SUPPLEMENT TO NOTE PURCHASE AGREEMENT

THIS SUPPLEMENT is entered into as of September 30, 2016 (this “Supplement”) between NATIONAL HEALTH INVESTORS, INC., a corporation organized under the laws of Maryland (the “Company”); and the Purchasers listed in the attached Schedule A (the “Purchasers”).

A.    The Company has entered into a Note Purchase Agreement dated as of November 3, 2015 with the purchasers listed in Schedule B thereto, as amended by First Amendment to Note Purchase Agreement dated as of August 15, 2016, and Second Amendment to Note Purchase Agreement dated as of September 30, 2016 (as so amended, the “Note Purchase Agreement”); and

B.    The Company desires to issue and sell, and the Purchasers desire to purchase, an additional Series of Notes (as defined in the Note Purchase Agreement) which shall be guaranteed by each of the Subsidiary Guarantors and Limited Guarantors pursuant to the Note Purchase Agreement and in accordance with the terms set forth below;

NOW, THEREFORE, the Company, the Subsidiary Guarantors, the Limited Guarantors and the Purchasers agree as follows:

1.Authorization of the New Series of Notes. The Company has authorized the issue and sale of, and the Subsidiary Guarantors and Limited Guarantors have authorized the guarantee of, $75,000,000 aggregate principal amount of the Company’s Notes to be designated as its 3.93% Senior Notes, Series 2016-1, due September 30, 2024 (the “Series 2016-1 Notes”, such term to include any such Notes issued in substitution therefor pursuant to Section 13 of the Note Purchase Agreement). The Series 2016-1 Notes shall be substantially in the form set out in Exhibit 1 to this Supplement, with such changes therefrom, if any, as may be approved by the Purchasers and the Company.

2.    Sale and Purchase of Series 2016-1 Notes. Subject to the terms and conditions of this Supplement and the Note Purchase Agreement, the Company will issue and sell to each of the Purchasers, and the Purchasers will purchase from the Company, at the Closing provided for in Section 3, Series 2016-1 Notes in the principal amount specified opposite their respective names in the attached Schedule A at the purchase price of 100% of the principal amount thereof. The obligations of the Purchasers hereunder are several and not joint obligations and no Purchaser shall have any liability to any Person for the performance or non-performance by any other Purchaser hereunder.

3.    Closing. The sale and purchase of the Series 2016-1 Notes to be purchased by the Purchasers shall occur at the offices of Chapman and Cutler LLP, 111 West Monroe Street, Chicago, Illinois 60603 at 11:00 a.m., New York city time, at a closing (the “Closing”) on September 30, 2016 or on such other Business Day thereafter on or prior to September 30, 2016 as may be agreed upon by the Company and the Purchasers. At the Closing the Company will deliver to each Purchaser the Series 2016-1 Notes to be purchased by it in the form of a single Note (or such greater number

of Series 2016-1 Notes in denominations of at least $100,000 as such Purchaser may request) dated the date of the Closing and registered in its name (or in the name of its nominee), against delivery by such Purchaser to the Company or its order of immediately available funds in the amount of the purchase price therefor by wire transfer of immediately available funds for the account of the Company to account number ###-###-#### at Pinnacle Bank, 150 3^rd Avenue South, Nashville, Tennessee 37201 with the routing number ###-###-####. If at the Closing the Company shall fail to tender such Series 2016-1 Notes to a Purchaser as provided above in this Section 3, or any of the conditions specified in Section 4 of the Note Purchase Agreement, as modified or expanded by Section 4 hereof, shall not have been fulfilled to such Purchaser’s reasonable satisfaction, such Purchaser shall, at its election, be relieved of all further obligations under this Supplement, without thereby waiving any rights it may have by reason of such failure or such nonfulfillment.

4.    Conditions to Closing. Each Purchaser’s obligation to purchase and pay for the Series 2016-1 Notes to be sold to it at the Closing is subject to the fulfillment to its reasonable satisfaction, prior to or at the Closing, of the conditions set forth in Section 4 of the Note Purchase Agreement, as hereafter modified, and to the following additional conditions:

(a)    all references to “Notes” therein shall be deemed to include the Series 2016-1 Notes, and all references to “Series 2015-1 Notes” in Section 4 shall be deemed to be replaced by reference to the Series 2016-1 Notes;

(b)    Section 4.1 will be subject to the changes set forth in the attached Schedule B;

(c)    the Guaranty Agreements delivered under Section 4.5 in connection with the Series 2015-1 Notes shall be ratified and confirmed by each of the Subsidiary Guarantors and Limited Guarantors for the benefit of the Series 2016-1 Notes; and

(d)    the Second Amendment to Note Purchase Agreement among the Company, the Subsidiary Guarantors, the Limited Guarantors and the holders of the Series 2015-1 Notes (as defined in the Note Purchase Agreement) shall be effective on or prior to the date of this Supplement.

5.    Representations and Warranties of the Company. The Company represents and warrants to each Purchaser that each of the representations and warranties contained in Section 5 of the Note Purchase Agreement is true and correct as of the date hereof (a) except that (i) all references to “Purchaser” and “you” therein shall be deemed to refer to the Purchasers hereunder, (ii) all references to “this Agreement” shall be deemed to refer to the Note Purchase Agreement as supplemented by this Supplement, (iii) all references to “Notes” therein shall be deemed to include the Series 2016-1 Notes and (iv) all references to “Series 2015-1 Notes” in Section 5 shall be deemed to be replaced by reference to the Series 2016-1 Notes and (b) except for changes to such representations and warranties or the Schedules referred to therein, which changes are set forth in the attached Schedule B.

6.    Representations of the Purchasers. Each Purchaser severally confirms to the Company that the representations set forth in Section 6 of the Note Purchase Agreement are true

and correct as to such Purchaser, except that all references to “Series 2015-1 Notes” in Section 6 shall be deemed to be replaced by reference to the Series 2016-1 Notes.

7.    Payment and Prepayment of the Series 2016-1 Notes.

(a)    As provided therein, the entire unpaid principal balance of each Series 2016-1 Note shall be due and payable on the Maturity Date thereof.

(b)    All prepayment provisions in Section 8 of the Note Purchase Agreement shall apply to the Series 2016-1 Notes equally as “Notes” thereunder.

8.    Additional Covenants. On the date of Closing, the Company shall provide the holders of the Series 2016-1 Notes with a confirmation of the credit rating applicable to such Notes from an NRSRO satisfactory to the Required Holders.

9.    Applicability of Note Purchase Agreement. Except as otherwise expressly provided herein (and expressly permitted by the Note Purchase Agreement), all of the provisions of the Note Purchase Agreement are incorporated by reference herein and shall apply to the Series 2016-1 Notes as if expressly set forth in this Supplement except that all references to “Notes” therein shall be deemed to include the Series 2016-1 Notes.

10.    Ratification and Confirmation of Guaranty Agreements. By executing below, each of the Subsidiary Guarantors and Limited Guarantors acknowledges the foregoing Supplement, agrees to its terms and conditions (including the issuance of the Series 2016-1 Notes in the aggregate principal amount of $75,000,000 pursuant hereto), and confirms that all terms, conditions and covenants contained in (a) the Guaranty Agreement dated as of November 3, 2015, and (b) the Limited Guaranty dated as of November 3, 2015, relating to the Note Purchase Agreements and each of the Notes issued thereunder (including any additional Series of Notes), are hereby ratified and confirmed, remain in full force and effect and are legal, valid and binding obligations of the undersigned enforceable against the undersigned in accordance with their terms.

IN WITNESS WHEREOF, the Company, the Subsidiary Guarantors, the Limited Guarantors and the Purchasers have caused this Supplement to be executed and delivered as of the date set forth above.

American Home Assurance Company (554933)

c/o The Bank of New York Mellon

Attn: P & I Department

Fax: (718) 315-3076

Notes due January 13, 2023 and (ii) $100,000,000 4.51% Series B Senior Notes due January 13, 2027.

FOR VALUE RECEIVED, the undersigned, NATIONAL HEALTH INVESTORS, INC. (herein called the “Company”), a corporation organized and existing under the laws of the State of Maryland, hereby promises to pay to [____________], or registered assigns, the principal sum of [_____________________] DOLLARS (or so much thereof as shall not have been prepaid) on September 30, 2024 (the “Maturity Date”), with interest (computed on the basis of a 360-day year of twelve 30‑day months) (a) on the unpaid balance hereof at the rate of 3.93% per annum from the date hereof, payable quarterly, on the 30th day of March, June, September and December in each year, commencing with the March 30, June 30, September 30 or December 30 next succeeding the date hereof, and on the Maturity Date, until the principal hereof shall have become due and payable, and (b) to the extent permitted by law, (x) on any overdue payment of interest and (y) during the continuance of an Event of Default, on such unpaid balance and on any overdue payment of any Make-Whole Amount, at a rate per annum from time to time equal to the greater of (i) 5.93% or (ii) 2.00% over the rate of interest publicly announced by JPMorgan Chase Bank, N.A. from time to time in New York, New York as its “base” or “prime” rate, payable quarterly as aforesaid (or, at the option of the registered holder hereof, on demand).

Payments of principal of, interest on and any Make-Whole Amount with respect to this Note are to be made in lawful money of the United States of America at JPMorgan Chase Bank, N.A. or at such other place as the Company shall have designated by written notice to the holder of this Note as provided in the Note Purchase Agreement referred to below.

This Note is one of a series of Senior Notes (herein called the “Notes”) issued pursuant to the Note Purchase Agreement, dated as of November 3, 2015 (as from time to time amended and supplemented, the “Note Purchase Agreement”), including as supplemented by the Supplement dated as of September ___, 2016, between the Company and the respective Purchasers named therein and is entitled to the benefits thereof. Each holder of this Note will be deemed, by its acceptance hereof, to have (i) agreed to the confidentiality provisions set forth in Section 20 of the Note Purchase

Agreement and (ii) made the representation set forth in Section 6.2 of the Note Purchase Agreement and, so long as no Default or Event of Default then exists, the representation in the last sentence of Section 6.1. Unless otherwise indicated, capitalized terms used in this Note shall have the respective meanings ascribed to such terms in the Note Purchase Agreement.

This Note is a registered Note and, as provided in the Note Purchase Agreement, upon surrender of this Note for registration of transfer accompanied by a written instrument of transfer duly executed, by the registered holder hereof or such holder’s attorney duly authorized in writing, a new Note for a like principal amount will be issued to, and registered in the name of, the transferee. Prior to due presentment for registration of transfer, the Company may treat the person in whose name this Note is registered as the owner hereof for the purpose of receiving payment and for all other purposes, and the Company will not be affected by any notice to the contrary.

This Note is subject to optional prepayment, in whole or from time to time in part, at the times and on the terms specified in the Note Purchase Agreement, but not otherwise.

If an Event of Default occurs and is continuing, the principal of this Note may be declared or otherwise become due and payable in the manner, at the price (including any applicable Make-Whole Amount) and with the effect provided in the Note Purchase Agreement.

This Note shall be construed and enforced in accordance with, and the rights of the Company and the holder of this Note shall be governed by, the law of the State of New York excluding choice-of-law principles of the law of such State that would permit the application of the laws of a jurisdiction other than such State.