Document:

<PAGE>

                                                                Exhibit 10.141

                                 FIFTH AMENDMENT
                                       TO
                                  REVENUE BOND
                                 LEASE AGREEMENT
                                       and
                         MORTGAGE AND INDENTURE OF TRUST

         THIS FIFTH AMENDMENT is entered into by and between THE MEDICAL CLINIC
BOARD OF THE CITY OF HARTFORD, ALABAMA (the "Board"), DIVERSICARE LEASING CORP.,
(the "Tenant"), COLONIAL BANK, N.A. (FORMERLY COLONIAL BANK) ("Colonial"), CITY
BANK OF HARTFORD ("City Bank") and SLOCOMB NATIONAL BANK ("Slocomb"), and is
effective as of November 2, 2003.

         WHEREAS, on June 28, 1996 the Board executed and delivered to Colonial
a $2,450,000.00 Mortgage and Indenture of Trust (the "First Mortgage") on the
Project (as that term is defined in the First Mortgage). This First Mortgage
pertains to the property described on Exhibit "A" attached hereto and is
recorded in Official Record Book 273 at Pages 105 to 139 in the Office of the
Judge of Probate of Geneva County, Alabama. This First Mortgage secures the
obligations due under Revenue Bond - Series 1996 No. R1 (Diversicare Leasing
Corp. Project) issued by the Board in the original principal amount of
$2,450,000.00 (the "Colonial Bond").

         WHEREAS, on June 28, 1996 the Board executed and delivered to Slocomb a
$83,500.00 Mortgage and Indenture of Trust (the "Second Mortgage") on the
Project (as that term is defined in the Second Mortgage). This Second Mortgage
pertains to the property described on Exhibit "A" attached hereto and is
recorded in Official Record Book 273 at Pages 140 to 174 in the Office of the
Judge of Probate of Geneva County, Alabama. This Second Mortgage secures the
obligations due under a Revenue Bond - Series 1996 No. R2 (Diversicare Leasing
Corp. Project) issued by the Board in the original principal amount of
$83,500.00 (the "Slocomb Bond").

         WHEREAS, on June 28, 1996 the Board executed and delivered to City Bank
a $83,500.00 Mortgage and Indenture of Trust (the "Third Mortgage") on the
Project (as that term is defined in the Third Mortgage). This Third Mortgage
pertains to the property described on Exhibit "A" attached hereto and is
recorded in Official Book 273 at Pages 175 to 209 in the Office of the Judge of
Probate of Geneva County, Alabama. This Third Mortgage secures the obligations
due under a Revenue Bond - Series 1996 No. R3 (Diversicare Leasing Corp.
Project) issued by the Board in the original principal amount of $83,500.00 (the
"City Bank Bond").

         WHEREAS, the Second Mortgage and the Third Mortgage and the
corresponding Slocomb Bond and the City Bank Bond are in parity each with the
other.

                                       1
<PAGE>

         WHEREAS, on June 28, 1996, the Board and Tenant entered into a Lease
Agreement (the "Lease") pertaining to the property described on Exhibit "A"
attached hereto ("the Leased Realty") and the Project (as that term is defined
in the Lease). The Lease is recorded in Official Book 273 at Pages 210 to 246 in
the Office of the Judge of Probate of Geneva County, Alabama.

         WHEREAS, on August 1, 2001 the Board, the Tenant, Colonial, City Bank
and Slocomb entered into a First Amendment to Revenue Bond, Lease Agreement and
Mortgage and Indenture of Trust (the "First Amendment"). The First Amendment is
recorded in Official Book 413 at Pages 125 to 135 in the Office of the Judge of
Probate of Geneva County, Alabama.

         WHEREAS, effective August 1, 2002 the Board, the Tenant, Colonial, City
Bank and Slocomb entered into a Second Amendment to Revenue Bond, Lease
Agreement and Mortgage and Indenture of Trust (the "Second Amendment"). The
Second Amendment is recorded in Official Book 445 at Pages 281 to 292 in the
Office of the Judge of Probate of Geneva County, Alabama.

         WHEREAS, effective November 2, 2002 the Board, the Tenant, Colonial,
City Bank and Slocomb entered into a Third Amendment to Revenue Bond, Lease
Agreement and Mortgage and Indenture of Trust (the "Third Amendment"). The Third
Amendment is recorded in Official Book 453 at Pages 149 to 160 in the Office of
the Judge of Probate of Geneva County, Alabama.

         WHEREAS, effective May 2, 2003 the Board, the Tenant, Colonial, City
Bank and Slocomb entered into a Fourth Amendment to Revenue Bond, Lease
Agreement and Mortgage and Indenture of Trust (the "Third Amendment"). The
Fourth Amendment is recorded in Official Book 471 at Pages 308 to 319 in the
Office of the Judge of Probate of Geneva County, Alabama.

         WHEREAS, Tenant has requested Board, Colonial, City Bank and Slocomb to
extend the maturity date of the Colonial Bond, the City Bank Bond and the
Slocomb Bond to November 2, 2004, and the Board, Colonial, City Bank, and
Slocomb are agreeable to do so provided Tenant, Board, Colonial, City Bank and
Slocomb enter into this agreement and cause the First Mortgage, Second Mortgage,
Third Mortgage, Colonial Bond, City Bank Bond, Slocomb Bond, the Lease, and the
documents executed in connection therewith to be modified as provided herein and
to be ratified and reconfirmed as so modified.

         NOW THEREFORE, in consideration of the terms and conditions contained
herein, and to induce Board, Colonial, City Bank and Slocomb to extend the
maturity date of the Colonial Bond, the City Bank Bond and the Slocomb Bond, the
First Mortgage, the Second Mortgage, the Third Mortgage, the Colonial Bond, the
City Bank Bond, the Slocomb Bond, the Lease and the agreements executed in
connection therewith are hereby amended as follows:

    1.   The maturity date or final payment date of the Colonial Bond is hereby
         extended to November 2, 2004, the number of payments due on the
         Colonial Bond is increased from fifty nine (59) to ninety-nine (99),
         and the second, third and fourth sentence of the Colonial

                                       2
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         Bond are hereby amended to state:

                  "Such principal and interest shall mature and be payable
                  (unless duly redeemed prior thereto) in ninety-nine (99)
                  consecutive monthly payments on the second (2nd) day of each
                  month from August 2, 1996, through and including October 2,
                  2004, consisting of the amount of principal and interest at
                  the greater of the Base Lending Rate of Bondholder plus one
                  percent (1.00%) or 6.50% that is necessary to amortize the
                  outstanding balance at such rate by August 2, 2021, and a
                  final payment due on November 2, 2004, in the amount of all
                  principal and interest outstanding on this obligation.
                  Interest on the outstanding balance shall be calculated on the
                  360-day accrual method by multiplying the product of the
                  principal amount outstanding by the applicable rate stated
                  herein by the actual number of days elapsed divided by 360.
                  The applicable interest rate is the greater of the Base
                  Lending Rate plus one percent (1.00%), or 6.50%."

2.       The maturity date or final payment date of the Slocomb Bond is hereby
         extended to November 2, 2004, the number of payments due on the Slocomb
         Bond is increased from fifty nine (59) to ninety-nine (99), and the
         second, third and fourth sentence of the Slocomb Bond is hereby amended
         to state:

                  "Such principal and interest shall mature and be payable
                  (unless duly redeemed prior thereto) in ninety-nine (99)
                  consecutive monthly payments on the second (2nd) day of each
                  month from August 2, 1996, through and including October 2,
                  2004, consisting of the amount of principal and interest at
                  the greater of the Base Lending Rate of Bondholder plus one
                  percent (1.00%) or 6.50% that is necessary to amortize the
                  outstanding balance at such rate by August 2, 2021, and a
                  final payment due on November 2, 2004, in the amount of all
                  principal and interest outstanding on this obligation.
                  Interest on the outstanding balance shall be calculated on the
                  360-day accrual method by multiplying the product of the
                  principal amount outstanding by the applicable rate stated
                  herein by the actual number of days elapsed divided by 360.
                  The applicable interest rate is the greater of the Base
                  Lending Rate plus one percent (1.00%), or 6.50%."

3.       The maturity date or final payment date of the City Bank Bond is hereby
         extended to November 2, 2004, the number of payments due on the City
         Bank Bond is increased from fifty nine (59) to ninety-nine (99), and
         the second, third and fourth sentence of the City Bank Bond is hereby
         amended to state:

                  "Such principal and interest shall mature and be payable
                  (unless duly redeemed prior thereto) in ninety-nine (99)
                  consecutive monthly payments on the second (2nd) day of each
                  month from August 2, 1996, through and including October 2,
                  2004, consisting of the amount of principal and interest

                                       3
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                  at the greater of the Base Lending Rate of Bondholder plus one
                  percent (1.00%) or 6.50% that is necessary to amortize the
                  outstanding balance at such rate by August 2, 2021, and a
                  final payment due on November 2, 2004, in the amount of all
                  principal and interest outstanding on this obligation.
                  Interest on the outstanding balance shall be calculated on the
                  360-day accrual method by multiplying the product of the
                  principal amount outstanding by the applicable rate stated
                  herein by the actual number of days elapsed divided by 360.
                  The applicable interest rate is the greater of the Base
                  Lending Rate plus one percent (1.00%), or 6.50%."

4.       The form of the Colonial Bond contained in the preamble of the First
         Mortgage is amended in conformity with paragraph 1 hereof.

5.       The form of the Slocomb Bond contained in the preamble of the Second
         Mortgage is amended in conformity with paragraph 2 hereof.

6.       The form of the City Bank Bond contained in the preamble of the Third
         Mortgage is amended in conformity with paragraph 3 hereof.

7.       The Lease is hereby amended as follows:

         a.       The duration of the Lease Term as set forth in Section 3.1 of
                  the Lease is extended from midnight of August 2, 2001 to
                  midnight of November 2, 2004, and the first sentence of
                  Section 3.1 of the Lease is hereby amended as follows:

                           "The term of this Lease Agreement and of the Lease
                           herein made shall begin on the date of delivery of
                           this Lease Agreement and, subject to the provisions
                           of this Lease Agreement, shall continue until
                           midnight of November 2, 2004.

         b.       Tenant's option to renew contained in Section 9.2 of the Lease
                  is only exercisable upon full payment of the Bonds.

8.       Tenant acknowledges its obligations under the Lease to pay the Colonial
         Bond, the City Bank Bond and the Slocomb Bond in installments when same
         comes due in accordance with the terms thereof, and in full upon
         maturity.

9.       Tenant further reaffirms and ratifies the Security Agreement entered
         into by Tenant for the benefit of Colonial, and agrees to be bound by
         the terms thereof.

10.      Tenant further reaffirms and ratifies the Security Agreement entered
         into by Tenant for the benefit of Slocomb, and agrees to be bound by
         the terms thereof.

11.      Tenant further reaffirms and ratifies the Security Agreement entered
         into by Tenant for the benefit of City Bank, and agrees to be bound by
         the terms thereof.

                                       4
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12.      Tenant further reaffirms and ratifies the Hazardous Substances
         Indemnification and Warranty Agreement entered into by Tenant for the
         benefit of Colonial, and agrees to be bound by the terms thereof.

13.      Tenant further reaffirms and ratifies the Hazardous Substances
         Indemnification and Warranty Agreement entered into by Tenant for the
         benefit of Slocomb, and agrees to be bound by the terms thereof.

14.      Tenant further reaffirms and ratifies the Hazardous Substances
         Indemnification and Warranty Agreement entered into by Tenant for the
         benefit of City Bank, and agrees to be bound by the terms thereof.

In addition hereto, all of the documents and agreements executed in connection
with the First Mortgage, the Second Mortgage, the Third Mortgage, the Colonial
Bond, the City Bank Bond, the Slocomb Bond, the Lease or the agreements executed
in connection therewith or pertaining thereto (the "Agreements") are hereby
amended in accordance with the terms as herein cited.

Tenant and Board hereby agree and direct Colonial, City Bank and Slocomb to take
any action necessary to conform the First Mortgage, the Second Mortgage, the
Third Mortgage, the Colonial Bond, the City Bank Bond, the Slocomb Bond, the
Lease and the Agreements as to the terms as herein cited and by these presents
accepts and confirms their liability under such documents and agreements with
the terms as herein modified.

All of the terms and provisions of the Fourth Amendment, Third Amendment, Second
Amendment, First Amendment, First Mortgage, Second Mortgage, Third Mortgage,
Colonial Bond, City Bank Bond, Slocomb Bond and the Lease not specifically
amended herein, are hereby reaffirmed, ratified and restated. This Amendment
amends the agreements and is not a novation thereof.

This Agreement may be executed in any number of counterparts, each of which
shall be deemed to be an original and all of which, when taken together, shall
constitute one and the same instrument.

This Agreement shall be construed and enforced in accordance with the laws of
the State of Alabama.

                                       5
<PAGE>

         IN WITNESS WHEREOF, we have hereunto set our hands and seals effective
as of the 2st day of November, 2003.

BOARD                                       THE MEDICAL CLINIC BOARD OF THE
                                            CITY OF HARTFORD, ALABAMA

SEAL                                        BY:  /s/ Hubert H. Strickland
                                                 ------------------------------
                                                        (Its Chairman)
ATTEST:

/s/ David W. Rousseau
---------------------
(Its Secretary-Treasurer)

STATE OF ALABAMA
COUNTY OF GENEVA

         I, the undersigned, a Notary Public in and for said County, in said
State, hereby certify that Hubert H. Strickland, whose name as Chairman of THE
MEDICAL CLINIC BOARD OF THE CITY OF HARTFORD, ALABAMA, a corporation, is signed
to the foregoing instrument and who is known to me, acknowledged before me on
this day that, being informed of the contents of said instrument, he/she, as
such officer, and with full authority, executed the same voluntarily, as an act
of said corporation, acting in its capacity as aforesaid.

         Given under my hand and official seal, this the 30th day of December,
2003.

                                            /s/ Dolores G. Jones
                                            -----------------------------------
                                            NOTARY PUBLIC
                                            My Commission Expires: 5/16/2004

                                       6

<PAGE>

TENANT:                                  DIVERSICARE LEASING CORP., a Tennessee
                                         Corporation

                                         BY: /s/ William R. Council, III
                                             ----------------------------------
                                                  (Its President)

STATE OF Tennessee
COUNTY OF Williamson

         I, the undersigned, a Notary Public in and for said County, in said
State, hereby certify that William R. Council, III, whose name as President of
DIVERSICARE LEASING CORP., a corporation, is signed to the foregoing instrument
and who is known to me, acknowledged before me on this day that, being informed
of the contents of said instrument, he/she, as such officer, and with full
authority, executed the same voluntarily, as an act of said corporation, acting
in its capacity as aforesaid.

         Given under my hand and official seal, this the 11th day of December,
2003.

                                         /s/ Brenda Wimsatt
                                         ---------------------------------
                                         NOTARY PUBLIC
                                         My Commission Expires: 09/24/2005
                                                               -----------

                                       7
<PAGE>

COLONIAL                                   COLONIAL BANK N.A.
                                           (FORMERLY COLONIAL BANK)

                                           BY: /s/ Blaine Brint
                                               -----------------------------
                                               (Its: Senior Vice President)
                                                     ---------------------

STATE OF ALABAMA
COUNTY OF JEFFERSON

         I, the undersigned, a Notary Public in and for said County, in said
State, hereby certify that Blaine Brint, whose name as Senior Vice President of
COLONIAL BANK, N.A. (formerly Colonial Bank), a corporation, is signed to the
foregoing instrument and who is known to me, acknowledged before me on this day
that, being informed of the contents of said instrument, he/she, as such
officer, and with full authority, executed the same voluntarily, as an act of
said corporation, acting in its capacity as aforesaid.

         Given under my hand and official seal, this the 4th day of December,
2003.

                                           /s/  Christina D. Cavadel
                                           ------------------------------------
                                           NOTARY PUBLIC
                                           My Commission Expires: 11/5/2005

                                       8
<PAGE>

CITY BANK                                CITY BANK OF HARTFORD

                                         BY:  /s/ W. H. Kennedy
                                              -----------------------
                                              (Its: President / CEO)
                                                    ----------------

STATE OF ALABAMA
COUNTY OF GENEVA

         I, the undersigned, a Notary Public in and for said County, in said
State, hereby certify that W. H. Kennedy, whose name as President and CEO of
CITY BANK OF HARTFORD, a corporation, is signed to the foregoing instrument and
who is known to me, acknowledged before me on this day that, being informed of
the contents of said instrument, he/she, as such officer, and with full
authority, executed the same voluntarily, as an act of said corporation, acting
in its capacity as aforesaid.

         Given under my hand and official seal, this the 5th day of December,
2003.

                                           /s/ Joy H. Enfinger
                                          -------------------------------------
                                          NOTARY PUBLIC
                                          My Commission Expires: 7/20/2004
                                                                 --------------

                                       9
<PAGE>

SLOCOMB:                                    SLOCOMB NATIONAL BANK

                                            BY: /s/ Joseph H. Johnson
                                                ------------------------------
                                                (Its Executive Vice President)
                                                     -------------------------

STATE OF ALABAMA
COUNTY OF GENEVA

         I, the undersigned, a Notary Public in and for said County, in said
State, hereby certify that Joseph H. Johnson, whose name as Executive Vice
President of SLOCOMB NATIONAL BANK, a corporation, is signed to the foregoing
instrument and who is known to me, acknowledged before me on this day that,
being informed of the contents of said instrument, he/she, as such officer, and
with full authority, executed the same voluntarily, as an act of said
corporation, acting in its capacity as aforesaid.

         Given under my hand and official seal, this the 8th day of December,
2003.

                                            /s/ Carol S. Reeder
                                            -----------------------------------
                                            NOTARY PUBLIC
                                            My Commission Expires: 3/10/2007
                                                                   ------------

                                       10

<PAGE>

                    ACKNOWLEDGEMENT AND CONSENT BY GUARANTOR

         ADVOCAT INC. (the "Guarantor"), the guarantor of i) the Colonial Bond,
ii) the Slocomb Bond, iii) the City Bank Bond, iv) the obligations of Tenant to
Colonial, v) the obligations of Tenant to Slocomb, and vi) the obligations of
Tenant to City Bank, hereby acknowledges and consents to this Fifth Amendment,
and Guarantor's obligations under its guaranty thereto, and hereby reaffirms and
restates its guaranty obligations to Colonial, Slocomb, and City Bank as
evidenced by those certain Guaranty(s) dated June 28, 1996 and delivered to
Colonial, Slocomb and City Bank.

                                               ADVOCAT INC.

                                               BY:  /s/ William R. Council, III
                                                    ----------------------------
                                                        (Its President)
                                                             ---------

STATE OF TENNESSEE
COUNTY OF WILLIAMSON

         I, the undersigned, a Notary Public in and for said County, in said
State, hereby certify that William R. Council, III, whose name as President of
ADVOCAT INC, a corporation, is signed to the foregoing instrument and who is
known to me, acknowledged before me on this day that, being informed of the
contents of said instrument, he/she, as such officer, and with full authority,
executed the same voluntarily, as an act of said corporation, acting in its
capacity as aforesaid.

         Given under my hand and official seal, this the 11th day of December,
2003.

                                               /s/ Brenda Wimsatt
                                               --------------------------------
                                               NOTARY PUBLIC
                                               My Commission Expires: 9/24/2005
                                                                      ---------

                                       11

<PAGE>

                                   EXHIBIT "A"
--------------------------------------------------------------------------------

A parcel of land in the Town of Hartford, Geneva County, Alabama and being more
particularly described as follows: Commencing at the accepted Southeast corner
of the SW 1/4 of the NE 1/4 of Section 31, Township 2 North, Range 24 East, and
thence South 86 degrees 55 minutes 23 seconds West 518.20 feet to the East
right-of-way of Toro Road, thence North 62 degrees 02 minutes 38 seconds West
along the East right-of-way of said road 321.72 feet, thence North 47 degrees 36
minutes 56 seconds West along the East right-of-way of said road a chord
distance of 479.47 feet to the Point of Beginning; and thence North 25 degrees
18 minutes 41 seconds West along the East right-of-way of said road a chord
distance of 258.31 feet, thence North 17 degrees 54 minutes 10 seconds West
along the East right-of-way of said road 216.53 feet, thence North 86 degrees 42
minutes 53 seconds East along an existing fence 187.87 feet, thence North 86
degrees 51 minutes 44 seconds East 418.20 feet, thence South 03 degrees 35
minutes 50 seconds East 317.88 feet, thence South 70 degrees 52 minutes 05
seconds West 475.86 feet to the point of beginning. Said parcel being in the SW
1/4 of the NE 1/4 of Section 31, Township 2 North, Range 24 East, and containing
4.91 acres, more or less.

--------------------------------------------------------------------------------

THIS INSTRUMENT PREPARED BY AND AFTER
RECORDATION SHOULD BE RETURNED TO:
William B. Hairston III
ENGEL HAIRSTON & JOHANSON, P.C.
4th Floor, 109 North 20th Street
Birmingham, Alabama 35203
(205) 328-4600

                                       12<PAGE>

                                                                EXHIBIT 10.142

                               FIRST AMENDMENT TO
                            SHARE PURCHASE AGREEMENT

         This First Amendment to Share Purchase Agreement (the "Amendment") is
executed as of February 17, 2004, among

                                 DIVERSICARE LEASING CORP., a corporation
                                 incorporated under the laws of Tennessee,
                                 (the "VENDOR")

                                 - and -

                                 ADVOCAT INC., a corporation incorporated under
                                 the laws of Delaware, ("ADVOCAT")

                                 -  and -

                                 DIVERSICARE CANADA MANAGEMENT  SERVICES CO.,
                                 INC., a corporation incorporated under the
                                 laws of Ontario, (the "CORPORATION")

                                 -  and -

                                 DCMS HOLDINGS INC., a corporation incorporated
                                 under the laws of Ontario, (THE "PURCHASER")

         WHEREAS, the Vendor, Advocat, the Corporation and the Purchaser entered
into that certain Share Purchase Agreement dated August 25, 2003 (the
"Agreement").

         WHEREAS, the parties now desire to amend certain terms and provisions
of the Agreement as set forth herein.

         NOW, THEREFORE, for and in consideration of the premises and the
agreements, covenants, representations and warranties hereinafter set forth and
for other good and valuable consideration, the receipt and adequacy of all of
which are acknowledged and agreed, the parties hereto agree as follows:

         1. Section 3.01 of the Agreement is hereby deleted in its entirety and
replaced with the following:

<PAGE>

         SECTION 3.01 CLOSING

                  The transfer of the Purchased Shares and payments required
         pursuant to Article Two hereof shall take place at Suite 5800, 40 King
         Street West, Toronto, Ontario or such other place as Vendor and
         Purchaser may mutually agree.

                  Unless otherwise agreed, Closing shall take place at 11:00
         a.m. on the date (the "CLOSING DATE") that is the first Business Day
         fifteen (15) days following the date on which all approvals necessary
         in order to complete the transactions contemplated by this Agreement
         have been received from the Ministry of Health and Long Term Care
         pursuant to the Nursing Homes Act (Ontario). Unless the Vendor and
         Purchaser mutually agree, the Closing Date shall not occur later than
         March 31, 2004. Conditional upon completion of Closing, the effective
         date for the Closing shall be the close of business on the last
         Business Day of the month prior to the Closing Date (the "EFFECTIVE
         DATE").

         2. Except as set forth herein, the Agreement is unmodified and remains
in full force and effect.

         IN WITNESS WHEREOF, the parties have duly executed this Amendment the
date and year first above written.

                                      DIVERSICARE LEASING CORP.

                                      Per:  /s/ William R. Council III
                                          -------------------------------------
                                               Name:  William R. Council III
                                               Title: President

                                      ADVOCAT INC.

                                      Per:  /s/ William R. Council III
                                          -------------------------------------
                                               Name:  William R. Council III
                                               Title: President

                                      DIVERSICARE CANADA MANAGEMENT
                                      SERVICES CO., INC.

                                      Per:  /s/ P. Richardson
                                          -------------------------------------
                                               Name:  Paul Richardson
                                               Title: President

                                      DCMS HOLDINGS INC.

                                      Per:  /s/ D. Gesauldi
                                          -------------------------------------
                                               Name:  Domenic Gesauldi
                                               Title: President

                                      Per:
                                          ------------------------------------
                                             Name:
                                             Title:

                                       2

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