Document:

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                                                                   Exhibit 10.30

                            AMENDMENT NO. 4 TO THE
               RETIREMENT SAVINGS PLAN FOR CERTAIN EMPLOYEES OF
                           VENCOR AND ITS AFFILIATES

     This is Amendment No. 4 to the Retirement Savings Plan For Certain
Employees Of Vencor And Its Affiliates (the "Plan") as amended and restated as
of January 1, 1997.

                                    RECITAL

     WHEREAS, Vencor, Inc. (the "Company") maintains the Plan and has reserved
the right in Section 9.1 of the Plan to amend the Plan from time to time in its
discretion. The Company now wishes to amend the Plan to reflect that Ventas,
Inc. will no longer be a participating employer effective January 1, 1999 and to
clarify the elimination of the option of receiving a distribution upon the
attainment of age 70 1/2 while still employed.

                                   AMENDMENT

     The Plan is hereby amended as follows:

     1.   The first sentence of Section of 1.15 of the Plan is hereby amended
effective as of January 1, 1999, so as amended it shall read in its entirety as
follows:

     Employer means (i) Vencor, Inc. (provided that effective May 1,
     1998, Employer means Vencor , Inc. (formerly Vencor Healthcare,
     Inc.); and (ii) each of the legal entities, or any successor
     thereto, which participates in the VRSP as of January 1, 1997 or
     which thereafter is a part of the Company and adopts the VRSP for
     its eligible Employees with the consent of the Sponsoring
     Employer; and (iii) any entity that is managed by the Company
     pursuant to a management agreement, provided that the entity
     which provides management services has adopted this Plan for the
     benefit of its employees (as evidenced as of January 1, 1997 by
     their name being listed on Appendix A); and (iv) Atria
     Communities, Inc.; and (v) each legal entity, or any successor
     thereto, which would be part of the Company if Atria Communities,
     Inc. were substituted for Vencor , Inc. in the definition of
     "Company" herein, and which has adopted the Plan for its eligible
     Employees with the consent of the Sponsoring Employer (as
     evidenced as of January 1, 1997 by their name being listed on
     Appendix A); and (vi) the partnerships listed on Appendix A
     hereto or which hereafter become participating employers pursuant
     to the procedure in Article 12 hereof

     2.   Section 5.6(c) of the Plan is hereby amended, effective as of December
31, 1998, so that as amended it shall read in its entirety as follows:
<PAGE>

     Notwithstanding any other provisions of the Plan, the payment of
     a Participant's benefits hereunder shall begin by payment of a
     lump sum of the entire Accounts of the Participant no later than
     the April 1 following the calendar year in which the Participant
     has both attained age 70 1/2 and has retired, provided that for
     5% owners as defined in Section 416 of the Code, distribution
     must begin by April 1 following the calendar year in which the
     Participant attains age 70 1/2, regardless of whether the
     Participant has retired; and further provided that a Participant
     who had attained age 70 1/2 on or before December 31, 1998 shall
     have the option to take a lump sum distribution even while
     employed, at the April 1 following attainment of age 70 1/2, if
     the Participant so elects in writing, and, if so elected, shall
     receive a distribution on or before December 31 of the year after
     attainment of age 70 1/2, and again each year thereafter while
     still employed, shall receive a similar distribution of all
     amounts accrued in Accounts of the Participant since the last
     such distribution.

     IN WITNESS WHEREOF, this Amendment No. 4 is hereby adopted this 22nd day of
December, 1998.

                                    By: /s/ Cecelia A. Hagan
                                        --------------------------------------

                                    Title: Vice President of Human Resources
                                           -----------------------------------<PAGE>

                                                                   Exhibit 10.48

                             AMENDMENT NO. TWO TO
                             --------------------
                    SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN
                    --------------------------------------

     THIS AMENDMENT NO. TWO ("Amendment") to the Vencor, Inc. Supplemental
Executive Retirement Plan is entered into as of the 15th day of January, 1999.

     Reason for Amendment. This Amendment is intended to enable the Vencor, Inc.
     --------------------
Supplemental Executive Retirement Plan ("SERP Plan") to provide for the purchase
of deferred annuities and the extinguishment of corresponding liabilities
accrued under the Plan.

     Amendment.  The SERP Plan shall be amended by inserting a new Section 4.3
     ---------
that reads as follows:

     Section 4.3 Deferred Annuities. The Committee, in its sole discretion, may
                 ------------------
     cause all or a portion of the benefits which would otherwise be
     payable under this Plan to instead be provided by the purchase of
     a deferred annuity owned by the Participant. The annuity shall
     provide payments substantially equal to the after-tax value of
     the Participant's vested benefit under the Plan as of a specified
     date, as determined by an actuary. If an annuity is purchased for
     a Participant, the benefits otherwise payable under this Plan
     shall be reduced by an amount equal to the pre-tax value of the
     annuity.

     At the same time a deferred annuity is purchased by the Company
     for a Participant, the employer shall pay withholding tax on
     behalf of a Participant. The payment shall approximate the amount
     necessary to compensate the Participant for the net increase in
     state, local, federal income and employment taxes resulting from
     the recognition of taxable income due to purchasing the annuity.
     The amount of the withholding tax payment shall equal:

               Annuity Premium     x     Participant's tax rate
                                         -----------------------
                                       (1 - Participant's tax rate)

     IN WITNESS WHEREOF, Vencor, Inc. has executed this instrument as of the
date first above written.

                                    VENCOR, INC.

                                    By: /s/ Jill L. Force
                                        --------------------------------------
                                        Jill L. Force, Senior Vice President
                                        and General Counsel<PAGE>

                                                                   Exhibit 10.49

                            AMENDMENT NO. THREE TO
                            ----------------------
                     SUPPLEMENT EXECUTIVE RETIREMENT PLAN
                     ------------------------------------

     THIS AMENDMENT NO. THREE ("Amendment") to the Vencor, Inc. Supplemental
Executive Retirement Plan is adopted on the 31/st/ day of December, 1999.
                                            ------

     Reason for Amendment. This Amendment is intended to suspend indefinitely
     --------------------
the accrual of future benefits under the Vencor, Inc. Supplemental Executive
Retirement Plan (as amended by Amendments Nos. 1 and 2 thereto, the "SERP Plan")
for all participants therein, effective as of December 31, 1999.  This Amendment
is also intended to provide for the deferral of the distribution of
participants' benefits under the SERP Plan until the earlier of (i) the
attainment of age 65 and (ii) death.

     Amendments.
     ----------

     1.   The SERP Plan is hereby amended, as of December 31, 1999, by adding a
          new Section 3.7 to read in its entirety as follows:

               Section 3. 7  Suspension of Benefit Accruals. Notwithstanding any
                             ------------------------------
               other provision of the Plan (other than Section 3.6 hereof),
               effective as of December 31, 1999, all accrual of benefits under
               the Plan are suspended indefinitely with respect to all
               Participants in the Plan as of such date. Accordingly, from and
               after December 31, 1999, the Normal Retirement Benefit or Early
               Retirement Benefit payable to any Participant under the Plan and
               such Participant's Vested Percentage in such benefit shall be
               calculated and determined solely on the basis of the
               Participant's Participant Category (within the meaning of Section
               3.1(a) hereof as of December 31, 1999, the Years of Service
               completed by the Participant as of December 31, 1999 and the
               Participant's Compensation as of December 31, 1999. The
               provisions of this Section 3.7 shall apply to all Participants
               and in all events, including in calculating the benefits, if any,
               payable under the Plan in the event of a Participant's
               Disability, Termination of Employment, Normal Retirement or Early
               Retirement.

     2.   The SERP Plan is hereby amended, as of December 31, 1999, by amending
          Section 4.1 thereof to read in its entirety as follows:

               Section 4.1 Commencement of Payments. Notwithstanding any other
                           ------------------------
               provision of the Plan (other than Section 3.6 hereof), all
               payments under the Plan with respect to benefits that have
               accrued as of December 31, 1999, to the extent not
<PAGE>

               paid on or prior to such date, shall begin to be made not earlier
               than the earlier of (i) the first day of the calendar month
               immediately following the calendar month in which the Participant
               attains age 65 and (ii) the first day of the calendar month
               immediately following the calendar month in which the Participant
               dies. To the extent that a payment is required to begin, pursuant
               to this Section 4.1, on a date later than the date that it would
               otherwise have begun to be paid pursuant to any other provisions
               of this Plan, the amount of the benefit that shall be paid shall
               be the actuarial equivalent of the benefit that would have been
               payable without regard to this Section 4.1. For this purpose,
               actuarial equivalence shall be determined using the factors set
               forth in Section 3.5 hereof.

     3.   The SERP is hereby amended by amending the words "in Sections 3.1,
          3.2, 3.3 and 4.1" in the first sentence of Section 3.6 thereof to read
          "in Sections 3.1, 3.2, 3.3, 3.7 and 4.1".

     IN WITNESS WHEREOF, Vencor, Inc. has executed this instrument on the date
first above written.

                                         VENCOR, INC.

                                         By: /s/ Owen E. Dorsey
                                             ---------------------------------
                                             Chief Administrative Officer

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