Document:

EX-10.1

FIRST AMENDMENT TO PURCHASE AGREEMENT AND ESCROW INSTRUCTIONS

This First Amendment to Purchase Agreement and Escrow Instructions (this “Amendment”)
is made and entered into as of February 23, 2010 (the “Effective Date”) by and between G&E
HC REIT II PARKWAY MEDICAL CENTER, LLC, a Delaware limited liability company, its successors and
assigns (“Buyer”), and PARKWAY MEDICAL CENTER, LLC, an Ohio limited liability company
(“Seller”).

RECITALS

A. Seller and Buyer entered into that certain Purchase Agreement and Escrow Instructions with
an effective date of January 28, 2010 (the “Agreement”), with respect to the purchase and
sale of that certain parcel of real property located at 3609 and 3619 Park East Drive, Beachwood,
Ohio 44122 (and known as Parkway Medical Center), and known as permanent parcel number 742-29-014
(the “Real Property”), as described in greater detail in the Agreement. All capitalized
terms not otherwise defined herein shall have the meaning given such terms in the Agreement.

B. Seller and Buyer desire to amend the Agreement by extending the Due Diligence Period as
provided herein.

AGREEMENT

NOW, THEREFORE, for and in consideration of the mutual covenants contained herein and other
good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged by
the parties hereto, Seller and Buyer agree as follows:

1. Incorporation of Recitals. The foregoing recitals are incorporated herein and made
a part hereof as if set forth in their entirety.

2. Due Diligence Period. The last sentence of Section 3(A) of the Agreement is hereby
deleted in its entirety and replaced with the following:

The “Due Diligence Period” shall commence on the Effective Date
and expire at 5 P.M. EST on March 12, 2010.

3. Amendment. Except as specifically modified by this Amendment, the Agreement is
hereby ratified and confirmed, and all of the terms and provisions of the Agreement remain in full
force and effect. In the event of a conflict between the terms of this Amendment and the
Agreement, the terms of this Amendment shall prevail. This Amendment contains the entire
understanding of Seller and Buyer with respect to the subject matter hereof, and supersedes all
prior or contemporaneous written or oral agreements and understandings between the parties hereto
pertaining to any such matter.

4. Counterparts. Seller and Buyer intend and agree that (i) faxed or emailed
signatures of this Amendment shall constitute original signatures and (ii) a faxed or emailed
version of this Amendment containing the signature (original, faxed or emailed) of Seller and Buyer
shall be counterparts, each of which will constitute an original and all of which shall comprise
the entire Amendment. Seller and Buyer further agree that the acknowledgement of this Amendment by
Escrow Agent is not required for this Amendment to be binding and effective as between Seller and
Buyer.

[Remainder of page intentionally left blank]

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IN WITNESS WHEREOF, the undersigned have executed this Amendment as of the date first written
above.

“SELLER”

PARKWAY MEDICAL CENTER, LLC,

an Ohio limited liability company

By: /s/ Donald M. King

Donald M. King,

its Manager

EXECUTED on this the 24th day of February, 2010.

“BUYER”

G&E HC REIT II PARKWAY MEDICAL CENTER, LLC, a Delaware limited liability company

By: GRUBB & ELLIS HEALTHCARE REIT II HOLDINGS, LP, a Delaware limited partnership

Title: Sole Member

By: GRUBB & ELLIS HEALTHCARE REIT II, INC., a Maryland corporation

Title: General Partner

By: /s/ Andrea R. Biller

Name: Andrea R. Biller

Title: Executive Vice-President

EXECUTED on this the 23rd day of February, 2010.

The undersigned Escrow Agent acknowledges the foregoing.

ESCROW AGENT:

RESOURCE TITLE AGENCY

By: /s/ Deborah Lawrence-Auten

Name: Deborah Lawrence-Auten

Its: Senior Vice President

Date: February 24, 2010

2EX-10.1

RESTRICTED STOCK AWARD AGREEMENT

Pursuant to the

FINANCIAL INSTITUTIONS, INC.

2009 MANAGEMENT STOCK INCENTIVE PLAN

	 
	Name of Employee:

	Date of Grant:

	Number of Shares:

	Value of each Share on Date of Grant:

This RESTRICTED STOCK AGREEMENT (the “Agreement”), dated as of       , is made between
Financial Institutions, Inc. (the “Company”) and the above-named individual (the “Participant”) to
record the granting of Restricted Stock on        (the “Date of Grant”) to the Participant
pursuant to the Financial Institutions, Inc. 2009 Management Stock Incentive Plan (the “Plan”) by
the Company’s Compensation Committee (the “Committee”) pursuant to Section 2 of the Plan.

This Agreement is intended to satisfy the requirements for long term restricted stock grants
under the Department of Treasury’s interim final regulations governing executive compensation for
recipients of financial assistance under the Troubled Asset Relief Program, 31 CFR part 30, and
related guidance (the “TARP Rules”), whose requirements are hereby incorporated by reference. This
Agreement shall be interpreted and construed in accordance with that intent, and the award under
this Agreement is subject to the TARP Rules.

The Committee and the Participant hereby agree as follows:

1. Grant of Shares. The Committee hereby grants to the Participant, as of the Date of
Grant, subject to and in accordance with the terms and conditions of the Plan, the TARP Rules and
this Agreement, XXXX            shares of the Company’s Common Stock, par value $.01 per share (the
“Common Stock”). The grant of shares of Common Stock to the Participant, evidenced by this
Agreement, is an award of Restricted Stock (as defined in the Plan) and such shares of Restricted
Stock are referred to herein as the “Shares.”

2. Vesting of Shares. There are two vesting requirements that must be satisfied
before the Participant becomes vested in the Shares: a service requirement and a performance
requirement. Both the performance requirement and the service requirement must be satisfied before
a Share will vest.

a. Performance Requirement

A “Gateway Goal”, which is Five Star Bank’s Composite “CAMELS” rating in place on December 31,
2010, must be met before the applicable performance measures are considered. The “Gateway Goal” is
a composite “CAMELS” rating of x or better. If the Gateway Goal is not satisfied, all Shares
issued under this Agreement shall be forfeited.

There are three applicable performance measures for determining whether the performance
requirement is satisfied: earnings per share; efficiency ratio; and non-performing asset
percentage. For purposes of this Agreement, “earnings per share” shall mean such amount as is
reported on the Company’s audited financial statements. “Efficiency ratio” shall mean the ratio of
expense to revenue as reported in the Company’s annual report to shareholders on Form 10-K.
“Non-performing asset percentage” shall mean ratio of the Company’s non-performing assets to total
assets. As specified in the tables set forth below, a threshold, target and maximum performance
goal has been established for each performance measure, and weighting has been established for each
of the performance measures.

The number of Shares earned under the performance requirement will depend on the Company’s
performance in 2010 versus the performance goals and the number of Shares that are subject to each
performance measure. The following tables are used for this calculation:

Performance Goals for 2010

	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	Shares Subject to
	Performance Measures	 	Threshold	 	Target	 	Maximum	 	Performance Measure
	Earnings Per Share

	 	$x.xx
	 	$x.xx
	 	$x.xx
	 	 	60	%
	 

	 	 
	 	 
	 	 
	 	 	 	 
	Efficiency Ratio

	 	xx.x%
	 	xx.x%
	 	xx.x%
	 	 	20	%
	 

	 	 
	 	 
	 	 
	 	 	 	 
	Non-performing Asset

Percentage

	 	

x.xx%
	 	

x.xx%
	 	

x.xx%
	 	

20%

	 

	 	 
	 	 
	 	 
	 	 	 	 

Percentage of Shares Earned at Threshold, Target and Maximum

	 	 	 	 	 	 	 	 	 
	Threshold	 	Target	 	Maximum
	40%

	 	 	80	%	 	 	100	%
	 

	 	 	 	 	 	 	 	 

The number of Shares satisfying the performance requirement will be calculated taking into
account each performance measure, the percentage of Shares that may be earned under that
performance measure and comparing the Company’s performance to the performance goals set forth
above. For example, assume a participant is awarded x,xxx shares of restricted stock and the
Company’s earnings per share for 2010 is $x.xx. Under those facts, the number of Shares that would
be earned under the earnings per share performance measure would be calculated by multiplying the
total number of shares by the percentage of shares that are subject to the earnings per share
performance measure and by the percentage of shares that are earned for performance at target
(x,xxx shares x 60% x 80% = xxx shares). No shares are earned for a performance measure if the
Company does not achieve the threshold level of performance, and no additional shares are awarded
for performance above the maximum level of performance. All calculations are rounded to the
nearest whole number of shares. If the actual performance level falls between designated levels of
performance (e.g., between threshold and target or between target and maximum), the percentage used
for the calculation will be extrapolated. For example, if the actual performance level falls half
way between the threshold and target levels, the percentage used in the calculations would be the
halfway point between the percentages for the threshold and target levels (i.e., 60%).

Example: Assume a participant received a restricted stock grant of x,xxx Shares and the
Company’s earnings per share, efficiency ratio and non-performing asset percentage for 2010 were
$x.xx, xx.x% and x.xx%, respectively. Based on these results, the number of Shares that would be
earned under the performance requirement would be calculated, as follows:

	 	 	 	Earnings per share: x,xxx Shares x 60% x ((($x.xx-$x.xx)/($x.xx-$x.xx) x (100%-80%)) + 80%)
= xxx Shares

	 	 	 	Efficiency Ratio: x,xxx Shares x 20% x 80% = xxx Shares

	 	 	 	Non-performing asset ratio: x,xxx Shares x 20% x (((x.xx% — x.xx%)/(x.xx%-x.xx%) x
(80%-40%)) + 40%) = xxx Shares.

	 	 	 	Total Shares = xxx + xxx + xxx = xxx Shares

The determination of the satisfaction of a performance requirement will be made as of the date
the Company files its audited financials with the Securities and Exchange Commission for the
relevant year; provided, however, that in the event those financials are restated the determination
shall be made as of the date the restated financials are filed with the SEC. The Committee will
certify, in writing, the Company’s performance under the performance measures and the number of
Shares that have been earned based on the performance requirement.

b. Service Requirement

Shares earned based on the performance requirement must also satisfy the service requirement
as follows:

(i) if the Participant provides substantial services and remains in continuous employment with
the Company (or an affiliated entity that is treated along with the Company as a TARP Recipient
(within the meaning of the TARP Rules)) until the second anniversary of the Date of Grant, 50% of
the Shares that satisfy the performance requirement will vest; and

(i) if the Participant provides substantial services and remains in continuous employment with
the Company(or an affiliated entity that is treated along with the Company as a TARP Recipient
(within the meaning of the TARP Rules)) until the third anniversary of the Date of Grant, the
remaining 50% of the Shares that satisfy the performance requirement will vest.

Except as provided below, if the Participant ceases to be employed by the Company before the
Shares vest under the service vesting schedule, the Shares shall be immediately forfeited. There
shall be no accelerated vesting due to a Change in Control.

Notwithstanding the foregoing, if prior to the date the Shares vest under the service vesting
requirement the Participant’s employment with the Company terminates by reason of the Participant’s
death, or disability, all Shares that have vested under the performance requirement but have not
yet vested under the service requirement shall immediately vest. All Shares that are subject to a
performance requirement that is not satisfied shall be forfeited.

3. Forfeiture. Shares that do not become vested in accordance with the vesting
criteria set forth in Section 2 shall be forfeited to the Company.

4. TARP Transferability Restrictions. Vested Shares awarded under this Agreement
shall not become transferable (as defined in 26 CFR 1.83–3(d)), at any time earlier than permitted
under the following schedule (except as necessary to reflect a merger or acquisition of the TARP
Recipient (within the meaning of the TARP Rules)):

	 	(a)	 	25% of the Shares granted at the time of repayment of 25% of
the aggregate financial assistance received.

	 	(b)	 	An additional 25% of the Shares granted (for an aggregate total
of 50% of the Shares) at the time of repayment of 50% of the aggregate
financial assistance received.

	 	(c)	 	An additional 25% of the Shares granted (for an aggregate total
of 75% of the Shares granted) at the time of repayment of 75% of the aggregate
financial assistance received.

	 	(d)	 	The remainder of the Shares granted at the time of repayment of
100% of the aggregate financial assistance received.

Notwithstanding the foregoing, in the case of Restricted Stock for which the Participant does
not make an election under section 83(b) of the Internal Revenue Code (26 U.S.C. 83(b)), at any
time beginning with the date upon which the Restricted Stock becomes substantially vested (as
defined in 26 CFR 1.83–3(b)) and ending on December 31 of the calendar year including that date, a
portion of the Restricted Stock may be made transferable as may reasonably be required to pay the
Federal, State, local, or foreign taxes that are anticipated to apply to the income recognized due
to this vesting, and the amounts made transferable for this purpose shall not count toward the
percentages in the schedule above.

5. Legend. Each share certificate representing the Shares shall bear a legend
indicating that such Shares are “Restricted Stock” and are subject to the provisions of this
Agreement and the Plan.

6. Withholding Taxes. If the Participant is an employee of the Company or any of its
Subsidiaries, the Participant shall remit to the Company in cash the amount needed to satisfy any
federal, state or local withholding taxes that may arise or be applicable as the result of the
award or vesting of the Shares. The Participant may, with the Committee’s consent, elect to
satisfy, totally or in part, such Participant’s obligations pursuant to this section by electing to
have Shares withheld, or to deliver previously owned Shares that have been held for at least six
(6) months, provided that the election is made in writing on or prior to the vesting of shares
pursuant to Section 2 hereof.

7. General Restrictions on Issuance of Stock Certificates. The Company shall not be
required to deliver any certificate representing the Shares until it has been furnished with such
opinions, representations or other documents as it may deem necessary or desirable, in its
discretion, to ensure compliance with any law or rules of the Securities and Exchange Commission or
any other governmental authority having jurisdiction under the Plan or over the Company, the
Participant, or the Shares or any interests granted thereunder.

8. Rights as Shareholder. Except for the transfer and other restrictions set forth
elsewhere in this Agreement and in the Plan, the Participant, as record holder of the Shares, shall
possess all the rights of a holder of the Company’s Common Stock (including voting); provided,
however, that the Participant shall not have the right to receive any dividends on unvested Shares;
and provided further, however, that prior to becoming vested and transferable the certificates
representing such Shares shall be held by the Company for the benefit of the Participant. As the
Shares become vested and transferable, certificates representing such Shares shall be released to
the Participant. As noted above, the Participant shall not receive any dividends on unvested
Shares, and such dividends shall be permanently forfeited.

9. Transferability — Restricted Share Certificates. The Shares may not be sold,
transferred, pledged, assigned, encumbered, or otherwise alienated or hypothecated until they
become fully vested and transferable in accordance with Sections 2 and 4 of this Agreement and then
only to the extent permitted under this Agreement and the Plan and by applicable securities laws.
Prior to full vesting and transferability, all rights with respect to the Shares granted to a
Participant under the Plan shall be available, during such Participant’s lifetime, only to such
Participant.

10. Stock Power. Concurrently with the execution of this Agreement, the Participant
shall deliver to the Company a stock power, endorsed in blank, relating to the Shares. Such stock
power shall be in the form attached hereto as Exhibit A. The stock power with respect to any
certificate representing Shares that do not vest shall be completed in the name of the Company by
an officer of the Company, and the Shares shall be returned to either authorized but unissued
shares or treasury shares, depending on their original source.

11. Section 83(b) Election. The Participant may elect, within 30 days of the Date of
Grant pursuant to Section 83(b) of the Internal Revenue Code, to include in his or her gross income
the fair market value of the Shares covered by this Agreement in the taxable year of grant. The
election must be made by filing the appropriate notice with the Internal Revenue Service within 30
days of the Date of Grant. If the Participant makes this election, the Participant shall promptly
notify the Company by submitting to the Committee a copy of the election notice filed with the
Internal Revenue Service.

12. Adjustment of Shares. As provided by the Plan, in the event of any change in the
Common Stock of the Company by reason of any stock dividend, stock split, recapitalization,
reorganization, merger, consolidation, split-up, combination, or exchange of Shares, or of any
similar change affecting the Common Stock, the Shares shall be adjusted automatically consistent
with such change to prevent substantial dilution or enlargement of the rights granted to, or
available for, the Participant hereunder.

13. No Employment Rights. Neither the Plan nor this award shall confer upon the
Participant any right with respect to continuance of employment by the Company or any affiliate nor
shall they interfere in any way with the right of the Company or any affiliate to terminate the
Participant’s employment at any time, with or without cause.

14. Coordination with Plan. The Employee hereby acknowledges receipt of a copy of the
Plan and agrees to be bound by all of the terms and provisions thereof including any that may
conflict with those contained in this Agreement. Capitalized terms used in this Agreement shall
have the meaning given to such terms under the Plan.

15. Notices. All notices to the Company shall be in writing and sent to the Company’s
Corporate Secretary at the Company’s offices. Notices to the Employee shall be addressed to the
Employee at the Employee’s address as it appears on the Company’s records.

IN WITNESS WHEREOF, the Committee and the Participant have caused this Restricted Stock
Agreement to be executed on the date set forth opposite their respective signatures, it being
further understood that the Date of Grant may differ from the date of signature.

	 	 	 
	Dated:
	 	FOR THE COMMITTEE:

	 	 	By:

	 	 	Name:

	 	 	Title:

	Dated:
	 	PARTICIPANT:

	 	 	By:

	 	 	Name:

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EXHIBIT A

STOCK POWER

FOR VALUE RECEIVED, the undersigned does hereby sell, assign and transfer to Financial
Institutions, Inc. (the “Company”), shares of the Company’s common stock represented by
Certificate No.   . The undersigned authorizes the Secretary of the Company to transfer
the stock on the books of the Company in the event of the forfeiture of any shares issued under the
Restricted Stock Agreement dated as of between the Company and the undersigned.

Dated:       

      

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