EXHIBIT 10.44 THIRD AMENDMENT TO GUARANTEE REIMBURSEMENT AGREEMENT This Third Amendment to Guarantee Reimbursement Agreement ("Amendment") dated as of April 1, 1992, is entered into by and between National Medical Enterprises, Inc., a Nevada corporation ("NME") and The Hillhaven Corporation, a Nevada corporation ("New Hillhaven"). RECITALS A. New Hillhaven and NME entered into the Guarantee Reimbursement Agreement, dated as of January 31, 1990, which provides, among other things, for the reimbursement by New Hillhaven of all Obligations paid by NME after the Distribution Date. The Guarantee Reimbursement Agreement, as amended by the First Amendment to Guarantee Reimbursement Agreement, dated May 30, 1991, and the Second Amendment to Guarantee Reimbursement Agreement, dated October 2, 1991, and as may be further amended, restated, modified, supplemented, renewed or replaced from time to time, is referred to herein as the "Reimbursement Agreement." Unless otherwise defined herein, the terms defined in the Reimbursement Agreement are used herein as therein defined. B. First Healthcare Corporation ("FHC"), a wholly-owned subsidiary of New Hillhaven, currently leases nursing facilities and retirement centers (collectively referred to herein as the "Properties," and individually as a "Property") from certain subsidiaries of NME pursuant to 86 individual leases, each dated January 26, 1990 (as such leases have been or hereafter may be amended or modified from time to time, collectively referred to herein as the "Leases," and Individually as a "Lease"). C. FHC has exercised its options to purchase nine of the 86 Properties, as provided in the respective Leases, and in accordance with the terms of the December 4, 1991 letter from FHC and New Hillhaven to NME Properties Corp. D. Concurrently herewith, FHC and each of the subsidiaries of NME that is a Landlord (as defined in the Leases) have entered into that certain Omnibus Amendment to Leases, made as of April 1, 1992 ("Omnibus Amendment") which amends each of the remaining 77 Leases to provide, among other things, options to sell and options to purchase the Properties. E. Certain of the Properties are currently subject to (1) third party financing (individually, an "Existing Debt") or (2) a master lease superior and prior to the Lease (individually, a "Master Lease"). In conjunction with FHC's acquisition of the Properties pursuant to the exercised options referenced in Recital C above, and its acquisition of the Properties for which the options to sell and options to purchase contained in the Omnibus Amendment hereafter may be exercised, FHC may elect to assume, subject to obtaining the consent of NME, the applicable Landlord and the third party lender or master landlord, as the case may be, certain Existing Debt and Master Leases covering such Properties. F. NME and the Landlords are unwilling to permit FHC to assume any such Existing Debt or Master Lease unless New Hillhaven agrees to guaranty the payment and performance of such Existing Debt and Master Lease being assumed by FHC, to the extent that NME or any subsidiary or affiliate of NME remains primarily or contingently liable for such Existing Debt or Master Lease. G. New Hillhaven and NME desire to amend the Reimbursement Agreement to add the Existing Debit and Master Leases which may be assumed by FHC, to the extent NME or any subsidiary or affiliate of NME shall remain primarily or contingently liable therefor, as Obligations under the Reimbursement Agreement. NOW THEREFORE, in consideration of the foregoing Recitals and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto, intending to be legally bound, hereby agree to amend, modify and supplement the Reimbursement Agreement as follows: AGREEMENT 1. Assumed Obligations. To the extent NME or any subsidiary or affiliate of -------------------- NME remains primarily or contingently liable therefor, all Existing Debt and Master Leases (respectively referred to herein as the "Assumed Existing Debt" and the "Assumed Master Leases") assumed by FHC in conjunction with its acquisition of the Properties for which (a) FHC has exercised its options to purchase as described in Recital C above, or (b) the options to sell and options to purchase contained in the Omnibus Amendment are hereafter exercised, are hereby added as, and shall be deemed to be, "Obligations" under (and as defined in) the Reimbursement Agreement, and all terms, covenants and conditions of the Reimbursement Agreement, except as expressly provided in Paragraph 2 below, shall apply to such Assumed Existing Debts and Assumed Master Leases. 2. Guaranty Fee. The guaranty fee provisions of Section 2 of the ------------- Reimbursement Agreement shall not apply to either (a) the Assumed Existing Debts or (b) the Assumed Master Leases. Instead, New Hillhaven shall pay to NME a guaranty fee equal to 1% per annum, from the date FHC completes its purchase of each such Property subject to any Assumed Existing Debt or Assumed Master Lease, on (i) the daily outstanding balance of each such Assumed Existing Debt, and (ii) the daily outstanding balance of all rent payments which will become due under each such Assumed Master Lease, for the balance of the term of each such Assumed Existing Debt or Assumed Master Lease. Such guaranty fee shall be paid in quarterly installments on the last business day of each fiscal quarter, commencing on the last day of the first fiscal quarter immediately following the date on which such Assumed Existing Debt or Assumed Master Lease is assumed by FHC. The principal amount of the Assumed Existing Debts and Assumed Master Leases shall not be included as part of the outstanding Obligations under Section 2(c)(i) of the Reimbursement Agreement for the purposes of calculating the guaranty fee referred to in Section 2 of the Reimbursement Agreement. 3. Effect on Reimbursement Agreement. Except as expressly amended by this ---------------------------------- Amendment, all of the terms and conditions of the Reimbursement Agreement shall remain in full force and effect. 4. Captions. The captions and headings used herein are for the convenience of --------- reference and shall not be construed in any manner to limit or modify any of the terms hereof. 5. Governing Law. This Amendment shall be governed by and construed in -------------- accordance with the laws of the State of California. 6. Counterparts. This Amendment may be executed in counterparts, each of ------------- which shall be an original, but all of which together shall constitute but one and the same Instrument. IN WITNESS WHEREOF, each of the parties hereto has caused this Amendment to be duly executed on its behalf as of the date first set forth above. NATIONAL MEDICAL ENTERPRISES, INC. By:[SIGNATURE NOT LEGIBLE] ---------------------------------- Title: SR. EXEC. V.P. ------------------------------- THE HILLHAVEN CORPORATION By: Robert F. Pacquer ---------------------------------- Title: /s/ ROBERT F. PACQUER ------------------------------- SR VICE PRESIDENT EXHIBIT C --------- (LEASES SUBJECT TO MASTER LEASES) Fac. Facility Name No. and Address Description of Master Lease - ----- ------------- --------------------------- 804 Hillhaven Convalescent Lease dated July 3, 1969, by Center and Nursing and between St. Vincent's Home Hospital, as lessor, and 2728 10th Avenue Medicenters of America, Inc., Birmingham, AL as lessee (ground lease). 824 Hillhaven Convalescent Lease dated November 30, 1966, Center and Nursing by and between Earl B. Wert Home and Ellen R. Wert, as lessors, 1758 Springhill Avenue and Medicenters of America, Mobile, AL Inc., as lessee (ground lease) 525 Hillhaven Convalescent Lease dated June 11, 1962, by Hospital and between Mary G. Newcom, 920 W. LaVeta Richard B. Newcom and Mary Orange, CA Beth Potter Querfurth, as lessor, and Orange Square Development Corporation, as lessee (ground lease). 781 Bashford East Lease dated February 13, 1962 Healthcare by and between Cesare Bertoli 3535 Bardstown Road and Kathleen H. Bertoli, as Louisville, KY lessor, and Heritage Home Nursing and Convalescent Care, Inc. (formerly Wendav, Inc.), as lessee. 572 Winchester Place I Lease Agreement dated October 29, 36 Lehman Drive 1976 by and between Harley and Canal Winchester, OH George Reynolds, as Lessor and AEON, Inc., as lessee. PART II (Subleases Subject to Master Lease) Fac. Facility Name No. and Address Description of Lease - ----- ---------------------- -------------------- 804 Hillhaven Convalescent Lease dated July 3, 1969, by Center and Nursing and between St. Vincent's Home Hospital, as lessor, and 2728 10th Avenue Medicenters of America, Inc., Birmingham, AL as lessee [ground lease]. 824 Hillhaven Convalescent Lease dated November 30, 1966, Center and Nursing by and between Earl B. Wert Home and Ellen R. Wert, as lessors, 1758 Springhill Avenue and Medicenters of America, Mobile, AL Inc., as lessee [ground lease]. 7104 Villa Campana Lease and Aquisition Agreement Retirement Center dated February 1, 1983 by and 6653 E. Carondelet Dr. between the Industrial Tucson, AZ Development Authority of the County of Pima, as lessor, and The Hillhaven Corporation, as lessee. 525 Hillhaven Convalescent Lease dated June 11, 1962, by Hospital and between Mary G. Newcom, 920 W. LaVeta Richard B. Newcom and Mary Orange, CA Beth Potter Querfurth, as lessor, and Orange Square Development Corporation, as lessee [ground lease]. 809 Country Club Home Lease and Agreement dated 400 Sunset Dr. January 1, 1973 by and between P.O. Box 319 the City of Council Grove, as Council Grove, KS lessor, and Country Club Home, Inc., as lessee. 833 Sedgwick Convalescent Lease and Agreement dated Center September 20, 1974 by and 712 Monroe between the City of Sedgwick, Box 49 as lessor, and Sedgwick Sedgwick, KS Convalescent Center, Inc., a Kansas corporation, as lessee. EXHIBIT B January 4, 1990 --------- (Page 11 of 13) Fac. Facility Name No. and Address Description of Lease - ----- ---------------------- -------------------- 857, Hammond Holiday Home Lease dated January l, 1980 by 858 114 West 11th and between the City of Larned, KS Larned, Kansas, as lessor, and Hammond Holiday Home, Inc., a Kansas corporation, as lessee. 861 Green Meadows Nursing Lease dated July 1, 1982 by Center and between the City of 215 N. Larmar St. Haysville, Sedgwick County, Haysville, KS Kansas, as lessor, and Green Meadows Nursing Center, Inc., as lessee. 781 Bashford East Lease dated February 13, 1962 Healthcare by and between Cesare Bertoli 3535 Bardstown Road and Kathleen H. Bertoli, as Louisville, KY lessor, and Heritage Home Nursing and Convalescent Care, Inc. (formerly Wendav, Inc.), as lessee. 592 Greenbriar Terrace Lease dated October 1, 1972 by Healthcare and between Samuel A. Tamposi, 55 Harris Road Gerald Q. Nash, as lessor, and Nashua, NH Greenbriar Nursing Home Corp., as lessee [ground lease]. 572 Winchester Place I Lease Agreement dated October 36 Lehman Drive 29, 1976 by and between Harley Canal Winchester, OH and George Reynolds, as Lessor and AEON, Inc., as lessee. 822 Hillhaven Convalescent Lease Agreement dated Center December 1, 1979 by and 605 Primacy Parkway between the Health and Memphis, TN Educational Facilities Board of the County of Shelby, Tennessee, as lessor, and Hillhaven, Inc., a Delaware corporation, as lessee. EXHIBIT B January 4, 1990 --------- (Page 12 of 13) Fac. Facility Name No. and Address Description of Lease - ----- ---------------------- -------------------- 559 Birchwood Terrace Lease dated June 17, 1964 by Healthcare and between Henry H. Riordan 43 Starr Farm Road and Charles M. Jones, trustees Burlington, VT of the Will of John J. Flynn, as lessor, and Birchwood Development Corporation, as lessee. 769 North Ridge Care Lease Agreement dated June 1, Center 1983 by and between City of 1445 N. 7th Street Manitowoc, Wisconsin, as Manitowoc, WI lessor, and HH Holding Co., Inc., a Delaware corporation, as lessee. 773 Mount Carmel Lease Agreement dated June 1, Healthcare Center 1983 by and between City of 677 E. State St. Burlington, as lessor, and HH Burlington, WI Holding Co., Inc., a Delaware corporation, as lessee. EXHIBIT B January 4, 1990 --------- (Page 13 of 13) THE HILLHAVEN CORPORATION LIST OF LEASED NME FACILITIES FACILITIES UNDER CAPITALIZED NME LEASES --------------------------------------- 1 AL 804 BIRMINGHAM 2 AL 824 MOBILE 3 AV 818 LITTLE ROCK 4 AZ 436 VALLEY HOUSE AZ 437 VALLEY HOUSE - HSE 5 AZ 742 BELLS LODGE - PHOENIX 6 AZ 851 VILLA CAMPANA AZ 852 VILLA CAMPANA - HSE 7 CA 149 FAIR OAKS - SACRAMENTO 8 CA 150 SAN FRANCISCO 9 CA 203 CONCORD (HACIENDA) 10 CA 320 BURLINGAME 11 CA 410 SANTA PAULA 12 CA 411 ARLINGTON (ALTA VISTA) 13 CA 420 OXNARD (MAYWOOD ACRES) 14 CA 427 TWIN PINES-SANTA PAULA 15 CA 525 ORANGE 16 CA 727 SAN PABLO (BROOKVIEW) 17 CA 737 SAN LEANDRO 18 CA 738 ALAMEDA (SHORELINE) 19 CO 859 NORTHGLENN 20 CT 562 NEW BRITAIN (ANDREW HOUSE) 21 CT 563 CAMELOT-NEW LONDON 22 CT 565 NORWICH HAMILTON PAVILION 23 CT 566 WINDSOR (MOUNTAIN VIEW) 24 CT 567 NUTMEG PVLN NEW LONDON 25 CT 568 ENFIELD (PRKWY PAVILION) 26 FL 115 W PALM BEACH 27 FL 117 EAST MANOR-SARASOTA 28 FL 124 SANFORD 29 FL 125 TITUSVILLE 30 FL 836 MEDICENTER-TAMPA 31 GA 155 SAVANNAH 32 GA 645 MARIETTA GA 8645 MARIETTA - HEAD INJURY 33 IN 286 COLOMBIA - EVANSVILLE 34 IN 779 BEDFORD (WESTVIEW MANOR) 35 KS 838 TOPEKA 36 KY 781 BASHFORD EAST LOUISVILLE 37 KY 783 LEXINGTON 38 MT 416 GREAT FALLS (PARK PLACE) 39 MT 433 DILLON (PARKVIEW ACRES) 48 NC 116 DURHAM 41 NC 136 LASALLE - DURHAM 42 NC 188 WILMINGTON 43 NC 191 SILAS CREEK-WINSTON 44 NC 706 HENDERSON (GUARDIAN CARE) 45 NC 707 MONROE (GUARDIAN CARE) 46 NC 710 NEW BERN (GUARDIAN CARE) 47 NC 711 KINSTON (GUARDIAN CARE) 48 NC 713 ZEBULON (GUARDIAN CARE) 49 NC 724 GASTONIA (HH HEALTH CARE) 50 NC 806 CHAPEL HILL (HHCC) 51 NH 593 HANOVER TERRACE 52 NV 145 RENO 53 NV 641 TORREY PINES - LAS VEGAS 54 OH 560 FRANKLIN WOODS COLOMBUS 55 OH 570 PICKERINGTON 56 OH 572 WINCHESTER CANAL 57 OH 802 AKRON 58 OK 233 BARTLESVILLE OK 234 BARTLESVILLE - APTS. 59 TN 132 MADISON 60 UT 655 SALT LAKE CITY (CC) 61 UT 690 WASATCH VILLA-SLC 62 VA 026 NORFOLK 63 VA 842 MEDICENTER - VA BEACH 64 WA 114 ARDEN - SEATTLE 65 WA 127 LONGVIEW - NORTHWEST 66 WA 158 BELLINGHAM 67 WA 160 FIRST HILL - SEATTLE 68 WA 180 VANCOUVER (CC) 69 WA 105 HHNH-VANCOUVER 70 WA 462 QUEEN ANNE-SEATTLE 71 WI 767 APPLETON (COLONY OAKS) 72 WI 769 MANITOWOC (NORTH RIDGE) 73 WI 770 NEENAH (VALLHAVEN) 74 WY 481 RAWLINS (PARK MANOR) 75 WY 482 RIVERTON (FREMONT MANOR) 76 WY 483 ROCK SPRINGS KIMBERLY MNR LEASED NME FACILITIES WITH EXECUTED PURCHASE OPTION --------------------------------------------------- 77 CT 561 TORRINGTON (ADAMS HOUSE), 78 KS 844 WICHITA 79 KS 857 LARNED (HAMMOND) KS 858 LARNED (HAMMOND) 80 MO 446 COLOMBIA 81 KS 833 SEDGWICK 82 MO 834 SPRINGFIELD (HHCC) 83 NC 176 ORANGE-DURHAM 84 NV 640 LAS VEGAS (CC) 85 WY 441 MOUNTAIN TOWERS-CHEYENNE