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                                                                   EXHIBIT 10.32
 
                                 AMENDMENT TO

          MASTER AGREEMENT FOR INFUSION THERAPY PRODUCTS AND SERVICES


     AGREEMENT made and entered into to as of the 19th day of September 1997 by
and between Vitalink Pharmacy Services, Inc. ("Vitalink") and ManorCare Health
Services, Inc. ("MCHS").

     WHEREAS, Vitalink and MCHS have previously entered into that certain Master
Agreement for Infusion Therapy Products and Services dated June 1, 1991 (the
"Agreement"); and

     WHEREAS, Vitalink and MCHS desire to amend the Agreement.

     NOW, THEREFORE, in consideration of the mutual covenants herein, and other
good and sufficient consideration, receipt of which is acknowledged, the parties
agree as follows:

     1.   Section 1 of the Agreement is replaced in its entirety by the 
          following new Section 1:

          1.   TERM. The term of this Agreement shall be from June 1, 1991 to
          September 30, 2002. At each October 1 during the remaining period of
          this Agreement, the term shall automatically renew for an additional
          one (1) year period unless either party notifies the other party of
          its intent not to renew no later than ninety (90) days prior to each
          such October 1.

     2.   Section 5 of the Agreement is replaced in its entirety by the
          following new Section 5:

          5.   INFUSION CHARGES:
               ---------------- 

               A. Vitalink's charges for infusion therapy drugs under each
          separate Infusion Therapy Services Agreement shall be based upon
          prevailing market rates for each Facility. "Market rates" shall be
          defined as those within the fiftieth percentile (50%) of charges paid
          by similar licensed non-MCHS facilities that receive similar services
          from Vitalink. MCHS shall be allowed to audit Vitalink's books and
          records to verify market rates.

               B. Effective January 1, 1998, Vitalink's charges for infusion
          therapy services under each separate Infusion Therapy Services
          Agreement for residents whose charges are paid by a third party payor
          such as an insurance company,
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          HMO, or Medicare risk contract payor shall be as stated in Exhibit A,
          attached hereto.

     3.   Each Infusion Therapy Services Agreement for the Facilities shall be
          deemed to have been amended consistently with the terms, conditions
          and obligations contained herein.

     4.   Except as specifically provided herein the Agreement remains in full 
          force and effect.

     IN WITNESS WHEREOF, the parties enter into this Agreement on the date first
above written.


                                       VITALINK PHARMACY SERVICES, INC.



ATTEST:/s/ Robert W. Horner III        By: /s/ Donna L. De Nardo          
       ------------------------            ------------------------------
           Secretary
                                       Title: President
                                              ---------------------------
                                       
                                       MANORCARE HEALTH SERVICES, INC.

ATTEST:/s/ K. Peter Kemezys            By: /s/ James H. Rempe             
       ------------------------            ------------------------------
           Secretary
                                       Title:  Senior Vice President
                                              ---------------------------
_
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                                   EXHIBIT A
                                   ---------


1.  MCHS will pay Vitalink a percentage of the per diem rate received by MCHS
    for each managed care patient whether such patient receives medication or
    not, as set forth below.

2.  If a managed care patient in a MCHS facility receives no medications,
    Vitalink will be paid 7.2% of the per diem rate received by MCHS for such
    patient.

3.  If the contracted per diem rate received by MCHS includes routine
    medications only (i.e., oral, topical medications and all insulin), Vitalink
    will be paid 7.2% of the per diem rate for each day of service.

4.  If the contracted per diem rate received by MCHS includes routine (i.e.,
    oral, topical medications and all insulin) and extraordinary (i.e.,
    injectible (excluding insulin) and infusion medications) Vitalink will be
    paid 13% of the per diem rate for each day of service.

5.  If the managed care contract with MCHS excludes all medications, MCHS will
    so advise Vitalink in writing in advance of accepting any such patient.
    Vitalink and the managed care organization will thereafter negotiate drug
    prices separately. Vitalink will be solely responsible for the billing and
    collection of any services provided in such circumstances.

6.  The percentages described above will be paid for all MCHS patients covered
    by managed care contracts and referred through the MCHS Coordinated Care
    Center. MCHS will notify the pharmacy at the time of admission that a
    patient is covered under a managed care contract. If such patients are not
    identified at such time, then usual and customary pricing will be utilized
    by Vitalink and paid by MCHS.

7.  All managed care patients will be subject to a formulary as agreed upon by
    Vitalink and the managed care organization which identifies those drugs
    which may be therapeutically substituted. In addition, drugs with extremely
    high cost (i.e., AWP per dose greater than $35.00) will be carved out of any
    such contract between the managed care organization and MCHS and be treated
    separately. In the event that Vitalink and the managed care organization
    cannot agree to such formulary, Vitalink has the right to refuse to provide
    services to the patients of such managed care organization. In the event
    that Vitalink so refuses, Manor Care shall have the right to identify an
    alternative provider for such services.

8.  The percentages set forth above will be reviewed periodically (i.e., every
    six months). The review will compare the current actual percentages (based
    on actual utilization at usual and customary charges divided by the
    applicable per diem rates) to those percentages set forth above. The
    percentage of the per diem rate to be billed thereafter will be the
    percentages set forth above plus or minus 50% of the difference between
    those percentages and the current actual percentages depending on whether
    the current actual percentages are higher (plus) or lower (minus) than the
    percentages set forth above.

    At the time of discharge, any drugs not administered to managed care
    patients, are to be returned to the pharmacy or disposed of in compliance
    with government regulations. Unused medications may not be sent home with
    patients.