AMENDMENT TO MASTER LEASE AND MEMORANDUM OF LEASE BY AND AMONG KINDRED HEALTHCARE, INC

EXHIBIT 10.51

After recording, this document

should be returned to:

Thomas H. Page

Barack Ferrazzano Kirschbaum

& Nagelberg LLP

200 West Madison Street, Suite 3900

Chicago, Illinois 60606

This document was prepared by:

T. Richard Riney, Esq.

10350 Ormsby Park Place

Suite 300

Louisville, Kentucky 40223

AMENDMENT TO MASTER LEASE AND MEMORANDUM OF LEASE

BY AND AMONG

KINDRED HEALTHCARE, INC.

(f/k/a Vencor, Inc.),

KINDRED HEALTHCARE OPERATING, INC.

(f/k/a Vencor Operating, Inc.),

AND

VENTAS REALTY, LIMITED PARTNERSHIP

AMENDMENT TO MASTER LEASE

AND MEMORANDUM OF LEASE

THIS AMENDMENT TO MASTER LEASE AND MEMORANDUM OF LEASE (hereinafter this “ Amendment ”) is dated as of the 7th day of August, 2007 (the “ Effective Date ”), and is by and among VENTAS REALTY, LIMITED PARTNERSHIP, a Delaware limited partnership (together with its successors and assigns, “ Lessor ”) having an office at 10350 Ormsby Park Place, Suite 300, Louisville, Kentucky 40223, KINDRED HEALTHCARE, INC., a Delaware corporation (f/k/a Vencor, Inc.) (“ Kindred ”), and KINDRED HEALTHCARE OPERATING, INC ., a Delaware corporation (f/k/a Vencor Operating, Inc.) (“ Operator ”; Operator, jointly and severally with Kindred and permitted successors and assignees of Operator and Kindred, “ Tenant ”), both having an office at 680 South 4 ^th Avenue, Louisville, Kentucky 40202.

RECITALS

A. Lessor and Tenant heretofore entered into that certain Amended and Restated Master Lease Agreement No. 4 dated as of April 20, 2001 (the “ Original Lease ”), demising to Tenant (i) the real property described on Exhibit A attached hereto and made a part hereof, together with the improvements thereon (the “ Original Premises ”), and (ii) multiple other properties.

B. A Memorandum of Lease (the “ Memorandum ”) relating to the Original Lease as it affects the Original Premises was heretofore filed for record on April 26, 2001 in the office of the County Clerk for Warren County, Kentucky as document no. 374950 at Book D820, Page 765.

C. Lessor and Tenant heretofore entered into that certain Second Amended and Restated Master Lease Agreement No. 4 (the “ Amended and Restated Lease ”) dated as of April 27, 2007, pursuant to which the Original Lease was amended and restated in its entirety.

D. Lessor and Tenant desire to amend the Memorandum and the Amended and Restated Lease with respect to the Original Premises, in accordance with the terms and conditions of this Amendment.

NOW, THEREFORE, in consideration of the premises and other good and valuable consideration, the parties hereby amend the Memorandum and the Amended and Restated Lease as follows:

1. For all purposes of the Amended and Restated Lease and the Memorandum, the legal description for the Premises shall be amended and restated in its entirety to read as set forth in Exhibit B attached hereto and made a part hereof (the “ Revised Premises ”).

2. In addition to the other properties demised pursuant to the Amended and Restated Lease, Lessor hereby leases to Tenant, and Tenant takes and leases from Lessor, the Revised Premises pursuant to the terms and conditions of the Amended and Restated Lease.

3. Tenant shall have and hold the Revised Premises for a term that, unless sooner terminated as otherwise provided in the Amended and Restated Lease, shall expire on April 30,

2010. Thereafter, the term, as it relates to the Revised Premises, may be extended by Tenant for up to three (3) additional extended terms of five (5) years each, subject to the terms of the Amended and Restated Lease.

4. Lessor and Tenant agree that the party obligated to cause or pay for any maintenance, repair, replacements, alterations or improvements to the Revised Premises shall not permit any lien to be filed against the Revised Premises as a result of such activities. To the extent recognized by applicable law, no lien arising as a result of Tenant’s activities shall affect Lessor’s interest in the Revised Premises, and no lien arising as a result of Lessor’s activities shall affect or take priority over Tenant’s interest in the Revised Premises as created by the Amended and Restated Lease.

5. Lessor and Tenant acknowledge and agree that the Amended and Restated Lease relates to the Revised Premises and multiple other properties and that, as provided in the Amended and Restated Lease, the Amended and Restated Lease demises all of such properties as a unified commercial operating lease and Lessor is not obligated, and may not be required, to lease less than all of such properties pursuant to the Amended and Restated Lease.

6. This Amendment and any amendment hereto may be signed in any number of counterparts, each of which shall be an original, with the same effect as if the signatures thereto were upon the same instrument.

7. Tenant has no present right or option to p