Document:

gen_Ex10_9

		
			Exhibit 10.9
		

		
			Execution Version
		

		
			AMENDMENT NO. 3 TO CREDIT AGREEMENT
		

		
			This Amendment No. 3 to Credit Agreement (this “Agreement”), dated as of July 29, 2016 (the “Effective Date”), is entered into by and among GENESIS HEALTHCARE, INC., a Delaware corporation (“Genesis Healthcare”), and Genesis Healthcare’s direct and indirect subsidiaries listed on Annex I hereto (together with Genesis Healthcare, collectively, “Borrowers”), the financial institutions who are or hereafter become parties to the Credit Agreement (as defined below) as lenders (the “Lenders”) and L/C issuers (“L/C Issuers”) and HEALTHCARE FINANCIAL SOLUTIONS, LLC, a Delaware limited liability company, as Administrative Agent for the Lenders and L/C Issuers (in such capacity, and together with its successors and permitted assigns, “Administrative Agent”).
		

		
			WHEREAS, Borrowers, the Lenders, L/C Issuers and Administrative Agent are parties to that certain Third Amended and Restated Credit Agreement, dated as of February 2, 2015, as amended by that certain Amendment No. 1 to Credit Agreement, dated as of April 28, 2016, and that certain Amendment No. 2 to Credit Agreement, dated as of May 19, 2016 (as it may have been further amended, restated, supplemented or otherwise modified through the date hereof, the “Existing Credit Agreement” and as amended hereby and as it may be further amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), pursuant to which Administrative Agent, L/C Issuers and Lenders have agreed, among other things, to provide to Borrowers certain loans and other financial accommodations in accordance with the terms and conditions set forth therein;
		

		
			WHEREAS, Borrowers have requested that Administrative Agent and each Lender agree to amend certain provisions of the Existing Credit Agreement; and
		

		
			WHEREAS, Administrative Agent and each Lender is willing to agree to Borrowers’ request for such amendments, subject to and in accordance with the terms and conditions set forth in this Agreement. 
		

		
			NOW, THEREFORE, Borrowers, Administrative Agent, each Lender and each L/C Issuer each hereby agrees as follows:
		

			
	
			
				 1.
			Recitals; Definitions.    The foregoing recitals, including all terms defined therein, are incorporated herein and made a part hereof.  All capitalized terms used herein (including, without limitation, in the foregoing recitals) and not defined herein shall have the meanings given to such terms in the Credit Agreement and the rules of interpretation set forth in Section 1.4 thereof are incorporated herein mutatis mutandis.

			
	
			
				 2.
			Amendments to the Existing Credit Agreement.  Subject to the terms and conditions of this Agreement, including, without limitation, the conditions to effectiveness set forth in Section 3 below:

			
	
			
				 (a)
			The Existing Credit Agreement is hereby amended to delete the stricken text (indicated textually in the same manner as the following example: stricken text) and to add the double-underlined text (indicated textually in the same manner as the following example: double-underlined text) as set forth in the pages of the Credit Agreement attached as Exhibit A hereto; and

			
	
			
				 (b)
			Exhibits A, B, C, D, E, F, G, J, L and M to the Existing Credit Agreement shall be amended to delete the stricken text (indicated textually in the same manner as the following example: stricken text) and to add the double-underlined text (indicated textually in the same manner as the following example: double-underlined text) as set forth in the pages of such Exhibits to the Credit Agreement attached as Exhibit B hereto.

		
			 
		

		 

 

			
	
			
				 (c)
			Exhibit I to the Existing Credit Agreement shall be replaced in its entirety with the form of Borrowing Base Certificate attached hereto as Exhibit C.  

			
	
			
				 (d)
			Exhibit K to the Existing Credit Agreement shall be replaced in its entirety with the form of Intercreditor Agreement attached hereto as Exhibit D.

			
	
			
				 3.
			Conditions.  The effectiveness of this Agreement is subject to the following conditions, each in form and substance satisfactory to Administrative Agent:

			
	
			
				 (a)
			Administrative Agent shall have received a fully executed copy of this Agreement;

			
	
			
				 (b)
			Loan Parties shall have delivered to Administrative Agent that certain fee letter, dated as of or before the date hereof, between Administrative Agent and Genesis Healthcare;

			
	
			
				 (c)
			Administrative Agent shall have received copies of UCC and other appropriate search reports and of all effective prior filings listed therein, together with evidence of the termination of such prior filings and other documents with respect to the priority of the security interest of Administrative Agent in the Collateral, in each case as may be reasonably requested by Administrative Agent;

			
	
			
				 (d)
			Administrative Agent shall have received a certificate of the secretary or other officer of each Loan Party attaching such Loan Party’s Constituent Documents (except that in lieu of delivering true, complete and correct copies of such Constituent Documents, the secretary may certify that the Constituent Documents have not been amended, modified, or rescinded since the delivery of the Secretary’s Certificate last delivered to Administrative Agent, and that such Constituent Documents remain in full force and effect as of the date hereof) and resolutions approving the transactions contemplated hereby;

			
	
			
				 (e)
			Administrative Agent shall have received a certificate executed by a Responsible Officer of Genesis Healthcare to the effect that (i) no Default or Event of Default shall have occurred or be continuing or result from this Amendment, and (ii) all of the representations and warranties set forth in the Loan Documents to which it is a party continue to be true and correct in all material respects as of the date hereof as if made on the date hereof and as if fully set forth herein, except to the extent (A) such representations and warranties by their terms expressly relate only to a prior date (in which case such representations and warranties shall be true and correct in all material respects as of such prior date) or (B) any such representation or warranty is no longer true, correct or complete due to the occurrence of one or more events that are permitted to occur (or are not otherwise prohibited) under the Loan Documents;

			
	
			
				 (f)
			Administrative Agent shall have received a Compliance Certificate duly executed by a Responsible Officer of Ultimate Parent and substantially in the form of Exhibit H to the Credit Agreement;

			
	
			
				 (g)
			Administrative Agent shall have received a Borrowing Base Certificate duly executed by a Responsible Officer of Ultimate Parent and substantially in the form of Exhibit I to the Credit Agreement;

			
	
			
				 (h)
			Administrative Agent shall have received a duly executed favorable opinion of Skadden, Arps, Slate, Meagher & Flom LLP, as Delaware, California, Illinois, Massachusetts, Texas and New York counsel to the Loan Parties, addressed to Administrative Agent, the L/C Issuers and the Lenders;

			
	
			
				 (i)
			Administrative Agent shall have received fully executed copies of the following documents: (i) the Term Loan Agreement and other Term Loan Documents, (ii) the Intercreditor 

		
			
		

		 

		

			2

		

 

		
			Agreement, (iii) the Lease Consent and Amendment Agreements, (iv) the Master Lease Intercreditor Agreements and (v) a payoff letter in respect of the indebtedness under the Original Term Loan Agreement. 
		

			
	
			
				 (j)
			After giving effect to this Agreement, no Default or Event of Default shall have occurred and be continuing as of the date hereof under this Agreement, the Credit Agreement or any other Loan Document;

			
	
			
				 (k)
			Loan Parties shall have paid all fees, costs and expenses associated with the Agreement; and

			
	
			
				 (l)
			Loan Parties shall have delivered such further documents, information, certificates, records and filings as Administrative Agent may reasonably request. 

			
	
			
				 4.
			Reaffirmation of Loan Documents.  By executing and delivering this Agreement, each Loan Party hereby (i) reaffirms, ratifies and confirms its Obligations under the Credit Agreement, the Notes and the other Loan Documents, as applicable, (ii) agrees that this Agreement shall be a “Loan Document” under the Credit Agreement and (iii) hereby expressly agrees that the Credit Agreement, the Notes and each other Loan Document shall remain in full force and effect.

			
	
			
				 5.
			Reaffirmation of Grant of Security Interest in Collateral.  Each Loan Party hereby expressly reaffirms, ratifies and confirms its obligations under the Security Agreement, including its mortgage, grant, pledge and hypothecation to Administrative Agent for the benefit of the Secured Parties, of the Lien on and security interest in, all of its right, title and interest in, all of the Collateral. 

			
	
			
				 6.
			Confirmation of Representations and Warranties; Liens; No Default.  Each Loan Party that is party hereto hereby confirms that (i) all of the representations and warranties set forth in the Loan Documents to which it is a party continue to be true and correct in all material respects as of the date hereof as if made on the date hereof and as if fully set forth herein, except to the extent (A) such representations and warranties by their terms expressly relate only to a prior date (in which case such representations and warranties shall be true and correct in all material respects as of such prior date) or (B) any such representation or warranty is no longer true, correct or complete due to the occurrence of one or more events that are permitted to occur (or are not otherwise prohibited) under the Loan Documents, (ii) there are no continuing Defaults or Events of Default that have not been waived or cured, (iii) subject to the terms and conditions of the Loan Documents, Administrative Agent has and shall continue to have valid, enforceable and perfected Liens on the Collateral with the priority set forth in the Intercreditor Agreement, for the benefit of the Secured Parties, pursuant to the Loan Documents or otherwise granted to or held by Administrative Agent, for the benefit of the Secured Parties, subject only to Liens expressly permitted pursuant to Section 8.2 of the Credit Agreement, and (iv) the agreements and obligations of Borrowers and each other Loan Party contained in the Loan Documents and in this Agreement constitute the legal, valid and binding obligations of Borrowers and each other Loan Party, enforceable against Borrowers and each other Loan Party in accordance with their respective terms, except to the extent limited by general principles of equity and by bankruptcy, insolvency, fraudulent conveyance, or other similar laws affecting creditors’ rights generally.  

			
	
			
				 7.
			No Other Amendments.  Except as expressly set forth in this Agreement, the Credit Agreement and all other Loan Documents shall remain unchanged and in full force and effect.  This Agreement shall be limited precisely and expressly as drafted and shall not be construed as consent to the amendment, restatement, modification, supplementation or waiver of any other terms or provisions of the Credit Agreement or any other Loan Document.

		
			
		

		 

		

			3

		

 

			
	
			
				 8.
			Release.  As of the date of this Agreement, each Loan Party (i) agrees that, to its knowledge, Administrative Agent, each L/C Issuer and each Lender has fully complied with its obligations under each Loan Document required to be performed prior to the date hereof, (ii) agrees that no Loan Party has any defenses to the validity, enforceability or binding effect of any Loan Document and (iii) fully and irrevocably releases any claims of any nature whatsoever that it may now have against Administrative Agent, each L/C Issuer and each Lender and relating in any way to this Agreement, the Loan Documents or the transactions contemplated thereby.

			
	
			
				 9.
			Costs and Expenses.  The payment of all fees, costs and expenses incurred by Administrative Agent in connection with the preparation and negotiation of this Agreement shall be governed by Section 11.3 of the Credit Agreement.

			
	
			
				 10.
			Governing Law.  This Agreement shall be governed by and construed in accordance with the laws of the State of New York.

			
	
			
				 11.
			Successors/Assigns.  This Agreement shall bind, and the rights hereunder shall inure to, the respective successors and assigns of the parties hereto, subject to the provisions of the Loan Documents.

			
	
			
				 12.
			Headings.  Section headings in this Agreement are included for convenience of reference only and shall not constitute a part of this Agreement for any other purpose.

			
	
			
				 13.
			Counterparts.  This Agreement may be executed in any number of counterparts and by different parties in separate counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement.  Signature pages may be detached from multiple separate counterparts and attached to a single counterpart.  Delivery of an executed signature page of this Agreement by facsimile transmission or Electronic Transmission shall be as effective as delivery of a manually executed counterpart hereof.  Any party delivering an executed counterpart of this Agreement by facsimile transmission or Electronic Transmission shall also deliver an original executed counterpart of this Agreement but the failure to deliver an original executed counterpart shall not affect the validity, enforceability or binding effect of this Agreement.

		
			[SIGNATURE PAGES FOLLOW]
		

		
			 
		

		
			

		 

		

			4

		

 

IN WITNESS WHEREOF, each of the undersigned has executed this Agreement or has caused the same to be executed by its duly authorized representatives as of the date first above written.
		

		
			 
		

			
					
						BORROWERS:

					
					
						GENESIS HEALTHCARE, INC.

				
	
					
						 

					
					
						a Delaware corporation

				
	
					
						 

					
					
						By:

					
					
						/s/ Michael S. Sherman

				
	
					
						 

					
					
						Name:

					
					
						Michael S. Sherman

				
	
					
						 

					
					
						Title:

					
					
						SVP

				
	
					
						 

					
					
						FC-GEN OPERATIONS INVESTMENT, LLC

				
	
					
						 

					
					
						a Delaware limited liability company

				
	
					
						 

					
					
						By:

					
					
						/s/ Michael S. Sherman

				
	
					
						 

					
					
						Name:

					
					
						Michael S. Sherman

				
	
					
						 

					
					
						Title:

					
					
						SVP

				
	
					
						 

					
					
						EACH OF THE ENTITIES LISTED ON ANNEX I ATTACHED HERETO:

				
	
					
						 

					
					
						 

					
					
						By: FC-GEN OPERATIONS INVESTMENT, LLC, its authorized agent

				
	
					
						 

					
					
						By:

					
					
						/s/ Michael S. Sherman

				
	
					
						 

					
					
						Name:

					
					
						Michael S. Sherman

				
	
					
						 

					
					
						Title:

					
					
						SVP

				

		
			 
		

		
			 
		

		
			[Signatures Continue on Following Pages]
		

		
			
		

		

		 

		

			 

		

 

	
					
						 

					
					
						 

					
					
						 

				
	
					
						ADMINISTRATIVE AGENT:

					
					
						 

				
	
					
						 

					
					
						HEALTHCARE FINANCIAL SOLUTIONS, LLC, a Delaware limited liability company

				
	
					
						 

					
					
						By:

					
					
						/s/ Thomas A. Buckelew

				
	
					
						 

					
					
						Name:

					
					
						Thomas A. Buckelew

				
	
					
						 

					
					
						Title:

					
					
						Duly Authorized Signatory

				
	
					
						 

					
					
						 

				
	
					
						 

					
					
						 

				
	
					
						L/C ISSUER:

					
					
						 

				
	
					
						 

					
					
						HEALTHCARE FINANCIAL SOLUTIONS, LLC, a Delaware limited liability company

				
	
					
						 

					
					
						By:

					
					
						/s/ Thomas A. Buckelew

				
	
					
						 

					
					
						Name:

					
					
						Thomas A. Buckelew

				
	
					
						 

					
					
						Title:

					
					
						Duly Authorized Signatory

				

		
			 
		

		
			 
		

		
			[Signatures Continue on Following Page]
		

		
			
		

		

		 

		

			 

		

 

	
					
						LENDER:

					
					
						 

				
	
					
						 

					
					
						HEALTHCARE FINANCIAL SOLUTIONS, LLC, in its capacity as a Revolving Credit Lender

				
	
					
						 

					
					
						By:

					
					
						/s/ Thomas A. Buckelew

				
	
					
						 

					
					
						Name:

					
					
						Thomas A. Buckelew

				
	
					
						 

					
					
						Title:

					
					
						Duly Authorized Signatory

				

		
			 
		

		
			 
		

		
			[Signatures Continue on Following Page]
		

		
			
		

		

		 

		

			 

		

 

	
					
						 

					
					
						 

					
					
						 

				
	
					
						LENDER:

					
					
						 

				
	
					
						 

					
					
						BARCLAYS BANK PLC, in its capacity as a Revolving Credit Lender

				
	
					
						 

					
					
						By:

					
					
						/s/ Sean Duggan

				
	
					
						 

					
					
						Name:

					
					
						Sean Duggan

				
	
					
						 

					
					
						Title:

					
					
						Assistant Vice President

				

		
			 
		

		
			 
		

		
			[Signatures Continue on Following Page]
		

		
			
		

		

		 

		

			 

		

 

	
					
						LENDER:

					
					
						 

				
	
					
						 

					
					
						WELLS FARGO CAPITAL FINANCE, LLC, in its capacity as a Revolving Credit Lender

				
	
					
						 

					
					
						By:

					
					
						/s/ Henry Slauson

				
	
					
						 

					
					
						Name:

					
					
						Henry Slauson

				
	
					
						 

					
					
						Title:

					
					
						Vice President

				

		
			 
		

		
			 
		

		
			[Signatures Continue on Following Page]
		

		
			
		

		

		 

		

			 

		

 

	
					
						LENDER:

					
					
						 

				
	
					
						 

					
					
						CAPITAL ONE, N.A., in its capacity as a Revolving Credit Lender

				
	
					
						 

					
					
						By:

					
					
						/s/ Thomas A. Buckelew

				
	
					
						 

					
					
						Name:

					
					
						Thomas A. Buckelew

				
	
					
						 

					
					
						Title:

					
					
						Duly Authorized Signatory

				

		
			 
		

		
			 
		

		
			[Signatures Continue on Following Page]
		

		
			
		

		

		 

		

			 

		

 

	
					
						LENDER:

					
					
						 

				
	
					
						 

					
					
						MIDCAP FUNDING IV TRUST, in its capacity as a Revolving Credit Lender

				
	
					
						 

					
					
						By: Apollo Capital Management, L.P., its investment manager

				
	
					
						 

					
					
						By: Apollo Capital Management, GP, LLC, its general partner

				
	
					
						 

					
					
						By:

					
					
						/s/ Maurice Amsellem

				
	
					
						 

					
					
						Name:

					
					
						Maurice Amsellem

				
	
					
						 

					
					
						Title:

					
					
						Authorized Signatory

				

		
			 
		

		
			 
		

		
			[End of Signature Pages]
		

		
			 
		

		
			 
		

		
			

		 

		

			 

		

 

ANNEX I
		

		
			 
		

		
			BORROWERS 
		

		
			 
		

		
			1 EMERSON DRIVE NORTH OPERATIONS LLC
		

		
			1 EMERSON DRIVE SOUTH OPERATIONS LLC
		

		
			1 MAGNOLIA DRIVE OPERATIONS LLC
		

		
			1 SUTPHIN DRIVE OPERATIONS LLC
		

		
			10 WOODLAND DRIVE OPERATIONS LLC
		

		
			100 CHAMBERS STREET OPERATIONS LLC
		

		
			100 EDELLA ROAD OPERATIONS LLC
		

		
			100 ST. CLAIRE DRIVE OPERATIONS LLC
		

		
			1000 ASSOCIATION DRIVE OPERATIONS LLC
		

		
			1000 LINCOLN DRIVE OPERATIONS LLC
		

		
			1000 ORWIGSBURG MANOR DRIVE OPERATIONS LLC
		

		
			1000 SCHUYLKILL MANOR ROAD OPERATIONS LLC
		

		
			101 13TH STREET OPERATIONS LLC
		

		
			1020 SOUTH MAIN STREET OPERATIONS LLC
		

		
			106 TYREE STREET OPERATIONS LLC
		

		
			1080 SILVER LAKE BOULEVARD OPERATIONS LLC
		

		
			11 DAIRY LANE OPERATIONS LLC
		

		
			1100 NORMAN ESKRIDGE HIGHWAY OPERATIONS LLC
		

		
			1104 WELSH ROAD OPERATIONS LLC
		

		
			1113 NORTH EASTON ROAD OPERATIONS LLC
		

		
			1145 POQUONNOCK ROAD OPERATIONS LLC
		

		
			115 EAST MELROSE AVENUE OPERATIONS LLC
		

		
			115 SUNSET ROAD OPERATIONS LLC
		

		
			1201 RURAL AVENUE OPERATIONS LLC
		

		
			1203 WALKER ROAD OPERATIONS LLC
		

		
			12-15 SADDLE RIVER ROAD OPERATIONS LLC
		

		
			12325 NEW HAMPSHIRE AVENUE DIALYSIS SERVICES LLC
		

		
			12325 NEW HAMPSHIRE AVENUE OPERATIONS LLC
		

		
			1240 PINEBROOK ROAD, LLC
		

		
			1245 CHURCH ROAD OPERATIONS LLC
		

		
			125 HOLLY ROAD OPERATIONS LLC
		

		
			1251 RURAL AVENUE OPERATIONS LLC
		

		
			128 EAST STATE STREET ASSOCIATES, LLC
		

		
			1350 E. LOOKOUT DRIVE OPERATIONS LLC
		

		
			1361 ROUTE 72 WEST OPERATIONS LLC
		

		
			140 PRESCOTT STREET OPERATIONS LLC
		

		
			1400 WOODLAND AVENUE OPERATIONS LLC
		

		
			1400 WOODLAND AVENUE PROPERTY LLC
		

		
			1419 ROUTE 9 NORTH OPERATIONS LLC
		

		
			144 MAGNOLIA DRIVE OPERATIONS LLC
		

		
			150 EDELLA ROAD OPERATIONS LLC
		

		
			1501 SE 24TH ROAD, LLC
		

		
			1515 LAMBERTS MILL ROAD OPERATIONS LLC
		

		
			1526 LOMBARD STREET SNF OPERATIONS LLC
		

		
			1539 COUNTRY CLUB ROAD OPERATIONS LLC
		

		
			1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

16 FUSTING AVENUE OPERATIONS LLC
		

		
			161 BAKERS RIDGE ROAD OPERATIONS LLC
		

		
			1631 RITTER DRIVE OPERATIONS LLC
		

		
			1680 SPRING CREEK ROAD OPERATIONS LLC
		

		
			1700 PINE STREET OPERATIONS LLC
		

		
			1700 WYNWOOD DRIVE OPERATIONS LLC
		

		
			1718 SPRING CREEK ROAD OPERATIONS LLC
		

		
			175 BLUEBERRY LANE OPERATIONS LLC
		

		
			1775 HUNTINGTON LANE, LLC
		

		
			1785 SOUTH HAYES STREET OPERATIONS LLC
		

		
			1801 TURNPIKE STREET OPERATIONS LLC
		

		
			1801 WENTWORTH ROAD OPERATIONS LLC
		

		
			184 BETHLEHEM PIKE OPERATIONS LLC
		

		
			191 HACKETT HILL ROAD OPERATIONS LLC
		

		
			1980 SUNSET POINT ROAD, LLC
		

		
			2 DEER PARK DRIVE OPERATIONS LLC
		

		
			20 MAITLAND STREET OPERATIONS LLC
		

		
			20 SUMMIT STREET OPERATIONS LLC
		

		
			200 MARTER AVENUE OPERATIONS LLC
		

		
			200 REYNOLDS AVENUE OPERATIONS LLC
		

		
			200 SOUTH RITCHIE AVENUE OPERATIONS LLC
		

		
			201 WOOD STREET OPERATIONS LLC
		

		
			205 ARMSTRONG AVENUE OPERATIONS LLC
		

		
			2101 FAIRLAND ROAD OPERATIONS LLC
		

		
			211-213 ANA DRIVE OPERATIONS LLC
		

		
			22 SOUTH STREET OPERATIONS LLC
		

		
			22 TUCK ROAD OPERATIONS LLC
		

		
			2240 WHITE HORSE MERCERVILLE ROAD OPERATIONS LLC
		

		
			225 EVERGREEN ROAD OPERATIONS LLC
		

		
			227 EVERGREEN ROAD OPERATIONS LLC
		

		
			227 PLEASANT STREET OPERATIONS LLC
		

		
			2305 RANCOCAS ROAD OPERATIONS LLC
		

		
			239 PLEASANT STREET OPERATIONS LLC
		

		
			24 OLD ETNA ROAD OPERATIONS LLC
		

		
			24 TRUCKHOUSE ROAD OPERATIONS LLC
		

		
			240 BARKER ROAD OPERATIONS LLC
		

		
			25 EAST LINDSLEY ROAD OPERATIONS LLC
		

		
			25 RIDGEWOOD ROAD OPERATIONS LLC
		

		
			2507 CHESTNUT STREET OPERATIONS LLC
		

		
			2600 HIGHLANDS BOULEVARD, NORTH, LLC
		

		
			2601 EVESHAM ROAD OPERATIONS LLC
		

		
			262 TOLL GATE ROAD OPERATIONS LLC
		

		
			2720 CHARLES TOWN ROAD OPERATIONS LLC
		

		
			290 HANOVER STREET OPERATIONS LLC
		

		
			290 RED SCHOOL LANE OPERATIONS LLC
		

		
			2900 TWELFTH STREET NORTH, LLC
		

		
			292 APPLEGARTH ROAD OPERATIONS LLC
		

		
			3 INDUSTRIAL WAY EAST OPERATIONS LLC
		

		
			3 PARK DRIVE OPERATIONS LLC
		

		
			30 PRINCETON BOULEVARD OPERATIONS LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

30 WEBSTER STREET OPERATIONS LLC
		

		
			30 WEST AVENUE OPERATIONS LLC
		

		
			300 COURTRIGHT STREET OPERATIONS LLC
		

		
			3000 BALFOUR CIRCLE OPERATIONS LLC
		

		
			3001 EVESHAM ROAD OPERATIONS LLC
		

		
			302 CEDAR RIDGE ROAD OPERATIONS LLC
		

		
			315 UPPER RIVERDALE ROAD LLC
		

		
			32 HOSPITAL HILL ROAD OPERATIONS LLC
		

		
			3227 BEL PRE ROAD OPERATIONS LLC
		

		
			329 EXEMPLA CIRCLE OPERATIONS LLC
		

		
			330 FRANKLIN TURNPIKE OPERATIONS LLC
		

		
			331 HOLT LANE OPERATIONS LLC
		

		
			333 GRAND AVENUE OPERATIONS LLC
		

		
			333 GREEN END AVENUE OPERATIONS LLC
		

		
			3330 WILKENS AVENUE OPERATIONS LLC
		

		
			3330 WILKENS AVENUE PROPERTY LLC
		

		
			336 SOUTH WEST END AVENUE OPERATIONS LLC
		

		
			3485 DAVISVILLE ROAD OPERATIONS LLC
		

		
			35 MARC DRIVE OPERATIONS LLC
		

		
			35 MILKSHAKE LANE OPERATIONS LLC
		

		
			350 HAWS LANE OPERATIONS LLC
		

		
			3590 WASHINGTON PIKE OPERATIONS LLC
		

		
			3590 WASHINGTON PIKE PROPERTY LLC
		

		
			3809 BAYSHORE ROAD OPERATIONS LLC
		

		
			3865 TAMPA ROAD, LLC
		

		
			390 RED SCHOOL LANE OPERATIONS LLC
		

		
			4 HAZEL AVENUE OPERATIONS LLC
		

		
			40 PARKHURST ROAD OPERATIONS LLC
		

		
			400 GROTON ROAD OPERATIONS LLC
		

		
			4140 OLD WASHINGTON HIGHWAY OPERATIONS LLC
		

		
			422 23RD STREET OPERATIONS LLC
		

		
			438 23RD STREET OPERATIONS LLC
		

		
			44 KEYSTONE DRIVE OPERATIONS LLC
		

		
			440 NORTH RIVER STREET OPERATIONS LLC
		

		
			450 EAST PHILADELPHIA AVENUE OPERATIONS LLC
		

		
			455 BRAYTON AVENUE OPERATIONS LLC
		

		
			4602 NORTHGATE COURT, LLC
		

		
			462 MAIN STREET OPERATIONS LLC
		

		
			464 MAIN STREET OPERATIONS LLC
		

		
			4901 NORTH MAIN STREET OPERATIONS LLC
		

		
			4927 VOORHEES ROAD, LLC
		

		
			5 ROLLING MEADOWS DRIVE OPERATIONS LLC
		

		
			50 MULBERRY TREE STREET OPERATIONS LLC
		

		
			500 EAST PHILADELPHIA AVENUE OPERATIONS LLC
		

		
			500 SOUTH DUPONT BOULEVARD OPERATIONS LLC
		

		
			5101 NORTH PARK DRIVE OPERATIONS LLC
		

		
			515 BRIGHTFIELD ROAD OPERATIONS LLC
		

		
			525 GLENBURN AVENUE OPERATIONS LLC
		

		
			530 MACOBY STREET OPERATIONS LLC
		

		
			536 RIDGE ROAD OPERATIONS LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

54 SHARP STREET OPERATIONS LLC
		

		
			5485 PERKIOMEN AVENUE OPERATIONS LLC
		

		
			549 BALTIMORE PIKE OPERATIONS LLC
		

		
			55 COOPER STREET OPERATIONS LLC
		

		
			550 GLENWOOD OPERATIONS LLC
		

		
			550 GLENWOOD PROPERTY LLC
		

		
			5501 PERKIOMEN AVENUE OPERATIONS LLC
		

		
			56 WEST FREDERICK STREET OPERATIONS LLC
		

		
			59 HARRINGTON COURT OPERATIONS LLC
		

		
			590 NORTH POPLAR FORK ROAD OPERATIONS LLC
		

		
			600 PAOLI POINTE DRIVE OPERATIONS LLC
		

		
			6000 BELLONA AVENUE OPERATIONS LLC
		

		
			6040 HARFORD ROAD OPERATIONS LLC
		

		
			61 COOPER STREET OPERATIONS LLC
		

		
			610 DUTCHMAN'S LANE OPERATIONS LLC
		

		
			610 TOWNBANK ROAD OPERATIONS LLC
		

		
			613 HAMMONDS LANE OPERATIONS LLC
		

		
			625 STATE HIGHWAY 34 OPERATIONS LLC
		

		
			63 COUNTRY VILLAGE ROAD OPERATIONS LLC
		

		
			642 METACOM AVENUE OPERATIONS LLC
		

		
			65 COOPER STREET OPERATIONS LLC
		

		
			650 EDISON AVENUE OPERATIONS LLC
		

		
			656 DILLON WAY OPERATIONS LLC
		

		
			660 COMMONWEALTH AVENUE OPERATIONS LLC
		

		
			677 COURT STREET OPERATIONS LLC
		

		
			699 SOUTH PARK ROAD OPERATIONS LLC
		

		
			7 BALDWIN STREET OPERATIONS LLC
		

		
			70 GILL AVENUE OPERATIONS LLC
		

		
			700 MARVEL ROAD OPERATIONS LLC
		

		
			700 TOLL HOUSE AVENUE OPERATIONS LLC
		

		
			700 TOWN BANK ROAD OPERATIONS LLC
		

		
			710 JULIAN ROAD OPERATIONS LLC
		

		
			710 JULIAN ROAD PROPERTY LLC
		

		
			715 EAST KING STREET OPERATIONS LLC
		

		
			72 SALMON BROOK DRIVE OPERATIONS LLC
		

		
			723 SUMMERS STREET OPERATIONS LLC
		

		
			7232 GERMAN HILL ROAD OPERATIONS LLC
		

		
			735 PUTNAM PIKE OPERATIONS LLC
		

		
			7395 W. EASTMAN PLACE OPERATIONS LLC
		

		
			75 HICKLE STREET OPERATIONS LLC
		

		
			7520 SURRATTS ROAD OPERATIONS LLC
		

		
			7525 CARROLL AVENUE OPERATIONS LLC
		

		
			77 MADISON AVENUE OPERATIONS LLC
		

		
			7700 YORK ROAD OPERATIONS LLC
		

		
			777 LAFAYETTE ROAD OPERATIONS LLC
		

		
			78 OPAL STREET LLC
		

		
			8 ROSE STREET OPERATIONS LLC
		

		
			80 MADDEX DRIVE OPERATIONS LLC
		

		
			800 WEST MINER STREET OPERATIONS LLC
		

		
			8015 LAWNDALE STREET OPERATIONS LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

810 SOUTH BROOM STREET OPERATIONS LLC
		

		
			8100 WASHINGTON LANE OPERATIONS LLC
		

		
			825 SUMMIT STREET OPERATIONS LLC
		

		
			84 COLD HILL ROAD OPERATIONS LLC
		

		
			840 LEE ROAD OPERATIONS LLC
		

		
			841 MERRIMACK STREET OPERATIONS LLC
		

		
			843 WILBUR AVENUE OPERATIONS LLC
		

		
			845 PADDOCK AVENUE OPERATIONS LLC
		

		
			850 PAPER MILL ROAD OPERATIONS LLC
		

		
			867 YORK ROAD OPERATIONS LLC
		

		
			8710 EMGE ROAD OPERATIONS LLC
		

		
			8720 EMGE ROAD OPERATIONS LLC
		

		
			89 MORTON STREET OPERATIONS LLC
		

		
			899 CECIL AVENUE OPERATIONS LLC
		

		
			905 PENLLYN PIKE OPERATIONS LLC
		

		
			91 COUNTRY VILLAGE ROAD OPERATIONS LLC
		

		
			9101 SECOND AVENUE OPERATIONS LLC
		

		
			9109 LIBERTY ROAD OPERATIONS LLC
		

		
			9109 LIBERTY ROAD PROPERTY LLC
		

		
			93 MAIN STREET SNF OPERATIONS LLC
		

		
			932 BROADWAY OPERATIONS LLC
		

		
			9701 MEDICAL CENTER DRIVE OPERATIONS LLC
		

		
			9738 WESTOVER HILLS BOULEVARD OPERATIONS LLC
		

		
			ALEXANDRIA CARE CENTER, LLC
		

		
			ALTA CARE CENTER, LLC
		

		
			ANAHEIM TERRACE CARE CENTER, LLC
		

		
			BAY CREST CARE CENTER, LLC
		

		
			BELEN MEADOWS HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			BELMONT NURSING CENTER, LLC
		

		
			BETA FACTOR HOME CARE, LLC
		

		
			BEYONDFAITH HOMECARE & REHAB OF ALBUQUERQUE, LLC
		

		
			BLUE RIVER KANSAS CITY PROPERTY, LLC
		

		
			BLUE RIVER REHABILITATION CENTER, LLC
		

		
			BRADFORD SQUARE NURSING, LLC
		

		
			BRIER OAK ON SUNSET, LLC
		

		
			CAREERSTAFF HOLDCO, INC.
		

		
			CAREERSTAFF UNLIMITED, LLC
		

		
			CARMEL HILLS HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			CARMEL HILLS INDEPENDENCE PROPERTY, LLC
		

		
			CITY VIEW VILLA, LLC
		

		
			CLAIRMONT LONGVIEW PROPERTY, LLC
		

		
			CLAIRMONT LONGVIEW, LLC
		

		
			CLOVIS HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			COLONIAL TYLER CARE CENTER, LLC
		

		
			CORNERSTONE HOSPICE ARIZONA, LLC
		

		
			CORNERSTONE HOSPICE CALIFORNIA, LLC
		

		
			COURTYARD JV LLC
		

		
			CREEKSIDE HOME CARE II, LLC
		

		
			CREEKSIDE HOSPICE II, LLC
		

		
			CRESTVIEW NURSING, LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

DEVONSHIRE CARE CENTER, LLC
		

		
			DIANE DRIVE OPERATIONS LLC
		

		
			ELMCREST CARE CENTER, LLC
		

		
			FALMOUTH HEALTHCARE, LLC
		

		
			FC-GEN HOSPICE HOLDINGS, LLC
		

		
			FC-GEN OPERATIONS INVESTMENT, LLC
		

		
			FIVE NINETY SIX SHELDON ROAD OPERATIONS LLC
		

		
			FLATONIA OAK MANOR, LLC
		

		
			FLORIDA HOLDINGS I, LLC
		

		
			FLORIDA HOLDINGS II, LLC
		

		
			FLORIDA HOLDINGS III, LLC
		

		
			FORT WORTH CENTER OF REHABILITATION, LLC
		

		
			FORTY EIGHT NICHOLS STREET OPERATIONS LLC
		

		
			FORTY SIX NICHOLS STREET OPERATIONS LLC
		

		
			FORTY SIX NICHOLS STREET PROPERTY, LLC
		

		
			FOUNTAIN CARE CENTER, LLC
		

		
			FOUNTAIN ORANGE PROPERTY, LLC
		

		
			FOUNTAIN SENIOR ASSISTED LIVING, LLC
		

		
			FOUNTAIN VIEW SUBACUTE AND NURSING CENTER, LLC
		

		
			FRANKLIN WOODS JV LLC
		

		
			GEN OPERATIONS I, LLC
		

		
			GEN OPERATIONS II, LLC
		

		
			GENESIS ADMINISTRATIVE SERVICES LLC
		

		
			GENESIS BAYVIEW JV HOLDINGS, LLC
		

		
			GENESIS CARE INNOVATIONS, LLC
		

		
			GENESIS CO HOLDINGS LLC
		

		
			GENESIS CT HOLDINGS LLC
		

		
			GENESIS DE HOLDINGS LLC
		

		
			GENESIS DIAMOND OPERATIONS LLC
		

		
			GENESIS ELDERCARE NETWORK SERVICES, LLC
		

		
			GENESIS ELDERCARE PHYSICIAN SERVICES, LLC
		

		
			GENESIS ELDERCARE REHABILITATION SERVICES, LLC
		

		
			GENESIS HEALTH VENTURES OF NEW GARDEN, LLC
		

		
			GENESIS HEALTHCARE, INC.
		

		
			GENESIS HEALTHCARE LLC
		

		
			GENESIS HOLDINGS, LLC
		

		
			GENESIS HOSPITALITY SERVICES LLC
		

		
			GENESIS IP LLC
		

		
			GENESIS MA HOLDINGS LLC
		

		
			GENESIS MD HOLDINGS LLC
		

		
			GENESIS NH HOLDINGS LLC
		

		
			GENESIS NJ HOLDINGS LLC
		

		
			GENESIS OMG OPERATIONS LLC
		

		
			GENESIS OPERATIONS II LLC
		

		
			GENESIS OPERATIONS III LLC
		

		
			GENESIS OPERATIONS IV LLC
		

		
			GENESIS OPERATIONS LLC
		

		
			GENESIS OPERATIONS V LLC
		

		
			GENESIS OPERATIONS VI LLC
		

		
			GENESIS PA HOLDINGS LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

GENESIS PARTNERSHIP LLC
		

		
			GENESIS PROSTEP, LLC
		

		
			GENESIS RI HOLDINGS LLC
		

		
			GENESIS STAFFING SERVICES LLC
		

		
			GENESIS TX HOLDINGS LLC
		

		
			GENESIS VA HOLDINGS LLC
		

		
			GENESIS VT HOLDINGS LLC
		

		
			GENESIS WV HOLDINGS LLC
		

		
			GHC BURLINGTON WOODS DIALYSIS JV LLC
		

		
			GHC DIALYSIS JV LLC
		

		
			GHC HOLDINGS II LLC
		

		
			GHC HOLDINGS LLC
		

		
			GHC JV HOLDINGS LLC
		

		
			GHC MATAWAN DIALYSIS JV LLC
		

		
			GHC PAYROLL LLC
		

		
			GHC PROPERTY MANAGEMENT LLC
		

		
			GHC RANDALLSTOWN DIALYSIS JV LLC
		

		
			GHC SELECTCARE LLC
		

		
			GHC TX OPERATIONS LLC
		

		
			GHC WINDSOR DIALYSIS JV LLC
		

		
			GRANITE LEDGES JV LLC
		

		
			GRANT MANOR LLC
		

		
			GREAT FALLS HEALTH CARE COMPANY, L.L.C.
		

		
			GRS JV LLC
		

		
			GUADALUPE SEGUIN PROPERTY, LLC
		

		
			GUADALUPE VALLEY NURSING CENTER, LLC
		

		
			HALLETTSVILLE REHABILITATION AND NURSING CENTER, LLC
		

		
			HALLMARK INVESTMENT GROUP, LLC
		

		
			HALLMARK REHABILITATION GP, LLC
		

		
			HANCOCK PARK REHABILITATION CENTER, LLC
		

		
			HARBORSIDE CONNECTICUT LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE DANBURY LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE HEALTH I LLC
		

		
			HARBORSIDE HEALTHCARE ADVISORS LIMITED PARTNERSHIP
		

		
			By: KHI LLC, its general partner
		

		
			HARBORSIDE HEALTHCARE LIMITED PARTNERSHIP
		

		
			By: KHI LLC, its general partner
		

		
			HARBORSIDE HEALTHCARE, LLC
		

		
			HARBORSIDE MASSACHUSETTS LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE NEW HAMPSHIRE LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE TOLEDO BUSINESS LLC, its general partner
		

		
			HARBORSIDE NORTH TOLEDO LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE OF CLEVELAND LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE OF DAYTON LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

HARBORSIDE OF OHIO LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE POINT PLACE, LLC
		

		
			HARBORSIDE REHABILITATION LIMITED PARTNERSHIP
		

		
			By: CAREERSTAFF UNLIMITED, INC., its general partner
		

		
			HARBORSIDE RHODE ISLAND LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			HARBORSIDE SWANTON, LLC
		

		
			HARBORSIDE SYLVANIA, LLC
		

		
			HARBORSIDE TOLEDO BUSINESS LLC
		

		
			HARBORSIDE TOLEDO LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE TOLEDO BUSINESS LLC, its general partner
		

		
			HARBORSIDE TROY, LLC
		

		
			HBR BARDWELL LLC
		

		
			HBR BARKELY DRIVE, LLC
		

		
			HBR BOWLING GREEN LLC
		

		
			HBR BROWNSVILLE, LLC
		

		
			HBR CAMPBELL LANE, LLC
		

		
			HBR DANBURY, LLC
		

		
			HBR ELIZABETHTOWN, LLC
		

		
			HBR KENTUCKY, LLC
		

		
			HBR LEWISPORT, LLC
		

		
			HBR MADISONVILLE, LLC
		

		
			HBR OWENSBORO, LLC
		

		
			HBR PADUCAH, LLC
		

		
			HBR STAMFORD, LLC
		

		
			HBR TRUMBULL, LLC
		

		
			HBR WOODBURN, LLC
		

		
			HC 63 OPERATIONS LLC
		

		
			HHCI LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE TOLEDO BUSINESS LLC, its general partner
		

		
			HIGHLAND HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			HOLMESDALE HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			HOLMESDALE PROPERTY, LLC
		

		
			HOME HEALTH CARE OF THE WEST, LLC
		

		
			HOSPICE CARE OF THE WEST, LLC
		

		
			HOSPITALITY LUBBOCK PROPERTY, LLC
		

		
			HOSPITALITY NURSING AND REHABILITATION CENTER, LLC
		

		
			HUNTINGTON PLACE LIMITED PARTNERSHIP
		

		
			By: 1775 HUNTINGTON LANE, LLC, its general partner
		

		
			INDEPENDENCE MISSOURI PROPERTY, LLC
		

		
			KANSAS CITY TRANSITIONAL CARE CENTER, LLC
		

		
			KENNETT CENTER, L.P.
		

		
			By: GENESIS HEALTH VENTURES OF NEW GARDEN, INC., its general partner KHI LLC
		

		
			KLONDIKE MANOR LLC
		

		
			LEGACY HOME CARE II, LLC
		

		
			LEGACY HOSPICE II, LLC
		

		
			LEISURE YEARS NURSING, LLC
		

		
			LIBERTY TERRACE HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			LIBERTY TERRACE MISSOURI PROPERTY, LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

LIVE OAK NURSING CENTER, LLC
		

		
			LOUISBURG HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			MAGNOLIA JV LLC
		

		
			MARIETTA HEALTHCARE, LLC
		

		
			MARYLAND HARBORSIDE LLC
		

		
			MASHPEE HEALTHCARE, LLC
		

		
			MASSACHUSETTS HOLDINGS I, LLC
		

		
			MASTHEAD, LLC
		

		
			MONTANA PREMIER CARE, LLC
		

		
			MONTEBELLO CARE CENTER, LLC
		

		
			MONUMENT LA GRANGE PROPERTY, LLC
		

		
			MONUMENT REHABILITATION AND NURSING CENTER, LLC
		

		
			NEVADA PREMIER CARE, LLC
		

		
			NINE HAYWOOD AVENUE OPERATIONS LLC
		

		
			OAKLAND MANOR NURSING CENTER, LLC
		

		
			ODD LOT LLC
		

		
			OHIO HOLDINGS I, LLC
		

		
			OWENTON MANOR NURSING, LLC
		

		
			PDDTSE LLC
		

		
			PEAK MEDICAL ASSISTED LIVING, LLC
		

		
			PEAK MEDICAL COLORADO NO. 2, LLC
		

		
			PEAK MEDICAL COLORADO NO. 3, LLC
		

		
			PEAK MEDICAL IDAHO OPERATIONS HOLDCO, INC.
		

		
			PEAK MEDICAL IDAHO OPERATIONS, LLC
		

		
			PEAK MEDICAL LAS CRUCES NO. 2, LLC
		

		
			PEAK MEDICAL LAS CRUCES, LLC
		

		
			PEAK MEDICAL MONTANA OPERATIONS, LLC
		

		
			PEAK MEDICAL NEW MEXICO NO. 3, LLC
		

		
			PEAK MEDICAL OF BOISE, LLC
		

		
			PEAK MEDICAL OF COLORADO, LLC
		

		
			PEAK MEDICAL OF IDAHO, LLC
		

		
			PEAK MEDICAL OF ROSWELL HOLDCO, INC.
		

		
			PEAK MEDICAL OF UTAH HOLDCO, INC.
		

		
			PEAK MEDICAL OF UTAH, LLC
		

		
			PEAK MEDICAL ROSWELL, LLC
		

		
			PEAK MEDICAL, LLC
		

		
			PINE TREE VILLA LLC
		

		
			PM OXYGEN SERVICES, LLC
		

		
			PREFERRED DESIGN, LLC
		

		
			PROCARE ONE NURSES, LLC
		

		
			PROPERTY RESOURCE HOLDINGS, LLC
		

		
			REGENCY HEALTH SERVICES HOLDCO, INC.
		

		
			REGENCY HEALTH SERVICES, LLC
		

		
			REGENCY NURSING, LLC
		

		
			RESPIRATORY HEALTH SERVICES LLC
		

		
			RIO HONDO SUBACUTE AND NURSING CENTER, LLC
		

		
			RIVERSIDE RETIREMENT LIMITED PARTNERSHIP
		

		
			By: HARBORSIDE HEALTH I LLC, its general partner
		

		
			ROCKY MOUNTAIN HOME CARE II, LLC
		

		
			ROCKY MOUNTAIN HOSPICE OF BILLINGS, LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

ROCKY MOUNTAIN HOSPICE OF BUTTE, LLC
		

		
			ROCKY MOUNTAIN HOSPICE OF MISSOULA, LLC
		

		
			ROMNEY HEALTH CARE CENTER LIMITED PARTNERSHIP
		

		
			By: GENESIS OPERATIONS VI LLC, its general partner
		

		
			ROUTE 92 OPERATIONS LLC
		

		
			ROYALWOOD CARE CENTER, LLC
		

		
			SADDLE SHOP ROAD OPERATIONS LLC
		

		
			SALISBURY JV LLC
		

		
			SHARON CARE CENTER, LLC
		

		
			SHAWNEE GARDENS HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			SHAWNEE PROPERTY, LLC
		

		
			SHG PARTNERSHIP, LLC
		

		
			SHG RESOURCES, LLC
		

		
			SIGNATURE HOSPICE & HOME HEALTH, LLC
		

		
			SKIES HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			SKILES AVENUE AND STERLING DRIVE OPERATIONS LLC
		

		
			SKILLED HEALTHCARE, LLC
		

		
			SOUTHWEST PAYROLL SERVICES, LLC
		

		
			SOUTHWOOD AUSTIN PROPERTY, LLC
		

		
			SOUTHWOOD CARE CENTER, LLC
		

		
			SPRING SENIOR ASSISTED LIVING, LLC
		

		
			SR-73 AND LAKESIDE AVENUE OPERATIONS LLC
		

		
			ST. ANTHONY HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			ST. CATHERINE HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			ST. ELIZABETH HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			ST. JOHN HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			ST. THERESA HEALTHCARE AND REHABILITATION CENTER, LLC
		

		
			STATE STREET ASSOCIATES, L.P.
		

		
			By: STATE STREET ASSOCIATES, INC., its general partner
		

		
			STATE STREET KENNETT SQUARE, LLC
		

		
			STILLWELL ROAD OPERATIONS LLC
		

		
			SUMMIT CARE PARENT, LLC
		

		
			SUMMIT CARE PHARMACY, LLC
		

		
			SUMMIT CARE, LLC
		

		
			SUN HEALTHCARE GROUP, INC.
		

		
			SUN VALLEY HOME CARE II, LLC
		

		
			SUN VALLEY HOSPICE II, LLC
		

		
			SUNBRIDGE BECKLEY HEALTH CARE LLC
		

		
			SUNBRIDGE BRASWELL ENTERPRISES, LLC
		

		
			SUNBRIDGE BRITTANY REHABILITATION CENTER HOLDCO, INC.
		

		
			SUNBRIDGE BRITTANY REHABILITATION CENTER, LLC
		

		
			SUNBRIDGE CARE ENTERPRISES WEST, LLC
		

		
			SUNBRIDGE CARE ENTERPRISES, LLC
		

		
			SUNBRIDGE CARMICHAEL REHABILITATION CENTER, LLC
		

		
			SUNBRIDGE CARMICHAEL REHABILITATION CENTER HOLDCO, INC.
		

		
			SUNBRIDGE CHARLTON HEALTHCARE, LLC
		

		
			SUNBRIDGE CIRCLEVILLE HEALTH CARE LLC
		

		
			SUNBRIDGE CLIPPER HOME OF PORTSMOUTH, LLC
		

		
			SUNBRIDGE CLIPPER HOME OF ROCHESTER, LLC
		

		
			SUNBRIDGE DUNBAR HEALTH CARE LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

SUNBRIDGE GARDENDALE HEALTH CARE CENTER, LLC
		

		
			SUNBRIDGE GLENVILLE HEALTH CARE, LLC
		

		
			SUNBRIDGE GOODWIN NURSING HOME HOLDCO, INC.
		

		
			SUNBRIDGE GOODWIN NURSING HOME, LLC
		

		
			SUNBRIDGE HALLMARK HEALTH SERVICES HOLDCO, INC.
		

		
			SUNBRIDGE HALLMARK HEALTH SERVICES, LLC
		

		
			SUNBRIDGE HARBOR VIEW REHABILITATION CENTER HOLDCO, INC.
		

		
			SUNBRIDGE HARBOR VIEW REHABILITATION CENTER LLC
		

		
			SUNBRIDGE HEALTHCARE, LLC
		

		
			SUNBRIDGE JEFF DAVIS HEALTHCARE, LLC
		

		
			SUNBRIDGE MARION HEALTH CARE LLC
		

		
			SUNBRIDGE MEADOWBROOK REHABILITATION CENTER LLC
		

		
			SUNBRIDGE MOUNTAIN CARE MANAGEMENT HOLDCO, INC.
		

		
			SUNBRIDGE MOUNTAIN CARE MANAGEMENT, LLC
		

		
			SUNBRIDGE NURSING HOME, LLC
		

		
			SUNBRIDGE OF HARRIMAN, LLC
		

		
			SUNBRIDGE PARADISE REHABILITATION CENTER HOLDCO, INC.
		

		
			SUNBRIDGE PARADISE REHABILITATION CENTER, LLC
		

		
			SUNBRIDGE PUTNAM HEALTH CARE LLC
		

		
			SUNBRIDGE REGENCY-NORTH CAROLINA, LLC
		

		
			SUNBRIDGE REGENCY-TENNESSEE, LLC
		

		
			SUNBRIDGE RETIREMENT CARE ASSOCIATES, LLC
		

		
			SUNBRIDGE SALEM HEALTH CARE LLC
		

		
			SUNBRIDGE SHANDIN HILLS REHABILITATION CENTER LLC
		

		
			SUNBRIDGE STOCKTON REHABILITATION CENTER HOLDCO, INC.
		

		
			SUNBRIDGE STOCKTON REHABILITATION CENTER, LLC
		

		
			SUNBRIDGE SUMMERS LANDING HOLDCO, INC.
		

		
			SUNBRIDGE SUMMERS LANDING, LLC
		

		
			SUNBRIDGE WEST TENNESSEE HOLDCO, INC.
		

		
			SUNBRIDGE WEST TENNESSEE, LLC
		

		
			SUNDANCE REHABILITATION AGENCY, LLC
		

		
			SUNDANCE REHABILITATION HOLDCO, INC.
		

		
			SUNDANCE REHABILITATION LLC
		

		
			SUNMARK OF NEW MEXICO, LLC
		

		
			THE CLAIRMONT TYLER, LLC
		

		
			THE EARLWOOD, LLC
		

		
			THE HEIGHTS OF SUMMERLIN, LLC
		

		
			THE REHABILITATION CENTER OF ALBUQUERQUE, LLC
		

		
			THE REHABILITATION CENTER OF INDEPENDENCE, LLC
		

		
			THE REHABILITATION CENTER OF OMAHA, LLC
		

		
			THIRTY FIVE BEL-AIRE DRIVE SNF OPERATIONS LLC
		

		
			THREE MILE CURVE OPERATIONS LLC
		

		
			TOWN AND COUNTRY BOERNE PROPERTY, LLC
		

		
			TOWN AND COUNTRY MANOR, LLC
		

		
			VINTAGE PARK AT ATCHISON, LLC
		

		
			VINTAGE PARK AT BALDWIN CITY, LLC
		

		
			VINTAGE PARK AT EUREKA, LLC
		

		
			VINTAGE PARK AT FREDONIA, LLC
		

		
			VINTAGE PARK AT GARDNER, LLC
		

		
			VINTAGE PARK AT HIAWATHA, LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

VINTAGE PARK AT HOLTON, LLC
		

		
			VINTAGE PARK AT LENEXA, LLC
		

		
			VINTAGE PARK AT LOUISBURG, LLC
		

		
			VINTAGE PARK AT NEODESHA, LLC
		

		
			VINTAGE PARK AT OSAGE CITY, LLC
		

		
			VINTAGE PARK AT OSAWATOMIE, LLC
		

		
			VINTAGE PARK AT OTTAWA, LLC
		

		
			VINTAGE PARK AT PAOLA, LLC
		

		
			VINTAGE PARK AT SAN MARTIN, LLC
		

		
			VINTAGE PARK AT STANLEY, LLC
		

		
			VINTAGE PARK AT TONGANOXIE, LLC
		

		
			VINTAGE PARK AT WAMEGO, LLC
		

		
			VINTAGE PARK AT WATERFRONT, LLC
		

		
			WAKEFIELD HEALTHCARE, LLC
		

		
			WESTFIELD HEALTHCARE, LLC
		

		
			WESTWOOD MEDICAL PARK OPERATIONS LLC
		

		
			WILLOW CREEK HEALTHCARE CENTER, LLC
		

		
			WOODLAND CARE CENTER, LLC
		

		
			WOODSPOINT LLC
		

		
			ONE PRICE DRIVE OPERATIONS LLC
		

		
			1165 EASTON AVENUE OPERATIONS LLC
		

		
			1165 EASTON AVENUE PROPERTY, LLC
		

		
			120 MURRAY STREET OPERATIONS LLC
		

		
			120 MURRAY STREET PROPERTY LLC
		

		
			1351 OLD FREEHOLD ROAD OPERATIONS LLC
		

		
			1420 SOUTH BLACK HORSE PIKE OPERATIONS LLC
		

		
			1420 SOUTH BLACK HORSE PIKE PROPERTY, LLC
		

		
			201 NEW ROAD OPERATIONS LLC
		

		
			2015 EAST WEST HIGHWAY OPERATIONS LLC
		

		
			2015 EAST WEST HIGHWAY PROPERTY, LLC
		

		
			23 FAIR STREET OPERATIONS LLC
		

		
			23 FAIR STREET PROPERTY, LLC
		

		
			261 TERHUNE DRIVE OPERATIONS LLC
		

		
			261 TERHUNE DRIVE PROPERTY, LLC
		

		
			279 CABOT STREET OPERATIONS LLC
		

		
			279 CABOT STREET PROPERTY LLC
		

		
			3000 HILLTOP ROAD OPERATIONS LLC
		

		
			3000 HILLTOP ROAD PROPERTY, LLC
		

		
			40 WHITEHALL ROAD OPERATIONS LLC
		

		
			40 WHITEHALL ROAD PROPERTY LLC
		

		
			400 29TH STREET NORTHEAST OPERATIONS LLC
		

		
			400 29TH STREET NORTHEAST PROPERTY LLC
		

		
			475 JACK MARTIN BOULEVARD OPERATIONS LLC
		

		
			4755 SOUTH 48TH STREET OPERATIONS LLC
		

		
			4755 SOUTH 48TH STREET PROPERTY LLC
		

		
			55 KONDRACKI LANE OPERATIONS LLC
		

		
			55 KONDRACKI LANE PROPERTY, LLC
		

		
			56 HAMILTON AVENUE OPERATIONS LLC
		

		
			740 OAK HILL ROAD OPERATIONS LLC
		

		
			740 OAK HILL ROAD PROPERTY LLC
		

		
			
		

		
			

		 

		

			Exhibit C

		

 

800 MEDCALF LANE NORTH OPERATIONS LLC
		

		
			800 MEDCALF LANE NORTH PROPERTY LLC
		

		
			8000 ILIFF DRIVE OPERATIONS LLC
		

		
			8000 ILIFF DRIVE PROPERTY LLC 
		

		
			 
		

		 

		

			Exhibit CExhibit

QORVO, INC.
2012 STOCK INCENTIVE PLAN 
Restricted Stock Unit Agreement 
(Director Annual/Supplemental RSUs)

THIS AGREEMENT, including any special terms and conditions for the Participant’s country set forth in the appendix attached hereto (the “Appendix”) (together with Schedule A, attached hereto, the “Agreement”), is made effective as of the Grant Date (as defined in Section 2 below) between QORVO, INC., a Delaware corporation (the “Company”), and _________________, a Director (the “Participant”).
RECITALS:
In furtherance of the purposes of the Qorvo, Inc. 2012 Stock Incentive Plan (As Assumed by Qorvo, Inc. and Amended and Restated Effective January 1, 2015) (Formerly, the RF Micro Devices, Inc. 2012 Stock Incentive Plan), as it may be amended (the “Plan”), the Company and the Participant hereby agree as follows:
1.Incorporation of Plan.  The rights and duties of the Company and the Participant under this Agreement shall in all respects be subject to and governed by the provisions of the Plan, the terms of which are incorporated herein by reference.  In the event of any conflict between the provisions in the Agreement and those of the Plan, the provisions of the Plan shall govern, unless the Administrator determines otherwise.  Unless otherwise defined herein, capitalized terms in this Agreement shall have the same definitions as set forth in the Plan.
2.Terms of Award.  The following terms used in this Agreement shall have the meanings set forth in this Section 2:
		
	a.
	The “Participant” is _______________.

		
	b.
	The “Grant Date” is ______________.

		
	c.
	The “Restriction Period” is the period beginning on the Grant Date and ending on such date or dates and occurrence of such conditions as described in Schedule A, which is attached hereto and expressly made a part of this Agreement.

		
	d.
	The number of shares of Common Stock subject to the award of Restricted Stock Units granted under this Agreement shall be __________ shares (the “Shares”).  

3.Grant of Award of Restricted Stock Units.  Subject to the terms of this Agreement and the Plan, the Company hereby grants the Participant an award of Restricted Stock Units (the “Award”) for that number of Shares as is set forth in Section 2.  The Participant expressly acknowledges that the terms of Schedule A shall be incorporated herein by reference and shall constitute part of this Agreement.  The Company and the Participant further acknowledge that the Company’s signature on the signature page hereof, and the Participant’s signature on the Grant Letter contained in Schedule A, shall constitute their acceptance of all of the terms of this Agreement.
4.Stockholder Rights.  The Participant or his or her legal representatives, legatees or distributees shall not be deemed to be the holder of any Shares subject to the Award and shall not have any dividend rights (except as otherwise provided in Section 3 of Schedule A), voting rights or other rights as a 

        

stockholder unless and until (and then only to the extent that) the Award has vested and certificates for such Shares have been issued and delivered to him, her or them (or, in the case of uncertificated shares, other written evidence of ownership in accordance with Applicable Law shall have been provided).
5.Vesting and Earning of Award.  Subject to the terms of the Plan and this Agreement, the Award shall be deemed vested and earned, and the Shares subject to the Award shall be distributable as provided in Section 7 herein, upon such date or dates, and subject to such conditions, as are described in this Agreement, including Section 2 of Schedule A.  Without limiting the effect of the foregoing, the Shares subject to the Award may vest in installments over a period of time, if so provided in Schedule A.  The Participant expressly acknowledges that the Award shall vest only upon such terms and conditions as are provided in this Agreement (including but not limited to Schedule A) and otherwise in accordance with the terms of the Plan.  Without limiting the effect of the foregoing, the Participant understands and agrees that the Administrator may delay the vesting of the Award (or portion thereof) and (subject to Code Section 409A) the issuance of the underlying Shares in order to comply with Applicable Law or applicable policies of the Company implemented to ensure compliance with such laws (including but not limited to insider trading provisions and the Company's insider trading policy); provided, however, that any such delay in vesting of the Award or issuance of Shares shall not apply to any Shares subject to an effective Rule 10b5-1 trading plan.  The Administrator has sole authority to determine whether and to what degree the Award has vested and been earned and is payable and to interpret the terms and conditions of this Agreement and the Plan.
6.Effect of Termination of Service; Forfeiture of Award.  Except as may be otherwise provided in the Plan or this Agreement (including but not limited to Schedule A), in the event of the termination of service of the Participant for any reason (whether by the Company or by the Participant, whether voluntary or involuntary, and regardless of the reason for such termination and whether or not found to be invalid or in breach of laws in the jurisdiction where the Participant is rendering services or the terms of his or her service agreement, if any) and all or part of the Award has not been earned or vested as of the Participant’s Termination Date pursuant to the terms of this Agreement, then the Award, to the extent not vested as of the Participant’s Termination Date, shall be forfeited immediately upon such termination, and the Participant shall have no further rights with respect to the Award or the Shares underlying that portion of the Award that has not yet been earned and vested.  The Participant expressly acknowledges and agrees that the termination of his or her service shall (except as may otherwise be provided in this Agreement or the Plan) result in forfeiture of the Award and the Shares to the extent the Award has not been earned and vested as of his or her Termination Date.
For purposes of the Award (and except as otherwise required under Code Section 409A), the Termination Date occurs on the date the Participant is no longer actively providing services to the Company and will not be extended by any notice period (e.g., the Participant’s period of service would not include any contractual notice period or any period of “garden leave” or similar period mandated under laws in the jurisdiction where the Participant is providing services, or the terms of his or her service agreement, if any); and the Administrator shall have the exclusive discretion to determine when the Participant is no longer actively providing services for purposes of the Award (including whether the Participant may still be considered to be providing services while on a leave of absence).
7.Settlement of Award; Election to Defer Delivery.  
(a)The Award, if earned in accordance with the terms of this Agreement, shall be payable in whole Shares.  The total number of Shares that may be acquired upon vesting of the Award (or portion thereof) shall be rounded down to the nearest whole share.  A certificate or certificates for the Shares subject to the Award or portion thereof shall be issued in the name of the 

2
        

Participant or his or her beneficiary (or, in the case of uncertificated shares, other written evidence of ownership in accordance with Applicable Law shall be provided) as soon as practicable after, and only to the extent that, the Award or portion thereof has vested and Shares are distributable, unless the Participant has made an irrevocable deferral election to defer delivery of Shares subject to the Award in accordance with Section 7(b) below.  Subject to any deferral election of the Participant in accordance with Section 7(b) below, Shares or any other benefit subject to the Award shall, upon vesting of the Award, be issued and distributed to the Participant (or his or her beneficiary) no later than the later of (i) the fifteenth (15th) day of the third month following the Participant’s first taxable year in which the amount is no longer subject to a substantial risk of forfeiture, or (ii) the fifteenth (15th) day of the third month following the end of the Company’s first taxable year in which the amount is no longer subject to a substantial risk of forfeiture, or otherwise in accordance with Code Section 409A.  
(b)Unless the Administrator determines otherwise, the Participant shall have the right to elect a deferral of the timing of delivery to be made with respect to the Shares subject to the Award.  The terms of such deferral shall be in accordance with the elections of the Participant set forth on the “Director Deferral Election Form”. 
8.No Right of Continued Service.  Nothing contained in this Agreement or the Plan shall confer upon the Participant any right to continue in the service of the Company or to interfere in any way with the right of the Company or its stockholders to terminate the Participant’s service at any time.  Except as otherwise expressly provided in the Plan and this Agreement (including but not limited to Schedule A), all rights of the Participant under the Plan with respect to the unvested portion of his or her Award shall terminate upon the Termination Date.  The grant of the Award does not create any obligation to grant further awards.
9.Nontransferability of Award and Shares.  The Award shall not be transferable (including by sale, assignment, pledge or hypothecation) other than by will or the laws of descent and distribution.  The designation of a beneficiary in accordance with the Plan (to the extent permitted by the Administrator) does not constitute a transfer.  The Participant shall not sell, transfer, assign, pledge or otherwise encumber the Shares subject to the Award until such Shares have been issued and delivered to the Participant.
10.Withholding; Tax Consequences.
(a)The Participant acknowledges that, regardless of any action taken by the Company, the ultimate liability for all income tax, social insurance, payroll tax, fringe benefits tax, payment on account or other tax-related items related to the Participant’s participation in the Plan and legally applicable to the Participant (“Tax-Related Items”) is and remains the Participant’s responsibility and may exceed the amount actually withheld by the Company.  Further, if the Participant is subject to Tax-Related Items in more than one jurisdiction, the Participant acknowledges that the Company may be required to withhold or account for Tax-Related Items in more than one jurisdiction.
(b)Prior to any relevant taxable or tax withholding event, as applicable, the Participant agrees to make adequate arrangements satisfactory to the Company to satisfy all Tax-Related Items.  In this regard, the Participant authorizes the Company or its respective agents to satisfy their withholding obligations with regard to all Tax-Related Items by withholding Shares to be issued upon settlement of the Award.  The Company may withhold or account for Tax-Related Items by considering minimum statutory withholding rates or other applicable withholding rates.  For tax purposes, the Participant is deemed to have been issued the full number of Shares subject to the 

3
        

vested portion of the Award, notwithstanding that a number of the Shares are held back solely for the purpose of paying the Tax-Related Items.  In the event that the Company determines that withholding Shares is problematic under applicable local laws or has materially adverse accounting consequences, by his or her acceptance of the Award, the Participant authorizes the Company and any brokerage firm determined acceptable to the Company to sell, on his or her behalf, a whole number of Shares from those Shares issuable to the Participant as the Company determines to be appropriate to generate cash proceeds sufficient to satisfy the obligation for Tax-Related Items.  If withholding is performed from proceeds from the sale of Shares, the Company may withhold for Tax-Related Items by considering maximum applicable rates, in which case the Participant may receive a refund of any over-withheld amount in cash and will have no entitlement to the Shares equivalent.  Alternatively, the Company may (subject to any Code Section 409A considerations) satisfy their withholding obligations for Tax-Related Items by withholding from the Participant’s wages or other cash compensation.  The Company may refuse to issue or deliver the Shares or the proceeds of the sale of Shares if the Participant fails to comply with his or her obligations in connection with the Tax-Related Items.
(c)The Participant acknowledges that the Company has made no warranties or representations to the Participant with respect to the Tax-Related Items (including but not limited to income tax consequences) with respect to the transactions contemplated by this Agreement, and the Participant is in no manner relying on the Company or its representatives for an assessment of such tax consequences.  The Participant further acknowledges that there may be adverse tax consequences upon the grant or vesting of the Award and/or the acquisition or disposition of the Shares subject to the Award and the receipt of any dividends, and that he or she has been advised that he or she should consult with his or her own attorney, accountant and/or tax advisor regarding the decision to enter into this Agreement and the consequences thereof.  The Participant also acknowledges that the Company has no responsibility to take or refrain from taking any actions in order to achieve a certain tax result for the Participant.
11.Nature of Grant.  In accepting the Award, the Participant acknowledges, understands and agrees that:
(a)the Plan is established voluntarily by the Company, is discretionary in nature, and may be amended, suspended or terminated by the Company at any time, to the extent permitted by the Plan;
(b)all decisions with respect to future equity-based awards to the Participant, if any, will be at the sole discretion of the Company; 
(c)the Participant’s participation in the Plan is voluntary; 
(d)the Award and any Shares acquired under the Plan, and the value of and income attributable to the same, are not intended to replace any pension rights or compensation;
(e)the future value of the Shares underlying the Award is unknown and cannot be predicted; 
(f)unless otherwise provided in the Plan, the Award and the benefits evidenced by this Agreement do not create any entitlement to have the Award or any such benefits transferred to, or assumed by, another company nor be exchanged, cashed out or substituted for, in connection with any corporate transaction affecting the Common Stock; 

4
        

(g)no claim or entitlement to compensation or damages shall arise from forfeiture of the Award resulting from the Participant’s termination of service (for any reason whatsoever whether or not later found to be invalid or in breach of laws in the jurisdiction where the Participant is providing services or the terms of his or her service agreement, if any); and
(h)if the Participant is providing services outside of the U.S., neither the Company nor any Affiliate shall be liable for any foreign exchange rate fluctuation between the Participant’s local currency and the U.S. dollar that may affect the value of the Award or of any amounts due to the Participant pursuant to the vesting of the Award or the subsequent sale of any Shares acquired upon vesting.
12.Data Privacy.  The Participant hereby explicitly and unambiguously consents to the collection, use and transfer, in electronic or other form, of his or her personal data as described in this Agreement and any other Award grant materials by and among, as applicable, the Company and any Affiliate for the exclusive purpose of implementing, administering and managing his or her participation in the Plan.
The Participant understands that the Company may hold certain personal information about him or her, including, but not limited to, his or her name, home address and telephone number, date of birth, social insurance number or other identification number, salary, nationality, job title, any shares of Common Stock or directorships held in the Company or any Affiliate, details of all Restricted Stock Units or any other entitlement to Shares awarded, canceled, exercised, vested, unvested or outstanding in his or her favor (“Data”), for the exclusive purpose of implementing, administering and managing the Plan.
The Participant understands that Data will be transferred to Fidelity Stock Plan Services, LLC (“Fidelity”) or to any other third party assisting in the implementation, administration and management of the Plan.  The Participant understands that the recipients of Data may be located in the Participant’s country or elsewhere, and that the recipient’s country may have different data privacy laws and protections than his or her country.  The Participant understands that, if he or she resides outside the U.S., the Participant may request a list with the names and addresses of any potential recipients of Data by contacting his or her local Human Resources representative.  The Participant authorizes the Company, Fidelity and any other recipients of Data which may assist the Company (presently or in the future) with implementing, administering and managing the Plan to receive, possess, use, retain and transfer Data, in electronic or other form, for the purposes of implementing, administering and managing his or her participation in the Plan, including any requisite transfer of Data as may be required to a broker or other third party with whom the Participant may elect to deposit any Shares purchased upon vesting of the Award. The Participant understands that Data will be held only as long as is necessary to implement, administer and manage his or her participation in the Plan.  The Participant understands that, if he or she resides outside the U.S., the Participant may, at any time, view Data, request additional information about the storage and processing of Data, require any necessary amendments to Data or refuse or withdraw the consents herein, in any case without cost, by contacting in writing the Company.  Further, the Participant understands that he or she is providing the consents herein on a purely voluntary basis.  If the Participant does not consent, or if the Participant later seeks to revoke the consent, his or her service status will not be affected solely by such actions of the Participant; the only consequence of refusing or withdrawing the consent is that the Company would not be able to grant Restricted Stock Units or other equity awards to the Participant or administer or maintain such awards.  Therefore, the Participant understands that refusing or withdrawing the consent may affect his or her ability to participate in the Plan. For more information on the consequences of his or her refusal to consent or withdrawal of consent, the Participant understands that he or she may contact the Company.

5
        

13.Administration.  The authority to construe and interpret this Agreement and the Plan, and to administer all aspects of the Plan, shall be vested in the Administrator, and the Administrator shall have all powers with respect to this Agreement as are provided in the Plan, including but not limited to the sole authority to determine whether and to what degree the Award has been earned and vested.  Any interpretation of this Agreement by the Administrator and any decision made by it with respect to this Agreement is final and binding.
14.Superseding Agreement; Successors and Assigns.  This Agreement supersedes any statements, representations or agreements of the Company with respect to the grant of the Award, any other equity-based awards or any related rights, and the Participant hereby waives any rights or claims related to any such statements, representations or agreements.  Except as may be otherwise provided in the Plan, this Agreement does not supersede or amend any existing Change in Control Agreement, Inventions, Confidentiality and Nonsolicitation Agreement, Noncompetition Agreement, Severance Agreement, Employment Agreement or any other similar agreement between the Participant and the Company or an Affiliate, including, but not limited to, any restrictive covenants contained in such agreements.  This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective executors, administrators, next-of-kin, successors and assigns.
15.Governing Law and Venue.  Except as otherwise provided in the Plan or herein, this Agreement shall be construed and enforced according to the laws of the State of Delaware, without regard to the conflict of laws provisions of any state, and in accordance with applicable federal laws of the United States.  For purposes of litigating any dispute that arises directly or indirectly from the relationship of the parties evidenced by the Award or this Agreement, the parties hereby submit to and consent to the exclusive jurisdiction of the State of North Carolina and agree that such litigation shall be conducted only in the courts of Guilford County, North Carolina, or the federal courts of the United States for the Middle District of North Carolina, and no other courts, such jurisdiction being where the Award is made and/or to be performed.
16.Electronic Delivery and Participation.  The Company may, in its sole discretion, decide to deliver to and obtain Participant’s acceptance of any documents related to the Award or future awards of Restricted Stock Units that may be granted under the Plan by electronic means or request the Participant’s consent to participate in the Plan by electronic means.  The Participant hereby consents to receive and accept such documents by electronic delivery and, if requested, to agree to participate in the Plan through an on-line or electronic system established and maintained by the Company or a third party designated by the Company.
17.Language.  If the Participant has received this Agreement, or any other document related to the Award and/or the Plan translated into a language other than English and if the meaning of the translated version is different than the English version, the English version will control.
18.Appendix.  The Award shall be subject to any special terms and conditions for the Participant’s country set forth in the Appendix, if any.  If the Participant relocates to one of the countries included in the Appendix during the term of the Award, the special terms and conditions for such country shall apply to him or her to the extent the Company determines that the application of such provisions is necessary or advisable for legal or administrative reasons.  The Appendix constitutes part of this Agreement. 
19.Imposition of Other Requirements.  The Company reserves the right to impose other requirements on the Award and the Shares acquired upon vesting of the Award, to the extent the Company determines it is necessary or advisable for legal or administrative reasons, and to require the Participant to sign any additional agreements or undertakings that may be necessary to accomplish the foregoing.

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20.Amendment; Waiver.  Subject to the terms of the Plan and this Agreement, this Agreement may be modified or amended only by the written agreement of the parties hereto.  Notwithstanding the foregoing, the Administrator shall have unilateral authority to amend this Agreement (without Participant consent) to the extent necessary to comply with Applicable Law or changes to Applicable Law (including but not limited to U.S. federal securities laws and Code Section 409A).  The waiver by the Company of a breach of any provision of this Agreement by the Participant shall not operate or be construed as a waiver of any subsequent breach by the Participant.
21.Notices.  Except as may be otherwise provided by the Plan, any written notices provided for in this Agreement or the Plan shall be in writing and shall be deemed sufficiently given if either hand delivered or if sent by fax or overnight courier, or by postage paid first class mail.  Notices sent by mail shall be deemed received three (3) business days after mailed but in no event later than the date of actual receipt.  Notice may also be provided by electronic submission, if and to the extent permitted by the Administrator.  Notices shall be directed, if to the Participant, at the Participant’s address indicated by the Company’s records, or if to the Company, at the Company’s principal office located in Greensboro, NC, attention Corporate Treasurer, Qorvo, Inc.
22.Severability.  The provisions of this Agreement are severable and if any one or more provisions may be determined to be illegal or otherwise unenforceable, in whole or in part, the remaining provisions shall nevertheless be binding and enforceable.
23.Restrictions on Award and Shares.  The Company may impose such restrictions on the Award and any Shares or other benefits underlying the Award as it may deem advisable, including without limitation restrictions under the U.S. federal securities laws, the requirements of any stock exchange or similar organization and any blue sky, state or foreign securities laws applicable to such Award or Shares.  Notwithstanding any other provision in the Plan or this Agreement to the contrary, the Company shall not be obligated to issue, deliver or transfer Shares, to make any other distribution of benefits, or to take any other action, unless such delivery, distribution or action is in compliance with all Applicable Law (including but not limited to the requirements of the Securities Act).  The Company may cause a restrictive legend to be placed on any certificate for Shares issued pursuant to the Award in such form as may be prescribed from time to time by Applicable Law or as may be advised by legal counsel.  The Administrator may delay the right to receive or dispose of Shares (or other benefits) upon settlement of the Award at any time if the Administrator determines that allowing issuance of Shares (or distribution of other benefits) would violate any federal, state or foreign securities laws or applicable policies of the Company, and the Administrator may provide in its discretion that any time periods to receive Shares (or other benefits) subject to the Award are tolled or extended during a period of suspension or delay (subject to any Code Section 409A considerations); provided, however, that any such delay, suspension, tolling or extension  shall not apply to any Shares subject to an effective Rule 10b5-1 trading plan. 
24.Counterparts; Further Instruments. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument.  The parties hereto agree to execute such further instruments and to take such further action as may be reasonably necessary to carry out the purposes and intent of this Agreement.
25.Compliance with Recoupment, Ownership and Other Policies or Agreements.  As a condition to receiving this Award, the Participant agrees that he or she shall abide by all provisions of any equity retention policy, compensation recovery policy, stock ownership guidelines and/or other similar policies maintained by the Company, each as in effect from time to time and to the extent applicable to the Participant 

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from time to time.  In addition, the Participant shall be subject to such compensation recovery, recoupment, forfeiture, or other similar provisions as may apply at any time to the Participant under Applicable Law. 
26.Foreign Asset/Account Reporting Requirements.  The Participant acknowledges that there may be certain foreign asset and/or account reporting requirements which may affect his or her ability to acquire or hold the Shares acquired under the Plan or cash received from participating in the Plan (including from any dividends paid on the Shares acquired under the Plan) in a brokerage or bank account outside his or her country.  The Participant may be required to report such accounts, assets or transactions to the tax or other authorities in his or her country.  The Participant also may be required to repatriate sale proceeds or other funds received as a result of participating in the Plan to his or her country through a designated bank or broker within a certain time after receipt.  The Participant acknowledges that it is his or her responsibility to be compliant with such regulations, and the Participant should speak to his or her personal advisor on this matter.

[Signature Page to Follow]

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IN WITNESS WHEREOF, this Agreement has been executed on behalf of the Company and by the Participant effective as of the Grant Date stated herein.

QORVO, INC.
By: ______________________________________
Robert A. Bruggeworth
President and Chief Executive Officer
Attest:
__________________________________
Jeffrey C. Howland
Secretary 

[Signature Page of Participant to Follow on Schedule A/Grant Letter]

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Qorvo, Inc. 
2012 Stock Incentive Plan   
Restricted Stock Unit Agreement 
(Director Annual/Supplemental RSUs)
Schedule A/Grant Letter
1.Grant Terms.  Pursuant to the terms and conditions of the Company’s 2012 Stock Incentive Plan, as it may be amended (the “Plan”), and the Restricted Stock Unit Agreement (Director Annual/Supplemental RSUs) attached hereto, including any special terms and conditions for your country in the Appendix attached thereto (together, the “Agreement”), you (the “Participant”) have been granted an award of Restricted Stock Units (the “Award”) for the number of shares of Common Stock (the “Shares”) as set forth below.  Unless otherwise defined herein, capitalized terms in this Schedule A shall have the same definitions as set forth in the Agreement and the Plan.
	
					
	 
	Participant:
	 
	____________________
	 

	 
	Grant Date:
	 
	____________________
	 

	 
	Shares Subject to Award:
	 
	____________________
	 

2.Vesting of Award.  [Modify vesting schedule as appropriate.]
(a)The Award shall be deemed vested with respect to one hundred percent (100%) of the Shares subject to the Award on the earlier of (i) the first anniversary of the Grant Date or (ii) the day before the Company’s first annual meeting of stockholders occurring after the Grant Date, in each case subject to the continued service of the Participant as a Director through such vesting date.
(b)    Notwithstanding the provisions of Section 2(a) above, in the event of the Participant’s death or Disability (as defined in the Plan), the Award shall automatically fully vest, effective as of the date of the Participant’s death or the date of Disability as determined by the Administrator, as applicable.

3.    Dividends.    If the Company pays a dividend at any time after the Grant Date, such dividends shall be paid to the Participant in accordance with Section 7 of the Agreement upon and to the extent of the vesting of the underlying Shares.  For clarity, if the Participant makes a timely election to defer payment of the Shares pursuant to the Plan, and the Company pays a dividend at any time after the Grant Date, such dividend shall be treated in accordance with Section 7(b) of the Agreement upon and to the extent of the vesting and distribution of the underlying Shares.

[Signature Page to Follow]

A-1

By my signature below, I, the Participant, hereby acknowledge receipt of this Grant Letter and the Agreement, including any special terms and conditions for my country in the Appendix attached thereto.  I understand that the Grant Letter and its provisions are incorporated by reference into the Agreement and constitute a part of the Agreement.  By my signature below, I further agree to be bound by the terms of the Plan and the Agreement, including but not limited to the terms of the Grant Letter.  The Company reserves the right to treat the Award and the Agreement as cancelled, void and of no effect if the Participant fails to return a signed copy of the Grant Letter within thirty (30) days of receipt.

Signature:                                      Date:              

Note:  If there are any discrepancies in the name shown above, please make the appropriate corrections on this form and return to Treasury Department, Qorvo, Inc., 7628 Thorndike Road, Greensboro, NC  27409-9421. Please retain a copy of the Agreement, including this Grant Letter, for your files.

A-2

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