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                                                                   EXHIBIT 10.19

                              EMPLOYMENT AGREEMENT

         THIS EMPLOYMENT AGREEMENT (the "Agreement") dated as of December 1,
2003 by and between Genesis HealthCare Corporation, a Pennsylvania corporation
with its principal place of business at 101 East State Street, Philadelphia, PA
19348 (the "Company"), and James McKeon (the "Executive"), which shall be
effective as of the date upon which the Spin-Off (as defined below) is
consummated (the "Effective Date"). In the event that the Spin-Off is not
consummated prior to July 1, 2004, this Agreement shall be void ab initio and of
no further force and effect, and the Current Employment Agreement (as defined
below) shall become immediately effective and binding in full on the parties as
if the Executive's rights under the same had never been waived by this
Agreement.


                                   WITNESSETH
                                   ----------


         WHEREAS, the Company desires to employ the Executive as an employee of
the Company, and the Executive desires to provide services to the Company, all
upon the terms and conditions hereinafter set forth; and

         WHEREAS, the Executive currently is employed by Genesis Health
Ventures, Inc. ("GHV") pursuant to an employment agreement dated September 1,
2000 and amended on October 2, 2001 ("Current Employment Agreement"); and

         WHEREAS, GHV is contemplating a spin-off (the "Spin-Off") of the
Company; and

         WHEREAS, the consummation of the Spin-Off and potential changes to the
Executive's employment may trigger the right of the Executive under Section 5 of
the Current Employment Agreement to a lump-sum payment equal to two times the
sum of the Executive's Average Base Salary (as defined in the Current Employment
Agreement) plus the Executive's Average Assumed Cash Incentive Compensation (as
defined in the Current Employment Agreement); and

         WHEREAS, in consideration of (i) a lump-sum payment equal to one times
Average Base Salary plus Average Assumed Cash Incentive Compensation, payable
upon consummation of the Spin-Off "Lump Sum Bonus", (ii) a term of employment
through October 1, 2005 (subject to extension) pursuant to the terms and
conditions of this Agreement commencing upon consummation of the Spin-Off, and
(iii) the award of stock options, restricted stock and a spin bonus as set forth
in the attached Exhibit A (which the Executive acknowledges is good and valuable
consideration), the Executive, after due consideration, has agreed to waive any
rights the Executive may have under the Current Employment Agreement; and



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         WHEREAS, upon due consideration, the Executive acknowledges that the
consideration set forth herein is reasonable and adequate, including the terms
of employment and covenants contained herein; and

         WHEREAS, it is the intent of the parties that upon the Effective Date
the Current Employment Agreement shall be superseded by this Agreement.

         NOW, THEREFORE, in consideration of the premises and mutual agreements
hereinafter set forth, and intending to be legally bound hereby, the parties
hereto agree as follows:

Offer and Acceptance of Employment. The Company hereby agrees to employ the
Executive as Chief Financial Officer and Executive's principal place of business
shall be located at 101 East State Street, Kennett Square, PA 19348. The
Executive accepts such employment and agrees to perform the customary
responsibilities of such position during the term of this Agreement. The
Executive will perform such other duties as may from time to time be reasonably
assigned to the Executive by the Board of Directors of the Company (the
"Board"), provided such duties are consistent with and do not interfere with the
performance of the duties described herein and are of a type customarily
performed by persons of similar titles with similar corporations. Nothing in
this Agreement shall preclude the Executive from serving as a director, trustee,
officer of, or partner in, any other firm, trust, corporation or partnership or
from pursuing personal investments, as long as such activities do not interfere
with the Executive's performance of the Executive's duties hereunder or violate
the terms of Section 8 hereof.

Period of Employment.

         Period of Employment. The period of the Executive's employment under
this Agreement shall commence on the Effective Date and shall, unless sooner
terminated pursuant to Section 4, terminate on October 1, 2005 (such period, as
extended from time to time, herein referred to as the "Term"). Subject to
Section 2(b), and if the Term has not been terminated pursuant to Section 4, on
October 1, 2005 and on each October 1st thereafter (each such October 1st, an
"Automatic Extension Date") the Term shall be extended for an additional period
of one year.

         Termination of Automatic Extension by Notice. The Company (with the
affirmative vote of two-thirds of the non-management membership of the Board at
a meeting of the Board called and held for such purpose) or the Executive may
elect to terminate the automatic extension of the Term set forth in Section 2(a)
("Automatic Extension") by giving written notice of such election. Any notice
given hereunder must be given not less than 60 days prior to the applicable
Automatic Extension Date.

Compensation and Benefits.

         Base Salary. As long as the Executive remains an employee of the
Company, the Executive will be paid a base salary of $325,000 which shall
continue at this rate, subject to adjustment as hereinafter provided. The

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Executive's base salary shall be reviewed periodically and the Company may
increase such base salary, by an amount, if any, it determines to be
appropriate. Any such increase shall not reduce or limit any other obligation of
the Company hereunder. The Executive's annual base salary payable hereunder, as
it may be increased from time to time and without reduction for any amounts
deferred as described below, is referred to herein as "Base Salary". The
Executive's Base Salary, as in effect from time to time, may not be reduced by
the Company without the Executive's consent, provided that the Base Salary
payable under this paragraph shall be reduced to the extent the Executive elects
to defer or reduce such salary under the terms of any deferred compensation or
savings plan or other employee benefit arrangement maintained or established by
the Company. The Company shall pay the Executive the portion of the Executive's
Base Salary not deferred in accordance with its customary periodic payroll
practices.

         Incentive Compensation. The Executive shall be eligible to participate
in stock option, incentive compensation and other plans at a level consistent
with the Executive's position with the Company and the Company's then current
policies and practices.

         Benefits, Perquisites and Expenses.

                  Benefits. During the Term, the Executive shall be eligible to
participate in (1) each welfare benefit plan sponsored or maintained by the
Company, including, without limitation, each life, hospitalization, medical,
dental, health, accident or disability insurance or similar plan or program of
the Company, and (2) each pension, profit sharing, retirement, deferred
compensation or savings plan sponsored or maintained by the Company, in each
case, whether now existing or established hereafter, to the extent that the
Executive is eligible to participate in any such plan under the generally
applicable provisions thereof. With respect to the pension or retirement
benefits payable to the Executive, the Executive's service credited for purposes
of determining the Executive's benefits and vesting shall be determined in
accordance with the terms of the applicable plan or program. Nothing in this
Section 3(c), in and of itself, shall be construed to limit the ability of the
Company to amend or terminate any particular plan, program or arrangement. For
the purposes of defining years of service, the Executive shall be given credit
for his/her years of service with Genesis Health Ventures, Inc.

                  Vacation. During the Term, the Executive shall be entitled to
the number of paid vacation days in each anniversary year determined by the
Company from time to time for its senior executive officers, but not less than
four (4) weeks in any anniversary year. The Executive shall also be entitled to
all paid holidays given by the Company to its senior officers. Vacation days
which are not used during any calendar year may not be accrued, nor shall the
Executive be entitled to compensation for unused vacation days, during the Term
or upon termination of employment.

                  Perquisites. During the Term, the Executive shall be entitled
to receive such perquisites (e.g., fringe benefits) as are generally provided to
other senior officers of the Company in accordance with the then current
policies and practices of the Company.

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                  Business Expenses. During the Term, the Company shall pay or
reimburse the Executive for all reasonable expenses incurred or paid by the
Executive in the performance of the Executive's duties hereunder, upon
presentation of expense statements or vouchers and such other information as the
Company may reasonably require and in accordance with the generally applicable
policies and practices of the Company.

Employment Termination.

         The Term of employment under this Agreement may be earlier terminated
only as follows:

         Cause. The Company shall have the right to terminate the Executive's
employment for Cause. For purposes hereof, a termination by the Company for
"Cause" shall mean termination by action of at least two-thirds of the
non-management membership of the Board at a meeting duly called and held upon at
least 15 days prior written notice to the Executive specifying the particulars
of the action or inaction alleged to constitute "Cause" because of (i) the
Executive's conviction of, or plea of guilty or nolo contendere to, any felony
(whether or not involving the Company or any of its subsidiaries) or any other
crime involving moral turpitude which subjects, or if generally known, would
subject, the Company or any of its subsidiaries to public ridicule or
embarrassment, (ii) fraud or other willful misconduct by the Executive in
respect of the Executive's obligations under this Agreement, or (iii) willful
refusal or continuing failure to attempt, without proper cause and, other than
by reason of illness, to follow the lawful directions of the Board following
thirty days prior written notice to the Executive of the Executive's refusal to
perform, or failure to attempt to perform such duties and which during such
thirty day period such refusal or failure to attempt is not cured by the
Executive. "Cause" shall not include a bona fide disagreement over a corporate
policy, so long as the Executive does not willfully violate on a continuing
basis specific written directions from the Board, which directions are
consistent with the provisions of this Agreement. Action or inaction by the
Executive shall not be considered "willful" unless done or omitted by the
Executive intentionally and without the Executive's reasonable belief that the
Executive's action or inaction was in the best interests of the Company, and
shall not include failure to act by reason of total or partial incapacity due to
physical or mental illness.

         Without Cause. Notwithstanding anything to the contrary contained in
this Agreement, the Company may, at any time after at least 30 days prior
written notice in accordance with Section 4(f) hereof to the Executive,
terminate the Executive's employment hereunder without Cause.

         Death or Disability. If the Executive dies, the Executive's employment
shall terminate as of the date of death. If the Executive develops a disability,
the Company may terminate the Executive's employment for Disability. As used in
this Agreement, the term "Disability" shall mean incapacity due to physical or
mental illness which has caused the Executive to be unable to substantially
perform the essential functions of the Executive's duties with or without a
reasonable accommodation with the Company on a full time basis for (i) a period
of six consecutive months, or (ii) for shorter periods aggregating more than six
months in any twelve month period. During any period of Disability, the
Executive agrees to submit to reasonable medical examinations upon the
reasonable request, and at the expense, of the Company.

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         Good Reason. The Executive may terminate the Executive's employment for
Good Reason within sixty (60) days following the Executive's knowledge of the
occurrence of an event that constitutes Good Reason. For purposes of this
Agreement, "Good Reason" shall mean any of the following, without the
Executive's written consent:

                  the assignment to the Executive by the Company of any duties
materially adversely inconsistent with the Executive's status with the Company
or a substantial alteration in the nature or status of the Executive's
responsibilities from those in effect on the Effective Date, or a reduction in
the Executive's titles or offices as in effect on the Effective Date, or any
removal of the Executive from, or any failure to reelect the Executive to, any
of such positions, except in connection with the termination of the Executive's
employment for Disability or Cause or as a result of the Executive's death or by
the Executive other than for Good Reason;

                  a reduction by the Company in the Executive's Base Salary as
in effect on the date hereof or as the same may be increased from time to time
during the term of this Agreement;

                  any relocation of Executive's principal place of employment to
a location more than forty-five (45) miles beyond the location set forth in
Section 1 of this Agreement;

                  any material failure by the Company to comply with any of the
provisions of this Agreement including the failure by the Company to award the
stock options set forth in Section 3(c) or bonus as set forth in the proposal
and waiver letter to the Executive dated July 15, 2003; and

                  the termination by the Board of the Automatic Extension
pursuant to Section 2(b) of this Agreement.

         Executive's Voluntary Termination. Notwithstanding anything to the
contrary contained in this Agreement, the Executive may, at any time after at
least 60 days but no more than 90 days prior written notice in accordance with
Section 4(f) hereof to the Company, terminate voluntarily the Executive's
employment hereunder.

         Notice of Termination. Any termination, except for death, pursuant to
this Section 4 shall be communicated by a Notice of Termination. For purposes of
this Agreement, a "Notice of Termination" shall mean a written notice which
shall indicate those specific termination provisions in this Agreement relied
upon and which sets forth in reasonable detail the facts and circumstances
claimed to provide a basis for termination of the Executive's employment under
the provision so indicated.

         Date of Termination. "Date of Termination" shall mean (i) if this
Agreement is terminated by the Company for Disability, 30 days after Notice of
Termination is given to the Executive (provided that the Executive shall not

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have returned to the performance of the Executive's duties on a full-time basis
during such 30-day period), (ii) if the Executive's employment is terminated due
to the Executive's death, on the date of death; (iii) if the Executive's
employment is terminated due to the Executive's voluntary resignation pursuant
to Section 4 (e), the date specified in the notice (which shall not be less than
60 days nor more than 90 days from the date such Notice of Termination is
given); or (iii) if the Executive's employment is terminated for any other
reason, the date specified in the Notice of Termination (which shall not be less
than 30 days from the date such Notice of Termination is given).

Payments upon Termination.

         Termination Due to Death or Disability. Upon the Executive's death or
the termination of the Executive's employment by reason of the Disability of the
Executive, to the extent not theretofore paid or provided, (i) the Company shall
pay to the Executive's estate or the Executive, as applicable, within 30 days
after the Date of Termination (1) the Executive's full Base Salary and other
accrued benefits earned up to the last day of the month of the Executive's death
or termination of employment by reason of the Executive's Disability, (2) all
deferred compensation of any kind, including, without limitation, any amounts
earned under any bonus plan, and (3) if any bonus, under any bonus plan of the
Company, shall be payable in respect of the year in which the Executive's death
or termination of employment by reason of the Executive's Disability occurs,
such bonus(es) prorated up to the last day of the month of the Executive's death
or termination of employment by reason of the Executive's Disability and (ii)
all restricted stock, stock option and performance share awards made to the
Executive and outstanding as of the Date of Termination shall automatically
become fully vested as of the Date of Termination.

         Termination for Cause. If the Executive's employment shall be
terminated for Cause, the Company shall pay the Executive, within 30 days after
the Date of Termination: (i) the Executive's full Base Salary through the Date
of Termination at the rate in effect at the time Notice of Termination is given,
and (ii) all deferred compensation of any kind. The Company shall have no
further obligations to the Executive under this Agreement.

         Termination by the Executive for Good Reason or by the Company for
Reasons other than for Cause, Disability or Death.

                  In the event (1) the Company terminates the Executive's
employment during the Term other than for Cause, death or Disability, or (2) the
Executive resigns during the Term for Good Reason, then (I) the Company shall
make a lump-sum cash payment to the Executive, within 30 days after the Date of
Termination, equal to the sum of (x) the Executive's Average Base Salary (as
defined below) and (y) the Executive's Average Assumed Cash Incentive
Compensation (as defined below); and (II) all stock options, stock awards and
similar equity rights, if any, granted to the Executive and outstanding as of
the Date of Termination shall vest and become exercisable immediately prior to
the Date of Termination and shall remain exercisable for a period of ninety (90)
days following the Date of Termination (or, if sooner, the end of the scheduled
term). "Executive's Average Base Salary" means the Executive's Base Salary for

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the most recent two years (including the year in which the Date of Termination
occurs) divided by two. "Executive's Average Assumed Cash Incentive
Compensation" means all annual bonuses earned under the Company's annual
incentive compensation plan (which is intended to be a cash plan as of the
Effective Date) in consideration of services for the two (2) most recent
completed fiscal years prior to the Date of Termination, divided by two (2), or
the average annual bonuses earned in such shorter number of fiscal years during
which an annual bonus incentive program existed. Notwithstanding anything herein
to the contrary, in the event that the Executive resigns for Good Reason
pursuant to Section 4(d) herein or Executive's employment is terminated by the
Company without Cause pursuant to Section 4 (b) herein, during the 24-month
period following a Change of Control, then, in addition to the other benefits to
which the Executive shall be entitled under this Section 5(c), the Company shall
pay the Executive within 30 days after the Date of Termination a lump-sum cash
payment equal to one-half (0.5) times the sum of (x) the Executive's Average
Base Salary (as defined above) and (y) the Executive's Average Assumed Cash
Incentive Compensation (as defined above). For the purposes of this Section, the
Executive's Base Salary and annual incentive compensation earned during the
Executive's employment with GHV shall be treated as if it were compensation from
the Company.

         The payments under this Section are subject to, and conditional upon,
the Executive executing and not revoking a general release of all statutory and
common law claims relating to employment and termination from employment in a
form provided by the Company.

                  Following (1) termination of the Executive's employment by the
Company during the Term other than for Cause, death, or Disability or (2) the
Executive's resignation during the Term for Good Reason, the Company shall also
maintain in full force and effect, for the continued benefit of the Executive
and his dependents for a period equal to the greater of (x) the period of the
then current Term without giving effect to such termination or (y) two (2)
years, all employee insurance benefit plans and programs to which the Executive
was entitled prior to the Date of Termination (including, without limitation,
the health, dental, vision, life and other voluntary insurance programs, but
specifically excluding any company paid disability plan or program provided by
the Company) if the Executive's continued participation is permissible under the
general terms and provisions of such plans and programs and the Executive
continues to pay all applicable premiums. In the event that the Executive's
participation in any health, medical or life insurance plan or program is
barred, the Company shall obtain and pay for, on the Executive's behalf,
individual insurance plans, policies or programs which provide to the Executive
health, medical, and life insurance coverage which is equivalent to the
insurance coverage to which the Executive was entitled prior to the date of
termination.

                  The Executive recognizes and accepts that the Company shall
not, in any case, be responsible for any additional amount, severance pay,
termination pay, severance obligation, incentive compensation payments, costs,
attorneys fees or other damages whatsoever arising from termination of the
Executive's employment, above and beyond those specifically provided for herein.
Notwithstanding anything herein to the contrary, the Executive shall maintain
his/her rights under any Company sponsored qualified or nonqualified retirement
plan.

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Change of Control.

         For purposes of this Agreement, the term "Change of Control" shall mean
the occurrence of any of the following within the 18-month period after the
Effective Date:

                  (a) The acquisition by any individual, entity or group (within
the meaning of Section 13(d)(3) or 14(d)(2) of the Securities Exchange Act of
1934, as amended (the "Exchange Act")) (a "Person") of beneficial ownership
(within the meaning of Rule 13d-3 promulgated under the Exchange Act) of
twenty-five percent (25%) or more of either (A) the then-outstanding shares of
common stock of the Company (the "Outstanding Company Common Stock") or (B) the
combined voting power of the then-outstanding voting securities of the Company
entitled to vote generally in the election of directors (the "Outstanding
Company Voting Securities"); provided, however, that, for purposes of this
Section 6(a), the following acquisitions shall not constitute a Change of
Control: (i) any acquisition directly from the Company, (ii) any acquisition by
the Company, (iii) any acquisition by any employee benefit plan (or related
trust) sponsored or maintained by the Company or any of its affiliates, (iv) any
acquisition by any corporation pursuant to a transaction that complies with
Sections 6(c)(i), 6(c)(ii) and 6(c)(iii), (v) any acquisition by any underwriter
temporarily holding securities pursuant to an offering of such securities, (vi)
any acquisition by Goldman Sachs Capital Partners or Highland Capital, (vii) any
acquisition by the Executive or any group of persons including the Executive (or
any entity controlled by the Executive or any group of persons including the
Executive) or (viii) a beneficial owner of less than twenty-five percent (25%)
of the Outstanding Company Voting Securities that becomes a beneficial owner of
twenty-five percent (25%) or more of the Outstanding Company Voting Securities
solely by reason of redemption or repurchase of such securities by the Company
so long as such beneficial owner takes immediate action to reduce its beneficial
ownership of Company Voting Securities below twenty-five percent (25%);

                  (b) Any time at which individuals who, as of the date hereof,
constitute the Board (the "Incumbent Board") cease for any reason to constitute
at least a majority of the Board; provided, however, that any individual
becoming a director subsequent to the date hereof whose election, or nomination
for election by the Company's shareholders, was approved by a vote of at least a
majority of the directors then comprising the Incumbent Board shall be
considered as though such individual were a member of the Incumbent Board, but
excluding, for this purpose, any such individual whose initial assumption of
office occurs as a result of an actual or threatened election contest with
respect to the election or removal of directors or other actual or threatened
solicitation of proxies or consents by or on behalf of a Person other than the
Board; provided, further, that any individual becoming a director subsequent to
the date hereof who was elected by, or on the recommendation of any person
described in clause (vi) of Section 6(a) above pursuant to contractual rights as
of the Effective Date with respect to Outstanding Company Voting Securities
owned by such person shall be treated as a member of the Incumbent Board;

                  (c) Consummation of a reorganization, merger, statutory share
exchange or consolidation or similar corporate transaction involving the Company
or any of its subsidiaries, a sale or other disposition of all or substantially
all of the assets of the Company, or the acquisition of assets or stock of

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another entity by the Company or any of its subsidiaries (each, a "Business
Combination"), in each case unless, following such Business Combination, (i) all
or substantially all of the individuals and entities that were the beneficial
owners of the Outstanding Company Common Stock and the Outstanding Company
Voting Securities immediately prior to such Business Combination beneficially
own, directly or indirectly, more than fifty percent (50%) of the
then-outstanding shares of common stock and the combined voting power of the
then-outstanding voting securities entitled to vote generally in the election of
directors, as the case may be, of the corporation resulting from such Business
Combination (including, without limitation, a corporation that, as a result of
such transaction, owns the Company or all or substantially all of the Company's
assets either directly or through one or more subsidiaries) in substantially the
same proportions as their ownership immediately prior to such Business
Combination of the Outstanding Company Common Stock and the Outstanding Company
Voting Securities, as the case may be, (ii) no Person (excluding any corporation
resulting from such Business Combination or any employee benefit plan (or
related trust) of the Company or such corporation resulting from such Business
Combination) beneficially owns, directly or indirectly, twenty-five (25%) or
more of, respectively, the then-outstanding shares of common stock of the
corporation resulting from such Business Combination or the combined voting
power of the then-outstanding voting securities of such corporation, except to
the extent that such ownership existed prior to the Business Combination, and
(iii) at least a majority of the members of the board of directors of the
corporation resulting from such Business Combination were members of the
Incumbent Board at the time of the execution of the initial agreement or of the
action of the Board providing for such Business Combination; or

                  (d) Approval by the shareholders of the Company of a complete
liquidation or dissolution of the Company.

Certain Tax Matters.

         Anything in this Agreement to the contrary notwithstanding, in the
event it shall be determined that any Payment would be subject to the Excise
Tax, then the Executive shall be entitled to receive an additional payment (the
"Gross-Up Payment") in an amount such that, after payment by the Executive of
all taxes (and any interest or penalties imposed with respect to such taxes),
including, without limitation, any income taxes (and any interest and penalties
imposed with respect thereto) and Excise Tax imposed upon the Gross-Up Payment,
the Executive retains an amount of the Gross-Up Payment equal to the Excise Tax
imposed upon the Payments. The Company's obligation to make Gross-Up Payments
under this Section 7 shall not be conditioned upon the Executive's termination
of employment.

         Subject to the provisions of Section 7(c), all determinations required
to be made under this Section 7, including whether and when a Gross-Up Payment
is required, the amount of such Gross-Up Payment and the assumptions to be
utilized in arriving at such determination, shall be made by KPMG Peat Marwick,
or such other nationally recognized certified public accounting firm as may be
designated by the Executive (the "Accounting Firm"). The Accounting Firm shall
provide detailed supporting calculations both to the Company and the Executive

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within 15 business days of the receipt of notice from the Executive that there
has been a Payment or such earlier time as is requested by the Company. In the
event that the Accounting Firm is serving as accountant or auditor for the
individual, entity or group effecting the Change of Control, the Executive may
appoint another nationally recognized accounting firm to make the determinations
required hereunder (which accounting firm shall then be referred to as the
Accounting Firm hereunder). All fees and expenses of the Accounting Firm shall
be borne solely by the Company. Any Gross-Up Payment, as determined pursuant to
this Section 7, shall be paid by the Company to the Executive within 5 days of
the receipt of the Accounting Firm's determination. Any determination by the
Accounting Firm shall be binding upon the Company and the Executive. As a result
of the uncertainty in the application of Section 4999 of the Code at the time of
the initial determination by the Accounting Firm hereunder, it is possible that
Gross-Up Payments that will not have been made by the Company should have been
made (the "Underpayment"), consistent with the calculations required to be made
hereunder. In the event the Company exhausts its remedies pursuant to Section
7(c) and the Executive thereafter is required to make a payment of any Excise
Tax, the Accounting Firm shall determine the amount of the Underpayment that has
occurred and any such Underpayment shall be promptly paid by the Company to or
for the benefit of the Executive.

         The Executive shall notify the Company in writing of any claim by the
Internal Revenue Service that, if successful, would require the payment by the
Company of the Gross-Up Payment. Such notification shall be given as soon as
practicable, but no later than 10 business days after the Executive is informed
in writing of such claim. The Executive shall apprise the Company of the nature
of such claim and the date on which such claim is requested to be paid. The
Executive shall not pay such claim prior to the expiration of the 30-day period
following the date on which the Executive gives such notice to the Company (or
such shorter period ending on the date that any payment of taxes with respect to
such claim is due). If the Company notifies the Executive in writing prior to
the expiration of such period that the Company desires to contest such claim,
the Executive shall:

                  give the Company any information reasonably requested by the
Company relating to such claim,

                  take such action in connection with contesting such claim as
the Company shall reasonably request in writing from time to time, including,
without limitation, accepting legal representation with respect to such claim by
an attorney reasonably selected by the Company,

                  cooperate with the Company in good faith in order effectively
to contest such claim, and

                  permit the Company to participate in any proceedings relating
to such claim;

provided, however, that the Company shall bear and pay directly all costs and
expenses (including additional interest and penalties) incurred in connection
with such contest, and shall indemnify and hold the Executive harmless, on an
after-tax basis, for any Excise Tax or income tax (including interest and
penalties) imposed as a result of such representation and payment of costs and

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expenses. Without limitation on the foregoing provisions of this Section 7(c),
the Company shall control all proceedings taken in connection with such contest,
and, at its sole discretion, may pursue or forgo any and all administrative
appeals, proceedings, hearings and conferences with the applicable taxing
authority in respect of such claim and may, at its sole discretion, either pay
the tax claimed to the appropriate taxing authority on behalf of the Executive
and direct the Executive to sue for a refund or contest the claim in any
permissible manner, and the Executive agrees to prosecute such contest to a
determination before any administrative tribunal, in a court of initial
jurisdiction and in one or more appellate courts, as the Company shall
determine; provided, however, that, if the Company pays such claim and directs
the Executive to sue for a refund, the Company shall indemnify and hold the
Executive harmless, on an after-tax basis, from any Excise Tax or income tax
(including interest or penalties) imposed with respect to such payment or with
respect to any imputed income in connection with such payment; and provided,
further, that any extension of the statute of limitations relating to payment of
taxes for the taxable year of the Executive with respect to which such contested
amount is claimed to be due is limited solely to such contested amount.
Furthermore, the Company's control of the contest shall be limited to issues
with respect to which the Gross-Up Payment would be payable hereunder, and the
Executive shall be entitled to settle or contest, as the case may be, any other
issue raised by the Internal Revenue Service or any other taxing authority.

         If, after the receipt by the Executive of a Gross-Up Payment or payment
by the Company of an amount on the Executive's behalf pursuant to Section 7(c),
the Executive becomes entitled to receive any refund with respect to the Excise
Tax to which such Gross-Up Payment relates or with respect to such claim, the
Executive shall (subject to the Company's complying with the requirements of
Section 7(c), if applicable) promptly pay to the Company the amount of such
refund (together with any interest paid or credited thereon after taxes
applicable thereto). If, after payment by the Company of an amount on the
Executive's behalf pursuant to Section 7(c), a determination is made that the
Executive shall not be entitled to any refund with respect to such claim and the
Company does not notify the Executive in writing of its intent to contest such
denial of refund prior to the expiration of 30 days after such determination,
then the amount of such payment shall offset, to the extent thereof, the amount
of Gross-Up Payment required to be paid.

         Notwithstanding any other provision of this Section 7, the Company may,
in its sole discretion, withhold and pay over to the Internal Revenue Service or
any other applicable taxing authority, for the benefit of the Executive, all or
any portion of any Gross-Up Payment, and the Executive hereby consents to such
withholding.

         Definitions. The following terms shall have the following meanings for
purposes of this Section 7.

                  "Excise Tax" shall mean the excise tax imposed by Section 4999
of the Code, together with any interest or penalties imposed with respect to
such excise tax.

                                       11

<PAGE>

                  A "Payment" shall mean any payment or distribution in the
nature of compensation (within the meaning of Section 280G(b)(2) of the Code) to
or for the benefit of the Executive, whether paid or payable pursuant to this
Agreement or otherwise.

Executive's Covenants.

         Nondisclosure. At all times during and after the Term, the Executive
shall keep confidential and shall not, except with the Company's express prior
written consent, or except in the proper course of the Executive's employment
with the Company, directly or indirectly, communicate, disclose, divulge,
publish, or otherwise express, to any Person, or use for the Executive's own
benefit or the benefit of any Person, any trade secrets, confidential or
proprietary knowledge or information, no matter when or how acquired concerning
the conduct and details of the Company's business, including without limitation,
names of customers and suppliers, marketing methods, trade secrets, policies,
prospects and financial condition. For purposes of this Section 8, confidential
information shall not include any information which is now known by or readily
available to the general public or which becomes known by or readily available
to the general public other than as a result of any improper act or omission of
the Executive.

         Non-Competition. During the Term hereof and for a period of one (1)
year following the Executive's termination of employment for any reason, the
Executive shall not, except with the Company's express prior written consent,
directly or indirectly, in any capacity, for the benefit of any Person:

                  Solicit any Person who is or during such period becomes a
customer, supplier, salesman, agent or representative of the Company, in any
manner which interferes or might interfere with such Person's relationship with
the Company, or in an effort to obtain such Person as a customer, supplier,
salesman, agent, or representative of any business in competition with the
Company which conducts operations within 15 miles of any office or facility
owned, leased or operated by the Company or in any county, or similar political
subdivision, in which the Company conducts substantial business.

                  Solicit the employment of or (solely with respect to employees
who are then or were managing directors or officers of the Company) hire
(whether as an employee, officer, director, agent, consultant or independent
contractor), any person who is, or was at any time during the previous three (3)
months, an employee, consultant, officer or director of the Company or any of
its subsidiaries and affiliates (except for such employment by the Company or
any of its subsidiaries and affiliates);

                  Establish, engage, own, manage, operate, join or control, or
participate in the establishment, ownership (other than as the owner of less
than one percent of the stock of a corporation whose shares are publicly
traded), management, operation or control of, or be a director, officer,
employee, salesman, agent or representative of, or be a consultant to, any
Person in any business in competition with the Company, if such Person has any
office or facility at any location within 15 miles of any office or facility
owned, leased or operated by the Company or conducts substantial business in any
county, or similar political subdivision, in which the Company conducts
substantial business, or act or conduct himself in any manner which the
Executive would have reason to believe inimical or contrary to the best
interests of the Company.

                                       12

<PAGE>

         Enforcement. The Executive acknowledges that any breach by the
Executive of any of the covenants and agreements of this Section 8 ("Covenants")
will result in irreparable injury to the Company for which money damages could
not adequately compensate the Company, and therefore, in the event of any such
breach, the Company shall be entitled, in addition to all other rights and
remedies which the Company may have at law or in equity, to have an injunction
issued by any competent court enjoining and restraining the Executive and/or all
other Persons involved therein from continuing such breach. The existence of any
claim or cause of action which the Executive or any such other Person may have
against the Company shall not constitute a defense or bar to the enforcement of
any of the Covenants. If the Company is obliged to resort to litigation to
enforce any of the Covenants which has a fixed term, then such term shall be
extended for a period of time equal to the period during which a material breach
of such Covenant was occurring, beginning on the date of a final court order
(without further right of appeal) holding that such a material breach occurred,
or, if later, the last day of the original fixed term of such Covenant.

         Consideration. The Executive expressly acknowledges that the Covenants
are a material part of the consideration bargained for by the Company and,
without the agreement of the Executive to be bound by the Covenants, the Company
would not have agreed to enter into this Agreement.

         Scope. If any portion of any Covenant or its application is construed
to be invalid, illegal or unenforceable, then the other portions and their
application shall not be affected thereby and shall be enforceable without
regard thereto. If any of the Covenants is determined to be unenforceable
because of its scope, duration, geographical area or similar factor, then the
court making such determination shall have the power to reduce or limit such
scope, duration, area or other factor, and such Covenant shall then be
enforceable in its reduced or limited form.

No Obligation to Mitigate Damages; No Effect on Other Contractual Rights.

         The Executive shall not be required to mitigate damages or the amount
of any payment provided for under this Agreement by seeking other employment or
otherwise, nor shall the amount of payment provided for under this Agreement be
reduced by any compensation earned by the Executive as the result of employment
by another employer after the Date of Termination, or otherwise. The amounts
payable to the Executive under Section 5 hereof shall not be treated as damages
but as severance compensation to which the Executive is entitled by reason of
termination of the Executive's employment in the circumstances contemplated by
this Agreement.

Miscellaneous.

         Notices. All notices, requests, demands, consents or other
communications required or permitted to be given under this Agreement shall be
in writing and shall be deemed to have been duly given if and when (i) delivered

                                       13

<PAGE>

personally, (ii) mailed by first class certified mail, return receipt requested,
postage prepaid, or (iii) sent by a nationally recognized express courier
service, postage or delivery changes prepaid, with receipt, or (iv) delivered by
telecopy (with receipt, and with original delivered in accordance with any of
(i), (ii) or (iii) above) to the parties at their respective addresses stated
below or to such other addresses of which the parties may give notice in
accordance with this Section.

                           If to the Company, to:

                           Genesis HealthCare Corporation
                           101 East State Street
                           Kennett Square, PA 19348

                           Attention: Law Department
                           Attention: Chairman and Chief Executive Officer

                           with a copy to:

                           Blank Rome LLP
                           One Logan Square
                           Philadelphia, PA 19103

                           Attention:  Stephen E. Luongo, Esquire

                           If to the Executive, to:
                           James McKeon
                           1613 Broad Run Road
                           Landenberg, PA 19350


         Entire Understanding. This Agreement sets forth the entire
understanding between the parties with respect to the subject matter hereof and
supersedes all prior and contemporaneous, written, oral, expressed or implied,
communications, agreements and understandings with respect to the subject matter
hereof.

         Modification. This Agreement shall not be amended, modified,
supplemented or terminated except in writing signed by both parties. No action
taken by the Company hereunder, including without limitation any waiver, consent
or approval, shall be effective unless approved by a majority of the Board.

         Termination of Prior Employment Agreements. All prior employment
agreements between the Executive and the Company and/or any of its affiliates
(and any of their predecessors) are hereby terminated as of the Effective Date.

         Assignability and Binding Effect. This Agreement (including the
covenants set forth in Section 8) shall inure to the benefit of and shall be
binding upon the Company and its successors (including successors to all or

                                       14

<PAGE>

substantially all of the Company's assets) and permitted assigns and upon the
Executive and the Executive's heirs, executors, legal representatives,
successors and permitted assigns. This Agreement, including but not limited to
the covenants contained in Section 8 above, may be assigned or otherwise
transferred by the Company to any of its subsidiaries or other affiliates and by
such transferees to its subsidiaries or other affiliates, provided that, in any
assignment or transfer the assignee or transferee agrees to be bound by the
terms and conditions hereof. Upon assignment or transfer, the "Company" herein
shall mean the buyer, assignee or transferee of this Agreement. This Agreement
may not, however, be assigned by the Executive to a third party, nor may the
Executive delegate his duties under this Agreement.

         Severability. If any provision of this Agreement is construed to be
invalid, illegal or unenforceable, then the remaining provisions hereof shall
not be affected thereby and shall be enforceable without regard thereto.

         Counterparts. This Agreement may be executed in any number of
counterparts, each of which when so executed and delivered shall be an original
hereof, and it shall not be necessary in making proof of this Agreement to
produce or account for more than one counterpart hereof.

         Section Headings. Section and subsection headings in this Agreement are
inserted for convenience of reference only, and shall neither constitute a part
of this Agreement nor affect its construction, interpretation, meaning or
effect.

         References. All words used in this Agreement shall be construed to be
of such number and gender as the context requires or permits.

         Controlling Law. This Agreement is made under, and shall be governed
by, construed and enforced in accordance with, the substantive laws of the
Commonwealth of Pennsylvania applicable to agreements made and to be performed
entirely therein.

         Settlement of Disputes. Except with respect to injunctive relief under
Section 8 or otherwise, the Executive and the Company will attempt in good faith
to resolve any and all controversies, claims, and disputes of every kind and
nature, including both common law and statutory, between the parties to this
Agreement, arising out of or in connection with the Executive's employment
relationship, terms and conditions of employment, or separation of employment
with the Company for whatever reason, (including without limitation, any such
claim, dispute or controversy arising under any federal, state or local law,
statute, regulation or ordinance or arising under the Company's employee benefit
plans, policies or programs), including the existence, construction, validity,
interpretation or meaning, performance, non-performance, enforcement, operation,
breach, continuance, or termination of this Agreement (each, a "Dispute")
promptly by discussions between the parties to this Agreement. If the Dispute
cannot be resolved through such discussions, the Dispute shall be submitted to
arbitration in accordance with the National Rules for the Resolution of
Employment Disputes ("the Rules") of the American Arbitration Association
("AAA") then in effect, except as otherwise agreed to herein. The time

                                       15

<PAGE>

limitation for submitting a Dispute to arbitration pursuant to this Agreement is
sixty (60) days from the date of the occurrence giving rise to the Dispute,
unless the Dispute is based on statutory rights, in which case the applicable
statute of limitations governs the time period in which a Dispute must be
submitted to arbitration. By submitting a Dispute to arbitration pursuant to
this Agreement, the Executive and the Company acknowledge and agree to waive
their respective rights to seek relief in a judicial forum and before a jury.
The arbitration shall be conducted by a single arbitrator, selected by
alternately striking from a list of five arbitrators supplied by the AAA. The
arbitrator's fees shall be borne by the Company. The Executive and the Company
are separately responsible for their costs, transcript fees, expenses, witness
fees, attorney's fees and other costs associated with the arbitration. The
parties agree that any arbitration conducted pursuant to this section shall be
held in the county in which the Company's corporate headquarters is located (or
at such other location as shall be mutually agreed to by the parties). The
decision of the arbitrator shall be final and binding upon the parties. In
rendering a decision, the arbitrator shall apply all legal principles and
standards that would govern if the Dispute were being brought in a judicial
forum, including all statute of limitations and defenses. Discovery shall be
allowed pursuant to the Rules then in effect as the arbitrator determines
appropriate under the circumstances. The arbitrator may grant injunctions or
provide other relief available in a court of law or equity. Any action to
enforce or vacate the arbitrator's award shall be governed by the Federal
Arbitration Act, if applicable, and otherwise by applicable state law. If either
the Company or the Executive pursues any claim, dispute or controversy against
the other in a proceeding other than the arbitration provided for herein, the
responding party shall be entitled to dismissal or injunctive relief regarding
such action and recovery of all costs, losses and attorney's fees related to
such action. Nothing herein shall preclude the Company from seeking, in any
court of competent jurisdiction in Pennsylvania, damages, specific performance,
or other equitable or legal remedies in the case of any breach or threatened
breach by the Executive of this Agreement. The arbitrator shall be required to
apply the contractual provisions hereof or the Company's policies and procedures
in deciding any matter submitted to him and shall not have any authority, by
reason of this Agreement or otherwise, to render a decision that is contrary to
the mutual intent of the parties as set forth in this Agreement or the Company's
intent as set forth in the Company's policies and procedures. Any of the
parties, before or during the arbitration contemplated by this section, may
apply to a court for a temporary restraining order or preliminary injunction or
similar equitable relief to protect its interests pending completion of such
arbitration proceedings and, in particular, to enforce the provisions of this
section and to aid the arbitration contemplated thereby.

         Approval and Authorizations. The execution and the implementation of
the terms and conditions of this Agreement have been fully authorized by the
Board.

           Indulgences, Etc. Neither the failure nor delay on the part of either
party to exercise any right, remedy, power or privilege under this Agreement
shall operate as a waiver thereof, nor shall the single or partial exercise of
any right, remedy, power or privilege preclude any other or further exercise of
the same or any other right, remedy, power or privilege, nor shall any waiver of
any right, remedy, power or privilege with respect to any occurrence be
construed as a waiver of such right, remedy, power or privilege with respect to
any other occurrence. No waiver shall be effective unless it is in writing and
is signed by the party asserted to have granted such waiver.

                                       16

<PAGE>

         Legal Expenses. In the event that the Executive institutes any legal
action to enforce the Executive's rights under, or to recover damages for breach
of this Agreement, the Executive, if the Executive is the prevailing party,
shall be entitled to recover from the Company any reasonable expenses for
attorney's fees and disbursements incurred by the Executive.

                            [Signature Page follows]












                                       17

<PAGE>



         IN WITNESS WHEREOF, the parties hereto have executed this Agreement the
day and year first above mentioned, under seal, intending to be legally bound
hereby.



Attest:                                   GENESIS HEALTHCARE CORP.



/s/Eileen M. Coggins                      By:    /s/George V. Hager, Jr.
--------------------------                       ------------------------------
Secretary                                 Name:   George V. Hager, Jr.
                                          Title:  Chief Executive Officer


Witness                                   EXECUTIVE.



/s/ James W. Tabak                               By:    /s/James McKeon
--------------------------                       ------------------------------
                                          Name:   James McKeon










                    [SIGNATURE PAGE OF EMPLOYMENT AGREEMENT]


<PAGE>



                                    Exhibit A
                                    ---------

                     Lump Sum Bonus:             $318,200

                     Spin Bonus:                 $112,000

                     Stock Option Shares:          75,000

                     Restricted Stock Shares:      50,000