Document:

EX-10.1

 Exhibit 10.1 

OTONOMY, INC. 

EXECUTIVE EMPLOYMENT AGREEMENT 

This Employment Agreement (the “Agreement”) is entered into by and between Otonomy, Inc. (the “Company”), and Eric Loumeau
(“Executive”) as of the date the Company and Executive have each executed this Agreement, as set forth below. The terms of this Agreement will become effective on May 15, 2015 (the “Effective Date”). 

1. Duties and Scope of Employment. 

(a) Positions and Duties. As of the Effective Date, Executive will serve as the Company’s General Counsel and Chief Compliance
Officer. Executive will render such business and professional services in the performance of Executive’s duties, consistent with Executive’s position within the Company, as will reasonably be assigned to him by the Company’s Chief
Executive Officer. The period of Executive’s employment under this Agreement is referred to herein as the “Employment Term.” 

(b) Obligations. During the Employment Term, Executive will perform his duties faithfully and to the best of his ability and will
devote his full business efforts and time to the Company. For the duration of the Employment Term, Executive agrees not to actively engage in any other employment, occupation or consulting activity for any direct or indirect remuneration without the
prior approval of the Company’s Board of Directors (the “Board”). Executive further agrees to comply with all Company policies, including, for the avoidance of any doubt, any insider trading policies and compensation clawback policies
currently in existence or that may be adopted by the Company during the Term. 
 (c) Term of Agreement. The Agreement shall have an
initial term of 4 years (the “Initial Term”) commencing on the Effective Date, subject to earlier termination as provided in this Agreement. Unless either party gives at least 90 days’ notice prior to the expiration of the Initial
Term or the then-current Additional Term (as hereinafter defined), as applicable, this Agreement shall be renewed for a period of 1 year (each, an “Additional Term”), in each case, commencing on the expiration of the Initial Term or
the then-current Additional Term, as the case may be, subject to earlier termination as provided in Section 7 of this Agreement. In the event of a Change of Control, if there is less than twelve (12) months remaining in the Initial Term or
then-current Additional Term, as applicable, the term will automatically extend until the twelve (12) month anniversary following the Change of Control. If Executive becomes entitled to benefits under Section 7 during the Initial Term or
the then-current Additional Term of this Agreement, the Agreement will not terminate until all of the obligations of the parties hereto with respect to this Agreement have been satisfied. 

2. At-Will Employment. The parties agree that Executive’s employment with the Company will be “at-will” employment and
may be terminated at any time with or without cause or notice. Executive understands and agrees that neither his job performance nor promotions, commendations, bonuses or the like from the Company give rise to or in any way serve as the basis for
modification, amendment, or extension, by implication or otherwise, of his employment with the Company. However, as described in this Agreement, Executive may be entitled to severance 

 
benefits depending on the circumstances of Executive’s termination of employment with the Company. 

3. Compensation. 
 (a)
Base Salary. During the Employment Term, the Company will pay Executive an annual salary of $330,000 as compensation for services (the “Base Salary”). The Base Salary will be paid periodically in accordance with the Company’s
normal payroll practices and be subject to the usual, required withholdings. 
 (b) Target Bonus. As of the Company’s 2015
fiscal year, Executive will be eligible to receive an annual bonus of up to forty percent (40%) of Executive’s Base Salary, less applicable withholdings, upon achievement of performance objectives to be determined by the Board in its sole
discretion (the “Target Bonus”). The Target Bonus, or any portion thereof, will be paid as soon as practicable after the Board determines that the Target Bonus has been earned, but in no event shall the Target Bonus be paid after the later
of (i) the fifteenth (15th) day of the third (3rd) month following the close of the Company’s fiscal year in which the
Target Bonus is earned or (ii) March 15 following the calendar year in which the Target Bonus is earned. Any Target Bonus will be prorated for the number of months during the applicable fiscal year in which Executive provided services to
the Company. Subject to Section 7, Executive must remain an employee of the Company on the date the Target Bonus is paid in order to receive such Target Bonus. 

(c) Stock Option. It will be recommended to the Board of Directors (or a committee thereof) that Executive be granted a stock option to
purchase 100,000 shares at an exercise price equal to the fair market value on the date of grant (the “Option”). Subject to the accelerated vesting provisions set forth herein, the Option will vest as to 25% of the shares subject to the
Option one (1) year after the Option’s date of grant, and as to 1/48th of the shares subject to the Option monthly thereafter on the same day of the month as the Option’s date of grant (and if there is no corresponding day, the last
day of the month), so that the Option will be fully vested and exercisable four (4) years from the Option’s date of grant, subject to Executive continuing to provide services to the Company through the relevant vesting dates. Except as
provided herein, the Option will be subject to the terms, definitions and provisions of the Company’s 2014 Equity Incentive Plan (the “Option Plan”) and the stock option agreement by and between Executive and the Company (the
“Option Agreement”), both of which documents are incorporated herein by reference. 
 (d) Review and Adjustments.
Executive’s Base Salary, Target Bonus, and other compensatory arrangements will be subject to review and adjustment in accordance with the Company’s applicable policies, subject to Executive’s ability to resign for Good Reason and
receive severance benefits as set forth in Section 7. 
 (e) Signing Bonus. Subject to the following sentence, Executive will
receive a one-time hiring bonus of $15,000, less applicable withholdings, payable with Executive’s first paycheck from the Company following the Effective Date (the “Signing Bonus”). Executive will not be eligible to receive the
Signing Bonus if Executive has received, or as of the Effective Date is scheduled or otherwise entitled to receive, an incentive bonus of any kind from Executive’s prior employer. 

  
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 4. Employee Benefits. During the Employment Term, Executive will be entitled to
participate in the employee benefit plans currently and hereafter maintained by the Company of general applicability to other senior executives of the Company. The Company reserves the right to cancel or change the benefit plans and programs it
offers to its employees at any time. 
 5. Vacation. Executive will be entitled to paid vacation of one-hundred and sixty
(160) business hours per year in accordance with the Company’s vacation policy, with the timing and duration of specific hours off mutually and reasonably agreed to by the parties hereto. 

6. Expenses. The Company will reimburse Executive for reasonable travel, entertainment or other expenses incurred by Executive in the
furtherance of or in connection with the performance of Executive’s duties hereunder, in accordance with the Company’s expense reimbursement policy as in effect from time to time. 

7. Severance Benefits. 

(a) Termination Outside the Change of Control Period. If, outside of the Change of Control Period, the Company or its Affiliates
terminate Executive’s employment with the Company or its Affiliates, respectively, other than for Cause, death or Disability, or Executive resigns from such employment for Good Reason, then, subject to Section 8, Executive will receive the
following severance benefits: 
 (i) Salary Severance. Continuing payments of severance pay at a rate equal to Executive’s Base
Salary, at the highest rate in effect during the Term, for nine (9) months from the date of Executive’s termination of employment, which will be paid in accordance with the Company’s regular payroll procedures. 

(ii) Bonus Severance. Executive will receive a lump-sum payment, payable in accordance with the Company’s regular payroll
procedures, equal to the portion of the Executive’s Target Bonus as in effect for the fiscal year in which Executive’s termination of employment occurs prorated based on the actual amount of time Executive was employed by the Company
during the fiscal year (or the relevant performance period if something different than a fiscal year) during which the termination occurs. 

(iii) Continued Employee Benefits. If Executive elects continuation coverage pursuant to the Consolidated Omnibus Budget
Reconciliation Act of 1985, as amended (“COBRA”) within the time period prescribed pursuant to COBRA for Executive and Executive’s eligible dependents, the Company will reimburse Executive for the premiums necessary to continue group
health insurance benefits for Executive and Executive’s eligible dependents until the earlier of (A) a period of nine (9) months from the date of Executive’s termination of employment, (B) the date upon which Executive
and/or Executive’s eligible dependents becomes covered under similar plans or (C) the date upon which Executive ceases to be eligible for coverage under COBRA (such reimbursements, the “COBRA Premiums”). However, if the Company
determines in its sole discretion that it cannot pay the COBRA Premiums without potentially violating applicable law (including, without limitation, Section 2716 of the Public Health Service Act), the Company will in lieu thereof provide to
Executive a taxable monthly payment payable on the last day of a given month (except as provided by the following sentence), in an amount equal to the monthly COBRA premium 

  
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that Executive would be required to pay to continue Executive’s group health coverage in effect on the date of Executive’s termination of employment (which amount will be based on the
premium for the first month of COBRA coverage), which payments will be made regardless of whether Executive elects COBRA continuation coverage and will commence on the month following Executive’s termination of employment and will end on the
earlier of (x) the date upon which Executive obtains other employment or (y) the date the Company has paid an amount equal to nine (9) payments. For the avoidance of doubt, the taxable payments in lieu of COBRA Premiums may be used
for any purpose, including, but not limited to continuation coverage under COBRA, and will be subject to all applicable tax withholdings. Notwithstanding anything to the contrary under this Agreement, if at any time the Company determines in its
sole discretion that it cannot provide the payments contemplated by the preceding sentence without violating applicable law (including, without limitation, Section 2716 of the Public Health Service Act), Executive will not receive such payment
or any further reimbursements for COBRA premiums. 
 (iv) Equity. Vesting acceleration of Executive’s outstanding unvested
Equity Awards on the date of Executive’s termination equal to the number of shares subject to each such Equity Award that would have vested had Executive remained an employee of the Company for an additional twelve (12) months following
the date of termination. If, however, an outstanding Equity Award is to vest and/or the amount of the Equity Award to vest is to be determined based on the achievement of performance criteria, then the Equity Award will vest as to twenty-five
percent (25%) of the amount of the Equity Award assuming the performance criteria had been achieved at target levels for the relevant performance period(s). 

(b) Termination without Cause or Resignation for Good Reason within the Change of Control Period. If, within the Change of Control
Period, the Company or its Affiliates terminate Executive’s employment with the Company or its Affiliates, respectively, other than for Cause, death or Disability, or Executive resigns from such employment for Good Reason, then, subject to
Section 8, Executive will receive the following severance benefits from the Company: 
 (i) Salary Severance. A lump sum
severance payment equal to twelve (12) months of Executive’s Base Salary, at the highest rate in effect during the Term, which will be paid in accordance with the Company’s regular payroll procedures. For the avoidance of doubt, if
(A) Executive incurred a termination prior to a Change of Control that qualifies Executive for severance payments under Section 7(a)(i); and (B) a Change of Control occurs within the three (3)-month period following Executive’s
termination of employment that qualifies Executive for the superior benefits under this Section 7(b)(i), then Executive shall be entitled to a lump-sum payment of the amount calculated under this Section 7(b)(i), less amounts already paid
under Section 7(a)(i). 
 (ii) Bonus Severance. Executive will receive a lump-sum payment, payable in accordance with the
Company’s regular payroll procedures, equal to one hundred percent (100%) of the higher of (A) Executive’s target bonus as in effect for the fiscal year in which the Change of Control occurs or (B) Executive’s target
bonus as in effect for the fiscal year in which Executive’s termination of employment occurs. For avoidance of doubt, the amount paid to Executive pursuant to this Section 7(b)(ii) will not be prorated based on the actual amount of time
Executive is employed by the Company during the fiscal year (or the relevant performance period if something different than a fiscal year) during which the termination occurs. 

  
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 (iii) Continued Employee Benefits. If Executive elects continuation coverage pursuant to
COBRA within the time period prescribed pursuant to COBRA for Executive and Executive’s eligible dependents, the Company will reimburse Executive for the premiums necessary to continue group health insurance benefits for Executive and
Executive’s eligible dependents until the earlier of (A) a period of twelve (12) months from the date of Executive’s termination of employment, (B) the date upon which Executive and/or Executive’s eligible dependents
becomes covered under similar plans or (C) the date upon which Executive ceases to be eligible for coverage under COBRA (such reimbursements, the “COC COBRA Premiums”). However, if the Company determines in its sole discretion that it
cannot pay the COC COBRA Premiums without potentially violating applicable law (including, without limitation, Section 2716 of the Public Health Service Act), the Company will in lieu thereof provide to Executive a taxable monthly payment in an
amount equal to the monthly COBRA premium that Executive would be required to pay to continue Executive’s group health coverage in effect on the date of Executive’s termination of employment (which amount will be based on the premium for
the first month of COBRA coverage), which payments will be made regardless of whether Executive elects COBRA continuation coverage and will commence on the month following Executive’s termination of employment and will end on the earlier of
(x) the date upon which Executive obtains other employment or (y) the date the Company has paid an amount equal to twelve (12) payments. For the avoidance of doubt, the taxable payments in lieu of COBRA Premiums may be used for any
purpose, including, but not limited to continuation coverage under COBRA, and will be subject to all applicable tax withholdings. Notwithstanding anything to the contrary under this Agreement, if at any time the Company determines in its sole
discretion that it cannot provide the payments contemplated by the preceding sentence without violating applicable law (including, without limitation, Section 2716 of the Public Health Service Act), Executive will not receive such payment or
any further reimbursements for COBRA premiums. 
 (d) Equity. Vesting acceleration of one hundred percent (100%) of
Executive’s outstanding unvested Equity Awards on the date of Executive’s termination. If, however, an outstanding Equity Award is to vest and/or the amount of the Equity Award to vest is to be determined based on the achievement of
performance criteria, then the Equity Award will vest as to one hundred percent (100%) of the amount of the Equity Award assuming the performance criteria had been achieved at target levels for the relevant performance period(s). 

(e) Voluntary Resignation; Termination for Cause. If Executive’s employment with the Company or its Affiliates terminates
(i) voluntarily by Executive (other than for Good Reason) or (ii) for Cause by the Company, then Executive will not be entitled to receive severance or other benefits except for those (if any) as may then be established under the
Company’s then existing severance and benefits plans and practices or pursuant to other written agreements with the Company. 
 (f)
Disability; Death. If the Company terminates Executive’s employment as a result of Executive’s Disability, or Executive’s employment terminates due to Executive’s death, then Executive will not be entitled to receive
severance or other benefits except for those (if any) as may then be established under the Company’s then existing written severance and benefits plans and practices or pursuant to other written agreements with the Company. 

(g) Accrued Compensation. For the avoidance of any doubt, in the event of a termination of Executive’s employment with the Company
or its Affiliates, Executive will be 

  
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entitled to receive all accrued but unpaid vacation, expense reimbursements, wages, and other benefits due to Executive under any Company-provided plans, policies, and arrangements. 

(h) Transfer between the Company and Affiliates. For purposes of this Section 7, if Executive’s employment with the Company
or one of its Affiliates terminates, Executive will not be determined to have been terminated without Cause, provided Executive continues to remain employed by the Company or one of its Affiliates (e.g., upon transfer from on Affiliate to another);
provided, however, that the parties understand and acknowledge that any such termination could potentially result in Executive’s ability to resign for Good Reason. 

(i) Exclusive Remedy. In the event of a termination of Executive’s employment with the Company or its Affiliates, the provisions
of this Section 7 are intended to be and are exclusive and in lieu of any other rights or remedies to which Executive or the Company may otherwise be entitled, whether at law, tort or contract, in equity. Executive will be entitled to no
benefits, compensation or other payments or rights upon termination of employment other than those benefits expressly set forth in this Section 7. 

8. Conditions to Receipt of Severance. 

(a) Separation Agreement and Release of Claims. The receipt of any severance pursuant to Sections 7(a) or 7(b) will be subject to
(i) Executive resigning from all positions Executive may hold as an officer or director of the Company or any Affiliates and executing all documents the Company determines, in its sole discretion, are necessary to effectuate such resignations
prior to the Release Deadline (as defined below) (such resignation and execution of applicable documents, the “Resignations”), and (ii) Executive signing and not revoking a separation agreement and release of claims in a form attached
hereto as Exhibit A (the “Release”) and provided that such Release becomes effective and irrevocable no later than sixty (60) days following the termination date (such deadline, the “Release Deadline”). If the
Resignations and the Release do not become effective and irrevocable by the Release Deadline, Executive will forfeit any rights to severance or benefits under this Agreement. In no event will severance payments or benefits be paid or provided until
the Resignations and the Release become effective and irrevocable. Except as required by Section 8(b), any installment payments that would have been made to Executive prior to the Resignations and the Release becoming effective and irrevocable
but for the preceding sentence will be paid to Executive on the first regularly scheduled Company payroll date following the date the Resignations and the Release becomes effective and irrevocable, and the remaining payments will be made as provided
in the Agreement. 
 (b) Section 409A. 

  
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 (i) Notwithstanding anything to the contrary in this Agreement, no Deferred Payments will be
paid or otherwise provided until Executive has a “separation from service” within the meaning of Section 409A. Similarly, no severance payable to Executive, if any, pursuant to this Agreement that otherwise would be exempt from
Section 409A pursuant to Treasury Regulation Section 1.409A-1(b)(9) will be payable until Executive has a “separation from service” within the meaning of Section 409A. 

(ii) Any severance payments or benefits under this Agreement that would be considered Deferred Payments will be paid on, or, in the case of
installments, will not commence until, the sixtieth (60th) day following Executive’s separation from service, or, if later, such time as required by Section 8(b)(iii). Except as required by Section 8(b)(iii), any installment
payments that would have been made to Executive during the sixty (60) day period immediately following Executive’s separation from service but for the preceding sentence will be paid to Executive on the sixtieth (60th) day following
Executive’s separation from service and the remaining payments shall be made as provided in this Agreement. In no event will Executive have discretion to determine the taxable year of payment for any Deferred Payments. 

(iii) Notwithstanding anything to the contrary in this Agreement, if Executive is a “specified employee” within the meaning of
Section 409A at the time of Executive’s separation from service (other than due to death), then the Deferred Payments that are payable within the first six (6) months following Executive’s separation from service, will, to the
extent required to be delayed pursuant to Section 409A(a)(2)(B) of the Code, become payable on the date six (6) months and one (1) day following the date of Executive’s separation from service. All subsequent Deferred Payments,
if any, will be payable in accordance with the payment schedule applicable to each payment or benefit. Notwithstanding anything herein to the contrary, if Executive dies following Executive’s separation from service, but prior to the six
(6) month anniversary of the separation from service, then any payments delayed in accordance with this paragraph will be payable in a lump sum as soon as administratively practicable after the date of Executive’s death and all other
Deferred Payments will be payable in accordance with the payment schedule applicable to each payment or benefit. Each payment and benefit payable under this Agreement is intended to constitute a separate payment for purposes of
Section 1.409A-2(b)(2) of the Treasury Regulations. 
 (iv) Any amount paid under this Agreement that satisfies the requirements of
the “short-term deferral” rule set forth in Section 1.409A-1(b)(4) of the Treasury Regulations will not constitute Deferred Payments. 

(v) Any amount paid under this Agreement that qualifies as a payment made as a result of an involuntary separation from service pursuant to
Section 1.409A-1(b)(9)(iii) of the Treasury Regulations that does not exceed the Section 409A Limit (as defined below) will not constitute Deferred Payments. 

(vi) To the extent that any taxable reimbursements of expenses or in-kind benefits are provided, they shall be made in accordance with
Section 409A, including, but not limited to the following provisions: (i) the amount of any such expense reimbursement or in-kind benefit provided during Executive’s taxable year shall not affect any expenses eligible for
reimbursement in any other taxable year; (ii) the reimbursement of the eligible expense shall be made no later than the last day of the Executive’s taxable year that immediately follows the taxable year in which the expense

  
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was incurred; and (iii) the right to any reimbursement shall not be subject to liquidation or exchange for another benefit or payment. 

(vii) The foregoing provisions and all compensation and benefits provided for under this Agreement are intended to comply with or be exempt
from the requirements of Section 409A so that none of the severance payments and benefits to be provided hereunder will be subject to the additional tax imposed under Section 409A, and any ambiguities or ambiguous terms herein will be
interpreted to be exempt or so comply. The Company and Executive agree to work together in good faith to consider amendments to this Agreement and to take such reasonable actions which are necessary, appropriate or desirable to avoid imposition of
any additional tax or income recognition prior to actual payment to Executive under Section 409A. In no event will the Company reimburse Executive for any taxes that may be imposed on Executive as a result of Section 409A. 

9. Limitation on Payments. In the event that the severance and other benefits provided for in this Agreement or otherwise payable to
Executive (i) constitute “parachute payments” within the meaning of Section 280G of the Internal Revenue Code of 1986, as amended (the “Code”) and (ii) but for this Section 9, would be subject to the excise
tax imposed by Section 4999 of the Code, then Executive’s severance benefits under Section 7 will be either: 
 (a) delivered
in full, or 
 (b) delivered as to such lesser extent which would result in no portion of such severance benefits being subject to excise
tax under Section 4999 of the Code, 
 whichever of the foregoing amounts, taking into account the applicable federal, state and local income taxes and
the excise tax imposed by Section 4999 of the Code, results in the receipt by Executive on an after-tax basis, of the greatest amount of severance benefits, notwithstanding that all or some portion of such severance benefits may be taxable
under Section 4999 of the Code. If a reduction in severance and other benefits constituting “parachute payments” is necessary so that benefits are delivered to a lesser extent, reduction will occur in the following order:
(i) reduction of cash payments; (ii) cancellation of awards granted “contingent on a change in ownership or control” (within the meaning of Code Section 280G); (iii) cancellation of accelerated vesting of equity awards;
or (iv) reduction of employee benefits. In the event that acceleration of vesting of equity award compensation is to be reduced, such acceleration of vesting will be cancelled in the reverse order of the date of grant of Executive’s equity
awards. 
 Unless the Company and Executive otherwise agree in writing, any determination required under this Section 9 will be made in writing by a
nationally recognized certified professional services firm selected by the Company, the Company’s legal counsel or such other person or entity to which the parties mutually agree (the “Firm”) immediately prior to Change of Control,
whose determination will be conclusive and binding upon Executive and the Company for all purposes. For purposes of making the calculations required by this Section 9, the Firm may make reasonable assumptions and approximations concerning
applicable taxes and may rely on reasonable, good faith interpretations concerning the application of Sections 280G and 4999 of the Code. The Company and Executive will furnish to the Firm such information and documents as the Accountants may
reasonably request in order to make a determination under this Section. The Company will bear all costs the Firm may reasonably incur in connection with any calculations contemplated by this Section 5. 

  
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 10. Definition of Terms. The following terms referred to in this Agreement will have the
following meanings: 
 (a) Affiliate. “Affiliate” means the Company and any other parent or subsidiary corporation of the
Company, as such terms are defined in Section 424(e) and (1) of the Code. 
 (b) Cause. “Cause” means the
occurrence of any of the following events, as determined by the Board or a committee designated by the Board, in its sole discretion: (i) Executive’s conviction of, or plea of nolo contendere to, any felony or any crime involving moral
turpitude or dishonesty; (ii) Executive’s participation in a fraud or material act of dishonesty against the Company or any Affiliate; (iii) Executive’s willful and material breach of Executive’s duties hereunder that is not
cured within thirty (30) days after Executive’s receipt of written notice from the Board of such breach; (iv) Executive’s intentional and material damage to the property of the Company or an Affiliate; (v) Executive’s
material breach of the Proprietary Information and Inventions Agreement; or (vi) Executive’s failure to cooperate fully with the Company in connection with any and all existing or future litigation, arbitrations, mediations or
investigations whether internal or brought by or against the Company or any of its Affiliates in which the Company reasonably deems Executive’s cooperation is necessary or desirable. Notwithstanding the foregoing, prior to determining that
“Cause” under this Section 10(b) has occurred, the Company shall (A) provide to Executive in writing, in reasonable detail, the reasons for the determination that such Cause exists, (B) other than with respect to clause
(iii), above, which specifies the applicable period of time for Executive to remedy his or her breach, afford Executive a reasonable opportunity to remedy any such breach, unless the Board determines in good faith that such opportunity would be
futile or result in material harm to the Company or its Affiliates, and (C) make any decisions that such Cause exists in good faith. 

(c) Change of Control. “Change of Control” means the occurrence of any of the following events: 

(d) A change in the ownership of the Company which occurs on the date that any one person, or more than one person acting as a group
(“Person”), acquires ownership of the stock of the Company that, together with the stock held by such Person, constitutes more than fifty percent (50%) of the total voting power of the stock of the Company; provided, however, that for
purposes of this subsection, the acquisition of additional stock by any one Person, who is considered to own more than fifty percent (50%) of the total voting power of the stock of the Company will not be considered a Change of Control; or 

(e) A change in the effective control of the Company which occurs on the date that a majority of members of the Board is replaced during any
twelve (12) month period by Directors whose appointment or election is not endorsed by a majority of the members of the Board prior to the date of the appointment or election. For purposes of this clause (ii), if any Person is considered to be
in effective control of the Company, the acquisition of additional control of the Company by the same Person will not be considered a Change of Control; or 

(f) A change in the ownership of a substantial portion of the Company’s assets which occurs on the date that any Person acquires (or has
acquired during the twelve (12) month period ending on the date of the most recent acquisition by such person or persons) assets from the 

  
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Company that have a total gross fair market value equal to or more than fifty percent (50%) of the total gross fair market value of all of the assets of the Company immediately prior to such
acquisition or acquisitions; provided, however, that for purposes of this subsection (iii), the following will not constitute a change in the ownership of a substantial portion of the Company’s assets: (A) a transfer to an entity that is
controlled by the Company’s stockholders immediately after the transfer, or (B) a transfer of assets by the Company to: (1) a stockholder of the Company (immediately before the asset transfer) in exchange for or with respect to
the Company’s stock, (2) an entity, fifty percent (50%) or more of the total value or voting power of which is owned, directly or indirectly, by the Company, (3) a Person, that owns, directly or indirectly, fifty percent
(50%) or more of the total value or voting power of all the outstanding stock of the Company, or (4) an entity, at least fifty percent (50%) of the total value or voting power of which is owned, directly or indirectly, by a Person
described in this subsection (iii)(B)(3). For purposes of this subsection (iii), gross fair market value means the value of the assets of the Company, or the value of the assets being disposed of, determined without regard to any liabilities
associated with such assets. 
 (g) For purposes of this definition, persons will be considered to be acting as a group if they are owners
of a corporation that enters into a merger, consolidation, purchase or acquisition of stock, or similar business transaction with the Company. 

(h) Notwithstanding the foregoing, a transaction will not be deemed a Change of Control unless the transaction qualifies as a change in
control event within the meaning of Code Section 409A, as it has been and may be amended from time to time, and any proposed or final Treasury Regulations and Internal Revenue Service guidance that has been promulgated or may be promulgated
thereunder from time to time. 
 (i) Further and for the avoidance of doubt, a transaction will not constitute a Change of Control if:
(i) its sole purpose is to change the state of the Company’s incorporation, or (ii) its sole purpose is to create a holding company that will be owned in substantially the same proportions by the persons who held the Company’s
securities immediately before such transaction. 
 (j) Change of Control Period. “Change of Control Period” means the
period beginning on the date three (3) months prior to, and ending on the date that is twelve (12) months following, a Change of Control. 

(k) Code. “Code” means the Internal Revenue Code of 1986, as amended. 

(l) Deferred Payment. “Deferred Payment” means any severance pay or benefits to be paid or provided to Executive (or
Executive’s estate or beneficiaries) pursuant to this Agreement and any other severance payments or separation benefits, that in each case, when considered together, are considered deferred compensation under Section 409A. 

(m) Disability. “Disability” means that the Employee has been unable to perform Executive’s Company duties as the result
of Executive’s incapacity due to physical or mental illness, and such inability, at least twenty-six (26) weeks after its commencement or 180 days in any consecutive twelve (12) month period, is determined to be total and permanent by
a physician selected by the Company or its insurers and acceptable to Executive or Executive’s legal representative (such agreement as to acceptability not to be unreasonably withheld). Termination

  
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resulting from Disability may only be effected after at least thirty (30) days’ written notice by the Company of its intention to terminate the Employee’s employment. In the event
that the Employee resumes the performance of substantially all of Executive’s duties hereunder before the termination of Executive’s employment becomes effective, the notice of intent to terminate will automatically be deemed to have been
revoked. 
 (n) Equity Awards. “Equity Awards” means Executive’s outstanding stock options, stock appreciation rights,
restricted stock, restricted stock units, performance shares, performance stock units and any other Company equity compensation awards, including, for the avoidance of any doubt, the Option (to the extent outstanding). 

(o) Good Reason. “Good Reason” means Executive’s resignation within thirty (30) days following the expiration of
any Company cure period (discussed below) following the occurrence of one or more of the following, without Executive’s express written consent: (i) a material diminution of Executive’s authority, duties or responsibilities relative
to Executive’s authority, duties or responsibilities in effect immediately prior to such diminution; (ii) a material reduction by the Company in the salary or bonus opportunity of the Executive as in effect immediately prior to such
reduction; (iii) the relocation of Executive to a facility or a location more than thirty (30) miles from Executive’s then-present location; or (iv) any other action that constitutes a material breach by the Company of its
obligations to Executive under this Agreement. Executive’s resignation will not be deemed to be for Good Reason unless Executive has first provided the Company with written notice of the acts or omissions constituting the grounds for “Good
Reason” within ninety (90) days of the initial existence of the grounds for “Good Reason” and a reasonable cure period of not less than thirty (30) days following the date the Company receives such notice, and such condition
has not been cured during such period. 
 (p) Section 409A. “Section 409A” means Section 409A of the Code and any
final regulations and guidance thereunder and any applicable state law equivalent, as each may be amended or promulgated from time to time. 

(q) Section 409A Limit. “Section 409A Limit” will mean two (2) times the lesser of: (i) Executive’s
annualized compensation based upon the annual rate of pay paid to Executive during the Executive’s taxable year preceding the Executive’s taxable year of Executive’s separation from service as determined under Treasury Regulation
Section 1.409A-1(b)(9)(iii)(A)(1) and any Internal Revenue Service guidance issued with respect thereto; or (ii) the maximum amount that may be taken into account under a qualified plan pursuant to Section 401(a)(17) of the Internal
Revenue Code for the year in which Executive’s separation from service occurred. 
 11. Confidential Information Agreement. As a
condition of Executive’s continuing employment, Executive is required to sign and comply with an At-Will Employment, Confidential Information, Invention Assignment and Arbitration Agreement in
substantially the same form as attached hereto as Exhibit B (the “Confidential Information Agreement”) which requires, among other provisions, the assignment of patent rights to any invention made during Executive’s employment
at the Company, and non-disclosure of Company proprietary information. In the event of any dispute or claim relating to or arising out of Executive’s employment relationship, Executive and the Company
agree that (i) any and all disputes between Executive and the Company shall be fully and finally resolved by binding arbitration, (ii) Executive is waiving any and all rights to a jury 

  
 -11- 

 
trial but all court remedies will be available in arbitration, (iii) all disputes shall be resolved by a neutral arbitrator who shall issue a written opinion, (iv) the arbitration shall
provide for adequate discovery, and (v) the Company shall pay all the arbitration fees, except an amount equal to the filing fees Executive would have paid had Executive filed a complaint in a court of law. 

12. Assignment. This Agreement will be binding upon and inure to the benefit of (a) the heirs, executors and legal representatives
of Executive upon Executive’s death and (b) any successor of the Company. Any such successor of the Company will be deemed substituted for the Company under the terms of this Agreement for all purposes. For this purpose,
“successor” means any person, firm, corporation or other business entity which at any time, whether by purchase, merger or otherwise, directly or indirectly acquires all or substantially all of the assets or business of the Company. None
of the rights of Executive to receive any form of compensation payable pursuant to this Agreement may be assigned or transferred except by will or the laws of descent and distribution. Any other attempted assignment, transfer, conveyance or other
disposition of Executive’s right to compensation or other benefits will be null and void. 
 13. Notices. All notices, requests,
demands and other communications called for hereunder will be in writing and will be deemed given (i) on the date of delivery if delivered personally, (ii) one (1) day after being sent by a well established commercial overnight
service, or (iii) four (4) days after being mailed by registered or certified mail, return receipt requested, prepaid and addressed to the parties or their successors at the following addresses, or at such other addresses as the parties
may later designate in writing: 
 If to the Company: 

Otonomy, Inc. 
 Attn: Chief
Executive Officer 
 6275 Nancy Ridge Drive, Suite 100 

San Diego, CA 92121 
 If to
Executive: 
 at the last residential address known by the Company. 

14. Severability. In the event that any provision hereof becomes or is declared by a court of competent jurisdiction to be illegal,
unenforceable or void, this Agreement will continue in full force and effect without said provision. 
 15. Integration. This
Agreement, the Option Plan, the Option Agreement, and the Confidential Information Agreement represent the entire agreement and understanding between the parties as to the subject matter herein and supersede all prior or contemporaneous agreements
whether written or oral, including, for the avoidance of any doubt, the Offer Letter Agreement by and between Executive and the Company dated May 6, 2015. This Agreement may be modified only by agreement of the parties by a written instrument
executed by the parties that is designated as an amendment to this Agreement. 

  
 -12- 

 16. Waiver of Breach. The waiver of a breach of any term or provision of this Agreement,
which must be in writing, will not operate as or be construed to be a waiver of any other previous or subsequent breach of this Agreement. 

17. Headings. All captions and section headings used in this Agreement are for convenient reference only and do not form a part of this
Agreement. 
 18. Tax Withholding. All payments made pursuant to this Agreement will be subject to withholding of applicable taxes.

 19. Governing Law. This Agreement will be governed by the laws of the State of California (with the exception of its conflict of
laws provisions). 
 20. Acknowledgment. Executive acknowledges that he has had the opportunity to discuss this matter with and
obtain advice from his private attorney, has had sufficient time to, and has carefully read and fully understands all the provisions of this Agreement, and is knowingly and voluntarily entering into this Agreement. 

21. Counterparts. This Agreement may be executed in counterparts, and each counterpart will have the same force and effect as an
original and will constitute an effective, binding agreement on the part of each of the undersigned. 

  
 -13- 

 IN WITNESS WHEREOF, each of the parties has executed this Agreement, in the case of the Company
by their duly authorized officers, as of the day and year set forth below. 
  

									
	COMPANY:	 		 		 	
				
	OTONOMY, INC.	 		 		 	
					
	By:	 	 /s/ David A. Weber
	 		 	Date:	 	 5/9/15

	Title:	 	 President and Chief Executive Officer
	 		 		 	

									
				
	EXECUTIVE:	 		 		 	
				
	 /s/ Eric Loumeau
	 		 	Date:	 	 5/8/15

	Eric Loumeau	 		 		 	
		 		 		 		 	

 [SIGNATURE PAGE TO EXECUTIVE EMPLOYMENT AGREEMENT] 

  
 -14- 

 EXHIBIT A 

RELEASE AND WAIVER OF CLAIMS 

TO BE SIGNED FOLLOWING TERMINATION WITHOUT CAUSE 

OR RESIGNATION FOR GOOD REASON 

In consideration of the payments and other benefits set forth in the Employment Agreement dated May 15, 2015 (the
“Employment Agreement”), to which this form is attached, I, Eric Loumeau, hereby furnish OTONOMY, INC. (the “Company”), with the
following release and waiver (“Release and Waiver”). 
 In exchange for the
consideration provided to me by Section 7 of the Employment Agreement that I am not otherwise entitled to receive, I hereby generally and completely release the Company and its directors, officers, employees, shareholders, partners, agents,
attorneys, predecessors, successors, parent and subsidiary entities, insurers, Affiliates, and assigns from any and all claims, liabilities and obligations, both known and unknown, that arise out of or are in any way related to events, acts,
conduct, or omissions occurring prior to my signing this Release and Waiver. This general release includes, but is not limited to: (1) all claims arising out of or in any way related to my employment with the Company or the termination of that
employment; (2) all claims related to my compensation or benefits from the Company, including salary, bonuses, commissions, vacation pay, expense reimbursements, severance pay, fringe benefits, stock, stock options, or any other ownership
interests in the Company; (3) all claims for breach of contract, wrongful termination, and breach of the implied covenant of good faith and fair dealing; (4) all tort claims, including claims for fraud, defamation, emotional distress, and
discharge in violation of public policy; and (5) all federal, state, and local statutory claims, including claims for discrimination, harassment, retaliation, attorneys’ fees, or other claims arising under the federal Civil Rights Act of
1964 (as amended), the federal Americans with Disabilities Act of 1990, the federal Age Discrimination in Employment Act of 1967 (as amended) (“ADEA”), and the California Fair Employment and Housing Act (as amended).

 Notwithstanding the foregoing, nothing in this Release and Waiver shall constitute a release by me of any claims or damages based
on any right I may have to enforce the Company’s executory obligations under the Agreement, any right I may have to vested or earned compensation and benefits, or my eligibility for indemnification under applicable law, Company governance
documents, my indemnification agreement with the Company or under any applicable insurance policy with respect to my liability as an employee or officer of the Company. 

I also acknowledge that I have read and understand Section 1542 of the California Civil Code which reads as follows: “A
general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him or her must have materially affected his or her settlement with the
debtor.” I hereby expressly waive and relinquish all rights and benefits under that section and any law of any jurisdiction of similar effect with respect to any claims I may have against the Company. 

  
 -15- 

 I acknowledge that, among other rights, I am waiving and releasing any rights I may have under
ADEA, that this Release and Waiver is knowing and voluntary, and that the consideration given for this Release and Waiver is in addition to anything of value to which I was already entitled as an executive of the Company. If I am 40 years of age or
older upon execution of this Release and Waiver, I further acknowledge that I have been advised, as required by the Older Workers Benefit Protection Act, that: (a) the release and waiver granted herein does not relate to claims under the ADEA
which may arise after this Release and Waiver is executed; (b) I should consult with an attorney prior to executing this Release and Waiver; and (c) I have twenty-one (21) days from the date of termination of my employment with the
Company in which to consider this Release and Waiver (although I may choose voluntarily to execute this Release and Waiver earlier); (d) I have seven (7) days following the execution of this Release and Waiver to revoke my consent to this
Release and Waiver; and (e) this Release and Waiver shall not be effective until the seven (7) day revocation period has expired. 

I acknowledge my continuing obligations under my Proprietary Information and Inventions Agreement. Pursuant to the Proprietary Information and
Inventions Agreement I understand that among other things, I must not use or disclose any confidential or proprietary information of the Company and I must immediately return all Company property and documents (including all embodiments of
proprietary information) and all copies thereof in my possession or control. I understand and agree that my right to the severance pay I am receiving in exchange for my agreement to the terms of this Release and Waiver is contingent upon my
continued compliance with my Proprietary Information and Inventions Agreement. 
 This Release and Waiver constitutes the complete, final
and exclusive embodiment of the entire agreement between the Company and me with regard to the subject matter hereof. I am not relying on any promise or representation by the Company that is not expressly stated herein. This Release and Waiver may
only be modified by a writing signed by both me and a duly authorized officer of the Company. 
  

									
	Date:	 	  
	 		 	By:	 	  

					
		 		 		 	Name:	 	  

  
 -16- 

 EXHIBIT B 

AT-WILL EMPLOYMENT, CONFIDENTIAL INFORMATION, 

INVENTION ASSIGNMENT, AND ARBITRATION AGREEMENT 

  
 -17-EX 10.57 ARC HCT II 6.30.2015

Exhibit 10.57

SECOND AMENDMENT TO SENIOR SECURED 
REVOLVING CREDIT AGREEMENT AND OTHER LOAN DOCUMENTS
THIS SECOND AMENDMENT TO SENIOR SECURED REVOLVING CREDIT AGREEMENT AND OTHER LOAN DOCUMENTS (this “Amendment”) made as of the 26th day of June, 2015, by and among AMERICAN REALTY CAPITAL HEALTHCARE TRUST II OPERATING PARTNERSHIP, L.P., a Delaware limited partnership (“Borrower”), AMERICAN REALTY CAPITAL HEALTHCARE TRUST II, INC., a Maryland corporation (“REIT”), the parties executing below as Subsidiary Guarantors (the “Subsidiary Guarantors”; REIT and the Subsidiary Guarantors, collectively the “Guarantors”), KEYBANK NATIONAL ASSOCIATION (“KeyBank”), individually and as Agent for itself and the other Lenders from time to time a party to the Credit Agreement (as hereinafter defined) (KeyBank, in its capacity as Agent, is hereinafter referred to as “Agent”), and THE OTHER “LENDERS” WHICH ARE SIGNATORIES HERETO (KeyBank and such Lenders hereinafter referred to collectively as the “Lenders”).
W I T N E S S E T H:
WHEREAS, Borrower, Agent and certain of the Lenders entered into that certain Senior Secured Revolving Credit Agreement dated as of March 21, 2014, as amended by that certain First Amendment to Senior Secured Revolving Credit Agreement dated as of September 18, 2014 (collectively, the “Credit Agreement”); and
WHEREAS, Borrower has requested that the Agent and the Lenders make certain modifications to the terms of the Credit Agreement; and
WHEREAS, the Agent and the Lenders have agreed to make such modifications subject to the execution and delivery by Borrower and Guarantors of this Amendment.
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto do hereby covenant and agree as follows:
1.Definitions.  All the terms used herein which are not otherwise defined herein shall have the meanings set forth in the Credit Agreement.
2.    Modification of the Credit Agreement.  Borrower, the Lenders and Agent do hereby modify and amend the Credit Agreement as follows:
(a)    By deleting in its entirety the definition of “Extension Request” appearing in §1.1 of the Credit Agreement;
(b)    By deleting in their entirety the definitions of “Borrowing Base Capitalized Value Limit,” “Change of Control,” “EBITDA”, “Funds from Operations,” “Letter of Credit Sublimit,” “Maturity Date,” “Modified FFO”, “Swing Loan Commitment” and “Total Commitment” appearing in §1.1 of the Credit Agreement, and inserting in lieu thereof the following:
“Borrowing Base Capitalized Value Limit.  As of the date of determination, without duplication, the following amount determined individually for each 

Borrowing Base Asset that is a LTAC, Rehab, ASC, MOB, ILF, ALF or SNF:  (a) the Capitalized Value of such Borrowing Base Asset multiplied by fifty-five percent (55%), and (b) for any such Borrowing Base Asset that has not been owned by Borrower or a Subsidiary Guarantor for  eight (8) calendar quarters, the Property Cost of such Borrowing Base Asset multiplied by fifty-five percent (55%), in each case, as most recently determined under this Agreement.  The aggregate Borrowing Base Capitalized Value Limit for all Borrowing Base Assets shall be the sum of such calculations for all of the Borrowing Base Assets. 
Change of Control.  A Change of Control shall exist upon the occurrence of any of the following:
(a)    any Person (including a Person’s Affiliates and associates) or group (as that term is understood under Section 13(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and the rules and regulations thereunder) shall have acquired beneficial ownership (within the meaning of Rule 13d-3 under the Exchange Act) of a percentage (based on voting power, in the event different classes of stock or interests shall have different voting powers) of the voting stock or voting interests of REIT equal to at least twenty percent (20%);
(b)    as of any date a majority of the Board of Directors or Trustees or similar body (the “Board”) of REIT or the Borrower consists of individuals who were not either (i) directors or trustees of REIT or the Borrower as of the corresponding date of the previous year, or (ii) selected or nominated to become directors or trustees by the Board of REIT or the Borrower of which a majority consisted of individuals described in clause (i) above, or (iii) selected or nominated to become directors or trustees by the Board of REIT or the Borrower, which majority consisted of individuals described in clause (i) above and individuals described in clause (ii) above; 
(c)    REIT fails to own, directly or indirectly, at least fifty-one percent (51%) of the economic, voting and beneficial interest of the Borrower, or fails to own any of its interest in Borrower free and clear of any lien, encumbrance or other adverse claim;  
(d)    REIT fails to control the Borrower; 
(e)    the Borrower fails to own, directly or indirectly, free of any lien, encumbrance or other adverse claim (other than the Lien of the Agent granted pursuant to the Loan Documents and non-consensual Liens expressly permitted under §§8.2(i) and 8.2(ii)), at least one hundred percent (100%) of the economic, voting and beneficial interest of each Subsidiary Guarantor;  
(f)    before the Internalization, the Advisor, or a replacement advisor consented to in writing by the Majority Lenders, shall fail to be the advisor of the Borrower; or

2

(g)    at any time any of Randolph C. Read, Thomas P. D’Arcy, Todd Jensen, Edward F. Lange, Jr. or Elizabeth K. Tuppeny, shall die or become disabled or otherwise cease to be active on a daily basis in the management of the REIT or serve as board members of the REIT, and such event results in fewer than three (3) of such individuals, being active on a daily basis in the management of the REIT or serving as board members of the REIT; provided that if fewer than three (3) of such individuals shall continue to be active on a daily basis in the management of the REIT or serve as board members of the REIT, it shall not be a “Change of Control” if a replacement executive of comparable experience and reasonably satisfactory to the Majority Lenders shall have been retained within six (6) months of such event such that there are not fewer than three (3) such individuals active in the daily management of REIT or serving as board members of the REIT.
EBITDA.  With respect to any Person and its Subsidiaries with respect to any period (without duplication):  (a) Net Income (or Loss) on a Consolidated basis, in accordance with GAAP, exclusive of any income or losses from minority interests in the case of such Person or its Subsidiaries, acquisition costs for acquisitions, whether or not consummated, and one-time transaction costs related to the listing of the stock of REIT on a national exchange, and the following (but only to the extent included in determination of such Net Income (or Loss)):  (i) depreciation and amortization expense; (ii) Interest Expense; (iii) income tax expense; (iv) extraordinary or non-recurring gains and losses (including, without limitation, gains and losses on the sale of assets) and distributions to minority owners); and (v) non-cash charges; plus (b) such Person’s pro rata share of EBITDA of its Unconsolidated Affiliates as provided below.  With respect to Unconsolidated Affiliates, EBITDA attributable to such entities shall be excluded but EBITDA shall include a Person’s Equity Percentage of Net Income (or Loss) from such Unconsolidated Affiliates plus its Equity Percentage of the following to the extent included in the determination of such Net Income (or Loss):  (v) depreciation and amortization expense, (w) Interest Expense, (x) income tax expense, (y) extraordinary or nonrecurring gains and losses (including, without limitation, gains and losses on the sale of assets) and distributions to minority owners, and (z) non-cash charges; provided, however, that straight line leveling adjustments required under GAAP and amortization of intangibles pursuant to FAS 141R shall be excluded from the calculation of EBITDA.
Funds from Operations.  With respect to any Person with respect to any period, an amount equal to (a) the Net Income (or Loss) of such Person computed in accordance with GAAP, calculated without regard to gains (or losses) from debt restructuring and sales of property during such period, plus (b) depreciation with respect to such Person's real estate assets and amortization of such Person for such period, plus (c) non-cash charges (including but not limited to amortization of deferred financing costs), all after adjustment for unconsolidated partnerships and joint ventures. 

3

Adjustments for Unconsolidated Affiliates will be calculated to reflect funds from operations on the same basis. Funds from Operations shall be reported in accordance with NAREIT policies.
Letter of Credit Sublimit.  An amount equal to Twenty-Five Million and No/100 Dollars ($25,000,000.00), as the same may be changed from time to time in accordance with the terms of this Agreement.
Maturity Date.  March 21, 2019, or such earlier date on which the Loans shall become due and payable pursuant to the terms hereof.
Modified FFO.  With respect to any Person for any period, an amount equal to (a) the Funds from Operations of such Person for such period, plus (b) to the extent such amounts have reduced the calculation of Funds from Operations, costs and expenses incurred in connection with acquisitions, whether or not consummated, and one-time transaction costs related to the listing of the stock of REIT on a national exchange, during the applicable period, minus (c) an amount equal to the increase or decrease in income for such period as a result of the impact of straight line leveling adjustments of rents and market rent FAS 141 adjustments in accordance with GAAP.
Swing Loan Commitment.  An amount equal to Twenty-Five Million and No/100 Dollars ($25,000,000.00), as the same may be changed from time to time in accordance with the terms of this Agreement.
Total Commitment.  The sum of the Commitments of the Lenders, as in effect from time to time.  As of June 26, 2015, the Total Commitment is Five Hundred Million and No/100 Dollars ($500,000,000.00).  The Total Commitment may increase in accordance with §2.11.”
(c)    By deleting in its entirety the second (2nd) paragraph of the definition of “Applicable Margin” appearing in §1.1 of the Credit Agreement, which paragraph begins with the words “Notwithstanding the foregoing”;
(d)    By deleting in its entirety “2.12(a)(iv),” where it appears in §1.2(m) of the Credit Agreement;
(e)    By deleting in its entirety the number “$450,000,000.00” appearing in the fourth (4th) line of §2.11(a) of the Credit Agreement, and inserting in lieu thereof the number “$750,000,000.00”;
(f)    By deleting in its entirety §2.11(c) of the Credit Agreement, and inserting in lieu thereof the following:
“(c)    Upon the effective date of each increase in the Total Commitment pursuant to this §2.11, the Agent may unilaterally revise Schedule 1.1 to reflect the name and address, Commitment and Commitment Percentage of each Lender following such increase and the Borrower shall execute and 

4

deliver to the Agent a new Revolving Credit Note for each Lender whose Commitment has changed so that the principal amount of such Lender’s Revolving Credit Note shall equal its Commitment.  The Agent shall deliver such replacement Revolving Credit Note to the respective Lenders in exchange for the Revolving Credit Notes replaced thereby which shall be surrendered by such Lenders.  Such new Revolving Credit Notes shall provide that they are replacements for the surrendered Revolving Credit Notes, and that they do not constitute a novation, shall be dated as of the applicable Commitment Increase Date and shall otherwise be in substantially the form of the replaced Revolving Credit Notes.  In connection with the issuance of any new Revolving Credit Notes pursuant to this §2.11(c), the Borrower shall deliver an opinion of counsel, addressed to the Lenders and the Agent, relating to the due authorization, execution and delivery of such new Revolving Credit Notes and the enforceability thereof, in form and substance substantially similar to the opinion delivered in connection with the first disbursement under this Agreement. The surrendered Revolving Credit Notes shall be canceled and returned to the Borrower.”
(g)    By deleting in its entirety §2.12 of the Credit Agreement, and inserting in lieu thereof the following:  “§2.12 [Intentionally Omitted.]”;
(h)    By deleting the date “November 2, 2013” appearing in §4.2 of the Credit Agreement, and inserting in lieu thereof the date “April 10, 2015”;
(i)    By deleting in its entirety the first (1st) sentence of §5.2(a) of the Credit Agreement, and inserting in lieu thereof the following:
“The Agent may on behalf of the Lenders at any time on or after March 21, 2017, in its reasonable discretion, obtain updates to existing Appraisals of each of the Borrowing Base Assets.”
(j)    By deleting the words “on and after the first anniversary of the date of this Agreement,” appearing in §7.20(a)(vii) of the Credit Agreement;
(k)    By deleting in its entirety §7.20(a)(xi) of the Credit Agreement, and inserting in lieu thereof the following:
“(xi)    with respect to any Borrowing Base Asset that is leased to or operated by a single Non-Investment Grade Operator, such Borrowing Base Asset shall have a ratio of (a) EBITDAR for such tenant or operator to (b) all base rent and additional rent due and payable by a tenant under any Lease, in each case, during the previous twelve (12) calendar months, of not less than (x) 1.40 to 1.00 for any such Borrowing Base Asset that is a Rehab, LTAC or ASC, (y) 1.25 to 1.00 for any such Borrowing Base Asset that is a SNF, and (z) 1.10 to 1.00 for any such Borrowing Base Asset that is an ILF or ALF (provided that, for the purposes of this §7.20(a)(xi), a Non-Investment Grade Operator shall not include a TRS of REIT that leases such Borrowing Base Asset from Borrower or a Subsidiary Guarantor), it being understood that 

5

compliance with the foregoing covenant shall be determined on the basis of financial information provided by such Non-Investment Grade Operator regarding which no Borrower or Guarantor makes any representation or warranty; and provided further that if a single Non‐Investment Grade Operator leases or operates more than one Borrowing Base Asset described in clause (x), (y) or (z) pursuant to a master lease, and all of the properties subject to the master lease are Borrowing Base Assets, then for the purposes of calculating the ratios in clauses (x), (y) and (z) above, all of such Borrowing Base Assets subject to such master lease shall be included in calculating such ratio (for the avoidance of doubt, only Borrowing Base Assets of the type included in clauses (x), (y) or (z), respectively, shall be included when aggregating multiple Borrowing Base Assets subject to a master lease and shall not be aggregated across the types of properties described in clauses (x), (y) and (z)); and provided that Borrower may exclude from compliance with the foregoing covenant Borrowing Base Assets subject to this §7.20(a)(xi) whose Borrowing Base Capitalized Value Limit does not in the aggregate exceed ten percent (10%) of total Borrowing Base Capitalized Value Limit to the extent that the applicable Operators’ Agreement existing at the time of acquisition of such Borrowing Base Asset by Borrower or its Subsidiaries does not require the delivery of financial information sufficient to permit calculation of the foregoing covenant, or with respect to any Operators’ Agreement under which the Operator fails to deliver financial information to permit calculation of the foregoing covenant;”  
(l)    By deleting in its entirety §7.20(a)(xii) of the Credit Agreement, and inserting in lieu thereof the following:
“(xii)     any Eligible Real Estate leased to a single tenant or operator shall at all times have on a collective basis for all such Eligible Real Estate a weighted average remaining lease term (calculated by weighting the remaining lease term of such Eligible Real Estate (without regard to any extension options at the tenant’s discretion) by the Borrowing Base Capitalized Value Limit attributable to such Eligible Real Estate) of not less than five (5) years;”
(m)    By deleting in its entirety the first (1st) sentence of §8.7(a) of the Credit Agreement and inserting in lieu thereof the following new sentence: 
“(a)    The Borrower shall not pay any Distribution to the partners, members or other owners of the Borrower, and REIT shall not pay any Distribution to its partners, members or other owners of REIT, to the extent that the aggregate amount of such Distributions paid in any fiscal quarter, when added to the aggregate amount of all other Distributions paid in the same fiscal quarter and the preceding three (3) fiscal quarters, exceeds ninety-five percent (95%) of such Person’s Modified FFO for such period (the “Distribution Limit”) (provided that (X) during the time period commencing on April 1, 2014 and ending on September 30, 2014 (the “Dividend Limit Waiver Period”), Borrower or REIT may make Distributions in excess of the Distribution Limit 

6

so long as all Distributions made by Borrower or REIT during the Dividend Limit Waiver Period consist solely of cash dividends at such Person’s normal rate consistent with past practice paid on account of Equity Interests of REIT or its Subsidiaries which are then outstanding, (Y) during the time period commencing on October 1, 2014 and ending on September 30, 2016 (the “Increased Distributions Limit Period”), the Distribution Limit shall be increased to one hundred twenty-five percent (125%) of such Person’s Modified FFO and any Distributions paid by Borrower or REIT to their respective partners, members or other owners before the Increased Distributions Limit Period shall not be considered in the calculation of the limitations contained in this §8.7(a)(Y), it being agreed that during the Increased Distributions Limit Period, the aggregate amount of such permitted Distributions shall be determined by using only the quarters elapsed from October 1, 2014 (and annualizing such amount in a manner reasonably acceptable to Agent until there are four (4) fiscal quarters of results elapsed from October 1, 2014), and (Z) for the fiscal quarter ending December 31, 2016 and continuing thereafter, the Distribution Limit shall return to ninety-five percent (95%) of such Person’s Modified FFO and any Distributions paid by Borrower or REIT to their respective partners, members or other owners during the Increased Distributions Limit Period shall not be considered in the calculation of the limitations contained in this §8.7(a) for the period commencing October 1, 2016 and continuing thereafter, it being agreed that until four (4) fiscal quarters following October 1, 2016 have occurred, the aggregate amount of such permitted Distributions shall be determined by using the quarters elapsed from October 1, 2016 and annualizing such amount in a manner reasonably acceptable to Agent); provided that the limitations contained in this §8.7(a) shall not preclude the Borrower or REIT from making Distributions in an amount equal to the minimum distributions required under the Code to maintain the REIT Status of REIT, as evidenced by a certification of the principal financial officer or accounting officer of REIT containing calculations in detail reasonably satisfactory in form and substance to the Agent.”
(n)    By deleting in its entirety §9.5 of the Credit Agreement, and inserting in lieu thereof the following:  “§9.5 [Intentionally Omitted.]”;
(o)    By deleting in its entirety the proviso appearing in §12.1(f) and inserting in lieu thereof the following: “provided, however, that the events described in this § 12.1(f) shall not constitute an Event of Default unless such failure to perform, together with other failures to perform as described in §12.l(g), involves (i) any Recourse Indebtedness singly or in the aggregate totaling in excess of $25,000,000, or (ii) obligations for Non-Recourse Indebtedness singly or in the aggregate totaling in excess of $50,000,000.00;”; 
(p)    By deleting in its entirety §12.1(j) and inserting in lieu thereof the following: “(j) there shall remain in force, undischarged, unsatisfied and unstayed, for more than thirty (30) days, whether or not consecutive, one (I) or more uninsured or unbonded final judgments against 

7

the Borrower, any Guarantor or any of their respective Subsidiaries that, either individually or in the aggregate, exceed $25,000,000.00 per occurrence or during any twelve (12) month period;”;
(q)    By deleting the words “(other than pursuant to an extension of the Maturity Date pursuant to §2.12)” appearing in §18.4(ii) of the Credit Agreement;
(r)    By deleting the words “(except as provided in §2.12)” appearing in §27(f) of the Credit Agreement;
(s)    By deleting in its entirety Schedule 1.1 attached to the Credit Agreement and inserting in lieu thereof Schedule 1.1 attached to this Amendment and made a part hereof.
3.    Amendment of Borrower Assignment of Interests.  Borrower and Agent do hereby modify and amend each Assignment of Interests to which Borrower is a party (including the form of Assignment of Interests attached to the Credit Agreement as Exhibit K thereto) by deleting in its entirety the third (3rd) “WHEREAS” clause, appearing on page 1 thereof, and inserting in lieu thereof the following:
“WHEREAS, Assignor, KeyBank, the other Lenders which are now or hereafter a party thereto and the Agent have entered into that certain Senior Secured Revolving Credit Agreement dated as of March 21, 2014, as amended by that certain First Amendment to Senior Secured Revolving Credit Agreement dated as of September 18, 2014 and that certain Second Amendment to Senior Secured Revolving Credit Agreement and Other Loan Documents dated as of June 26, 2015 (as the same has been and may further be varied, extended, supplemented, consolidated, amended, replaced, increased, renewed or modified or restated from time to time, the “Credit Agreement”), pursuant to which the Lenders have agreed to provide to Assignor a revolving credit loan facility in the amount of up to $500,000,000.00 pursuant to the Credit Agreement, which facility may be increased to up to $750,000,000.00 pursuant to Section 2.11 of the Credit Agreement (the “Loan”), and which Loan is evidenced by, among other things, those certain Revolving Credit Notes made by Assignor to the order of the Lenders in the aggregate principal face amount of $500,000,000.00 and that certain Swing Loan Note made by Assignor to the order of KeyBank in the amount of $25,000,000.00 (together with all amendments, modifications, replacements, consolidations, increases, supplements and extensions thereof, collectively, the “Note”); and”.
4.    Amendment of TRS Assignment of Interests.  ARHC TRS Holdco II, LLC and Agent do hereby modify and amend each Assignment of Interests to which ARHC TRS Holdco II, LLC is a party by deleting in its entirety the third (3rd) “WHEREAS” clause, appearing on page 1 thereof, and inserting in lieu thereof the following:

8

“WHEREAS, American Realty Capital Healthcare Trust II Operating Partnership, L.P., a Delaware limited partnership (“Borrower”), KeyBank, the other Lenders which are now or hereafter a party thereto and the Agent have entered into that certain Senior Secured Revolving Credit Agreement dated as of March 21, 2014, as amended by that certain First Amendment to Senior Secured Revolving Credit Agreement dated as of September 18, 2014 and that certain Second Amendment to Senior Secured Revolving Credit Agreement and Other Loan Documents dated as of June 26, 2015 (as the same has been and may further be varied, extended, supplemented, consolidated, amended, replaced, increased, renewed or modified or restated from time to time, the “Credit Agreement”), pursuant to which the Lenders have agreed to provide to Borrower a revolving credit loan facility in the amount of up to $500,000,000.00 pursuant to the Credit Agreement, which facility may be increased to up to $750,000,000.00 pursuant to Section 2.11 of the Credit Agreement (the “Loan”), and which Loan is evidenced by, among other things, those certain Revolving Credit Notes made by Borrower to the order of the Lenders in the aggregate principal face amount of $500,000,000.00 and that certain Swing Loan Note made by Borrower to the order of KeyBank in the principal face amount of $25,000,000.00 (together with all amendments, modifications, replacements, consolidations, increases, supplements and extensions thereof, collectively, the “Note”).”
5.    Amendment of Indemnity Agreement.  Borrower, Guarantors and the Agent do hereby modify and amend the Indemnity Agreement (including the form of Indemnity Agreement attached to the Credit Agreement as Exhibit L thereto) by deleting in its entirety the third (3rd) “WHEREAS” clause, appearing on page 1 thereof, and inserting in lieu thereof the following:
“WHEREAS, the Lenders have agreed to provide to Borrower a revolving credit loan facility in the amount of up to $500,000,000.00 pursuant to the Credit Agreement, which facility may be increased to up to $750,000,000.00 pursuant to Section 2.11 of the Credit Agreement (the “Loan”), and which Loan is evidenced by, among other things, those certain Revolving Credit Notes made by Borrower to the order of the Lenders in the aggregate principal face amount of $500,000,000.00 and that certain Swing Loan Note made by Borrower to the order of KeyBank in the amount of the Swing Loan Commitment (together with all amendments, modifications, replacements, consolidations, increases, supplements and extensions thereof, collectively, the “Note”) and secured by, among other things, pledges of the Equity Interests of the Additional Guarantors held by Borrower (collectively, the “Pledges”);”.
6.    Amendment of Guaranty.  Agent and Guarantors do hereby modify and amend the Guaranty as follows:  
(a)    By deleting in its entirety Paragraph (a) of the Guaranty, appearing on page 1 thereof, and inserting in lieu thereof the following:

9

“(a)    the full and prompt payment when due, whether by acceleration or otherwise, either before or after maturity thereof, of the Revolving Credit Notes made by Borrower to the order of the Lenders (as defined in the Credit Agreement) in the aggregate principal face amount of up to $500,000,000.00, subject to increases resulting from increases in the Total Commitment to not more than $750,000,000.00 as provided in Section 2.11 of the Credit Agreement, and of the Swing Loan Note made by Borrower in the principal face amount of the Swing Loan Commitment, together with interest as provided in the Revolving Credit Notes and the Swing Loan Note and together with any replacements, supplements, renewals, modifications, consolidations, restatements, increases and extensions thereof; and”; and
(b)    By deleting the number “$450,000,000.00” appearing in the fifth (5th) line of paragraph (g) of the Guaranty, appearing on page 2 thereof, and inserting in lieu thereof the number “$750,000,000.00.”
7.    Commitments; Exiting Lender.  
(a)    Borrower and Guarantors hereby acknowledge and agree that as of the Effective Date (as hereinafter defined) and following satisfaction of all conditions thereto as provided herein, the amount of each Lender’s Commitment shall be the amount set forth on Schedule 1.1 attached hereto.  In connection with the Commitment Increase, each of BMO Harris Bank N.A. and Citizens Bank, National Association (each individually a “New Lender” and collectively, the “New Lenders”) shall be issued a Revolving Credit Note in the principal face amount of its Commitment, which will be a “Revolving Credit Note” under the Credit Agreement, and each New Lender shall be a Lender under the Credit Agreement.  In addition, each of the Lenders that is a party to the Credit Agreement that is increasing its Commitment shall be issued a replacement Revolving Credit Note in the amount of its Commitment, and each such increasing Lender will promptly return to Borrower its existing Revolving Credit Note marked “Replaced.”
(b)    Borrower and Guarantors hereby acknowledge and agree that as of the effective date of this Amendment and following satisfaction of all conditions thereto as provided herein, the Swing Loan Commitment shall be increased to $25,000,000.00.  In connection with the increase of the Swing Loan Commitment, KeyBank shall be issued a replacement Swing Loan Note in the principal face amount of $25,000,000.00 (the “Replacement Swing Loan Note”), and upon acceptance of the Replacement Swing Loan Note by KeyBank it will be the “Swing Loan Note” under the Credit Agreement.  KeyBank will promptly return to Borrower the existing Swing Loan Note marked “Replaced.”

10

(c)    By its signature below, each New Lender, subject to the terms and conditions hereof, hereby agrees to perform all obligations with respect to its respective Commitment as if such New Lender were an original Lender under and signatory to the Credit Agreement having a Commitment, as set forth above, equal to its respective Commitment, which obligations shall include, but shall not be limited to, the obligation to make Revolving Credit Loans to the Borrower with respect to its Commitment as required under §2.1 of the Credit Agreement, the obligation to pay amounts due in respect of Swing Loans as set forth in §2.5 of the Credit Agreement, the obligation to pay amounts due in respect of draws under Letters of Credit as required under §2.10 of the Credit Agreement, and in any case the obligation to indemnify the Agent as provided therein.  Each New Lender makes and confirms to the Agent and the other Lenders all of the representations, warranties and covenants of a Lender under Sections 14 and 18 of the Credit Agreement.  Further, each New Lender acknowledges that it has, independently and without reliance upon the Agent, any Titled Agent, any other Lender or on any affiliate or subsidiary of any thereof and based on the financial statements supplied by the Borrower and such other documents and information as it has deemed appropriate, made its own credit analysis and decision to become a Lender under the Credit Agreement.  Except as expressly provided in the Credit Agreement, the Agent shall have no duty or responsibility whatsoever, either initially or on a continuing basis, to provide any New Lender with any credit or other information with respect to the Borrower or Guarantors or to notify any New Lender of any Default or Event of Default.  No New Lender has relied on the Agent, any Titled Agent, any other Lender or any affiliate or subsidiary of any thereof as to any legal or factual matter in connection therewith or in connection with the transactions contemplated thereunder.  Each New Lender (i) represents and warrants as to itself that it is legally authorized to, and has full power and authority to, enter into this agreement and perform its obligations under this Amendment, the Credit Agreement and the other Loan Documents; (2) confirms that it has received copies of such documents and information as it has deemed appropriate to make its own credit analysis and decision to enter into this Amendment and become a party to the Credit Agreement; (3) agrees that it has and will, independently and without reliance upon any Lender, the Agent, any Titled Agent or any affiliate or subsidiary of any thereof and based upon such documents and information as it shall deem appropriate at the time, continue to make its own credit decisions in evaluating the Revolving Credit Loans, the Loan Documents, the creditworthiness of the Borrower and the Guarantors and the value of the Collateral and other assets of the Borrower and the Guarantors, and taking or not taking action under the Loan Documents; (4) appoints and authorizes the Agent to take such action as agent on its behalf and to exercise such powers as are reasonably incidental thereto pursuant to the terms of the Loan Documents; (5) agrees that, by this Amendment, it has become a party to and will perform in accordance with their terms all the obligations which by the terms of the Loan Documents are required to be performed by it as a Lender; and (6) represents and warrants that such New Lender is not a Person controlling, controlled by or under common control with, or which is not otherwise free from influence or control by, any of the Borrower or any Guarantor and is not a Defaulting Lender or an Affiliate of a Defaulting Lender.  Each New Lender acknowledges and confirms that its address for notices and Lending Office for Revolving Credit Loans are as set forth on the signature pages hereto.
(d)    On the Effective Date, JPMorgan Chase Bank, N.A. (the “Exiting Lender”) shall cease to be a Lender under, or a party to, the Loan Documents.  Contemporaneously with the effectiveness of this Amendment, the Borrower shall pay to the Exiting Lender all amounts due to the Exiting Lender under the Loan Documents, and the Agent and the Lenders hereby consent to such payments. Upon such payment, except for those terms, conditions, and provisi

11

ons, which by their express terms survive cancellation of Commitments hereunder or termination of any Lender’s obligations under the Loan Documents (including, without limitation, any applicable indemnification or reimbursement provisions), Exiting Lender’s Commitment under the Credit Agreement shall be reduced to $0 and terminated and Exiting Lender shall have no further rights, duties or obligations with respect to or under the Loan Documents.
(e)    On the Effective Date, the outstanding principal balance of the Revolving Credit Loans shall be reallocated among the Lenders such that the outstanding principal amount of Revolving Credit Loans owed to each Lender shall be equal to such Lender’s Commitment Percentage of the outstanding principal amount of all Revolving Credit Loans.  The participation interests of the Lenders in Swing Loans and Letters of Credit shall be similarly adjusted.  Each of those Lenders whose Commitment Percentage is increasing shall advance the funds to the Agent and the funds so advanced shall be distributed either (i) among the Lenders whose Commitment Percentage is decreasing as necessary to accomplish the required reallocation of the outstanding Revolving Credit Loans, or (ii) to the Exiting Lender for payment of any outstanding Revolving Credit Loans made by Exiting Lender, as necessary to accomplish the required reallocation of the outstanding principal balance of the Revolving Credit Loans.
8.    References to Loan Documents.  All references in the Loan Documents to the Credit Agreement, the Assignment of Interests, the Indemnity Agreement and the Guaranty shall be deemed a reference to the Credit Agreement, the Assignment of Interests, the Indemnity Agreement and the Guaranty as modified and amended herein.  
9.    Consent and Acknowledgment of Borrower and Guarantors.  By execution of this Amendment, the Guarantors hereby expressly consent to the modifications and amendments relating to the Credit Agreement, the Assignment of Interests, the Indemnity Agreement and the Guaranty as set forth herein and any other agreements or instruments executed in connection herewith, and Borrower and Guarantors hereby acknowledge, represent and agree that (a) the Credit Agreement, the Assignment of Interests, the Indemnity Agreement and the Guaranty, as modified and amended herein, and the other Loan Documents remain in full force and effect and constitute the valid and legally binding obligation of Borrower and Guarantors, as applicable, enforceable against such Persons in accordance with their respective terms, (b) that the Guaranty extends to and applies to the Credit Agreement and the other Loan Documents as modified and amended herein, and (c) that the execution and delivery of this Amendment and any other agreements or instruments executed in connection herewith does not constitute, and shall not be deemed to constitute, a release, waiver or satisfaction of Borrower’s or any Guarantor’s obligations under the Loan Documents.
10.    Representations and Warranties.  Borrower and Guarantors represent and warrant to Agent and the Lenders as follows:
(a)    Authorization.  The execution, delivery and performance of this Amendment and any other agreements or instruments executed in connection herewith and the transactions contemplated hereby and thereby (i) are within the authority of Borrower and Guarantors, (ii) have been duly authorized by all necessary proceedings on the part of the Borrower and Guarantors, (iii) do not and will not conflict with or result in any breach or contravention of any provision of law, statute, rule or regulation to which Borrower or any Guarantor is subject or any judgment, order, writ, injunction, license or permit applicable to Borrower or any Guarantor, (iv) do not and will not 

12

conflict with or constitute a default (whether with the passage of time or the giving of notice, or both) under any provision of the partnership agreement, articles of incorporation or other charter documents or bylaws of, or any agreement or other instrument binding upon, Borrower or any Guarantor or any of their respective properties, (v) do not and will not result in or require the imposition of any lien or other encumbrance on any of the properties, assets or rights of Borrower or any Guarantor and (vi) do not require the approval or consent of any Person other than those already obtained and delivered to the Agent.
(b)    Enforceability.  This Amendment and any other agreements or instruments executed in connection herewith to which Borrower or any Guarantor is a party are the valid and legally binding obligations of Borrower and Guarantors enforceable in accordance with the respective terms and provisions hereof, except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors’ rights and the effect of general principles of equity.
(c)    Governmental Approvals.  The execution, delivery and performance of this Amendment and any other agreements or instruments executed in connection herewith and the transactions contemplated hereby and thereby do not require the approval or consent of, or any filing or registration with, or the giving of any notice to, any court, department, board, governmental agency or authority other than those already obtained, and filings after the date hereof of disclosures with the SEC, or as may be required hereafter with respect to tenant improvements, repairs or other work with respect to any Real Estate.
(d)    Reaffirmation of Representations and Warranties.  Each of the representations and warranties made by or on behalf of the Borrower, the Guarantors or any of their respective Subsidiaries contained in the Credit Agreement, the other Loan Documents or in any document or instrument delivered pursuant to or in connection with the Credit Agreement or this Amendment is true and correct in all material respects as of the date hereof, with the same effect as if made at and as of the date hereof, except to the extent of changes resulting from transactions permitted by the Loan Documents (it being understood and agreed that, with respect to any representation or warranty which by its terms is made as of a specified date, such representation or warranty is reaffirmed hereby only as of such specified date).  To the extent that any of the representations and warranties contained in the Credit Agreement, any other Loan Document or in any document or instrument delivered pursuant to or in connection with the Credit Agreement or this Amendment is qualified by “Material Adverse Effect” or any other materiality qualifier, then the qualifier “in all material respects” contained in this Paragraph 10(d) shall not apply with respect to any such representations and warranties.
11.    No Default.  By execution hereof, the Borrower and the Guarantors certify that, immediately after giving effect to this Amendment, there exists no Default or Event of Default as of the date of this Amendment.
12.    Waiver of Claims.  Borrower and Guarantors acknowledge, represent and agree that none of such Persons has any defenses, setoffs, claims, counterclaims or causes of action of any kind or nature whatsoever arising on or before the date hereof with respect to the Loan Documents, the administration or funding of the Loan or the Letters of Credit or with respect to any acts or omissions of Agent or any Lender, or any past or present officers, agents or employees of Agent or 

13

any Lender pursuant to or relating to the Loan Documents, and each of such Persons does hereby expressly waive, release and relinquish any and all such defenses, setoffs, claims, counterclaims and causes of action arising on or before the date hereof, if any.
13.    Ratification.  Except as hereinabove set forth, all terms, covenants and provisions of the Credit Agreement, the Assignment of Interests, the Indemnity Agreement and the Guaranty remain unaltered and in full force and effect, and the parties hereto do hereby expressly ratify and confirm the Credit Agreement, the Assignment of Interests, the Indemnity Agreement and the Guaranty as modified and amended herein.  Nothing in this Amendment or any other document delivered in connection herewith shall be deemed or construed to constitute, and there has not otherwise occurred, a novation, cancellation, satisfaction, release, extinguishment or substitution of the indebtedness evidenced by the Notes or the other obligations of Borrower and Guarantors under the Loan Documents.
14.    Effective Date.  This Amendment shall be deemed effective and in full force and effect (the “Effective Date”) upon confirmation by the Agent of the satisfaction of the following conditions:
(a)the execution and delivery of this Amendment by Borrower, Guarantors, Agent, the Lenders and Exiting Lender;
(b)the delivery to Agent of an opinion of counsel to the Borrower and the Guarantors addressed to the Agent and the Lenders covering such matters as the Agent may reasonably request;
(c)the delivery to Agent of a Revolving Credit Note duly executed by the Borrower in favor of each New Lender and each Lender whose Commitment is increasing in the amount set forth next to such Lender’s name on Schedule 1.1 attached hereto;
(d)the delivery to Agent of a Swing Loan Note duly executed by Borrower in favor of Swing Loan Lender in the amount of the new Swing Loan Commitment;
(e)receipt by Agent of evidence that the Borrower shall have paid all fees due and payable with respect to this Amendment and the Commitment Increase;
(f)receipt by Agent of such other resolutions, certificates, documents, instruments and agreements as the Agent may reasonably request;
(g)delivery to Agent of (i) a Borrowing Base Certificate and (ii) a Compliance Certificate evidencing compliance with the covenants described in §9 of the Credit Agreement and the other covenants described in such Compliance Certificate, each adjusted to give pro forma effect to the advance of the Loans to be made on or about the date thereof; and
(h)The Borrower shall have paid the reasonable fees and expenses of Agent in connection with this Amendment.  
15.    Amendment as Loan Document.  This Amendment shall constitute a Loan Document.

14

16.    Counterparts.  This Amendment may be executed in any number of counterparts which shall together constitute but one and the same agreement.
17.    Titled Agents.  From and after the effectiveness of this Amendment, KeyBanc Capital Markets, Inc., BMO Capital Markets, Inc. and Citizens Bank, National Association shall be the Joint-Lead Arrangers, BMO Capital Markets, Inc. and Citizens Bank, National Association shall be the Co-Syndication Agents, and Capital One, National Association shall be the Documentation Agent.
18.    MISCELLANEOUS.  THIS AMENDMENT SHALL, PURSUANT TO NEW YORK GENERAL OBLIGATIONS LAW SECTION 5-1401, BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK.  This Amendment shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted successors, successors-in-title and assigns as provided in the Credit Agreement.  
[Signatures Begin On Next Page]

15

IN WITNESS WHEREOF, the parties hereto have hereto set their hands and affixed their seals as of the day and year first above written.
BORROWER:
AMERICAN REALTY CAPITAL HEALTHCARE TRUST II OPERATING PARTNERSHIP, L.P., a Delaware limited partnership
		
	By:
	AMERICAN REALTY CAPITAL 
HEALTHCARE TRUST II, INC., a Maryland 
corporation, its general partner

By:             /s/ Thomas D’Arcy    
 
Name:         Thomas D’Arcy    
 
Title:            Chief Executive Officer    
REIT:
AMERICAN REALTY CAPITAL HEALTHCARE TRUST II, INC., a Maryland corporation
By:             /s/ Thomas D’Arcy    
 
Name:         Thomas D’Arcy    
 
Title:            Chief Executive Officer    
[Signatures Continue on Following Page]

KeyBank/American Realty Capital Healthcare Trust II Operating Partnership, L.P. – 
Signature Page to Second Amendment to Senior Secured Revolving Credit Agreement

SUBSIDIARY GUARANTORS:
ARHC BMBWNIL01, LLC; 
ARHC LPELKCA01, LLC; 
ARHC SCCRLIA01, LLC; 
ARHC SFFLDIA01, LLC; 
ARHC SBBURIA01, LLC; 
ARHC FOMBGPA01, LLC; 
ARHC ARCLRMI01, LLC; 
ARHC LSSMTMO01, LLC; 
ARHC ALTSPFL01, LLC; 
ARHC FMWEDAL01, LLC; 
ARHC AHJACOH01, LLC; 
ARHC OLOLNIL01, LLC; 
ARHC LMHBGPA01, LLC; 
ARHC PHCTNIA01, LLC; 
ARHC BRHBGPA01, LLC; 
ARHC HBTPAFL01, LLC; 
ARHC ALJUPFL01, LLC; 
ARHC ALSTUFL01, LLC; 
ARHC SCTEMTX01, LLC; 
ARHC GHGVLSC01, LLC; 
ARHC TRS HOLDCO II, LLC; 
ARHC SCCRLIA01 TRS, LLC; 
ARHC SFFLDIA01 TRS, LLC; 
ARHC SBBURIA01 TRS, LLC; 
ARHC ARCLRMI01 TRS, LLC; 
ARHC LSSMTMO01 TRS, LLC; 
ARHC ALTSPFL01 TRS, LLC; 
ARHC PHCTNIA01 TRS, LLC; 
ARHC HBTPAFL01 TRS, LLC; 
ARHC ALJUPFL01 TRS, LLC; and 
ARHC ALSTUFL01 TRS, LLC, each a Delaware limited liability company
By:             /s/ Jesse C. Galloway    
 
Name:         Jesse C. Galloway    
 
Title:            Authorized Signatory    

[Signatures Continue on Following Page]

LENDERS:

KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as the Agent
By:             /s/ Wayne D. Horvath    
 
Name:         Wayne D. Horvath    
 
Title:            SVP    

REGIONS BANK
By:             /s/ David Blevins    
 
Name:         David Blevins    
 
Title:            Vice President    

CAPITAL ONE, NATIONAL ASSOCIATION
By:             /s/ John Robuck    
 
Name:         John Robuck    
 
Title:            Managing Director    

[Signatures Continue on Following Page]

BMO HARRIS BANK N.A.

By:             /s/ Lloyd Baron    
 
Name:         Lloyd Baron    
 
Title:            Director    

Address:
BMO Harris Bank N.A.
100 High Street, 26th Floor
Boston, Massachusetts  02110
Attn:  Lloyd Baron

CITIZENS BANK, NATIONAL ASSOCIATION

By:             /s/ Samuel A. Bluso    
 
Name:         Samuel A. Bluso    
 
Title:            Senior Vice President    

Address:
Citizens Bank, National Association 
1215 Superior Avenue 
Cleveland, Ohio  44114 
Attn:  Don Woods

JPMorgan Chase Bank, N.A. joins in the execution of this Amendment solely for the purposes of acknowledging that as of the Effective Date it will cease to be a party to the Loan Documents as provided in Paragraph 7(d) of the Amendment.
JPMORGAN CHASE BANK, N.A.
By:             /s/ Rita Lai    
 
Name:         Rita Lai    
 
Title:            Authorized Signer     

SCHEDULE 1.1
LENDERS AND COMMITMENTS
	
			
	Name and Address
	Commitment
	Commitment Percentage

	KeyBank National Association 
127 Public Square
Cleveland, Ohio  44114-1306
Attention:  Wayne Horvath 
Telephone:  216-689-3808 
Facsimile:  216-689-5970
	$125,000,000.00
	25.00%

	LIBOR Lending Office 
Same as Above
	 
	 

	BMO Harris Bank N.A.
100 High Street, 26th Floor
Boston, Massachusetts   02110
Attention:  Lloyd Baron
Telephone:  617-960-2372
Facsimile:     
	$125,000,000.00
	25.00%

	LIBOR Lending Office 
Same as Above
	 
	 

	Citizens Bank, National Association
1215 Superior Avenue
Cleveland, Ohio  44114
Attention:  Don Woods
Telephone:  216-277-0199
Facsimile:     
	$125,000,000.00
	25.00%

	LIBOR Lending Office 
Same as Above
	 
	 

	Capital One, National Association
4445 Willard Avenue, 6th Floor
Chevy Chase, Maryland  20815
Attention:  Danny Moore and 
Michael Mastronikolas 
Telephone:  301-280-2596;
                    301-280-0244 
Facsimile:   301-280-0299
	$75,000,000.00
	15.00%

	LIBOR Lending Office 
Same as Above
	 
	 

	Regions Bank
1900 5th Avenue North
Birmingham, Alabama  35203
Attention:  David Blevins
Telephone:  205-264-7504
Facsimile:  205-801-0343
	$50,000,000.00
	10.00%

	LIBOR Lending Office 
Same as Above
	 
	 

	TOTAL
	$500,000,000.00
	100%

SCHEDULE 1.1 – Page 1 of 1

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