Document:

EXHIBIT 10.3

                                                     February 16, 2005

KBL Healthcare Acquisition Corp. II
645 Madison Avenue, 14th Floor
New York, New York 10022

EarlyBirdCapital, Inc.
275 Madison Avenue
Suite 1203
New York, New York 10016

                  Re:      Initial Public Offering

Gentlemen:

     The undersigned stockholder, officer and director of KBL Healthcare
Acquisition Corp. II (``Company''), in consideration of EarlyBirdCapital, Inc.
(``EBC'') entering into a letter of intent (``Letter of Intent'') to underwrite
an initial public offering of the securities of the Company (''IPO'') and
embarking on the IPO process, hereby agrees as follows (certain capitalized
terms used herein are defined in paragraph 11 hereof):

     1. If the Company solicits approval of its stockholders of a Business
Combination, the undersigned will vote all Insider Shares owned by him in
accordance with the majority of the votes cast by the holders of the IPO Shares.

     2. In the event that the Company fails to consummate a Business Combination
within 18 months from the effective date (``Effective Date'') of the
registration statement relating to the IPO (or 24 months under the circumstances
described in the prospectus relating to the IPO), the undersigned will take all
reasonable actions within his power to cause the Company to liquidate as soon as
reasonably practicable. The undersigned hereby waives any and all right, title,
interest or claim of any kind in or to any distribution of the Trust Fund (as
defined in the Letter of Intent) as a result of such liquidation with respect to
his Insider Shares (``Claim'') and hereby waives any Claim the undersigned may
have in the future as a result of, or arising out of, any contracts or
agreements with the Company and will not seek recourse against the Trust

KBL Healthcare Acquisition Corp. II
EarlyBirdCapital, Inc.
February 16, 2005
Page 2

Fund for any reason whatsoever.

     3. In order to minimize potential conflicts of interest which may arise
from multiple affiliations, the undersigned agrees to present to the Company for
its consideration, prior to presentation to any other person or entity, any
suitable opportunity to acquire an operating business, until the earlier of the
consummation by the Company of a Business Combination, the liquidation of the
Company or until such time as the undersigned ceases to be an officer or
director of the Company, subject to any pre-existing fiduciary obligations the
undersigned might have.

     4. The undersigned acknowledges and agrees that the Company will not
consummate any Business Combination which involves a company which is affiliated
with any of the Insiders unless the Company obtains an opinion from an
independent investment banking firm reasonably acceptable to EBC that the
business combination is fair to the Company's stockholders from a financial
perspective.

     5. Neither the undersigned, any member of the family of the undersigned,
nor any Affiliate of the undersigned will be entitled to receive and will not
accept any compensation for services rendered to the Company prior to the
consummation of the Business Combination; provided that commencing on the
Effective Date, KBL Healthcare Ventures (``Related Party''), shall be allowed to
charge the Company an allocable share of Related Party's overhead, up to $7,500
per month, to compensate it for the Company's use of Related Party's offices,
utilities and personnel. Related Party and the undersigned shall also be
entitled to reimbursement from the Company for their out-of-pocket expenses
incurred in connection with seeking and consummating a Business Combination.

     6. Neither the undersigned, any member of the family of the undersigned, or
any Affiliate of the undersigned will be entitled to receive or accept a
finder's fee or any other compensation in the event the undersigned, any member
of the family of the undersigned or any Affiliate of the undersigned originates
a Business Combination.

     7. The undersigned will escrow his Insider Shares for the three year period
commencing on the Effective Date subject to the terms of a Stock Escrow
Agreement which the Company will enter into with the undersigned and an escrow
agent acceptable to the Company.

     8. The undersigned agrees to be the Chief Financial Officer and a member of
the Board of Directors of the Company until the earlier of the consummation

KBL Healthcare Acquisition Corp. II
EarlyBirdCapital, Inc.
February 16, 2005
Page 3

by the Company of a Business Combination or the liquidation of the Company. The
undersigned's biographical information furnished to the Company and EBC and
attached hereto as Exhibit A is true and accurate in all respects, does not omit
any material information with respect to the undersigned's background and
contains all of the information required to be disclosed pursuant to Section 401
of Regulation S-K, promulgated under the Securities Act of 1933. The
undersigned's Questionnaire furnished to the Company and EBC and annexed as
Exhibit B hereto is true and accurate in all respects. The undersigned
represents and warrants that:

  (a) he is not subject to or a respondent in any legal action for, any
injunction, cease-and-desist order or order or stipulation to desist or refrain
from any act or practice relating to the offering of securities in any
jurisdiction;

  (b) he has never been convicted of or pleaded guilty to any crime (i)
involving any fraud or (ii) relating to any financial transaction or handling of
funds of another person, or (iii) pertaining to any dealings in any securities
and he is not currently a defendant in any such criminal proceeding; and

  (c) he has never been suspended or expelled from membership in any securities
or commodities exchange or association or had a securities or commodities
license or registration denied, suspended or revoked.

     9. The undersigned has full right and power, without violating any
agreement by which he is bound, to enter into this letter agreement and to serve
as Chief Financial Officer and a member of the Board of Directors of the
Company.

     10. The undersigned authorizes any employer, financial institution, or
consumer credit reporting agency to release to EBC and its legal representatives
or agents (including any investigative search firm retained by EBC) any
information they may have about the undersigned's background and finances
(``Information''). Neither EBC nor its agents shall be violating the
undersigned's right of privacy in any manner in requesting and obtaining the
Information and the undersigned hereby releases them from liability for any
damage whatsoever in that connection.

     11. As used herein, (i) a ``Business Combination'' shall mean an
acquisition by merger, capital stock exchange, asset or stock acquisition,
reorganization or otherwise, of an operating business in the healthcare, or
healthcare related, industry; (ii) ``Insiders'' shall mean all officers,
directors and stockholders of the Company immediately prior to the IPO; (iii)
``Insider Shares'' shall mean all of the shares of Common Stock of the Company
owned by an Insider prior to the IPO; and (iv) ``IPO

KBL Healthcare Acquisition Corp. II
EarlyBirdCapital, Inc.
February 16, 2005
Page 4

Shares'' shall mean the shares of Common Stock issued in the Company's IPO.

                                                     Michael Kaswan
                                                     --------------
                                                     Print Name of Insider

                                                     /s/ Michael Kaswan
                                                     ------------------

EXHIBIT A

     Michael Kaswan has served as our chief operating officer and a member of
our board of directors since our inception. From July 1997 to November 1998, Mr.
Kaswan served as a senior associate of KBL Healthcare, Inc. Mr. Kaswan has been
an employee of KBL Healthcare Management Inc. since November 1998, and is
currently a managing director. He has also been affiliated with all of the KBL
Funds since November 1998. In June 1999, Mr. Kaswan co-founded Lumenos. Mr.
Kaswan has been a member of the board of directors of Reman Medical
Technologies, Inc., a private company that is developing implantable biomedical
sensors and communications systems, since September 2004 and of Scandius
Biomedical, Inc., a privately held medical device company that designs,
manufactures, and markets products with orthopedic sports medicine applications
since, December 2003. Mr. Kaswan received a B.S. from the University of Virginia
and an M.B.A. from Harvard Business School.EXHIBIT 10.4

                                                     February 16, 2005

KBL Healthcare Acquisition Corp. II
645 Madison Avenue, 14th Floor
New York, New York 10022

EarlyBirdCapital, Inc.
275 Madison Avenue
Suite 1203
New York, New York 10016

                  Re: Initial Public Offering

Gentlemen:

         The undersigned trustee, on behalf of The Juliana Pearl Berk-Krauss
Trust u/a dated July 27, 1998 ("Trust"), a stockholder of KBL Healthcare
Acquisition Corp. II ("Company"), in consideration of EarlyBirdCapital, Inc.
("EBC") entering into a letter of intent ("Letter of Intent") to underwrite an
initial public offering of the securities of the Company ("IPO") and embarking
on the IPO process, hereby agrees as follows (certain capitalized terms used
herein are defined in paragraph 9 hereof):

         1. If the Company solicits approval of its stockholders of a Business
Combination, the undersigned will vote all Insider Shares owned by the Trust in
accordance with the majority of the votes cast by the holders of the IPO Shares.

         2. In the event that the Company fails to consummate a Business
Combination within 18 months from the effective date ("Effective Date") of the
registration statement relating to the IPO (or 24 months under the circumstances
described in the prospectus relating to the IPO), the undersigned will vote all
Insider Shares owned by the Trust in favor of the Company's decision to
liquidate. The undersigned hereby waives any and all right, title, interest or
claim of any kind in or to any distribution of the Trust Fund (as defined in the
Letter of Intent) as a result of such liquidation with respect to his Insider
Shares ("Claim") and hereby waives any Claim the undersigned may have in the
future as a result of, or arising out of, any contracts or agreements with the
Company and will not seek recourse against the Trust Fund for any reason
whatsoever.

         3. The Trust will not consummate any Business Combination which
involves a company which is affiliated with any of the Insiders unless the
Company obtains an opinion from an independent investment banking firm
reasonably acceptable to EBC that the business combination is fair to the
Company's stockholders from a financial perspective.

         4. Neither the Trust, any member of the family of the undersigned, nor
any Affiliate of the undersigned will be entitled to receive and will not accept
any compensation for services rendered to the Company prior to the consummation
of the Business Combination; provided the undersigned shall be entitled to
reimbursement from the Company for their out-of-pocket expenses incurred in
connection with seeking and consummating a Business Combination.

         5. Neither the Trust, any member of the family of the undersigned, or
any Affiliate of the undersigned will be entitled to receive or accept a
finder's fee or any other compensation in the event the undersigned, any member
of the family of the undersigned or any Affiliate of the undersigned originates
a Business Combination.

         6. The Trust will escrow its Insider Shares for the three year period
commencing on the Effective Date subject to the terms of a Stock Escrow
Agreement which the Company will enter into with the undersigned and an escrow
agent acceptable to the Company.

         7. The Trust's Questionnaire furnished to the Company and EBC and
annexed as Exhibit B hereto is true and accurate in all respects. The
undersigned represents and warrants that the trustees of the Trust:

     (a) are not subject to or a respondent in any legal action for, any
injunction, cease-and-desist order or order or stipulation to desist or refrain
from any act or practice relating to the offering of securities in any
jurisdiction;

     (b) have never been convicted of or pleaded guilty to any crime (i)
involving any fraud or (ii) relating to any financial transaction or handling of
funds of another person, or (iii) pertaining to any dealings in any securities
and have not currently a defendant in any such criminal proceeding; and

     (c) have never been suspended or expelled from membership in any securities
or commodities exchange or association or had a securities or commodities
license or registration denied, suspended or revoked.

         8. The Trust has full right and power, without violating any agreement
by which he is bound, to enter into this letter agreement.

         9. As used herein, (i) a "Business Combination" shall mean an
acquisition by merger, capital stock exchange, asset or stock acquisition,
reorganization

or otherwise, of an operating business in the healthcare, or healthcare related,
industry; (ii) "Insiders" shall mean all officers, directors and stockholders of
the Company immediately prior to the IPO; (iii) "Insider Shares" shall mean all
of the shares of Common Stock of the Company owned by an Insider prior to the
IPO; and (iv) "IPO Shares" shall mean the shares of Common Stock issued in the
Company's IPO.

                                         The Juliana Pearl Berk-Krauss Trust
                                         u/a dated July 27, 1998
                                         Print Name of Insider

                                         /s/
                                         ---------------------------
                                         Signature

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