<PAGE>   1
Exhibit 2.7.1
                                 AMENDMENT NO. 1

                                       TO

                          AGREEMENT AND PLAN OF MERGER


         THIS AMENDMENT NO. 1 TO AGREEMENT AND PLAN OF MERGER is dated as of
October 9, 1996 and is by and among Unison HealthCare Corporation, a Delaware
corporation ("Parent"), Arkansas, Inc., a Colorado corporation ("Arkansas"),
David A. Kremser, an individual resident in Colorado ("Mr. Kremser") and John D.
Filkoski, an individual resident in Colorado ("Mr. Filkoski"), and relates to
the Agreement and Plan of Merger dated as of August 2, 1996 by and among Parent,
Arkansas, Mr. Kremser and Mr. Filkoski (the "Agreement"). Capitalized terms not
defined herein shall have the meanings set forth in the Agreement.

         WHEREAS, as provided for in Sections 7.13 and 8.7 of the Agreement,
Parent, Arkansas, Mr. Kremser and Mr. Filkoski initially anticipated that Parent
would enter into a definitive agreement to acquire the assets and business of
RehabWest, Inc. for an aggregate purchase price of $5,500,000 as a condition to
Closing; and

         WHEREAS, Parent will actually enter into a definitive agreement to
acquire the assets and business of RehabWest, Inc. for an aggregate purchase
price of $5,350,000; and

         WHEREAS, pursuant to Section 11.9 of the Agreement, Parent, Arkansas,
Mr. Kremser and Mr. Filkoski desire to amend the Agreement to reflect the
revised purchase price for RehabWest, Inc.

         NOW THEREFORE, IT IS HEREBY AGREED AS FOLLOWS:

         Section 1. Section 7.13 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."

         Section 2. Section 8.7 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."





<PAGE>   2

         IN WITNESS WHEREOF, the parties have executed and delivered this
Amendment No. 1 to Agreement and Plan of Merger as of the date first written
above.


         UNISON HEALTHCARE CORPORATION



By:      /S/ Paul J. Contris
         ---------------------------
         Paul J. Contris
         Executive Vice President



         ARKANSAS, INC.



By:      /s/ David A. Kremser
         ---------------------------
         David A. Kremser
         President



         DAVID A. KREMSER



         /S/ David A. Kremser



         JOHN D. FILKOSKI



         /S/ John D. Filkoski


<PAGE>   3
                                 AMENDMENT NO. 1

                                       TO

                          AGREEMENT AND PLAN OF MERGER


         THIS AMENDMENT NO. 1 TO AGREEMENT AND PLAN OF MERGER is dated as of
October 9, 1996 and is by and among Unison HealthCare Corporation, a Delaware
corporation ("Parent"), Cornerstone Care, Inc., a Colorado corporation
("Cornerstone"), David A. Kremser, an individual resident in Colorado ("Mr.
Kremser") and John D. Filkoski, an individual resident in Colorado ("Mr.
Filkoski"), and relates to the Agreement and Plan of Merger dated as of August
2, 1996 by and among Parent, Cornerstone, Mr. Kremser and Mr. Filkoski (the
"Agreement"). Capitalized terms not defined herein shall have the meanings set
forth in the Agreement.

         WHEREAS, as provided for in Sections 7.13 and 8.7 of the Agreement,
Parent, Cornerstone, Mr. Kremser and Mr. Filkoski initially anticipated that
Parent would enter into a definitive agreement to acquire the assets and
business of RehabWest, Inc. for an aggregate purchase price of $5,500,000 as a
condition to Closing; and

         WHEREAS, Parent will actually enter into a definitive agreement to
acquire the assets and business of RehabWest, Inc. for an aggregate purchase
price of $5,350,000; and

         WHEREAS, pursuant to Section 11.9 of the Agreement, Parent,
Cornerstone, Mr. Kremser and Mr. Filkoski desire to amend the Agreement to
reflect the revised purchase price for RehabWest, Inc.

         NOW THEREFORE, IT IS HEREBY AGREED AS FOLLOWS:

         Section 1. Section 7.13 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."

         Section 2. Section 8.7 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."




<PAGE>   4
         IN WITNESS WHEREOF, the parties have executed and delivered this
Amendment No. 1 to Agreement and Plan of Merger as of the date first written
above.


         UNISON HEALTHCARE CORPORATION



By:      /S/ Paul J. Contris
         ----------------------------------
         Paul J. Contris
         Executive Vice President



         CORNERSTONE CARE, INC.



By:      /S/ David A. Kremser
         ----------------------------------
         David A. Kremser
         President



         DAVID A. KREMSER



         /S/ David A. Kremser
         ----------------------------------


         JOHN D. FILKOSKI



         /S/ John D. Filkoski
         ----------------------------------

                                       -4-

<PAGE>   5
                                 AMENDMENT NO. 1

                                       TO

                          AGREEMENT AND PLAN OF MERGER


         THIS AMENDMENT NO. 1 TO AGREEMENT AND PLAN OF MERGER is dated as of
October 9, 1996 and is by and among Unison HealthCare Corporation, a Delaware
corporation ("Parent"), Douglas Manor, Inc., a Colorado corporation ("Douglas
Manor"), David A. Kremser, an individual resident in Colorado ("Mr. Kremser")
and John D. Filkoski, an individual resident in Colorado ("Mr. Filkoski"), and
relates to the Agreement and Plan of Merger dated as of August 2, 1996 by and
among Parent, Douglas Manor, Mr. Kremser and Mr. Filkoski (the "Agreement").
Capitalized terms not defined herein shall have the meanings set forth in the
Agreement.

         WHEREAS, as provided for in Sections 7.13 and 8.7 of the Agreement,
Parent, Douglas Manor, Mr. Kremser and Mr. Filkoski initially anticipated that
Parent would enter into a definitive agreement to acquire the assets and
business of RehabWest, Inc. for an aggregate purchase price of $5,500,000 as a
condition to Closing; and

         WHEREAS, Parent will actually enter into a definitive agreement to
acquire the assets and business of RehabWest, Inc. for an aggregate purchase
price of $5,350,000; and

         WHEREAS, pursuant to Section 11.9 of the Agreement, Parent, Douglas
Manor, Mr. Kremser and Mr. Filkoski desire to amend the Agreement to reflect the
revised purchase price for RehabWest, Inc.

         NOW THEREFORE, IT IS HEREBY AGREED AS FOLLOWS:

         Section 1. Section 7.13 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."

         Section 2. Section 8.7 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."




                                       -5-

<PAGE>   6


         IN WITNESS WHEREOF, the parties have executed and delivered this
Amendment No. 1 to Agreement and Plan of Merger as of the date first written
above.


         UNISON HEALTHCARE CORPORATION



By:      /S/ Paul J. Contris
         ----------------------------------
         Paul J. Contris
         Executive Vice President



         DOUGLAS MANOR, INC.



By:      /S/ David A. Kremser
         ----------------------------------
         David A. Kremser
         President



         DAVID A. KREMSER



         /S/ David A. Kremser
         ----------------------------------


         JOHN D. FILKOSKI



         /S/ John D. Filkoski
         ----------------------------------

                                       -6-

<PAGE>   7
                                 AMENDMENT NO. 1

                                       TO

                          AGREEMENT AND PLAN OF MERGER


         THIS AMENDMENT NO. 1 TO AGREEMENT AND PLAN OF MERGER is dated as of
October 9, 1996 and is by and among Unison HealthCare Corporation, a Delaware
corporation ("Parent"), Safford Care, Inc., a Colorado corporation ("Safford
Care"), David A. Kremser, an individual resident in Colorado ("Mr. Kremser") and
John D. Filkoski, an individual resident in Colorado ("Mr. Filkoski"), and
relates to the Agreement and Plan of Merger dated as of August 2, 1996 by and
among Parent, Safford Care, Mr. Kremser and Mr. Filkoski (the "Agreement").
Capitalized terms not defined herein shall have the meanings set forth in the
Agreement.

         WHEREAS, as provided for in Sections 7.13 and 8.7 of the Agreement,
Parent, Safford Care, Mr. Kremser and Mr. Filkoski initially anticipated that
Parent would enter into a definitive agreement to acquire the assets and
business of RehabWest, Inc. for an aggregate purchase price of $5,500,000 as a
condition to Closing; and

         WHEREAS, Parent will actually enter into a definitive agreement to
acquire the assets and business of RehabWest, Inc. for an aggregate purchase
price of $5,350,000; and

         WHEREAS, pursuant to Section 11.9 of the Agreement, Parent, Safford
Care, Mr. Kremser and Mr. Filkoski desire to amend the Agreement to reflect the
revised purchase price for RehabWest, Inc.

         NOW THEREFORE, IT IS HEREBY AGREED AS FOLLOWS:

         Section 1. Section 7.13 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."

         Section 2. Section 8.7 of the Agreement is amended by replacing the
                    term "$5,500,000" with the term "$5,350,000."
 


<PAGE>   8

         IN WITNESS WHEREOF, the parties have executed and delivered this
Amendment No. 1 to Agreement and Plan of Merger as of the date first written
above.


         UNISON HEALTHCARE CORPORATION



By:      /S/ Paul J. Contris
         ----------------------------------
         Paul J. Contris
         Executive Vice President



         SAFFORD CARE, INC.



By:      /S/ David A. Kremser
         ----------------------------------
         David A. Kremser
         President



         DAVID A. KREMSER



         /S/ David A. Kremser
         ----------------------------------


         JOHN D. FILKOSKI



         /S/ John D. Filkoski
         ----------------------------------


                                       -8-

<PAGE>   9
                         POST-EFFECTIVE AMENDMENT NO. 2
                           DATED AS OF MARCH 17, 1997

                                     TO FOUR
                         AGREEMENTS AND PLANS OF MERGER
                                      AMONG
                          UNISON HEALTHCARE CORPORATION
                                DAVID A. KREMSER
                                       AND
                                JOHN D. FILKOSKI
                                       AND
                                     EACH OF
                                 ARKANSAS, INC.
                             CORNERSTONE CARE, INC.
                               DOUGLAS MANOR, INC.
                               SAFFORD CARE, INC.
                         EACH DATED AS OF AUGUST 2, 1996


Background

         The parties have entered into those certain Agreements and Plans of
Merger dated as of August 2, 1996 (the "Original Agreements") pursuant to which
each of Arkansas, Inc., Cornerstone Care, Inc., Douglas Manor, Inc. and Safford
Care, Inc. (the "S Corporations") merged with and into a wholly owned subsidiary
of Unison HealthCare Corporation on or about October 31, 1996. Because the
financial results of the S Corporations were not and could not be known with
certainty at the time of the merger, the Original Agreements provided that the
Equity Adjustment Amount, as defined therein, would be determined and would be
paid to the party or parties entitled thereto pursuant to the Equity Adjustment
Procedure, all as more fully described in Sections 2.9 and 2.10 of the Original
Agreements.

         The parties have now determined that the net Equity Adjustment Amount
for the S Corporations is $1,053,010. The parties intended that this amount
would be paid in immediately available funds. The parties now desire to amend
the Original Agreements to provide that the Equity Adjustment Amount will be
paid in the form of one or more promissory notes in substantially the form of
Exhibit X hereto. To accomplish the foregoing intent, the parties agree as set
forth below.

Agreement

         1.       Equity Adjustment Amount. The parties hereby agree that the
                  net Equity Adjustment Amount under the Original Agreements is
                  $1,053,010.



<PAGE>   10
         2.       Amendment to Section 2.10(b). The parties hereby agree that
                  Section 2.10(b) of each of the Original Agreements shall be
                  amended by deleting the second sentence thereof in its
                  entirety and inserting therefor the following: "Payments may
                  be made either in immediately available funds or by one or
                  more promissory notes of Parent in form and substance
                  reasonably acceptable to the Company and the Warranting
                  Shareholders."

         3.       Ratification of Original Agreements. Each of the Original
                  Agreements, as amended hereby, is hereby ratified and affirmed
                  in all other respects.

         IN WITNESS WHEREOF, and pursuant to Section 11.9 of each of the
Original Agreements, the parties have executed this Amendment No. 1 as of the
date set forth above.

                                           UNISON HEALTHCARE
                                            CORPORATION


                                           By: /s/Phillip R. Rollins
                                               ---------------------------------
                                           Name: Phillip R. Rollins
                                           Title: EVP/COO

                                           ARKANSAS, INC.
                                           CORNERSTONE CARE, INC.
                                           DOUGLAS MANOR, INC.
                                           SAFFORD CARE, INC.


                                           By:  /S/ David Kremser
                                               ---------------------------------
                                           Name:  David Kremser
                                           Title: President

                                           DAVID A. KREMSER


                                           By: /S/ David A. Kremser
                                               ---------------------------------
                                           David A. Kremser, Personally

                                           JOHN D. FILKOSKI


                                           By: /S/ John D. Filkoski
                                               ---------------------------------
                                           John D. Filkoski, Personally


                                      -10-