Notice of Renewal

Exhibit 10.3

Notice of Renewal

April 26, 2012

Ventas Realty, Limited Partnership

c/o Ventas, Inc.

10350 Ormsby Park Place, Suite 300

Louisville, Kentucky 40223

Attention: Lease Administration

Ventas Realty, Limited Partnership

c/o Ventas, Inc.

10350 Ormsby Park Place, Suite 300

Louisville, Kentucky 40223

Attention: General Counsel

Re:    Second Amended and Restated Master Lease Agreement No. 4 – Notice of Renewal

Ladies and Gentlemen:

Kindred Healthcare, Inc., a Delaware corporation formerly known as Vencor, Inc. (“Kindred”), and Kindred Healthcare Operating, Inc., a Delaware corporation formerly known as Vencor Operating, Inc. (“Operator”; and together with Kindred and permitted successors and assigns of Operator and Kindred, “Tenant”) hereby give this renewal notice effective as of the date hereof to Ventas Realty, Limited Partnership, a Delaware limited partnership (together with its successors and assigns, “Lessor”) of their exercise of the five-year renewal option for Renewal Group 1, as more particularly set forth on Schedule A attached hereto, pursuant to Section 19.1 of that certain Second Amended and Restated Master Lease Agreement No. 4 (the “Master Lease”) by and between Lessor and Tenant dated as of April 27, 2007.

Tenant expressly reserves its right to deliver one or more additional renewal notices in accordance with Section 19.1 of the Master Lease or other master lease agreements currently in effect between Lessor and Tenant.

If you have any questions or concerns, please feel free to contact the undersigned at (502)  ###-###-####.

Sincerely,

Second Amended and Restated Master Lease

Agreement No. 4 — Notice of Renewal

Schedule A