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                                                                   EXHIBIT 10.19

                       TENTH AMENDMENT TO PROMISSORY NOTE

         THIS TENTH AMENDMENT TO PROMISSORY NOTE (this "Ninth Amendment") is
entered into as of the 1st day of April, 2006, by and between DIVERSICARE
ASSISTED LIVING SERVICES NC I, LLC, a Delaware limited liability company (the
"Borrower"), and GMAC COMMERCIAL MORTGAGE CORPORATION, a California corporation
(the "Lender").

                                    RECITALS

             A. The Borrower executed to the order of the Lender that certain
Promissory Note dated June 4, 1999, in the principal amount of $12,770,000 as
amended by that certain First Amendment to Promissory Note dated as of July 1,
2002, as amended by that Second Amendment to Promissory Note dated as of October
1, 2002, as amended by that Third Amendment to Promissory Note dated as of
December 1, 2002, as amended by that certain Fourth Amendment to Promissory Note
dated as of January 1, 2003, as amended by that certain Fifth Amendment to
Promissory Note dated as of June 18, 2003, as amended by that certain Sixth
Amendment to Promissory Note dated as of July 1, 2003, as amended by that
certain Seventh Amendment to Promissory Note dated as of June 30, 2004, as
amended by that certain Eighth Amendment to Promissory Note dated as of January
1, 2005, and as amended by that certain Ninth Amendment to Promissory Note dated
as of April 1, 2005 (the "Note"). Unless otherwise defined herein, capitalized
terms shall have the meaning assigned to them in the Note.

             B. The Borrower has requested that the Lender extend the Maturity
Date of the Note, and the Lender has agreed, upon certain conditions, one of
which is the execution of this Tenth Amendment.

                                    AGREEMENT

         NOW, THEREFORE, in consideration of the above Recitals and other good
and valuable consideration, the Borrower and the Lender hereby amend the Note as
follows:

             Section 4.1 of the Note, Maturity Date, is hereby amended to extend
the Maturity Date from April 1, 2006 until June 1, 2006. All references in the
Note to the "Maturity Date" are hereby amended to mean June 1, 2006.

         Except as expressly amended herein, the Note shall remain in full force
and effect in accordance with its terms and conditions.

         Notwithstanding the execution of this Tenth Amendment, the indebtedness
evidenced by the Note shall remain in full force and effect, and nothing
contained herein shall be interpreted or construed as resulting in a novation of
such indebtedness. The Borrower acknowledges and agrees that there are no
offsets or defenses to payment of the obligations evidenced by the Note, as
hereby

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amended, and hereby waives any defense, claim or counterclaim of the
Borrower regarding the obligations of the Borrower under the Note, as hereby
amended. The Borrower represents that there are no conditions of default or
facts or consequences which will or could lead to a default under the
obligations due from the Borrower under the Note, as amended herein, except as
disclosed by Borrower and Diversicare Management Services Co. in that certain
Quarterly Compliance Statement & Census Data report and that certain Compliance
Certificate, each for the period ending September 30, 2005, and signed by
Borrower's Chief Financial Officer and Vice President.

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         IN WITNESS WHEREOF, the Borrower and Lender have caused this Tenth
Amendment to be executed by their respective duly authorized representatives, as
of the date first set forth above.

                             BORROWER:

                             DIVERSICARE ASSISTED LIVING SERVICES NC I,
                             LLC, a Delaware limited liability company

                             By: Diversicare Assisted Living Services NC, LLC
                             Its: Sole Member

                             By: /s/ Glynn Riddle
                                 ----------------------------------------------
                                    Glynn Riddle,
                                    Chief Financial Officer

                             LENDER:

                             GMAC COMMERCIAL MORTGAGE CORPORATION, a California
                             corporation

                             By: /s/ Laura Y. McDonald
                                 ----------------------------------------------
                               Its: Senior Vice President
                                    -------------------------------------------

                                       3<PAGE>
                                                                   EXHIBIT 10.20

                               FIRST AMENDMENT TO
                            ASSET PURCHASE AGREEMENT

         THIS FIRST AMENDMENT TO ASSET PURCHASE AGREEMENT (the "AMENDMENT") is
made and entered into as of March 29, 2006, by and among DIVERSICARE ASSISTED
LIVING SERVICES NC I, LLC, A DELAWARE LIMITED LIABILITY COMPANY ("DALS I"),
DIVERSICARE ASSISTED LIVING SERVICES NC II, LLC, A DELAWARE LIMITED LIABILITY
COMPANY ("DALS II") (DALS I AND DALS II ARE COLLECTIVELY, "SELLERS"), AND
AGEMARK ACQUISITION, LLC, A NORTH CAROLINA LIMITED LIABILITY COMPANY ("BUYER").

                                    RECITALS:

         A. Buyer and Sellers are parties to that certain Asset Purchase
Agreement dated November 28, 2005 (the "AGREEMENT").

         B. Buyer and Sellers now desire to amend the terms set forth in the
Agreement as provided in this Amendment.

         C. Capitalized terms not otherwise defined in this Amendment shall have
the meanings set forth in the Agreement.

                                   AGREEMENT:

         NOW, THEREFORE, for and in consideration of the premises and the mutual
agreements, covenants, representations, and warranties set forth herein and in
the Agreement and other good and valuable consideration, the receipt and
adequacy of which are forever acknowledged and confessed, the parties hereto
agree as follows:

         1. Section 2.4 of the Agreement is hereby deleted in its entirety and
replaced with the following:

         2.4 Escrow Deposit. Buyer has previously deposited with Chicago Title
         ("ESCROW AGENT") the sum of One Hundred Thousand and No/100 Dollars
         ($100,000.00) (together with all interest thereon, the "ESCROWED
         AMOUNT"). The Escrowed Amount shall be held by Escrow Agent and paid,
         disbursed or applied as a credit against the Purchase Price as provided
         in this Agreement. The Escrowed Amount shall be held or placed by
         Escrow Agent in an interest bearing account and the term "Escrowed
         Amount" shall include any interest thereon. If the Closing occurs, the
         Escrowed Amount will be credited against the Purchase Price. If the
         Closing does not occur or the Agreement is otherwise terminated (i) by
         reason of Seller's default, Escrow Agent shall be irrevocably
         authorized and directed to release the Escrowed Amount to Buyer; or
         (ii) for any other reason, Escrow Agent shall be irrevocably authorized
         and directed to release the Escrowed Amount to the Sellers and such
         amounts shall be retained by Sellers as liquidated damages. This

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         Agreement shall constitute both an agreement among Sellers and Buyer
         and escrow instructions for Escrow Agent. If Escrow Agent requires a
         separate or additional escrow agreement to hold the Escrowed Amount,
         Buyer and Sellers hereby agree upon request by Escrow Agent to promptly
         execute and deliver such agreement; provided, that such agreement shall
         not modify or amend the provisions of this Agreement unless otherwise
         consented and agreed to in writing by Sellers and Buyer.

         2. Section 6.2(3) of the Agreement shall be deleted in its entirety and
replaced with the following:

                  (3) By Buyer or Sellers if Closing hereunder shall not have
                  taken place by April 14, 2006, or by such later date as shall
                  be agreed upon by an appropriate amendment to this Agreement
                  if the parties agree in writing to an extension, provided that
                  a party shall not have the right to terminate under this
                  Section 6.2(3) if the conditions precedent to such party's
                  obligation to close have been fully satisfied and such party
                  has failed or refused to close after being requested in
                  writing to close by the other party.

         3. EFFECT ON PURCHASE AGREEMENT; GENERAL PROVISIONS. Except as set
forth in this Amendment, the terms and provisions of the Agreement are hereby
ratified and declared to be in full force and effect. This Amendment shall be
governed by the provisions of the Agreement regarding choice of law, attorneys'
fees and successors and assigns. This Amendment shall become effective upon its
execution, which may occur in one or more counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same
instrument. Captions and paragraph headings are used herein for convenience
only, are not a part of this Amendment or the Agreement as amended by this
Amendment and shall not be used in construing either document. On and after the
date hereof, each reference in the Agreement to "this Agreement," "hereunder,"
"hereof," "herein," or words of like import, and each reference in the other
documents and agreements relating to the Agreement, shall mean and be a
reference to the Agreement as amended hereby.

                  [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

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         IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be
executed in multiple originals by their authorized officers, all as of the date
first above written.

                                  SELLERS:

                                  DIVERSICARE ASSISTED LIVING
                                  SERVICES NC I, LLC

                                  By:      Diversicare Assisted Living
                                           Services NC, LLC, the sole member

                                           By:      /s/ L. Glynn Riddle
                                                    -------------------

                                           Title:   EVP and CFO
                                                    -----------

                                  DIVERSICARE ASSISTED LIVING
                                  SERVICES NC II, LLC

                                  By:      Diversicare Assisted Living
                                           Services NC, LLC, the sole member

                                           By:      /s/ L. Glynn Riddle
                                                    -------------------

                                           Title:   EVP and CFO
                                                    -----------------

                                  BUYER:

                                  AGEMARK ACQUISITION, LLC

                                           By: /s/ Charles E. Trefzger Jr.
                                               ---------------------------

                                           Title:   Manager
                                                    -----------------

         SIGNATURE PAGE TO FIRST AMENDMENT TO ASSET PURCHASE AGREEMENT

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