EXECUTION COPY

     TENTH AMENDMENT AND CONSENT dated as of December 3, 2004 (this
“Amendment”), to the Credit Agreement dated as of September 22, 2000 (the
“Credit Agreement”), as heretofore amended, among Select Medical Corporation, a
Delaware corporation (the “Company”), Canadian Back Institute Limited, an
Ontario corporation and a wholly owned subsidiary of the Company (“CBIL” and,
together with the Company, the “Borrowers”), the Lenders party thereto, JPMorgan
Chase Bank, N.A. (formerly known as JPMorgan Chase Bank), as US Agent and US
Collateral Agent, JPMorgan Chase Bank, Toronto Branch (as successor to J.P.
Morgan Bank Canada), as Canadian Agent and Canadian Collateral Agent, Banc of
America Securities, LLC, as Syndication Agent, and CIBC, Inc., as Documentation
Agent.

     WHEREAS, the Borrowers have requested that the Lenders (such term and each
other capitalized term used but not otherwise defined herein having the meaning
assigned to it in the Credit Agreement) approve the amendment of certain
provisions of the Credit Agreement;

     WHEREAS, the undersigned Lenders are willing, on the terms and subject to
the conditions set forth herein, to approve such amendment;

     NOW, THEREFORE, in consideration of the premises, the Borrowers and the
undersigned Lenders hereby agree as follows:

     SECTION 1. Amendment. Effective as of the Amendment Effective Date (as
defined in Section 4), the parties hereto hereby amend the Credit Agreement as
follows:

     (a) Amendment of Section 1.01. Section 1.01 is hereby amended as follows:

     (i) The following new defined terms are added in their appropriate
alphabetical order:

     ““SemperCare Acquisition” means the Acquisition of SemperCare, Inc., a
Delaware corporation, by the Company made pursuant to an Agreement and Plan of
Merger and Reorganization, by and among the Company, Camp Hill Acquisition
Corp., a Delaware corporation, SemperCare, Inc. and Jeffrey J. Collinson, as
stockholders’ agent, substantially in the form delivered to the US Agent prior
to the Tenth Amendment Effective Date.”

     ““Tenth Amendment Effective Date” means the date on which the Tenth
Amendment to this Agreement shall have become effective in accordance with its
terms.”

     (ii) The definition of “Permitted Acquisition” is amended by inserting at
the end of clause (d) of such definition the following proviso:

 

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     “provided that the SemperCare Acquisition shall not be subject to the
limitation set forth in this clause (d) and, solely for the purposes of this
clause (d), shall be excluded in computing the aggregate consideration paid in
connection with Acquisitions during the fiscal year in which such Acquisition is
completed.”

     (b) Amendment of Section 6.05. Section 6.05(i) is hereby amended to read as
follows:

     “(i) other unsecured Indebtedness (A) of the Company or any Subsidiary
incurred in connection with Permitted Acquisitions or acquisitions of interests
in Joint Ventures permitted under Section 6.09, in each case, after the date
hereof or (B) of a Person existing at the time such Person becomes a Subsidiary
pursuant to a Permitted Acquisition after the date hereof; provided that such
Indebtedness was not created in contemplation of such Person becoming a
Subsidiary; provided further that the aggregate principal amount of all such
Indebtedness under this paragraph (i) outstanding at any time does not exceed
US$20,000,000;”

     SECTION 2. Consent. The undersigned Lenders hereby consent to the
acquisition of SemperCare, Inc., a Delaware corporation, by the Company made
pursuant to and on substantially the terms set forth in the Agreement and Plan
of Merger and Reorganization, by and among the Company, Camp Hill Acquisition
Corp., a Delaware corporation, SemperCare, Inc. and Jeffrey J. Collinson, as
stockholders’ agent, substantially in the form delivered to the US Agent prior
to the Amendment Effective Date.

     SECTION 3. Representations and Warranties. Each of the Borrowers represents
and warrants to each of the Lenders that, after giving effect to the amendments
contemplated hereby, (a) the representations and warranties of such Borrower set
forth in the Credit Agreement are true and correct in all material respects on
and as of the date of this Amendment, except to the extent such representations
and warranties expressly relate to an earlier date (in which case such
representations and warranties shall be true and correct in all material
respects as of the earlier date) and (b) no Default has occurred and is
continuing.

     SECTION 4. Effectiveness. This Amendment shall become effective as of the
date (the “Amendment Effective Date”) when the US Agent (or its counsel) shall
have received (i) counterparts of this Amendment signed on behalf of the
Borrowers and the Required Lenders or (ii) written evidence satisfactory to the
US Agent (which may include telecopy transmissions of signed signature pages)
that the Borrowers and the Required Lenders have signed counterparts of this
Amendment.

     SECTION 5. Applicable Law. THIS AMENDMENT SHALL BE CONSTRUED IN ACCORDANCE
WITH AND GOVERNED BY THE LAW OF THE STATE OF NEW YORK.

     SECTION 6. No Other Amendments. Except as expressly set forth herein, this
Amendment shall not by implication or otherwise limit, impair, constitute a

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waiver of, or otherwise affect the rights and remedies of any party under, the
Credit Agreement, nor alter, modify, amend or in any way affect any of the
terms, conditions, obligations, covenants or agreements contained in the Credit
Agreement, all of which are ratified and affirmed in all respects and shall
continue in full force and effect. This Amendment shall apply and be effective
only with respect to the provision of the Credit Agreement specifically referred
to herein. This Amendment shall constitute a “Loan Document” for all purposes of
the Credit Agreement and the other Loan Documents.

     SECTION 7. Counterparts. This Amendment may be executed in two or more
counterparts, each of which shall constitute an original, but all of which when
taken together shall constitute but one contract. Delivery of an executed
counterpart of a signature page of this Amendment by facsimile transmission
shall be as effective as delivery of a manually executed counterpart of this
Amendment.

     SECTION 8. Headings. Section headings used herein are for convenience of
reference only, are not part of this Amendment and are not to affect the
construction of, or to be taken into consideration in interpreting, this
Amendment.

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     IN WITNESS WHEREOF, the Borrower and the undersigned Lenders have caused
this Amendment to be duly executed by their duly authorized officers, all as of
the date first above written.

            SELECT MEDICAL CORPORATION,
          by /s/ Michael E. Tarvin        Name: Michael E. Tarvin         Title:
Senior Vice President     

            CANADIAN BACK INSTITUTE LIMITED,
          by /s/ Michael E. Tarvin        Name: Michael E. Tarvin         Title:
Vice President     

            JPMORGAN CHASE BANK, N.A. (FORMERLY KNOWN AS JPMORGAN CHASE BANK),
individually and as US Agent and US Collateral Agent,
          by /s/ Stephanie Parker        Name: Stephanie Parker         Title:
Vice President     

            JPMORGAN CHASE BANK, TORONTO BRANCH, individually and as Canadian
Agent and Canadian Collateral Agent,
          by /s/ Stephanie Parker        Name: Stephanie Parker         Title:
Vice President   

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:
 
CAYLON NEW YORK BRANCH

        by /s/ Charles Heidsieck        Name: Charles Heidsieck         Title:
Managing Director     

                      by /s/ Yannick Ergas        Name: Yannick Ergas        
Title: Vice President   

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

    CIBC INC.           by /s/ George Knight        Name: George Knight        
Title: Managing Director,
CIBC World Markets Corp., as agent 
 

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

CREDIT SUISSE FIRST BOSTON, acting through its New York Branch

        by /s/ Paul L. Colon        Name: Paul L. Colon         Title: Director 
   

                      by /s/ Karim Blasetti        Name: Karim Blasetti        
Title: Associate   

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

FLEET NATIONAL BANK

        by /s/ Kevin Wagley        Name: Kevin Wagley         Title: Senior Vice
President   

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

GENERAL ELECTRIC CAPITAL CORPORATION

        by /s/ Mei Nishiwaki        Name: Mei Nishiwaki         Title: Duly
Authorized Signatory     

                by             Name:
Title:  

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

PNC BANK, N.A.

        by /s/ Jeffrey DeLay        Name: Jeffrey DeLay         Title: Assistant
Vice President     

                by            Name:
Title:

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

SOCIETE GENERALE

        by /s/ Jerry Parisi        Name: Jerry Parisi         Title: Managing
Director     

                by            Name:
Title:

 

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            To approve the Tenth Amendment and Consent
(the “Amendment”) dated as of December 3, 2004
to the Select Medical Corporation Credit
Agreement:

Name of Institution:

WACHOVIA BANK, NATIONAL ASSOCIATION

        by /s/ Jeanette A. Griffith        Name: Jeanette A. Griffin        
Title: Director     

                by            Name:
Title: