey, CA 90240

Licensee: Downey Community Care LLC

Record Owner: Healthcare Investors, III
	

Victoria Healthcare Center

340 Victoria Street

Costa Mesa, CA 92627

Licensee: Costa Victoria Healthcare LLC

Record Owner: Eugene Woods, et al	
 	

Palomar Vista Healthcare Center

201 North Fig Street

Escondido, CA 92025

Licensee: West Escondido Healthcare LLC

Record Owner: Neale A. Perkins
	

Brookside Healthcare Center

105 Terracina Blvd.

Redlands, CA 92373

Licensee: Redbrook Healthcare Associates LLC

Record Owner: James F. Cotter	
 	

Sea Cliff Healthcare Center

18811 Florida Street

Huntington Beach, CA 92648

Licensee: HB Healthcare Associates LLC

Record Owner: Huntington Beach Convalescent

Hospital Asset Corporation
	 	 	 

18

 

	

Coronado Care Center

11411 N. 19th Avenue

Phoenix, AZ 85029

Licensee: North Mountain Healthcare LLC

Record Owner: Coronado Corporation	
 	

East Mesa Care Center

51 South 48th Street

Mesa, Arizona 85206

Licensee: Sunland Health Associates LLC

Record Owner: LTC Partners VI, L.P.
	

Waverly Park Healthcare Center

2001 N. Park Avenue

Tucson, AZ 85719

Licensee: Park Waverly Healthcare LLC

Record Owner: Park Villa Corporation	
 	

Vista Knoll Specialized Care Center

2000 Westwood Road

Vista, CA 92083

Licensee: Vista Woods Health Associates LLC

Record Owner: OHI Asset (CA), LLC
	

Arroyo Vista Healthcare Center

3022 45th Street

San Diego, CA 92105

Licensee: City Heights Health Associates LLC

Record Owner: OHI Asset (CA), LLC	
 	

Claremont Care Center

219 East Foothill Boulevard

Pomona, CA 91768

Lic'ee: Claremont Foothills Health Associates LLC

Record Owner: OHI Asset (CA), LLC
	

Glenwood Care Center

1300 North C Street

Oxnard, CA 93030

Licensee: C Street Health Associates LLC

Record Owner: Oxnard Investments, L.P.	
 	

Victoria Care Center

5445 Everglades Street

Ventura, CA 93003

Licensee: Victoria Ventura Healthcare LLC

Record Owner: SHP Lexington, LLC
	

North Mountain Medical & Rehabilitation Center

9155 North 3rd Street

Phoenix, AZ 85020

Licensee: Radiant Hills Health Associates LLC

Record Owner: Valley Health Holdings LLC	
 	

Palm Terrace Rehab & Healthcare Center

24962 Calle Aragon

Laguna Woods, CA 92653

Licensee: Gate Three Healthcare LLC

Record Owner: Laguna Hills Assisted I L.P.

19

   
Schedule 4.15(b)

Census Data as of

1-Nov-04 

	Facilities - Total Census
 
	 	Capacity
	 	11/1/2004
	 
	Northern Oaks (NO)	 	96	 	86	 
	San Antonio (CS)	 	120	 	68	 
	Temple (CT)	 	140	 	78	 
	The Village (VC)	 	114	 	78	 
	Texas(TX)	 	470	 	310	 
	

Tucson	
 	

 	
 	

 	
 
	Catalina (CC)	 	102	 	89	 
	Sabino Canyon (SB)	 	112	 	86	 
	Waverly Park (WP)	 	200	 	120	 
	 	 	414	 	295	 
	

Phoenix	
 	

 	
 	

 	
 
	Coronado (CR)	 	191	 	152	 
	Desert Sky (DS)	 	186	 	149	 
	Desert Sky Assisted (DA)	 	140	 	69	 
	Desert Terrace (DT)	 	108	 	91	 
	East Mesa (EM)	 	222	 	151	 
	Grand Court (GC)	 	167	 	143	 
	Greenfields (GF)	 	141	 	99	 
	Highland Manor (HM)	 	107	 	88	 
	North Mountain (NM)	 	155	 	146	 
	Arizona (AZ)	 	1,417	 	1,088	 
	

Northern California	
 	

 	
 	

 	
 
	Cloverdale (CH)	 	72	 	62	 
	Park Manor (PM)	 	79	 	66	 
	Park View (MT)	 	122	 	106	 
	Sonoma (SO)	 	144	 	106	 
	Summerfield (SM)	 	70	 	64	 
	Ukiah (UK)	 	57	 	51	 
	Willits Care (WC)	 	70	 	40	 
	N. California/Wash (C2)	 	614	 	495	 
	

West 1	
 	

 	
 	

 	
 
	Atlantic Memorial (AM)	 	109	 	85	 
	Bellflower (RV)	 	53	 	49	 
	Downey (BF)	 	70	 	62	 
	Royal Court (RC)	 	162	 	161	 
	Sea Cliff (SE)	 	123	 	179	 
	Sea Cliff ALF (SA)	 	143	 	60	 
	Shoreline (SL)	 	75	 	69	 
	Southland Care (SC)	 	120	 	116	 
	Southland Home (SH)	 	65	 	59	 
	Whittier Hills (PR)	 	158	 	152	 
	West 1 Total Census	 	1,078	 	992	 

20

 

	

West 2	
 	

 	
 	

 	
 
	Brookside (BS)	 	97	 	88	 
	Claremont Care (CL)	 	99	 	97	 
	Glendora (GL)	 	98	 	86	 
	Glenwood (GW)	 	99	 	96	 
	Panorama Gardens (PG)	 	151	 	147	 
	Premier Care (PC)	 	99	 	94	 
	Ventura (VI)	 	188	 	176	 
	West 2 Total Census	 	831	 	784	 
	

West 3	
 	

 	
 	

 	
 
	Arroyo Vista (AV)	 	53	 	49	 
	Lemon Grove (LG)	 	158	 	155	 
	Palomar (PV)	 	74	 	70	 
	Victoria (VH)	 	79	 	75	 
	Vista Knoll (VK)	 	119	 	108	 
	West 3 Total Census	 	483	 	457	 
	

Total	
 	

5,307	
 	

4,421	
 
	Census Change (Prior Monday)	 	 	 	(4	)
	Census:Less Current Mnth Aqc.	 	 	 	4,570	 
	Census Var: Less Curr Mo Acq	 	 	 	(6	)
	Census Same Store (2/29/2004)	 	 	 	4,187	 
	Census Var: Same Store (2/29/04)	 	 	 	(6	)

21

 

Share
Ownership 2004-11-10 

	 
	 	Shareholder (share amts reflect 4/04 split)
 
	 	01 Sh
	 	SOP Sh
	 	Qty#
	 	%
	 
	1	 	Douglas M. Easton	 	600,000	 	 	 	600,000	 	7.16	%
	2	 	V. Jay Brady	 	300,000	 	60,000	 	360,000	 	4.29	%
	3	 	Gregory K. Stapley	 	600,000	 	 	 	600,000	 	7.16	%
	4	 	Jutta Fisher	 	20,000	 	 	 	20,000	 	0.24	%
	5	 	Monte Nyman	 	20,000	 	 	 	20,000	 	0.24	%
	6	 	Robert L. Millet	 	20,000	 	 	 	20,000	 	0.24	%
	7	 	Raymon Brown	 	40,000	 	 	 	40,000	 	0.48	%
	8	 	Val J. Sneddon	 	20,000	 	 	 	20,000	 	0.24	%
	9	 	John Gurrieri	 	120,000	 	 	 	120,000	 	1.43	%
	10	 	Alan J. Norman	 	85,000	 	52,000	 	137,000	 	1.63	%
	11	 	Covey C. Christensen	 	80,000	 	 	 	60,000	 	0.95	%
	12	 	Jason Collette	 	50,000	 	 	 	50,000	 	0.60	%
	13	 	Andrew L. Johnson	 	50,000	 	 	 	50,000	 	0.60	%
	14	 	B. Laird Washburn	 	30,000	 	 	 	30,000	 	0.36	%
	15	 	Thomas A. Maloof	 	50,000	 	10,000	 	60,000	 	0.72	%
	16	 	Gordon Buechs	 	25,000	 	26,200	 	51,200	 	0.61	%
	17	 	Marcus Paxman	 	2,000	 	 	 	2,000	 	0.02	%
	18	 	Tyler Douglas	 	2,000	 	5,000	 	7,000	 	0.08	%
	19	 	Clayton H. Christensen	 	20,000	 	8,000	 	28,000	 	0.33	%
	20	 	Christie Ann Bohnsack	 	 	 	17,000	 	17,000	 	0.20	%
	21	 	Charles B. Blalack & Dolores B. Blalack, JTWROS	 	6,000	 	 	 	6,000	 	0.07	%
	22	 	Karen Ann Blalack & Barry Blackmore, JTWROS	 	6,000	 	 	 	6,000	 	0.07	%
	23	 	Douglas Millington Blalack & Antoinette Carman BI;	 	6,000	 	 	 	6,000	 	0.07	%
	24	 	Shirley Johnson	 	6,000	 	 	 	6,000	 	0.07	%
	25	 	T. Brook Townsend, III Trustee, The T. Brook Tow	 	24,000	 	 	 	24,000	 	0.29	%
	26	 	Charles Millington Blalack and Boni Buehler Blalack	 	131,000	 	10,000	 	141,000	 	1.68	%
	27	 	Nathan P. Ure	 	 	 	20,000	 	20,000	 	0.24	%
	28	 	Donnabelle Valido	 	 	 	2,000	 	2,000	 	0.02	%
	29	 	Gloria Miranda	 	 	 	2,000	 	2,000	 	0.02	%
	30	 	Julie Thompson	 	 	 	8,000	 	8,000	 	0.10	%
	31	 	Shirley Thompson	 	 	 	2,000	 	2,000	 	0.02	%
	32	 	Jim Guschl	 	 	 	10,000	 	10,000	 	0.12	%
	33	 	Julie Uychiat	 	 	 	2,000	 	2,000	 	0.02	%
	34	 	Joe B. Sneddon	 	 	 	800	 	800	 	0.01	%
	35	 	Lisa Matarazzo	 	 	 	9,000	 	9,000	 	0.11	%
	36	 	Christine A. Jones	 	 	 	8,000	 	8,000	 	0.10	%
	37	 	Michael C. Dalton	 	 	 	2,000	 	2,000	 	0.02	%
	38	 	David Sedgwick	 	 	 	13,000	 	13,000	 	0.16	%
	39	 	Tiffany Allen	 	 	 	4,000	 	4,000	 	0.05	%
	40	 	Roy E. Christensen and Carol M. Christensen as C	 	1,980,000	 	 	 	1,980,000	 	23.62	%
	41	 	Kameron Kay Christensen	 	20,000	 	 	 	20,000	 	0.24	%
	42	 	Christopher R. Christensen	 	1,980,000	 	 	 	1,980,000	 	23.62	%
	43	 	J. Richard Toolson and E. Louise Toolson as Co-Ti	 	300,000	 	 	 	300,000	 	3.58	%
	44	 	Andrew Ashton	 	 	 	9,000	 	9,000	 	0.11	 
	45	 	Berit Kuntz-Darby	 	 	 	60,000	 	60,000	 	0.72	%
	 	 	 	 	 	 	 	 	 	 	 	 

22

 

	46	 	S. Kendall Young	 	 	 	8,000	 	8,000	 	0.10	%
	47	 	Cynthia Hopkins	 	 	 	10,000	 	10,000	 	0.12	%
	48	 	Krista Lynn Mauiri	 	 	 	2,000	 	2,000	 	0.02	%
	49	 	David Connolly	 	 	 	8,000	 	8,000	 	0.10	%
	50	 	Antoinette T. Hubenette	 	 	 	10,000	 	10,000	 	0.12	%
	51	 	Matthew J. Church	 	 	 	8,000	 	8,000	 	0.10	%
	52	 	Shawn M. Laird	 	 	 	1,000	 	1,000	 	0.01	%
	53	 	Barbara L. Townsend, Trustee, The Barbara L. Tow	 	4,000	 	 	 	4.000	 	0.05	%
	54	 	Shirley T. Butterworth, Trustee, The Shirley T. Butt	 	4,000	 	 	 	4,000	 	0.05	%
	55	 	Kenneth M. Townsend	 	4,000	 	 	 	4,000	 	0.05	%
	56	 	Richard A. McKay	 	4,000	 	 	 	4,000	 	0.05	%
	57	 	Stanley W. Lyons and Myril Rosemary Lyons, Trust	 	2,000	 	 	 	2,000	 	0.02	%
	58	 	David R. Butterworth and Elaine M. Butterworth, JT	 	2,000	 	 	 	2,000	 	0.02	%
	59	 	Coburn Haskell, Trustee, The Coburn Haskell Rev	 	1,000	 	 	 	1,000	 	0.01	%
	60	 	Brad Zelden	 	 	 	4,000	 	4,000	 	0.05	%
	61	 	Michael N. Williams	 	 	 	4,000	 	4,000	 	0.05	%
	62	 	Dennis L. Carlson	 	 	 	1,000	 	1,000	 	0.01	%
	63	 	Cory R. Monette	 	 	 	2,000	 	2,000	 	0.02	%
	64	 	Dennis A. Horsch	 	 	 	1,000	 	1,000	 	0.01	%
	 	 	 	 	 	 	 	 	 	 	0.00	%
	Common Shares Outstanding	 	6,593,000	 	399,000	 	7,013,000	 	 	 
	

PREFERRED SERIES A SHARES	
 	

 	
 	

 	
 	

 	
 	

 	
 
	1	 	Ensign Group Investments, LLC	 	 	 	 	 	1,370,590	 	16.35	%
	Preferred Shares Outstanding	 	 	 	 	 	1,370,590	 	 	 
	

10-Nov TOTAL COMMON & PREFERRED OUTSTANDING	
 	

 	
 	

 	
 	

 	
 	

8,383,590	
 
	Issued & Unexercised Options	 	 	 	 	 	 	 	231,100	 
	Total	 	 	 	 	 	 	 	8,614,690	 
	

10-Nov 2001 STOCK OPTION PLAN	
 	

 	
 	

 	
 	

 	
 	

 	
 
	Options Authorized by Plan	 	 	 	 	 	990,000	 	15% of issued as	 
	Options/Shares Issued	 	 	 	 	 	(708,500	)	 	 
	Options Lapsed	 	 	 	 	 	78,400	 	 	 
	Available for issuance	 	 	 	 	 	359,900	 	 	 
	

Outstanding Options	
 	

 	
 	

 	
 	

630,100	
 	

 	
 
	Options Exercised	 	 	 	 	 	399,000	 	 	 
	Options issued/unexercised	 	 	 	 	 	231,100	 	 	 

23

QuickLinks

RECITALS

LIST OF SCHEDULES

SCHEDULES TO AMENDMENT NO. 1 TO AMENDED & RESTATED LOAN AGREEMENT (No. 14)

Second Amendment & Restatement to Loan and Security Agreement (No. 14) Consolidated Schedule 4.15(a)/4.16

Places of Business with Trade Names, Licensee and Record Owner Data (as of November 1, 2004) (See separate Schedule 4.15(b) for Census Data)QuickLinks
 -- Click here to rapidly navigate through this document

Exhibit 10.22  

$20,000,000.00  

 
 

AMENDMENT NO. 2 TO
  AMENDED AND RESTATED LOAN AND SECURITY AGREEMENT    
    

originally
dated as of March 25, 2004 by and among 

THE
ENSIGN GROUP, INC., ENSIGN WHITTIER WEST LLC,

ENSIGN WHITTIER EAST LLC, ENSIGN SANTA ROSA LLC, ENSIGN PANORAMA LLC, ENSIGN SABINO LLC,

ENSIGN SAN DIMAS LLC, ENSIGN MONTGOMERY LLC,

ENSIGN PALM I LLC, ENSIGN SONOMA LLC, ENSIGN CLOVERDALE LLC,

ENSIGN WILLITS LLC, ENSIGN PLEASANTON LLC,

24TH STREET HEALTHCARE ASSOCIATES LLC,

GLENDALE HEALTHCARE ASSOCIATES LLC,

ATLANTIC MEMORIAL HEALTHCARE ASSOCIATES, INC.,

ROSE PARK HEALTHCARE ASSOCIATES, INC.,

LEMON GROVE HEALTH ASSOCIATES LLC,

PRESIDIO HEALTH ASSOCIATES LLC, BELL VILLA CARE ASSOCIATES LLC,

DOWNEY COMMUNITY CARE LLC, COSTA VICTORIA HEALTHCARE LLC,

WEST ESCONDIDO HEALTHCARE LLC, REDBROOK HEALTHCARE ASSOCIATES LLC,

HB HEALTHCARE ASSOCIATES LLC, NORTH MOUNTAIN HEALTHCARE LLC,

PARK WAVERLY HEALTHCARE LLC, SUNLAND HEALTH ASSOCIATES LLC,

VISTA WOODS HEALTH ASSOCIATES LLC, CITY HEIGHTS HEALTH ASSOCIATES LLC,

CLAREMONT FOOTHILLS HEALTH ASSOCIATES LLC,

C STREET HEALTH ASSOCIATES LLC, VICTORIA VENTURA HEALTHCARE LLC

RADIANT HILLS HEALTH ASSOCIATES LLC, HIGHLAND HEALTHCARE LLC,

GATE THREE HEALTHCARE LLC, SOUTHLAND MANAGEMENT LLC,

MANOR PARK HEALTHCARE LLC, NORTHERN OAKS HEALTHCARE, INC.,

SALADO CREEK SENIOR CARE, INC., MCALLEN COMMUNITY HEALTHCARE, INC.,

WELLINGTON HEALTHCARE, INC.

(collectively, "Borrower") 

and

GENERAL ELECTRIC CAPITAL CORPORATION

("Lender") 

Amended
as of March 25, 2007 

 
 
 

AMENDMENT NO. 2 TO AMENDED AND
  RESTATED LOAN AND SECURITY AGREEMENT  
    

        THIS AMENDMENT NO. 2 TO AMENDED AND RESTATED LOAN AND SECURITY AGREEMENT (this
"Amendment") is made as of this 25th day of March 2007, by and among THE ENSIGN GROUP, INC., a
Delaware corporation, ENSIGN WHITTIER WEST LLC, a Nevada limited liability company, ENSIGN WHITTIER
EAST LLC, a Nevada limited liability company, ENSIGN SANTA ROSA LLC, a Nevada limited liability company, and  ENSIGN
PANORAMA LLC, a Nevada limited liability company, ENSIGN SABINO LLC, a Nevada
limited liability company, ENSIGN SAN DIMAS LLC, a Nevada limited liability company, ENSIGN
MONTGOMERY LLC, a Nevada limited liability company, ENSIGN CLOVERDALE LLC, a Nevada limited liability company,  ENSIGN PALM
I LLC, a Nevada limited liability company, ENSIGN SONOMA LLC, a Nevada limited
liability company, ENSIGN WILLITS LLC, a Nevada limited liability company, ENSIGN
PLEASANTON LLC, a Nevada limited liability company, 24th STREET HEALTHCARE ASSOCIATES LLC, a
Nevada limited liability
company, GLENDALE HEALTHCARE ASSOCIATES LLC, a Nevada limited liability company, ATLANTIC MEMORIAL HEALTHCARE
ASSOCIATES, INC., a Nevada corporation, and ROSE PARK HEALTHCARE ASSOCIATES, INC., a Nevada corporation,  LEMON GROVE HEALTH ASSOCIATES LLC,
 a Nevada limited liability company, PRESIDIO HEALTH
ASSOCIATES LLC, a Nevada limited liability company, BELL VILLA CARE ASSOCIATES LLC, a Nevada limited liability
company, DOWNEY COMMUNITY CARE LLC, a Nevada limited liability company, COSTA VICTORIA
HEALTHCARE LLC, a Nevada limited liability company, WEST ESCONDIDO HEALTHCARE LLC, a Nevada limited liability
company, REDBROOK HEALTHCARE ASSOCIATES LLC, a Nevada limited liability company, HB HEALTHCARE
ASSOCIATES LLC, a Nevada limited liability company, NORTH MOUNTAIN HEALTHCARE LLC, a Nevada limited liability
company, PARK WAVERLY HEALTHCARE LLC, a Nevada limited liability company, SUNLAND HEALTH
ASSOCIATES LLC, a Nevada limited liability company, VISTA WOODS HEALTH ASSOCIATES LLC, a Nevada limited liability
company, CITY HEIGHTS HEALTH ASSOCIATES LLC, a Nevada limited liability company, CLAREMONT FOOTHILLS HEALTH
ASSOCIATES LLC, a Nevada limited liability company, C STREET HEALTH ASSOCIATES LLC, a Nevada limited liability
company, and VICTORIA VENTURA HEALTHCARE LLC, a Nevada limited liability company, RADIANT HILLS HEALTH
ASSOCIATES LLC, a Nevada limited liability company, HIGHLAND HEALTHCARE LLC, a Nevada limited liability company,  GATE THREE
HEALTHCARE LLC, a Nevada limited liability company, SOUTHLAND MANAGEMENT LLC,
Nevada limited liability company, MANOR PARK HEALTHCARE LLC, a Nevada limited liability company, NORTHERN OAKS
HEALTHCARE, INC., a Nevada corporation, SALADO CREEK SENIOR CARE, INC., a Nevada corporation,  McALLEN COMMUNITY HEALTHCARE,
 INC., a Nevada corporation, WELLINGTON HEALTHCARE, INC., a
Nevada corporation (collectively "Borrower"), and GENERAL ELECTRIC CAPITAL CORPORATION, a Delaware corporation
("Lender"). 

 
 

RECITALS  
    

        A.    Pursuant
to that certain Amended and Restated Loan and Security Agreement dated as of March 25, 2004 by and between Borrower and Lender (as amended,
modified and restated from time to time, the "Loan Agreement"), the parties have established certain financing arrangements that allow funds to be borrowed from Lender in
accordance with the terms and conditions set forth in the Loan Agreement. 

        B.    The
parties now desire to amend the Loan Agreement in accordance with the terms and conditions set forth below. 

        NOW, THEREFORE, in consideration of the premises set forth above, the terms and conditions contained in this Amendment, and other good and
valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties have agreed to the following amendments to the Loan 

2

 

Agreement.
Capitalized terms used but not defined in this Amendment shall have the meanings that are set forth in the Loan Agreement. 

        1.    Amendment to Loan
Agreement.    Section 2.8(a) of the Loan Agreement is hereby amended by deleting the existing Section 2.8(a) in its entirety and by
inserting in lieu thereof the following new Section 2.8(a): 

        "(a)
Subject to Lender's right to cease making Revolving Credit Loans to Borrower upon or after any Event of Default, this Agreement shall be in effect until June 22, 2007, unless
terminated as provided in this Section 2.8 (the "Term"); provided, however, that notwithstanding
anything set forth in this Agreement to the contrary (including, without limitation, Section 6.23), in no event shall Borrower be entitled to terminate this Agreement prior to the repayment in
full of all amounts owed to Lender pursuant to the Real Estate Loan Documents." 

        2.    Confirmation of Representations and
Warranties.    Borrower hereby (a) confirms that all of the representations and warranties set forth in Article IV of the Loan Agreement
are true and correct, and (b) specifically represents and warrants to Lender that it has good and marketable title to all of its respective Collateral, free and clear of any lien or security
interest in favor of any other person or entity, except as identified in Schedule 1.39 and Schedule 4.19 to the Loan
Agreement, each as updated, and as otherwise permitted pursuant to the Loan Agreement. 

        3.    Effective Date.    This Amendment
shall be effective upon (a) Lender's receipt of this Amendment executed by a duly authorized member and/or officer of each Borrower and (b) the receipt by Lender of the Fee as
defined herein. 

        4.    Fees and Expenses.    

        (a)   As
consideration for Lender's agreement to negotiate and execute this Amendment, Borrower agrees to pay Lender on the date of this Amendment an amendment fee equal to
Twenty Five Thousand and No/100 Dollars ($25,000.00) (the "Fee") which Fee shall be deemed to have been earned in full by Lender as of the date of this
Amendment. Borrower hereby authorizes Lender to deduct such from the Revolving Credit Loan(s) made to Borrower until such Fee is paid in full. In the event that Borrower refinances all of the Loans
under this Loan Agreement with Lender through a $20 million credit facility, the terms of which are substantially similar to the terms set forth in that certain Proposal Letter dated as of
March 15, 2007 ("Potential Refinancing") on or before the expiration of the Term,
Lender shall credit the Fee amount towards any closing fees incurred in connection with the Potential Refinancing. 

        (b)   In
addition to the Fee, Borrower shall be responsible for the payment of all costs and expenses incurred by Lender in connection with the preparation of this Amendment
including any and all fees and expenses of Lender's in-house counsel. 

        5.    Updated Schedules.    As a
condition precedent to Lender's agreement to enter into this Amendment, and in order for this Amendment to be effective, Borrower shall revise, update and deliver to Lender all Schedules to the Loan
Agreement to update all information as necessary to make the Schedules previously delivered correct. Borrower hereby represents and warrants that the information set forth on the attached Schedules is
true and correct as of the date of this Amendment. The attached Schedules are hereby incorporated into the Loan Agreement as if originally set forth therein. 

        6.    Enforceability.    This Amendment
constitutes the legal, valid and binding obligation of each Borrower and is enforceable against each such Borrower in accordance with its terms. 

3

 

        7.    Reference to the Effect on the Loan
Agreement.    

        (a)   Upon
the effectiveness of this Amendment, each reference in the Loan Agreement to "this Agreement," "hereunder," "hereof," "herein" or words of similar import shall mean
and be a reference to the Loan Agreement as amended by this Amendment. 

        (b)   Except
as specifically amended above, the Loan Agreement and all other Loan Documents shall remain in full force and effect and are hereby ratified and confirmed. 

        (c)   The
execution, delivery and effectiveness of this Amendment shall not, except as expressly provided in this Amendment, operate as a waiver of any right, power or remedy
of Lender, nor constitute a waiver of any provision of the Loan Agreement or any other documents, instruments and agreements executed or delivered in connection with the Loan Agreement. 

        (d)   This
Amendment (together with any other document executed in connection herewith) is not intended to be, nor shall it be construed as, a novation of the
Loan Agreement. 

        8.    Governing Law.    This Amendment
shall be governed by and construed in accordance with the laws of the State of Maryland. 

        9.    Headings.    Section headings in
this Amendment are included for convenience of reference only and shall not constitute a part of this Amendment for any other purpose. 

        10.    Counterparts.    This Amendment
may be executed in counterparts, and such counterparts taken together shall be deemed to constitute one and the same instrument. 

[SIGNATURES FOLLOW]

4

 

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

	

 	
 	
LENDER:
	
 	
 	

GE HFS HOLDINGS, INC.

f/k/a Heller Healthcare Finance, Inc.

a Delaware corporation
	
 	
 	

By:	

/s/  MATTHEW SAWYER      

	 	 	Name: Matthew Sawyer

Title: Duly Authorized Signatory

5

 

	 	 	 	BORROWER:
	
  ATTEST/WITNESS:	
 	
THE ENSIGN GROUP, INC.

a Delaware corporation
	
 By:	

/s/  ALAN J. NORMAN      
	
 	

By:	

/s/  CHRISTOPHER R. CHRISTENSEN      

	 	Alan J. Norman	 	 	Christopher R. Christensen
	 	Vice President	 	 	President
	
 	

 	
 	
ENSIGN WHITTIER WEST LLC

ENSIGN WHITTIER EAST LLC

ENSIGN PANORAMA LLC

LEMON GROVE HEALTH ASSOCIATES LLC

BELL VILLA CARE ASSOCIATES LLC

DOWNEY COMMUNITY CARE LLC

COSTA VICTORIA HEALTHCARE LLC

WEST ESCONDIDO HEALTHCARE LLC

HB HEALTHCARE ASSOCIATES LLC

VISTA WOODS HEALTH ASSOCIATES LLC

CITY HEIGHTS HEALTH ASSOCIATES LLC

C STREET HEALTH ASSOCIATES LLC

VICTORIA VENTURA HEALTH CARE LLC

GATE THREE HEALTHCARE LLC

SOUTHLAND MANAGEMENT LLC

MANOR PARK HEALTHCARE LLC

each, a Nevada limited liability company
	
  ATTEST/WITNESS:	
 	

By:	

The Flagstone Group, Inc.

Its Sole Member
	
 By:	

/s/  SOON BURNAM      
	
 	

By:	

/s/  V. JAY BRADY      

	 	Soon Burnam	 	 	V. Jay Brady
	 	Treasurer	 	 	President
	
 	

 	
 	
ENSIGN SANTA ROSA LLC

ENSIGN MONTGOMERY LLC

ENSIGN CLOVERDALE LLC

ENSIGN SONOMA LLC

ENSIGN WILLITS LLC

ENSIGN PLEASANTON LLC

each, a Nevada limited liability company
	
  ATTEST/WITNESS:	
 	

By:	

Northern Pioneer Healthcare, Inc.

Its Sole Member
	
 By:	

/s/  SOON BURNAM      
	
 	

By:	

/s/  CORY E. MONETTE      

	 	Soon Burnam	 	 	Cory E. Monette
	 	Treasurer	 	 	President
	 	 	 	 	 

6

 

	
 	

 	
 	
ENSIGN SAN DIMAS LLC

ENSIGN PALM I LLC

REDBROOK HEALTHCARE ASSOCIATES LLC

CLAREMONT FOOTHILLS HEALTH ASSOCIATES LLC

each, a Nevada limited liability company
	
  ATTEST/WITNESS:	
 	

By:	

Touchstone Care, Inc.

Its Sole Member
	
 By:	

/s/  SOON BURNAM      
	
 	

By:	

/s/  JOHN ALBRECHTSEN      

	 	Soon Burnam	 	 	John Albrechtsen
	 	Treasurer	 	 	President
	
 	

 	
 	
ENSIGN SABINO LLC

24TH STREET HEALTHCARE ASSOCIATES LLC

GLENDALE HEALTHCARE ASSOCIATES LLC

PRESIDIO HEALTH ASSOCIATES LLC

NORTH MOUNTAIN HEALTHCARE LLC

PARK WAVERLY HEALTHCARE LLC

SUNLAND HEALTH ASSOCIATES LLC

RADIANT HILLS HEALTH ASSOCIATES LLC

HIGHLAND HEALTHCARE LLC

each, a Nevada limited liability company
	
  ATTEST/WITNESS:	
 	

By:	

Bandera Healthcare, Inc.

Its Sole Member
	
 By:	

/s/  SOON BURNAM      
	
 	

By:	

/s/  MICHAEL C. DALTON      

	 	Soon Burnam	 	 	Michael C. Dalton
	 	Treasurer	 	 	President
	
 	

 	
 	
ATLANTIC MEMORIAL HEALTHCARE ASSOCIATES, INC.

ROSE PARK HEALTHCARE ASSOCIATES, INC.
	 ATTEST/WITNESS:	 	each, a Nevada corporation
	
 By:	

/s/  SOON BURNAM      
	
 	

By:	

/s/  CHRISTOPHER R. CHRISTENSEN      

	 	Soon E. Burnam	 	 	Christopher R. Christensen
	 	 	 	 	President
	
 	

 	
 	
NORTHERN OAKS HEALTHCARE, INC.

SALADO CREEK SENIOR CARE, INC.

MCALLEN COMMUNITY HEALTHCARE, INC.

WELLINGTON HEALTHCARE, INC.
	 ATTEST/WITNESS:	 	each, a Nevada corporation
	
 By:	

/s/  SOON BURNAM      
	
 	

By:	

/s/  CHRISTOPHER R. CHRISTENSEN      

	 	Soon E. Burnam	 	 	Christopher R. Christensen
	 	 	 	 	President

7

 
 
 

LIST OF SCHEDULES    
    

	Schedule 1.39	—	Permitted Liens
	Schedule 4.1	—	Subsidiaries
	Schedule 4.5	—	Litigation
	Schedule 4.13	—	Non-Compliance with Law
	Schedule 4.14	—	Environmental Matters
	Schedule 4.15	—	Places of Business with patient census
	Schedule 4.16	—	Licenses
	Schedule 4.17	—	Stock Ownership
	Schedule 4.19	—	Borrowings and Guarantees
	Schedule 4.21	—	Trade Names
	Schedule 4.22	—	Joint Ventures
	Schedule 7.12	—	Transactions with Affiliates

8

  

 
 

EXHIBIT A
  SCHEDULES TO AMENDMENT NO. 2 TO
  AMENDED & RESTATED LOAN AGREEMENT  
    

	Sched
 
	 	Description
	 	Matters Covered

	1.39	 	Permitted Liens:	 	(i)    Landlord's liens, both statutory and contractual, contained in or created by the various leases, security agreement, pledges and related documentation covering the locations described in
Schedule 4.15, but only to the extent that such liens are contractually subordinated to Lender's liens and security interests pursuant to agreements between Lender and such landlords that are satisfactory to Lender
	
 	
 	

 	
 	

(ii)    (a) The lien of the Deed of Trust and Assignment of Rents by and between Ensign Southland LLC as Trustor and Continental Wingate Associates, Inc. as Beneficiary, affecting the California Property and
recorded January 30, 2001 at Document No. 01-0161647 in the office of the Los Angeles County Recorder, securing indebtedness in the original principal amount of $7,455,100, (b) all liens created or extended in connection with that
certain Second Amended and Restated Loan Agreement for a loan in the amount of $64,692,11.67 by and among Valley Health Holdings LLC, Sky Holdings AZ LLC, Terrace Holdings AZ LLC, Plaza Health Holdings LLC, Rillito
Holdings LLC, Mountainview Communitycare LLC, Meadowbrook Health Associates LLC, Cedar Avenue Holdings LLC, Granada Investments LLC, as borrowers, and General Electric Capital Corporation, as lender, dated December 29,
2006; and (c) the lien of the Deed of Trust and Security Agreement encumbering TEGI subsidiary Cherry Hill Health Holdings, Inc.'s Pacific Care Center facility, Hoquiam, Washington, securing a non-prepayable assumed $2,475,000 loan that
existed when the property was acquired in 2006.
	
 	
 	

 	
 	

(iii)    Liens permitted to be created by Sections 6.23 and 7.1(d) of the Loan Agreement.
	
 4.1	
 	

Subsidiaries:	
 	

See attached organizational chart for existing subsidiaries of The Ensign Group, Inc.
	
 4.5	
 	

Pending or Threatened Litigation:	
 	

There is currently no pending or threatened litigation which the Borrower believes would materially threaten Borrower's viability or ability to repay the Obligations; further, all claims pending or threatened against the Borrower are either covered
by insurance or, to the extent they are not, Borrower believes it has accrued adequate reserves in connection therewith.
	
 4.8	
 	

Defaults:	
 	

Relating to the representations in Section 4.8 of the Loan Agreement, and without admitting any default, reference is made to Schedule 4.5 above.
	
 4.13	
 	

Non-compliance with Law:	
 	

To the best of the actual knowledge of the officers of Borrower, there does not currently exist any material non-compliance with applicable laws.
	
 	
 	

 	
 	

 
	
 4.14	
 	

Environmental Matters:	
 	

To the best of the actual knowledge of the officers of The Ensign Group, Inc., there are no material adverse environmental matters associated with any of the properties occupied by TEGI's operating subsidiaries which require remediation or pose
a present threat of material harm or liability.
	 	 	 	 	 

Exh A-1

 

	
 4.15	
 	

Places of Business with patient census:	
 	

See consolidated Schedule 4.15(a)/4.16 and Schedule 4.15(b) at the end of this Exhibit A.
	
 4.16	
 	

Licenses:	
 	

The entity which currently holds or possesses the right to use the operating license for each of the facilities is as shown in consolidated Schedule 4.15(a)/4.16.
	
 4.17	
 	

Stock Ownership:	
 	

See separate Schedule 4.17 at the end of this Exhibit A.
	
 4.19	
 	

Borrowings:	
 	

Other than normal trade creditors, some or all of the entities comprising the Borrower are currently indebted to the following creditors in the following manners and amounts:
	
 	
 	

 	
 	

    a.    General Electric Capital Corporation; $20,000,000 Revolving Credit Facility for working capital.
	
 	
 	

 	
 	

    b.    General Electric Capital Corporation; $64,692,111.67 fixed asset loan secured by Deeds of Trust encumbering the assets owned by Valley Health Holdings LLC, Sky Holdings AZ LLC, Terrace
Holdings AZ LLC, Ensign Highland LLC, Plaza Health Holdings LLC, Rillito Holdings LLC, Mountainview Communitycare LLC, Cedar Avenue Holdings LLC and Granada Investments LLC.
	
 	
 	

 	
 	

    c.    Continental Wingate Associates, Inc.; $7,455,100 HUD-insured Loan secured by a Deed of Trust and Assignment of Rents on Ensign Southland LLC's Southland Care Center & Home facility,
Norwalk, California.
	
 	
 	

 	
 	

    d.    Wells Fargo Bank, N.A.; $2,475,000 loan secured by a Deed of Trust and Security Agreement on Cherry Hill Health Holdings, Inc.'s Pacific Care Center facility, Hoquiam, Washington.
	
 4.20	
 	

Labor Disputes:	
 	

A union organizing election was held at Sonoma Healthcare Center in May, 2002 at which a majority of the approximately 60 employees classified as Housekeeping, Laundry and CNAs voted to have union representation from SEIU Local 250. On
August 30, 2004, the National Labor Relations Board certified the union. The union has requested bargaining, and bargaining is ongoing. Operations at the facility and throughout the company have not been materially disrupted by union issues at
any time since the original organizing election.
	
 4.22	
 	

Joint Ventures:	
 	

None
	
 7.12	
 	

Transactions with Affiliates:	
 	

Pursuant to an internal corporate restructuring the entire equity interests in various operating entities were assigned by The Ensign Group, Inc. to its several regional subsidiaries as set forth on the attached organization chart.
	 	 	 	 	 

Exh A-2

 

	
 	
 	

 	
 	

Where an affiliate of The Ensign Group, Inc. owns the real property underlying a facility, the real estate holding subsidiary and the operating subsidiary enter into a lease agreement with respect to the facility. The attached organization chart
indicates those instances where TEGI affiliates own the occupied property. The standard lease form used for such affiliate transactions has been reviewed and approved by Lender's counsel in connection with the fixed asset financing referenced in
Schedule 1.39(ii)(b) above.
	
 	
 	

 	
 	

Ensign Facility Services, Inc., a subsidiary of TEGI, has entered into separate Consulting Services Agreements with each of the operating subsidiaries listed in the attached organizational chart, to provide centralized accounting, legal, risk
management, information technology human resources and similar support and services. A standard management fee which does not exceed five percent (5%) of monthly revenues is charged for such services.

— See
Attached Schedules 4.1, 4.15(a)/4.16, 4.15(b) and 4.17 — 

Exh A-3

  

 
 

Schedule 4.1
  Subsidiaries    
    

	The Ensign Group, Inc.

(Delaware Corporate; Qualified in California)
 

	The Flagstone group, Inc.
 
	 	Bandera Healthcare, Inc.
 
	 	Milestone Healthcare, Inc.
 
	 	Keystone Care, Inc.
 
	 	Northern Pioneer Healthcare, Inc.
 
	 	Touchstone Care, Inc.
 

	SOUTHERN CALIFORNIA	 	ARIZONA	 	UTAH	 	TEXAS	 	NORTHERN CALIFORNIA	 	SOUTHERN CALIFORNIA
	

Arroyo Vista Nursing Center

City Heights Health Associates LLC**

Parmunitum LLC*	
 	

Catalina Healthcare Center

Presidio Health Associates LLC**

Rillito Holdings LLC	
 	

Arlington Hills Healthcare Center

Avenues Healthcare, Inc.

Tenth East Holdings LLC	
 	

Cambridge Health & Rehabilitation Center

Richmond Senior Services, Inc.**

Golfview Holdings LLC	
 	

Cloverdale Healthcare Center

Ensign Cloverdale LLC**	
 	

Brookside Healthcare Center

Redbrook Healthcare Associates LLC**
	

	Atlantic Memorial Healthcare Center

Atlantic Memorial Healthcare Associates, Inc.**	 	Coronado Healthcare Center

North Mountain Healthcare LLC**

Adipiscor LLC*	 	Holladay Healthcare Center

Olympus Health, Inc.

Cottonwood Health Holdings LLC	 	Cambridge Square Retirement Center

Rosenburg Senior Living, Inc.**

Avenue N Holdings LLC	 	Northbrook Nursing & Rehabilitation Center

Ensign Willits LLC**	 	Claremont Care Center

Claremont Foothills Health Associates LLC**

Parmonitum LLC*
	

	Brookfield Healthcare Center

Downey Community Care LLC**

Moenium Holdings LLC*	 	Desert Sky Health and Rehabilitation Center

Glendale Healthcare Associates LLC**

Sky Holdings AZ LLC	 	Mt. Ogden Health & Rehabilitation Center

Washington Heights Healthcare, Inc.	 	Carrollton Health & Rehabilitation Center

Carrollton Heights Healthcare, Inc.

Trinity Mill Holdings LLC	 	Park View Gardens at Montgomery

Ensign Montgomery LLC**

Mountainview Communitycare LLC	 	Arbor Glen Care Center

Ensign San Dimas LLC**
	

	Camarillo Healthcare Center

Camarillo Community Care, Inc.**

Granada Investments LLC	 	Desert Terrace Nursing Center

24th Street Healthcare Associates LLC**

Terrace Holdings AZ LLC	 	IDAHO

Pocatello Care and Rehabilitation Center

Pocatello Health Services, Inc.	 	Lake Village Nursing & Rehabilitation Center

Grand Villa Phx. Inc.

Verde Villa Holdings LLC	 	Sonoma Healthcare Center

Ensign Sonoma LLC**	 	Premier Care Center for Palm Springs

Ensign Palm I LLC**
	

	Carmel Mountain Rehabilitation & Healthcare Center

Bernardo Heights Healthcare, Inc.**

CM Health Holdings LLC	 	East Mesa Healthcare Center

Sunland Health Associates LLC**

Adipiscor LLC*	 	 	 	Northern Oaks Living & Rehabilitation Center

Northern Oaks Healthcare, Inc.**	 	Summerfield Health Care Center

Ensign Santa Rosa LLC**	 	Upland Rehabilitation and Care Center

Upland Community Care, Inc.**

Cedar Avenue Holdings LLC
	

	Glenwood Care Center

C Street Health Associates LLC**	 	Grand Court of Mesa

Brown Road Senior Housing LLC**

Mosnium Holdings LLC*	 	 	 	Salado Creek Living & Rehabilitation Center

Salado Creek Senior Care, Inc.**	 	Ukiah Convalescant Hospital

Ensign Pleasanton LLC**	 	 
	

	Lemon Grove Care & Rehabilitation Center

Lemon Grove Health Associates LLC**	 	Greenfields Assisted Living

Greenfields Assisted Living LLC**	 	 	 	The Village Care Center

McAllan Community Healthcare, Inc.**	 	 	 	 
	

	Mission Care Center

Ramon Healthcare Associates, Inc.**	 	Highland Manor Health & Rehabilitation Center

Highland Healthcare LLC**

Ensign Highland LLC	 	 	 	Timberwood Nursing & Rehabilitation Center

Livingston Care Associates, Inc.**

Polk Health Holdings LLC	 	 	 	 
	

	Palm Terrace Healthcare & Rehabilitation Center

Gate Three Healthcare LLC**	 	North Mountain Medical & Rehabilitation Center

Radiant Hills Health Associates LLC**

Valley Health Holdings LLC	 	 	 	Wellington Place Living & Rehabilitation Center

Wellington Healthcare, Inc.**	 	 	 	 
	

	Palomar Vista Healthcare Center

West Escondido Healthcare LLC**	 	Sabino Canyon Rehabilitation and Care Center

Ensign Sabino LLC**

Meadowbrook Health Associates LLC	 	 	 	Willow Bend Nursing & Rehabilitation Center

Town East Healthcare, Inc.

Mesquite Health Holdings LLC	 	 	 	 
	

	Panorama Gardens Nursing & Rehabilitation Center

Ensign Panorama LLC**	 	Waverly Park Healthcare Center

Park Waverly Healthcare LLC**

Adipiscor LLC*	 	 	 	 	 	 	 	 
	

	Rosa Villa Healthcare Center

Bell Villa Care Associates LLC**

Moenium Holdings LLC*	 	Osborn Health and Rehabilitation

RenewCare of Scottsdale, Inc.	 	 	 	 	 	 	 	 

Sch. 4.1-1

 

	Royal Court Healthcare

Ensign Whittier West LLC**	 	 	 	 	 	 	 	 	 	 
	

	Sea Cliff Healthcare Center

HB Healthcare Associates LLC**	 	 	 	 	 	 	 	 	 	 
	

	Shoreline Healthcare Center

Rose Park Healthcare Associates, Inc.**

Long Beach Health Associates LLC	 	 	 	 	 	 	 	 	 	 
	

	Southland Care Center

Southland Management LLC**

Ensign Southland LLC	 	 	 	 	 	 	 	 	 	 
	

	Victoria Care Center

Victoria Ventura Healthcare LLC**	 	 	 	Miscellaneous

(Held by The Ensign Group, Inc.)	 	 	 	 
	

	Victoria Healthcare Center

Costa Victoria Healthcare LLC**	 	WASHINGTON

Emerald Hills Healthcare Center

Lynnwood Health Services, Inc.**

Snohomish Health Holdings LLC	 	SERVICE CENTER

Ensign Facilty Services, Inc.

(Nevada Corporation; Qualified in California)	 	 	 	 
	

	Vista Knoll Specialized Care Facility

Vista Woods Health Associates LLC**

Parmonitum LLC*	 	Pacific Care Center

Hoquiam Healthcare, Inc.**

Cherry Health Holdings, Inc.	 	SELF-INSURANCE

Standardbearer Insurance Company, Ltd.

(Cayman Islands Exempted Company)	 	 	 	 
	

	Whittier Hills Health Care Center**

Ensign Whittier East LLC	 	Park Manor Rehabilitation Center

Manor Park Healthcare LLC**

Plaza Health Holdings LLC	 	SHELF ENTITIES

Ensign Bellflower LLC

East Escondido Healthcare LLC

Ensign Napa LLC

Walnut Grove Campuscare LLC	 	 	 	 

KEY 

Line
1:  Facility Name 

Line
2:  Operating Entity: Held, as represented, by an operating group 

Line
3:  Holding Entity: All held directly by The Ensign Group, Inc. 

	*
	Master
tenant/sublessor

	**
	Entire
equity interest assigned to applicable regional subsidiary in corporate restructuring. 

Unless
noted otherwise, all entities are organized in Nevada and qualified to do business where located. 

All
subsidiaries are wholly owned. 

Sch. 4.1-2

  

 
 

Consolidated Schedule 4.15(a)/4.16
  Places of Business with Trade Names and Record Owner Data
  (As of March 1, 2007)
  (See separate Schedule 4.15(a) for Census Data)    

	Place of Business
	 	Address
	 	Licensee
	 	Record Owner

	Arbor Glen Care Center	 	1033 East Arrow Highway	 	Glendora, CA 91740	 	Ensign San Dimas LLC	 	Health Care Investors III
	

	Arlington Hills Healthcare Center	 	165 South 1000 East	 	Salt Lake City, UT 84102	 	Avenues Healthcare, Inc.	 	Tenth East Holdings LLC
	

	Arroyo Vista Nursing Center	 	3022 45th Street	 	San Diego, CA 92105	 	City Heights Health Assoc LLC	 	OHI Asset (CA), LLC
	

	Atlantic Memorial Healthcare Center	 	2750 Atlantic Avenue	 	Long Beach, CA 90806	 	Atlantic Memorial H'care Assoc, Inc.	 	RMA Land, LLC
	

	Brookfield Healthcare Center	 	9300 Telegraph Road	 	Downey, CA 90240	 	Downey Comm'ty Care LLC	 	Healthcare Investors, III
	

	Brookside Healthcare Center	 	105 Terracina Blvd.	 	Redlands, CA 92373	 	Redbrook H'care Associates LLC	 	James F. Cotter
	

	Camarillo Healthcare Center	 	205 Granada Street	 	Camarillo, CA 93010	 	Camarillo Com'ty Care, Inc.	 	Granada Investments LLC
	

	Cambridge Health & Rehabilitation Center	 	1106 Golfview	 	Richmond, TX 77469	 	Richmond Senior Services, Inc.	 	Golfview Holdings LLC
	

	Cambridge Square Retirement Center	 	2700 Avenue N	 	Rosenberg, TX 77471	 	Rosenburg Senior Living, Inc.	 	Avenue N Holdings LLC
	

	Carrollton Health & Rehabilitation Center	 	1618 Kirby Road	 	Carrollton, TX 75006	 	Carrollton Heights Healthcare, Inc.	 	Trinity Mill Holdings LLC
	

	Claremont Care Center	 	219 East Foothill Blvd.	 	Pomona, CA 91768	 	Claremont F'thills Health Assoc LLC	 	OHI Asset (CA), LLC
	

	Carmel Mtn Rehab & Healthcare Center	 	11895 Avenue of Industry	 	San Diego, CA 92128	 	Bernardo Heights Healthcare, Inc.	 	CM Holdings LLC
	

	Catalina Healthcare Center	 	2611 North Warren Ave.	 	Tucson, AZ 85719	 	Presidio Health Associates LLC	 	Rillito Holdings LLC
	

	Cloverdale Healthcare Center	 	300 Cherry Creek Road	 	Cloverdale, CA 95425	 	Ensign Cloverdale LLC	 	James F. Cotter
	

	Coronado Healthcare Center	 	11411 North 19th Avenue	 	Phoenix, AZ 85029	 	North Mountain Healthcare LLC	 	Coronado Corporation
	

	Desert Sky Health & Rehabilitation Center	 	5125 North 58th Avenue	 	Glendale, AZ 85301	 	Glendale H'care Associates LLC	 	Sky Holdings AZ LLC
	

	Desert Terrace Nursing Center	 	2509 North 24th Street	 	Phoenix, AZ 85008	 	24th Street H'care Assoc LLC	 	Terrace Holdings AZ LLC
	

	The Ensign Group, Inc.

Ensign Facility Services, Inc.	 	27101 Puerta Real, Suite 450	 	Mission Viejo, CA 92691	 	N/A	 	Mission Ridge Associates, L.L.C.
	

	East Mesa Healthcare Center	 	51 South 48th Street	 	Mesa, Arizona 85206	 	Sunland Health Associates LLC	 	LTC Partners VI, L.P.
	

	Emerald Hills Healthcare Center	 	5821 188th Street SW	 	Lynnwood, WA 98037	 	Lynnwood Health Services, Inc.	 	Snohomish Health Holdings LLC
	

	Glenwood Care Center	 	1300 North C Street	 	Oxnard, CA 93030	 	C Street Health Associates LLC	 	Oxnard Investments, L.P.
	

	Grand Court of Mesa	 	262 East Brown Road	 	Mesa, AZ 85201	 	Brown Road Sr Housing LLC	 	Moenium Holdings LLC
	

	Greenfields Assisted Living Community	 	723 East 2nd Avenue	 	Mesa, AZ 85204	 	Greenfields Assisted Livg LLC	 	Cascade Gardens Associates, L.P.
	

	Highland Manor Health & Rehab Center	 	4635 N. 14th Street	 	Phoenix, AZ 85014	 	Highland Healthcare LLC	 	Ensign Highland LLC
	

Sch. 4.15(a)/4.16-1

 

	Place of Business
	 	Address
	 	Licensee
	 	Record Owner

	Holladay Healthcare Center	 	4782 South Holladay Blvd.	 	Salt Lake City, UT 84117	 	Olympus Health, Inc.	 	Cottonwood Health Holdings LLC
	

	Lake Village Nursing & Rehab. Center	 	169 Lake Park Road	 	Lewisville, TX 75057	 	Grand Villa PHX, Inc. †	 	Verde Villa Holdings LLC
	

	Lemon Grove Care & Rehab Center	 	8351 Broadway	 	Lemon Grove, CA 91945	 	Lemon Grove Health Assoc LLC	 	MCS PGCH LLC et al
	

	Mission Care & Rehabilitation Center	 	4800 Delta Avenue	 	Rosemead, CA 91770	 	Ramon Healthcre Assoc, Inc.	 	Rosemead Assisted L.P.
	

	Mt. Ogden Health and Rehabilitat'n Center	 	375 East 5350 South	 	Washington Terr., UT 84405	 	Washington H'ts Healthcare, Inc.	 	St. Benedict's Hospital
	

	North Mountain Medical & Rehab Center	 	9155 North 3rd Street	 	Phoenix, AZ 85020	 	Radiant Hills Health Assoc LLC	 	Valley Health Holdings LLC
	

	Northern Oaks Living & Rehab Center	 	2722 Old Anson Road	 	Abilene, TX 79603	 	Northern Oaks Healthcare, Inc.	 	James F. Cotter
	

	Northbrook Nursing and Rehab Center	 	64 Northbrook Way	 	Willits, CA 95490	 	Ensign Willits LLC	 	James F. Cotter
	

	Osborn Health and Rehabilitation	 	3333 North Civic Center Plaza	 	Scottsdale, AZ 85251	 	RenewCare of Scottsdale, Inc.	 	Nationwide Health Properties, Inc.
	

	Pacific Care Center	 	3035 Cherry Street	 	Hoquiam, WA 98550	 	Hoquiam Healthcare, Inc.	 	Cherry Health Holdings, Inc.
	

	Palm Terrace Healthcare & Rehab Center	 	24962 Calle Aragon	 	Laguna Woods, CA 92637	 	Gate Three Healthcare LLC	 	Laguna Hills Assisted I L.P.
	

	Palomar Vista Healthcare Center	 	201 North Fig Street	 	Escondido, CA 92025	 	West Escondido Healthcare LLC	 	Neale A. Perkins
	

	Panorama Gardens Nursing & Reh Center	 	9541 Van Nuys Blvd.	 	Panorama City, CA 91402	 	Ensign Panorama LLC	 	Vannovi Properties, LLC
	

	Park Manor Rehabilitation Center	 	1710 Plaza Way	 	Walla Walla, WA 99362	 	Manor Park Healthcare LLC	 	Health Care Property Investors, Inc.
	

	Park View Gardens at Montgomery	 	3751 Montgomery Drive	 	Santa Rosa, CA 95405	 	Ensign Montgomery LLC	 	Mountainview Communitycare LLC
	

	Pocatello Care and Rehabilitation Center	 	527 Memorial Drive	 	Pocatello, ID 83201	 	Pocatello Health Services, Inc.	 	Portneuf Medical Center
	

	Premier Care Center for Palm Springs	 	2990 East Ramon Road	 	Palm Springs, CA 92264	 	Ensign Palm I LLC	 	Coachella House, Inc.
	

	Rose Villa Healthcare Center	 	9028 Rose Street	 	Bellflower, CA 90706	 	Bell Villa Care Associates LLC	 	Healthcare Investors, III
	

	Royal Court Healthcare	 	12385 E. Washington Blvd	 	Whittier, CA 90606	 	Ensign Whittier West LLC	 	Whittier West, L.L.C.
	

	Sabino Canyon Rehab & Care Center	 	5830 East Pima	 	Tucson, AZ 85712	 	Ensign Sabino LLC	 	Tucson-Cal Associates, LLC
	

	Salado Creek Living & Rehab Center	 	603 Corrine	 	San Antonio, TX 78218	 	Salado Creek Senior Care, Inc.	 	James F. Cotter
	

	Sea Cliff Healthcare Center	 	18811 Florida Street	 	Huntington Bch, CA 92648	 	HB Healthcare Associates LLC	 	Huntington Beach Convalescent Hospital Asset Corporation
	

	Shoreline Healthcare Center	 	4029 East Anaheim St.	 	Long Beach, CA 90804	 	Rose Park H'care Associates, Inc.	 	Long Beach Health Associates LLC
	

	Sonoma Healthcare Center	 	1250 Broadway	 	Sonoma, CA 95476	 	Ensign Sonoma LLC	 	James F. Cotter
	

	Southland & Southland Living	 	11701 Studebaker Road	 	Norwalk, CA 90650	 	Southland Management LLC	 	Ensign Southland LLC
	

Sch. 4.15(a)/4.16-2

 

	Place of Business
	 	Address
	 	Licensee
	 	Record Owner

	Summerfield Healthcare Center	 	1280 Summerfield Road	 	Santa Rosa, CA 95405	 	Ensign Santa Rosa LLC	 	Summerfield Development Co.
	

	Timberwood Nursing & Rehabilit'n Center	 	4001 Highway 59 North	 	Livingston, TX 77351	 	Livingston Care Associates, Inc.	 	Polk Health Holdings LLC
	

	Ukiah Convalescent Hospital	 	1349 South Dora	 	Ukiah, CA 95482	 	Ensign Pleasanton LLC	 	Ukiah SNF, LLC
	

	Upland Rehabilitation & Care Center	 	1221 East Arrow Hwy	 	Upland, CA 91786-4911	 	Upland Comty Care, Inc.	 	Cedar Avenue Holdings LLC
	

	The Village Care Center	 	615 No. Ware Road	 	McAllen, TX 78501	 	McAllen Comm'ty Healthcare, Inc.	 	James F. Cotter
	

	Victoria Care Center	 	5445 Everglades Street	 	Ventura, CA 93003	 	Victoria Ventura Healthcare LLC	 	SHP Lexington, LLC
	

	Victoria Healthcare Center	 	340 Victoria Street	 	Costa Mesa, CA 92627	 	Costa Victoria Healthcare LLC	 	Eugene Woods, et al
	

	Vista Knoll Specialized Care Facility	 	2000 Westwood Road	 	Vista, CA 92083	 	Vista Woods Health Assoc LLC	 	OHI Asset (CA), LLC
	

	Waverly Park Healthcare Center	 	2001 N. Park Avenue	 	Tucson, AZ 85719	 	Park Waverly Healthcare LLC	 	Park Villa Corporation
	

	Wellington Place Living & Rehab Center	 	1802 So. 31st	 	Temple, TX 76504	 	Wellington Healthcare, Inc.	 	James F. Cotter
	

	Whittier Hills Healthcare Center	 	10426 Bogardus Avenue	 	Whittier, CA 90603	 	Ensign Whittier East LLC	 	Whittier East, L.L.C.
	

	Willowbend Nursing & Rehab. Center	 	2231 Highway 80 East	 	Mesquite, TX 75150	 	Town East Healthcare, Inc.	 	Mesquite Health Holdings LLC
	

Sch. 4.15(a)/4.16-3

  

 
 

Schedule 4.15(b)
  Census Data as of 3/1/2007    
    

	Facility
	 	Beds
	 	Census

	

	The Flagstone Group, Inc. (S.Cal & WA)
	

	Atlantic Memorial	 	100	 	90
	

	Palm Terrace	 	99	 	91
	

	Sea Cliff	 	182	 	179
	

	Sea Cliff ALF	 	84	 	57
	

	Shoreline	 	75	 	67
	

	Victoria	 	79	 	68
	

	Camarillo	 	114	 	94
	

	Glenwood	 	99	 	88
	

	Mission Care	 	58	 	50
	

	Panorama Gardens	 	149	 	142
	

	Ventura	 	187	 	132
	

	Arroyo Vista	 	53	 	51
	

	Carmel Mountain	 	120	 	112
	

	Lemon Grove	 	158	 	154
	

	Palomar Vista	 	74	 	66
	

	Vista Knoll	 	120	 	110
	

	Emerald Hills	 	120	 	63
	

	Pacific Care	 	100	 	78
	

	Park Manor	 	79	 	68
	

	Brookfield	 	70	 	63
	

	Rose Villa	 	53	 	39
	

	Royal Court	 	162	 	152
	

	Southland Care	 	120	 	116
	

	Southland Home	 	70	 	56
	

	Whittier Hills	 	160	 	149
	

	Subsidiary Totals	 	2685	 	2335
	

	Northern Pioneer (N.Cal)
	

	Cloverdale	 	72	 	61
	

	Northbrook	 	71	 	42
	

	Park View	 	116	 	109
	

	Sonoma	 	137	 	107
	

	Summerfield	 	70	 	61
	

	Ukiah	 	58	 	50
	

	Subsidiary Totals	 	524	 	430
	

	Touchstone (S.Cal)
	

	Arbor Glen	 	95	 	77
	

	Brookside	 	97	 	90
	

	Claremont Care	 	99	 	84
	

	Premier Care	 	99	 	82
	

	Upland Rehab	 	203	 	163
	

	Subsidiary Totals	 	593	 	496
	

	Bandera Healthcare, Inc. (AZ)
	

	Catalina	 	102	 	90
	

	Sabino Canyon	 	107	 	94
	

	Waverly Park	 	200	 	77
	

	Desert Sky	 	186	 	154
	

	Desert Sky Assisted	 	105	 	74
	

	East Mesa	 	201	 	152
	

	Grand Court	 	174	 	175
	

	Greenfields	 	141	 	105
	

	Scottsdale	 	120	 	51
	

	Coronado	 	191	 	175
	

	Desert Terrace	 	108	 	92
	

	Highland Manor	 	107	 	87
	

	North Mountain	 	155	 	126
	

	Subsidiary Totals	 	1897	 	1452
	

	Keystone (TX, UT & ID)	 	 	 	 
	

	Cambridge Health and Rehab	 	118	 	74
	

	Cambridge Square ALF	 	44	 	32
	

	Carrollton Healthcare Center	 	108	 	77
	

	Lake Village	 	120	 	86
	

	Northern Oaks	 	96	 	88
	

	Salado Creek	 	124	 	75
	

	The Village	 	113	 	78
	

	Timberwood Nursing Home	 	120	 	102
	

	Wellington Place	 	140	 	81
	

	Willowbend Nursing & Rehab Ctr	 	162	 	67
	

	Arlington Hills	 	108	 	61
	

	Holladay	 	120	 	78
	

	Mt Ogden	 	108	 	54
	

	Pocatello Care & Rehab Ctr	 	88	 	72
	

	Subsidiary Totals	 	1569	 	1025
	

	
    	
 	

 	
 	

 
	

	The Ensign Group, Inc. Totals	 	7268	 	5738
	

	Twelve Month Average	 	0	 	0
	

Sch. 4.15(b)-1

  

 
 

Schedule 4.17
  CONFIDENTIAL    
    

	The Ensign Group, Inc.

Significant Shareholders	 	Balance

Dec 2006	 	%

Ownership
	

Count	
 	

 	
 	

 	
 	

 
	1	 	Roy Christensen	 	3,910,000	 	22.12%
	2	 	Christopher R. Christensen and Terri M. Christensen as Co-Trustees of the Christensen Family Trust dated 10/24/05	 	3,893,000	 	22.02%
	3	 	Gregory K. Stapley & Deborah S. Stapley as Co-trustees of the Stapley Family Trust uad 04/25/06	 	1,180,000	 	6.68%
	4	 	Jay Brady	 	720,000	 	4.07%
	5	 	Richard Toolson	 	600,000	 	3.39%
	6	 	Alan Norman	 	309,000	 	1.75%
	7	 	Blalack Trust	 	292,000	 	1.65%
	8	 	Gordon Buechs	 	120,400	 	0.68%
	9	 	Thomas Maloof	 	120,000	 	0.68%
	11	 	Cory Monette	 	76,000	 	0.43%
	12	 	David Sedgwick	 	45,500	 	0.26%
	13	 	Mike Dalton	 	45,500	 	0.26%
	14	 	Antoinette Hubenette	 	30,000	 	0.17%
	15	 	John Albrechtsen	 	24,500	 	0.14%
	16	 	Barry Port	 	9,500	 	0.05%
	17	 	Other	 	2,315,200	 	13.10%
	 	 	Common shares issued	 	13,690,600	 	 
	 	 	Common shares reserved for issuance under 2001 Incentive Plan	 	495,000	 	2.80%
	 	 	Common shares reserved for issuance under 2005 Incentive Plan	 	749,000	 	4.24%
	 	 	Preferred shares (Common Share equivalent)	 	2,741,180	 	15.51%
	 	 	 	 	
	 	 
	 	 	Total Shares Outstanding	 	17,675,780	 	100.00%
	 	 	 	 	
	 	 

Sch. 4.17-1

QuickLinks

AMENDMENT NO. 2 TO AMENDED AND RESTATED LOAN AND SECURITY AGREEMENT

AMENDMENT NO. 2 TO AMENDED AND RESTATED LOAN AND SECURITY AGREEMENT

RECITALS

LIST OF SCHEDULES

EXHIBIT A SCHEDULES TO AMENDMENT NO. 2 TO AMENDED & RESTATED LOAN AGREEMENT

Schedule 4.1 Subsidiaries

Consolidated Schedule 4.15(a)/4.16 Places of Business with Trade Names and Record Owner Data (As of March 1, 2007) (See separate Schedule 4.15(a) for Census Data)

Schedule 4.15(b) Census Data as of 3/1/2007

Schedule 4.17 CONFIDENTIAL

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