Document:

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                                                                     EXHIBIT 4.2

                             SUPPLEMENTAL INDENTURE

      SUPPLEMENTAL INDENTURE ("Supplemental Indenture"), dated as of March 16,
2005, among Genesis HealthCare Corporation, a Pennsylvania corporation (the
"Company"), the certain subsidiaries of the Company set forth on Schedule I
attached hereto (each, a "Guaranteeing Subsidiary"), the other Guarantors (as
defined in the Indenture referred to herein) party hereto and The Bank of New
York, as trustee under the Indenture referred to below (the "Trustee").

                               W I T N E S S E T H

      WHEREAS, the Company has heretofore executed and delivered to the Trustee
an indenture, dated as of October 28, 2003, as supplemented by that certain
Supplemental Indenture dated as of January 20, 2004 (as supplemented, the
"Indenture"), providing for the issuance of 8% Senior Subordinated Notes due
2013 (the "Notes");

      WHEREAS, the Indenture provides that under certain circumstances each
Guaranteeing Subsidiary shall execute and deliver to the Trustee a supplemental
indenture pursuant to which such Guaranteeing Subsidiary shall unconditionally
Guarantee all of the Company's Obligations under the Notes and the Indenture on
the terms and conditions set forth herein (the "Subsidiary Guarantee");

      WHEREAS, pursuant to Section 9.01 of the Indenture, the Trustee is
authorized to execute and deliver this Supplemental Indenture; and

      WHEREAS, effective as of March 2, 2005, upon execution of the amended and
restated Credit Agreement, the Guarantors set forth on Schedule II attached
hereto were released from any Obligations under the Notes and the Indenture and
such Guarantors are no longer parties to the Indenture (collectively, the
"Released Guarantors").

      NOW THEREFORE, in consideration of the foregoing and for other good and
valuable consideration, the receipt of which is hereby acknowledged, the parties
mutually covenant and agree for the equal and ratable benefit of the Holders of
the Notes as follows:

      1. CAPITALIZED TERMS. Capitalized terms used herein without definition
shall have the meanings assigned to them in the Indenture.

      2. AGREEMENT TO GUARANTEE. Each Guaranteeing Subsidiary hereby agrees as
follows:

                  (a) Along with all Guarantors named in the Indenture (other
            than the Released Guarantors), to jointly and severally Guarantee to
            each Holder of a Note authenticated and delivered by the Trustee and
            to the Trustee and its successors and assigns, the Notes or the
            obligations of the Company hereunder or thereunder, that:

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                        (i) the principal of, and premium, if any, and interest
            on the Notes will be promptly paid in full when due, whether at
            maturity, by acceleration, redemption or otherwise, and interest on
            the overdue principal of and interest on the Notes, if any, if
            lawful, and all other obligations of the Company to the Holders or
            the Trustee hereunder or thereunder will be promptly paid in full or
            performed, all in accordance with the terms hereof and thereof; and

                        (ii) in case of any extension of time of payment or
            renewal of any Notes or any of such other obligations, that same
            will be promptly paid in full when due or performed in accordance
            with the terms of the extension or renewal, whether at stated
            maturity, by acceleration or otherwise. Failing payment when due of
            any amount so Guaranteed or any performance so Guaranteed for
            whatever reason, the Guarantors shall be jointly and severally
            obligated to pay the same immediately.

                  (b) The obligations hereunder shall be unconditional,
            irrespective of the validity, regularity or enforceability of the
            Notes or the Indenture, the absence of any action to enforce the
            same, any waiver or consent by any Holder of the Notes with respect
            to any provisions hereof or thereof, the recovery of any judgment
            against the Company, any action to enforce the same or any other
            circumstance which might otherwise constitute a legal or equitable
            discharge or defense of a Guarantor.

                  (c) The following is hereby waived: diligence, presentment,
            demand of payment, filing of claims with a court in the event of
            insolvency or bankruptcy of the Company, any right to require a
            proceeding first against the Company, protest, notice and all
            demands whatsoever.

                  (d) This Subsidiary Guarantee shall not be discharged except
            by complete performance of the obligations contained in the Notes
            and the Indenture, and the Guaranteeing Subsidiary accepts all
            obligations of a Guarantor under the Indenture.

                  (e) If any Holder or the Trustee is required by any court or
            otherwise to return to the Company, the Guarantors, or any
            custodian, trustee, liquidator or other similar official acting in
            relation to either the Company or the Guarantors, any amount paid by
            either to the Trustee or such Holder, this Subsidiary Guarantee, to
            the extent theretofore discharged, shall be reinstated in full force
            and effect.

                  (f) The Guaranteeing Subsidiary shall not be entitled to any
            right of subrogation in relation to the Holders in respect of any
            obligations Guaranteed hereby until payment in full of all
            obligations Guaranteed hereby.

                  (g) As between the Guarantors, on the one hand, and the
            Holders and the Trustee, on the other hand, (x) the maturity of the
            obligations Guaranteed hereby may be accelerated as provided in
            Article 6 of the Indenture for the

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            purposes of this Subsidiary Guarantee, notwithstanding any stay,
            injunction or other prohibition preventing such acceleration in
            respect of the obligations Guaranteed hereby, and (y) in the event
            of any declaration of acceleration of such obligations as provided
            in Article 6 of the Indenture, such obligations (whether or not due
            and payable) shall forthwith become due and payable by the
            Guarantors for the purpose of this Subsidiary Guarantee.

                  (h) The Guarantors shall have the right to seek contribution
            from any non-paying Guarantor so long as the exercise of such right
            does not impair the rights of the Holders under the Subsidiary
            Guarantee.

                  (i) Pursuant to Section 10.02 of the Indenture, after giving
            effect to any maximum amount and all other contingent and fixed
            liabilities that are relevant under any applicable Bankruptcy or
            fraudulent conveyance laws, and after giving effect to any
            collections from, rights to receive contribution from or payments
            made by or on behalf of any other Guarantor in respect of the
            obligations of such other Guarantor under Article 10 of the
            Indenture, this new Subsidiary Guarantee shall be limited to the
            maximum amount permissible such that the obligations of such
            Guarantor under this Subsidiary Guarantee will not constitute a
            fraudulent transfer or conveyance.

      3. EXECUTION AND DELIVERY. Each Guaranteeing Subsidiary agrees that the
Subsidiary Guarantees shall remain in full force and effect notwithstanding any
failure to endorse on each Note a notation of such Subsidiary Guarantee.

      4. GUARANTEEING SUBSIDIARY MAY CONSOLIDATE, ETC. ON CERTAIN TERMS.

                  (a) Each Guaranteeing Subsidiary may not sell or otherwise
            dispose of all substantially all of its assets to, or consolidate
            with or merge with or into (whether or not such Guarantor is the
            surviving Person) another Person, other than the Company or another
            Guarantor unless:

                        (i) immediately after giving effect to such transaction,
            no Default or Event of Default exists; and

                        (ii) either (A) subject to Sections 10.04 and 10.05 of
            the Indenture, the Person acquiring the property in any such sale or
            disposition or the Person formed by or surviving any such
            consolidation or merger unconditionally assumes all the obligations
            of that Guarantor, pursuant to a supplemental indenture in form and
            substance reasonably satisfactory to the Trustee, under the Notes,
            the Indenture and the Subsidiary Guarantee on the terms set forth
            herein or therein; or (B) the Net Proceeds of such sale or other
            disposition are applied in accordance with the applicable provisions
            of the Indenture, including without limitation, Section 4.10
            thereof.

                  (b) In case of any such consolidation, merger, sale or
            conveyance and upon the assumption by the successor Person, by
            supplemental indenture, executed and delivered to the Trustee and
            satisfactory in form to the Trustee, of

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            the Subsidiary Guarantee endorsed upon the Notes and the due and
            punctual performance of all of the covenants and conditions of the
            Indenture to be performed by the Guarantor, such successor Person
            shall succeed to and be substituted for the Guarantor with the same
            effect as if it had been named herein as a Guarantor. Such successor
            Person thereupon may cause to be signed any or all of the Subsidiary
            Guarantees to be endorsed upon all of the Notes issuable under the
            Indenture which theretofore shall not have been signed by the
            Company and delivered to the Trustee. All the Subsidiary Guarantees
            so issued shall in all respects have the same legal rank and benefit
            under the Indenture as the Subsidiary Guarantees theretofore and
            thereafter issued in accordance with the terms of the Indenture as
            though all of such Subsidiary Guarantees had been issued at the date
            of the execution hereof.

                  (c) Except as set forth in Articles 4 and 5 and Section 10.05
            of Article 10 of the Indenture, and notwithstanding clauses (a) and
            (b) above, nothing contained in the Indenture or in any of the Notes
            shall prevent any consolidation or merger of a Guarantor with or
            into the Company or another Guarantor, or shall prevent any sale or
            conveyance of the property of a Guarantor as an entirety or
            substantially as an entirety to the Company or another Guarantor.

      5. RELEASES.

                  (a) In the event of any sale or other disposition of all or
            substantially all of the assets of any Guarantor, by way of merger,
            consolidation or otherwise, or a sale or other disposition of all of
            the Capital Stock of any Guarantor, in each case to a Person that is
            not (either before or after giving effect to such transaction) a
            Subsidiary of the Company, then such Guarantor (in the event of a
            sale or other disposition, by way of merger, consolidation or
            otherwise, of all of the Capital Stock of such Guarantor) or the
            corporation acquiring the property (in the event of a sale or other
            disposition of all or substantially all of the assets of such
            Guarantor) shall be released and relieved of any obligations under
            its Subsidiary Guarantee; provided that the Net Proceeds of such
            sale or other disposition are applied in accordance with the
            applicable provisions of the Indenture, including without limitation
            Section 4.10 of the Indenture. Upon delivery by the Company to the
            Trustee of an Officers' Certificate and an Opinion of Counsel to the
            effect that such sale or other disposition was made by the Company
            in accordance with the provisions of the Indenture, including
            without limitation Section 4.10 of the Indenture, the Trustee shall
            execute any documents reasonably required in order to evidence the
            release of any Guarantor from its obligations under its Subsidiary
            Guarantee.

                  (b) If the Company designates any Restricted Subsidiary that
            is a Guarantor as an Unrestricted Subsidiary in accordance with
            Section 4.18 of the Indenture, then such Guarantor shall be released
            and relieved of any Obligations under its Subsidiary Guarantee in
            accordance with the provisions of the Indenture.

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                  (c) Upon the full and unconditional release of a Guarantee by
            a Subsidiary under all then outstanding Credit Facilities, then such
            Guarantor shall be released and relieved of any Obligations under
            its Subsidiary Guarantee in accordance with the provisions of the
            Indenture; provided, however, that in the event that any such
            Subsidiary thereafter Guarantees any Indebtedness of the Company
            under any Credit Facility (or if any released Guarantee under any
            Credit Facility is reinstated or renewed), then such Subsidiary
            shall be required to be a Guarantor by executing a supplemental
            indenture and providing the Trustee with an Officer's Certificate
            and an Opinion of Counsel.

                  (d) Any Guarantor not released from its obligations under its
            Subsidiary Guarantee shall remain liable for the full amount of
            principal of and interest on the Notes and for the other obligations
            of any Guarantor under the Indenture as provided in Article 10 of
            the Indenture.

      6. SUBORDINATION. The Notes and the Subsidiary Guarantees are subordinated
to Senior Debt, as defined in the Indenture. To the extent provided in the
Indenture, Senior Debt must be paid before the Notes may be paid. Each of the
Company and the Guarantors agrees, and each Holder by accepting a Note and a
Subsidiary Guarantee agrees, to the subordination provisions contained in the
Indenture.

      7. NO RECOURSE AGAINST OTHERS. No past, present or future director,
officer, employee, incorporator, shareholder of a Guaranteeing Subsidiary, as
such, shall have any liability for any obligations of the Company or the
Guaranteeing Subsidiary under the Notes, any Subsidiary Guarantees, the
Indenture or this Supplemental Indenture or for any claim based on, in respect
of, or by reason of, such obligations or their creation. Each Holder of the
Notes by accepting a Note waives and releases all such liability. The waiver and
release are part of the consideration for issuance of the Notes. Such waiver may
not be effective to waive liabilities under the federal securities laws.

      8. NEW YORK LAW TO GOVERN. THIS SUPPLEMENTAL INDENTURE AND THE RIGHTS AND
DUTIES OF THE PARTIES HEREUNDER SHALL BE GOVERNED BY, AND CONSTRUED IN
ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK.

      9. COUNTERPARTS. The parties may sign any number of copies of this
Supplemental Indenture. Each signed copy shall be an original, but all of them
together represent the same agreement.

      10. EFFECT OF HEADINGS. The Section headings herein are for convenience
only and shall not affect the construction hereof.

      11. THE TRUSTEE. The Trustee shall not be responsible in any manner
whatsoever for or in respect of the validity or sufficiency of this Supplemental
Indenture or for or in respect of the recitals contained herein, all of which
recitals are made solely by each Guaranteeing Subsidiary and the Company.

                         -SIGNATURES ON FOLLOWING PAGES-

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      IN WITNESS WHEREOF, the parties hereto have caused this Supplemental
Indenture to be duly executed, all as of the date first above written.

Dated: March 16, 2005

                           APPLE VALLEY OPERATING CORP.

                           GMA CONSTRUCTION, INC.

                           THE SARAH BRAYTON PARTNERSHIP HOLDING COMPANY, INC.

                           THE SOMERSET PARTNERSHIP HOLDINGS COMPANY, INC.

                           By: /s/ James V. McKeon
                               ---------------------------
                               James V. McKeon
                               Chief Financial Officer of the foregoing entities

                           LAKE WASHINGTON, LTD.
                             By: Lake Manor, Inc., its general partner

                           STAFFORD ASSOCIATES OF N.J., L.P.
                             By: Southern Ocean GP, LLC, its general partner

                           THE APPLE VALLEY LIMITED PARTNERSHIP
                             By: The Apple Valley Partnership Holding Company,
                             Inc. and Apple Valley Operating Corp., its general
                             partners

                           WESTFORD NURSING AND RETIREMENT CENTER,
                           LIMITED PARTNERSHIP
                             By:  Westford Nursing and Retirement Center, Inc.,
                             its general partner

                           By: /s/ James V. McKeon
                               ------------------------------
                               James V. McKeon
                               Chief Financial Officer of the foregoing entities

                           SARAH BRAYTON GENERAL PARTNERSHIP
                             By: ADS Multicare Inc. and The Sarah Brayton
                             Partnership Holding Company, Inc., its general
                             partners

                           By: /s/ James V. McKeon
                               ------------------------------
                               James V. McKeon
                               Chief Financial Officer

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                           RIVERVIEW RIDGE LIMITED LIABILITY COMPANY

                           SOUTHERN OCEAN GP, L.L.C.

                           By: /s/ James V. McKeon
                               ----------------------------------
                               James V. McKeon
                               Chief Financial Officer of the foregoing entities

                           SOMERSET RIDGE L.L.C.
                             By: Somerset Ridge General Partnership, its Manager
                               By: Solomont Family Fall River Venture, Inc.,
                                   its general partner
                               By: The Somerset Partnership Holding Company,
                                   Inc., its general partner

                                   By: /s/ James V. McKeon
                                       ----------------------------------
                                       James V. McKeon
                                       Chief Financial Officer

                           THE COMPANY

                             GENESIS HEALTHCARE CORPORATION

                             By: /s/ James V. McKeon
                                 -----------------------------------
                                 Name: James V. McKeon
                                 Title: Chief Financial Officer

                           THE GUARANTORS

                             ACADEMY NURSING HOME, INC.

                             ADS APPLE VALLEY, INC.

                             ADS CONSULTING, INC.

                             ADS DANVERS ALF, INC.

                             ADS DARTMOUTH ALF, INC.

                             ADS HINGHAM ALF, INC.

                             ADS HINGHAM NURSING FACILITY, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                                ADS HOME HEALTH, INC.

                                ADS MANAGEMENT, INC.

                                ADS PALM CHELMSFORD, INC.

                                ADS RECUPERATIVE CENTER, INC.

                                ADS RESERVOIR WALTHAM, INC.

                                ADS SENIOR HOUSING, INC.

                                ADS/MULTICARE, INC.

                                ANR, INC.

                                APPLEWOOD HEALTH RESOURCES, INC.

                                ASL, INC.

                                ASSISTED LIVING ASSOCIATES OF BERKSHIRE, INC.

                                ASSISTED LIVING ASSOCIATES OF LEHIGH, INC.

                                ASSISTED LIVING ASSOCIATES OF SANATOGA, INC.

                                BERKS NURSING HOMES, INC.

                                BRIGHTWOOD PROPERTY, INC.

                                BRINTON MANOR, INC.

                                BURLINGTON WOODS CONVALESCENT CENTER, INC.

                                CAREFLEET, INC.

                                CENTURY CARE MANAGEMENT, INC.

                                CHATEAU VILLAGE HEALTH RESOURCES, INC.

                                CHELTENHAM LTC MANAGEMENT, INC.

                                CHG INVESTMENT CORP., INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                                CHNR-I, INC.

                                COLONIAL HALL HEALTH RESOURCES, INC.

                                CONCORD HEALTH GROUP, INC.

                                CONCORD SERVICE CORPORATION

                                CRESTVIEW CONVALESCENT HOME, INC.

                                CRESTVIEW NORTH, INC.

                                CRYSTAL CITY NURSING CENTER, INC.

                                CVNR, INC.

                                DAWN VIEW MANOR, INC.

                                DELM NURSING, INC.

                                DIANE MORGAN AND ASSOCIATES, INC.

                                DOVER HEALTHCARE ASSOCIATES, INC.

                                EIDOS, INC.

                                ELDERCARE RESOURCES CORP.

                                ELMWOOD HEALTH RESOURCES, INC.

                                ENCARE OF PENNYPACK, INC.

                                ENCARE OF QUAKERTOWN, INC.

                                ENCARE OF WYNCOTE, INC.

                                ENR, INC.

                                GENESIS ELDERCARE CENTERS - BELVEDERE, INC.

                                GENESIS ELDERCARE CENTERS - CHAPEL MANOR, INC.

                                GENESIS ELDERCARE CENTERS-HARSTON, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                                GENESIS ELDERCARE CENTERS - PENNSBURG, INC.

                                GENESIS ELDERCARE CORP.

                                GENESIS ELDERCARE DIAGNOSTIC SERVICES, INC.

                                GENESIS ELDERCARE HOME CARE SERVICES, INC.

                                GENESIS ELDERCARE HOSPITALITY SERVICES, INC.

                                GENESIS ELDERCARE LIVING FACILITIES, INC.

                                GENESIS ELDERCARE NATIONAL CENTERS, INC.

                                GENESIS ELDERCARE NETWORK SERVICES OF
                                  MASSACHUSETTS, INC.

                                GENESIS ELDERCARE NETWORK SERVICES, INC.

                                GENESIS ELDERCARE PARTNERSHIP CENTERS, INC.

                                GENESIS ELDERCARE PHYSICIAN SERVICES, INC.

                                GENESIS ELDERCARE PROPERTIES, INC.

                                GENESIS ELDERCARE REHABILITATION SERVICES, INC.

                                GENESIS ELDERCARE STAFFING SERVICES, INC.

                                GENESIS ELDERCARE TRANSPORTATION SERVICES, INC.

                                GENESIS HEALTH VENTURES OF ARLINGTON, INC.

                                GENESIS HEALTH VENTURES OF BLOOMFIELD, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                                GENESIS HEALTH VENTURES OF CLARKS SUMMIT, INC.

                                GENESIS HEALTH VENTURES OF INDIANA, INC.

                                GENESIS HEALTH VENTURES OF LANHAM, INC.

                                GENESIS HEALTH VENTURES OF MASSACHUSETTS, INC.

                                GENESIS HEALTH VENTURES OF NAUGATUCK, INC.

                                GENESIS HEALTH VENTURES OF NEW GARDEN, INC.

                                GENESIS HEALTH VENTURES OF POINT PLEASANT, INC.

                                GENESIS HEALTH VENTURES OF SALISBURY, INC.

                                GENESIS HEALTH VENTURES OF WAYNE, INC.

                                GENESIS HEALTH VENTURES OF WEST VIRGINIA, INC.

                                GENESIS HEALTH VENTURES OF WILKES-BARRE, INC.

                                GENESIS HEALTH VENTURES OF WINDSOR, INC.

                                GENESIS HEALTHCARE CENTERS HOLDINGS, INC.

                                GENESIS HEALTHCARE HOLDING COMPANY I, INC.

                                GENESIS HEALTHCARE HOLDING COMPANY II, INC.

                                GENESIS IMMEDIATE MED CENTER, INC.

                                GENESIS OF PALISADO AVENUE, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                                GENESIS PROPERTIES OF DELAWARE CORPORATION

                                GENESIS SELECTCARE CORP.

                                GENESIS/VNA PARTNERSHIP HOLDING COMPANY, INC.

                                GERIATRIC & MEDICAL COMPANIES, INC.

                                GERIATRIC AND MEDICAL INVESTMENTS CORPORATION

                                GERIATRIC AND MEDICAL SERVICES, INC.

                                GERI-MED CORP.

                                GLENMARK ASSOCIATES - DAWN VIEW MANOR, INC.

                                GLENMARK ASSOCIATES, INC.

                                GLENMARK PROPERTIES, INC.

                                GMA-BRIGHTWOOD, INC.

                                GMA-MADISON, INC.

                                GMA - UNIONTOWN, INC.

                                GMA PARTNERSHIP HOLDING COMPANY, INC.

                                GMC LEASING CORPORATION

                                GMC-LTC MANAGEMENT, INC.

                                GMS INSURANCE SERVICES, INC.

                                GOVERNOR'S HOUSE NURSING HOME, INC.

                                HEALTH RESOURCES OF ACADEMY MANOR, INC.

                                HEALTH RESOURCES OF BOARDMAN, INC.

                                HEALTH RESOURCES OF BROOKLYN, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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                                HEALTH RESOURCES OF CEDAR GROVE, INC.

                                HEALTH RESOURCES OF CINNAMINSON, INC.

                                HEALTH RESOURCES OF COLCHESTER, INC.

                                HEALTH RESOURCES OF COLUMBUS, INC.

                                HEALTH RESOURCES OF CUMBERLAND, INC.

                                HEALTH RESOURCES OF ENGLEWOOD, INC.

                                HEALTH RESOURCES OF EWING, INC.

                                HEALTH RESOURCES OF FARMINGTON, INC.

                                HEALTH RESOURCES OF GARDNER, INC.

                                HEALTH RESOURCES OF GLASTONBURY, INC.

                                HEALTH RESOURCES OF GROTON, INC.

                                HEALTH RESOURCES OF LAKEVIEW, INC.

                                HEALTH RESOURCES OF LEMONT, INC.

                                HEALTH RESOURCES OF MARCELLA, INC.

                                HEALTH RESOURCES OF MIDDLETOWN (RI), INC.

                                HEALTH RESOURCES OF MORRISTOWN, INC.

                                HEALTH RESOURCES OF NORTH ANDOVER, INC.

                                HEALTH RESOURCES OF ROCKVILLE, INC.

                                HEALTH RESOURCES OF TROY HILLS, INC.

                                HEALTH RESOURCES OF WALLINGFORD, INC.

                                HEALTH RESOURCES OF WARWICK, INC.

                                HEALTH RESOURCES OF WESTWOOD, INC.

                                HEALTHCARE RESOURCES CORP.

                                HELSTAT, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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<PAGE>

                                HILLTOP HEALTH CARE CENTER, INC.

                                HMNH REALTY, INC.

                                HNCA, INC.

                                HORIZON ASSOCIATES, INC.

                                HORIZON MOBILE, INC.

                                HORIZON REHABILITATION, INC.

                                HR OF CHARLESTON, INC.

                                HRWV HUNTINGTON, INC.

                                INNOVATIVE HEALTH CARE MARKETING, INC.

                                KEYSTONE NURSING HOME, INC.

                                KNOLLWOOD MANOR, INC.

                                KNOLLWOOD NURSING HOME, INC.

                                LAKE MANOR, INC.

                                LAKEWOOD HEALTH RESOURCES, INC.

                                LAUREL HEALTH RESOURCES, INC.

                                LEHIGH NURSING HOMES, INC.

                                LIFE SUPPORT MEDICAL EQUIPMENT, INC.

                                LIFE SUPPORT MEDICAL, INC.

                                LRC HOLDING COMPANY, INC.

                                LWNR, INC.

                                MABRI CONVALESCENT CENTER, INC.

                                MANOR MANAGEMENT CORP. OF GEORGIAN MANOR, INC.

                                MARLINTON ASSOCIATES, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       14
<PAGE>

                                MARLINTON PARTNERSHIP HOLDING COMPANY, INC.

                                MCKERLEY HEALTH CARE CENTER-CONCORD, INC.

                                MCKERLEY HEALTH CARE CENTERS, INC.

                                MERIDIAN HEALTH, INC.

                                MERIDIAN HEALTHCARE INVESTMENTS, INC.

                                MERIDIAN HEALTHCARE, INC.

                                MHNR, INC.

                                MNR, INC.

                                MONTGOMERY NURSING HOMES, INC.

                                MULTICARE AMC, INC.

                                NURSING AND RETIREMENT CENTER OF THE ANDOVERS,
                                  INC.

                                OAK HILL HEALTH CARE CENTER, INC.

                                PHC OPERATING CORP.

                                PHILADELPHIA AVENUE CORPORATION

                                POCAHONTAS CONTINUOUS CARE CENTER, INC.

                                PRESCOTT NURSING HOME, INC.

                                PROSPECT PARK LTC MANAGEMENT, INC.

                                PROVIDENCE FUNDING CORPORATION

                                PROVIDENCE HEALTH CARE, INC.

                                REST HAVEN NURSING HOME, INC.

                                RHS MEMBERSHIP INTEREST HOLDING COMPANY

                                RIDGELAND HEALTH RESOURCES, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

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<PAGE>

                                RIVERSHORES HEALTH RESOURCES, INC.

                                RLNR, INC.

                                ROSE HEALTHCARE, INC.

                                ROSE VIEW MANOR, INC.

                                RSNR, INC.

                                RVNR, INC.

                                S. T. B. INVESTORS, LTD.

                                SCHUYLKILL NURSING HOMES, INC.

                                SENIOR LIVING VENTURES, INC.

                                SENIOR SOURCE, INC.

                                SNOW VALLEY HEALTH RESOURCES, INC.

                                SOLOMONT FAMILY MEDFORD VENTURE, INC.

                                STAFFORD CONVALESCENT CENTER, INC.

                                STATE STREET ASSOCIATES, INC.

                                SVNR, INC.

                                THE ADS GROUP, INC.

                                THE APPLE VALLEY PARTNERSHIP HOLDING COMPANY,
                                  INC.

                                THE HOUSE OF CAMPBELL, INC.

                                THE MULTICARE COMPANIES, INC.

                                TMC ACQUISITION CORP.

                                TRI STATE MOBILE MEDICAL SERVICES, INC.

                                VALLEY MEDICAL SERVICES, INC.

                                VALLEY TRANSPORT AMBULANCE SERVICE, INC.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       16
<PAGE>

                                VERSALINK, INC.

                                VILLAS REALTY & INVESTMENTS, INC.

                                WALNUT LTC MANAGEMENT, INC.

                                WAYSIDE NURSING HOME, INC.

                                WEISENFLUH AMBULANCE SERVICE, INC.

                                WEST PHILA. LTC MANAGEMENT, INC.

                                WESTFORD NURSING AND RETIREMENT CENTER, INC.

                                WILLOW MANOR NURSING HOME, INC.

                                WYNCOTE HEALTHCARE CORP.

                                YE OLDE AMBULANCE COMPANY, INC.

                                YORK LTC MANAGEMENT, INC.

                                By: /s/ James V. McKeon
                                    -------------------------------------------
                                    Name: James V. McKeon
                                    Title: Chief Financial Officer of each of
                                           the foregoing entities

                                ADS APPLE VALLEY LIMITED PARTNERSHIP
                                  By: ADS Apple Valley, Inc., its general
                                      partner

                                ADS HINGHAM LIMITED PARTNERSHIP
                                  By: ADS Hingham Nursing Facility, Inc., its
                                      general partner

                                ADS RECUPERATIVE CENTER LIMITED PARTNERSHIP
                                  By: ADS Recuperative Center, Inc., its general
                                      partner

                                BREVARD MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                CARE HAVEN ASSOCIATES LIMITED PARTNERSHIP
                                  By: Glenmark Associates, Inc., its general
                                      partner

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       17
<PAGE>

                                CATONSVILLE MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc. and Meridian
                                      Health, Inc., its general partners

                                CUMBERLAND ASSOCIATES OF RHODE ISLAND, L.P.
                                  By: Health Resources of Cumberland, Inc., its
                                      general partner

                                EASTON MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc. and Meridian
                                      Health, Inc., its general partners

                                EDELLA STREET ASSOCIATES
                                  By: Genesis Health Ventures of Clarks Summit,
                                      Inc., its general partner

                                GENESIS ELDERCARE CENTERS I, L.P.
                                  By: Genesis Eldercare Partnership Centers,
                                      Inc., its general partner

                                GENESIS ELDERCARE CENTERS II, L.P.
                                  By: Genesis Eldercare Partnership Centers,
                                      Inc., its general partner

                                GENESIS ELDERCARE CENTERS III, L.P.
                                  By: Genesis Eldercare Partnership Centers,
                                      Inc., its general partner

                                GENESIS HEALTH VENTURES OF WEST VIRGINIA,
                                 LIMITED PARTNERSHIP
                                  By: Genesis ElderCare Network Services, Inc.
                                      and Genesis ElderCare Rehabilitation
                                      Services, Inc., its general partners

                                GENESIS PROPERTIES LIMITED PARTNERSHIP
                                  By: Genesis Health Ventures of Arlington,
                                      Inc., its general partner

                                GENESIS PROPERTIES OF DELAWARE LTD.
                                 PARTNERSHIP, L.P.
                                  By: Genesis Properties of Delaware
                                      Corporation, its general partner

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       18
<PAGE>

                                GLENMARK PROPERTIES I, LIMITED PARTNERSHIP
                                  By: Glenmark Associates, Inc., its general
                                      partner

                                GREENSPRING MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                GROTON ASSOCIATES OF CONNECTICUT, L.P.
                                  By: Health Resources of Groton, Inc., its
                                      general partner

                                HAMMONDS LANE MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc. and Meridian
                                      Health, Inc., its general partners

                                MCKERLEY HEALTH CARE CENTER-CONCORD
                                 LIMITED PARTNERSHIP
                                  By: McKerley Health Care Center-Concord, Inc.,
                                      its general partner

                                MERIDIAN/CONSTELLATION LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                MERIDIAN EDGEWOOD LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                MERIDIAN PERRING LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                MERIDIAN VALLEY LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                MERIDIAN VALLEY VIEW LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

                                MIDDLETOWN (RI) ASSOCIATES OF RHODE ISLAND, L.P.
                                  By: Health Resources of Middletown (RI), Inc.,
                                      its general partner

                                MILLVILLE MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Healthcare, Inc., its general
                                      partner

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       19
<PAGE>

                                NORTH CAPE CONVALESCENT CENTER ASSOCIATES, L.P.
                                  By: Geriatric and Medical Services, Inc., its
                                      general partner

                                PHILADELPHIA AVENUE ASSOCIATES
                                  By: Philadelphia Avenue Corporation, its
                                      general partner

                                POINT PLEASANT HAVEN LIMITED PARTNERSHIP
                                  By: Glenmark Associates, Inc. and GMA
                                      Partnership Holding Company, Inc., its
                                      general partners

                                RALEIGH MANOR LIMITED PARTNERSHIP
                                  By: Glenmark Associates, Inc., its general
                                      partner

                                RIVER STREET ASSOCIATES
                                  By: Genesis Health Ventures of Wilkes-Barre,
                                      Inc., its general partner

                                ROMNEY HEALTH CARE CENTER, LTD., LIMITED
                                 PARTNERSHIP
                                  By: Glenmark Associates, Inc., its general
                                      partner

                                SEMINOLE MERIDIAN LIMITED PARTNERSHIP
                                  By: Meridian Health, Inc., its general partner

                                SISTERVILLE HAVEN LIMITED PARTNERSHIP
                                  By: Glenmark Associates, Inc., its general
                                      partner

                                STATE STREET ASSOCIATES, L.P.
                                  By: State Street Associates, Inc., its general
                                      partner

                                TEAYS VALLEY HAVEN LIMITED PARTNERSHIP
                                  By: Glenmark Associates, Inc., its general
                                      partner

                                THE STRAUS GROUP-HOPKINS HOUSE, L.P.
                                  By: Encare of Wyncote, Inc., its general
                                      partner

                                THE STRAUS GROUP-QUAKERTOWN MANOR, L.P.
                                  By: Encare of Quakertown, Inc., its general
                                      partner

                                THERAPY CARE SYSTEMS, L.P.
                                  By: Genesis ElderCare Rehabilitation Services,
                                      Inc., its general partner

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       20
<PAGE>

                         VOLUSIA MERIDIAN LIMITED PARTNERSHIP
                           By: Meridian Health, Inc., its general partner

                         WALLINGFORD ASSOCIATES OF CONNECTICUT, L.P.
                           By: Health Resources of Wallingford, Inc., its
                               general partner

                         WARWICK ASSOCIATES OF RHODE ISLAND, L.P.
                           By: Health Resources of Warwick, Inc., its general
                               partner

                         By: /s/ James V. McKeon
                             -----------------------------------------
                             Name: James V. McKeon
                             Title: Chief Financial Officer of the respective
                                    general partners of each of the foregoing
                                    entities

                         HOLLY MANOR ASSOCIATES OF NEW JERSEY, L.P.
                           By: Encare of Mendham, L.L.C., its general partner

                         MERCERVILLE ASSOCIATES OF NEW JERSEY, L.P.
                           By: Breyut Convalescent Center, L.L.C., its general
                               partner

                         POMPTON ASSOCIATES, L.P.
                           By: Pompton Care, L.L.C., its general partner

                         THE STRAUS GROUP-OLD BRIDGE, L.P.
                           By: Health Resources of Emery, L.L.C., its general
                               partner

                         THE STRAUS GROUP-RIDGEWOOD, L.P.
                           By: Health Resources of Ridgewood, L.L.C., its
                               general partner

                         By: Century Care Management, Inc., the manager of the
                            respective general partners of each of the foregoing
                            entities

                         By: /s/ James V. McKeon
                             -----------------------------------------
                             Name: James V. McKeon
                             Title: Chief Financial Officer

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       21
<PAGE>

                         SOMERSET RIDGE LIMITED PARTNERSHIP
                           By: Somerset Ridge LLC, its general partner
                              By: Somerset Ridge General Partnership, its
                                  Manager
                              By: Solomont Family Fall River Venture, Inc.,
                                  its general partner

                           By: /s/ James V. McKeon
                               -----------------------------------------
                               Name: James V. McKeon
                               Title: Chief Financial Officer

                         ARCADIA ASSOCIATES
                           By: ADS/Multicare, Inc., its managing partner

                           By: /s/ James V. McKeon
                               ------------------------------
                               Name: James V. McKeon
                               Title: Chief Financial Officer

                         MCKERLEY HEALTH FACILITIES
                           By: Meridian Healthcare, Inc. and Meridian Health,
                               Inc., its partners

                           By: /s/ James V. McKeon
                               ------------------------------
                               Name: James V. McKeon
                               Title: Chief Financial Officer

                         SOMERSET RIDGE GENERAL PARTNERSHIP

                           By: Solomont Family Fall River Venture, Inc. and The
                           Somerset Partnership Holding Company, Inc., its
                           general partners

                           By: /s/ James V. McKeon
                               -----------------------------------
                               Name: James V. McKeon
                               Title: Chief Financial Officer

                           BREYUT CONVALESCENT CENTER, L.L.C.

                           ENCARE OF MENDHAM, L.L.C.

                           HEALTH RESOURCES OF BRIDGETON, L.L.C.

                           HEALTH RESOURCES OF CRANBURY, L.L.C.

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       22
<PAGE>
                            HEALTH RESOURCES OF EATONTOWN, L.L.C.

                            HEALTH RESOURCES OF EMERY, L.L.C.

                            HEALTH RESOURCES OF ENGLEWOOD, L.L.C.

                            HEALTH RESOURCES OF EWING, L.L.C.

                            HEALTH RESOURCES OF FAIR LAWN, L.L.C.

                            HEALTH RESOURCES OF JACKSON, L.L.C.

                            HEALTH RESOURCES OF RIDGEWOOD, L.L.C.

                            HEALTH RESOURCES OF SOUTH BRUNSWICK, L.L.C.

                            HEALTH RESOURCES OF WEST ORANGE, L.L.C.

                            POMPTON CARE, L.L.C.

                            ROEPHEL CONVALESCENT CENTER, L.L.C.

                            By: Century Care Management, Inc., the manager of
                               each of the foregoing entities

                            By: /s/ James V. McKeon
                                ------------------------------
                                Name: James V. McKeon
                                Title: Chief Financial Officer

                            GENESIS-GEORGETOWN SNF/JV, LLC

                            GLENMARK LIMITED LIABILITY COMPANY I

                            MILFORD ALF, LLC

                            RESPIRATORY HEALTH SERVICES LLC

                            By: /s/ James V. McKeon
                                --------------------------------
                                Name: James V. McKeon
                                Title: Chief Financial Officer

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       23
<PAGE>

                            SOMERSET RIDGE L.L.C.

                            By: Somerset Ridge General Partnership, its Manager
                              By: Solomont Family Fall River Venture, Inc., its
                                  general partner
                              By: The Somerset Partnership Holding Company,
                                  Inc., its general partner

                              By: /s/ James V. McKeon
                                  ----------------------------------
                                  Name: James V. McKeon
                                  Title: Chief Financial Officer

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       24
<PAGE>

                            THE BANK OF NEW YORK, as Trustee

                            By: /s/ Joseph Lloret
                                --------------------------------
                                Name: Joseph Lloret
                                Title: Assistant Treasurer

         [SIGNATURE PAGE TO SUPPLEMENTAL INDENTURE DATED MARCH 16, 2005]

                                       25
<PAGE>

                                                                      SCHEDULE I

                            Guaranteeing Subsidiaries

Apple Valley Operating Corp.
GMA Construction, Inc.
The Sarah Brayton Partnership Holding Company, Inc.
The Somerset Partnership Holding Company, Inc.
Lake Washington Ltd.
Stafford Associates of N.J., L.P.
The Apple Valley Limited Partnership
Westford Nursing and Retirement Center, L.P.
Sarah Brayton General Partnership
Riverview Ridge LLC
Southern Ocean GP, LLC
Somerset Ridge LLC

                                       26
<PAGE>

                                                                     SCHEDULE II

                               Released Guarantors

Health Resources of Solomont/Brookline, Inc.
Norristown Nursing and Rehabilitation Center Associates, L.P.
Therapy Care Systems, L.P.

                                       27<PAGE>

                                                                    EXHIBIT 10.1

                         GENESIS HEALTHCARE CORPORATION

                            2003 STOCK INCENTIVE PLAN

      1. Plan Purpose. The purpose of the Plan is to promote the long-term
interests of the Corporation and its shareholders by providing a means for
attracting and retaining officers, employees and directors of the Corporation
and its Affiliates by providing for Awards in the form of Restricted Stock.

      2. Definitions. The following definitions are applicable to the Plan:

      "Award" - means the grant of Restricted Stock, as provided in the Plan.

      "Affiliate" - means any "parent corporation" or "subsidiary corporation"
of the Corporation, as such terms are defined in Section 424(e) and (f),
respectively, of the Code.

      "Board" - means the Board of Directors of the Corporation.

      "Code" - means the Internal Revenue Code of 1986, as amended.

      "Committee" - means the Compensation Committee of the Board or a majority
of the Independent Directors of the Corporation's Board.

      "Continuous Service" - means the absence of any interruption or
termination of service as an officer, employee or director of the Corporation or
any Affiliate. Service shall not be considered interrupted in the case of sick
leave, military leave or any other leave of absence approved by the Corporation
or any Affiliate or in the case of transfers between payroll locations of the
Corporation, or between the Corporation, its subsidiaries or its successor.

      "Corporation" - means Genesis HealthCare Corporation, a Pennsylvania
corporation.

      "Fair Market Value" - means the last reported sale price of a share of the
Corporation's common stock on any stock exchange on which such stock is then
listed or admitted to trading, or on the NASDAQ Stock Market, on such date, or
if no sale took place on such day, the last such date on which a sale took
place, or if the common stock is not then quoted on the NASDAQ Stock Market, or
listed or admitted to trading on any stock exchange, the average of the bid and
asked prices in the over-the-counter market on such date, or if none of the
foregoing, a price determined in good faith by the Committee to equal the fair
market value per share of the common stock.

      "Independent Director" - shall have the meaning ascribed to it by the
National Association of Securities Dealers Inc. Rule 4200(a)(15) or any future
corresponding rule.

      "Non-Employee Director" - shall have the meaning intended by Rule
16b-3(b)(3) under the Securities Exchange Act of 1934, as amended, or any future
corresponding rule.

<PAGE>

      "Participant" - means any officer, employee or director of the Corporation
or its Affiliates selected to participate in the Plan.

      "Plan" - means the 2003 Stock Incentive Plan of the Corporation.

      "Restricted Period" - means the period(s) of time, if any, selected by the
Committee for the purpose of determining when restrictions are in effect under
Section 3 hereof with respect to Restricted Stock awarded under the Plan.

      "Restricted Stock" - means Shares which have been awarded to a Participant
subject to any restrictions referred to in Section 3 hereof, so long as such
restrictions are in effect.

      "Shares" - means the common stock, par value $0.01 per share, of the
Corporation.

      3. Terms and Conditions of Restricted Stock.

            (a) The Committee shall have full and complete authority, subject to
the limitations of the Plan, to grant Awards of Restricted Stock and, in
addition to the terms and conditions contained in paragraphs (b) through (i) of
this Section 3 and Section 7, to provide such other terms and conditions (which
need not be identical among Participants) with respect to such Awards, and the
lapsing of restrictions thereon, as the Committee shall determine. The dollar
value of Awards granted under the Plan shall be calculated based upon the Fair
Market Value of the Corporation's common stock on the date of the grant.

            (b) At the time of an Award, the Committee shall establish for each
Participant a Restricted Period, during which or at the expiration of which, as
the Committee shall determine and provide in the agreement referred to in
paragraph (f) of this Section 3, the Shares awarded as Restricted Stock shall
vest. Subject to any such other terms and conditions as the Committee shall
provide, Shares of Restricted Stock may not be sold, assigned, transferred,
pledged or otherwise encumbered by the Participant, except as hereinafter
provided, during the Restricted Period. The Committee may also establish a
period of time, after the expiration of the Restricted Period, if any, during
which the Participant must hold the Shares subject to the Award prior to sale.
Except for such restrictions, and subject to paragraphs (e) and (g) of this
Section 3 and Section 4 hereof, the Participant as owner of such Shares shall
have all the rights of a shareholder, including the right to vote the Shares.

            (c) Except as provided in Section 5 hereof, if a Participant ceases
to maintain Continuous Service for any reason (other than death or disability),
all Shares of Restricted Stock theretofore awarded to such Participant and which
at the time of such termination of Continuous Service are subject to the
restrictions imposed by paragraph (b) of this Section 3 shall upon such
termination of Continuous Service be forfeited and returned to the Corporation.
If a Participant ceases to maintain Continuous Service by reason of death or
disability, Restricted Stock then still subject to restrictions imposed by
paragraph (b) of this Section 3 will be free of those restrictions.

            (d) The Committee shall have the authority, in its discretion, to
accelerate the time at which any or all of the restrictions shall lapse with
respect thereto, or to remove any or all of such restrictions, whenever it may
determine that such action is appropriate by reason of

                                       2
<PAGE>

changes in applicable tax or other laws or other changes in circumstances
occurring after the commencement of such Restricted Period.

            (e) Each certificate in respect of Shares of Restricted Stock
awarded under the Plan shall be registered in the name of the Participant and
shall be held, together with a stock power endorsed in blank, by the
Corporation.

      To the extent Shares subject to Awards have not been registered under the
federal and state securities laws or an exemption is otherwise unavailable, the
certificates for common stock to be issued pursuant to the Plan shall bear the
following securities legend (the "Securities Legend"):

            The shares represented by this certificate have not been registered
            under the Securities Act of 1933, as amended, or under applicable
            state securities laws. The shares have been acquired for investment
            and may not be offered, sold, transferred, pledged or otherwise
            disposed of without an effective registration statement under the
            Securities Act of 1933, as amended, and under any applicable state
            securities laws or an opinion of counsel acceptable to the
            Corporation that the proposed transaction will be exempt from such
            registration.

The foregoing legend shall be removed upon registration of the legended shares
under the Securities Act of 1933, as amended, and under any applicable state
laws or upon receipt of any opinion of counsel acceptable to the Corporation
that said registration is no longer required.

            (f) At the time of any Award, the Participant shall enter into an
agreement with the Corporation substantially in the form attached hereto as
Appendix A, agreeing to the terms and conditions of the Award and such other
matters as the Committee, in its sole discretion, shall determine (the
"Restricted Stock Agreement"). At the time of any Award, the Committee may, in
its sole discretion, amend or supplement any of the terms contained in Appendix
A for any particular Participant.

            (g) The payment to the Participant of cash dividends declared or
paid on such Shares by the Corporation shall be deferred until the lapsing of
any restrictions imposed under paragraph (b) of this Section 3. Such deferred
dividends shall be held by the Corporation for the account of the Participant.
In such event, there shall be credited at the end of each year (or portion
thereof) interest on the amount of the account at the beginning of the year at a
rate per annum as the Board, in its discretion, may determine. Payment of
deferred dividends, together with interest accrued thereon, shall be made upon
the earlier to occur of the lapsing of the restrictions imposed under paragraph
(a) of this Section 3 or upon death or disability of the Participant.

            (h) At the expiration of the Restricted Period, if any, imposed by
paragraph (b) of this Section 3, the Corporation shall deliver to the
Participant (or where the relevant provision of paragraph (c) of this Section 3
applies in the case of a deceased Participant, to his legal representative,
beneficiary or heir) the certificate(s) and stock power deposited with it

                                       3
<PAGE>

pursuant to paragraph (e) of this Section 3. Notwithstanding the foregoing, the
Securities Legend described in paragraph (e) of Section 3 shall continue to be
included on all certificates as long as registration has not occurred.

            (i) The provisions of this section may be modified pursuant to the
terms of a Participant's employment agreement with the Company.

      4. Adjustments Upon Changes in Capitalization. In the event of any change
in the outstanding Shares subsequent to the effective date of the Plan by reason
of any reorganization, recapitalization, stock split, stock dividend,
combination or exchange of shares, merger, consolidation or any change in the
corporate structure or shares of the Corporation, the maximum aggregate number
and class of shares as to which Awards may be granted under the Plan shall be
appropriately adjusted by the Board, whose determination shall be conclusive.
Outstanding Awards shall be treated like all other outstanding Shares of common
stock. Any Shares of stock or other securities received, as a result of any of
the foregoing adjustment by the Board or as part of an adjustment provided to
shareholders in general, by a Participant with respect to an Award shall be
subject to the same restrictions and the certificate(s) or other instruments
representing or evidencing such Shares or securities shall be legended and
deposited with the Corporation in the manner provided in Section 3 hereof.

      5. Effect of Change in Control. Each of the events specified in the
following clauses (i) and (ii) of this Section 5 shall be deemed a "change in
control": (i) as a result of any transaction, any one shareholder becomes the
beneficial owner, directly or indirectly, of securities of the Corporation
representing more than 40% of the Shares of the Corporation or the combined
voting power of the Corporation's then outstanding securities; or (ii) any other
events deemed to constitute a "change in control" by the Committee. If the
Continuous Service of any Participant is involuntarily terminated for whatever
reason, except for cause, as defined by the Committee, at any time within 18
months after a change in control, unless the Committee shall otherwise provide,
any Restricted Period with respect to an Award to such Participant shall lapse
upon such termination and all Awards shall become fully vested in the
Participant. The provisions of this section may be modified pursuant to the
terms of a Participant's employment agreement with the Company.

      6. Assignment and Transfers. During the Restricted Period, no Award nor
any right or interest of a Participant in such Award set forth in any instrument
evidencing any Award under the Plan may be assigned, encumbered or transferred
except, in the event of the death of a Participant, by will or the laws of
descent and distribution.

      7. Administration.

            (a) This Plan shall be administered by the Committee. The Committee
shall consist of a minimum of two members of the Board, each of whom shall be a
Non-Employee Director and an Independent Director, except that the failure of
the Committee for any reason to be compared solely of Non-Employee Directors or
Independent Directors shall not prevent an Award being considered granted under
this Plan.

                                       4
<PAGE>

            (b) Except as limited by the express provisions of the Plan, the
Committee shall have sole and complete authority and discretion to: (i) select
Participants and grant Awards; (ii) determine individual Awards to be granted
under the Plan; (iii) determine the terms and conditions upon which Awards shall
be granted under the Plan; (iv) prescribe the form and terms of instruments
evidencing such grants; and (v) establish from time to time regulations for the
administration of the Plan, interpret the Plan, and make all determinations
deemed necessary or advisable for the administration of the Plan.

            (c) The Committee shall adopt such rules for the conduct of its
business and administration of this Plan as it considers desirable. A majority
of the members of the Committee shall constitute a quorum for all purposes. The
vote or written consent of a majority of the members of the Committee on a
particular matter shall constitute the act of the Committee on such matter. The
Committee shall have the right to construe the Plan and the Awards issued
pursuant to it, to correct defects and omissions and to reconcile
inconsistencies to the extent necessary to effectuate the Plan and the options
issued pursuant to it, and such action shall be final, binding and conclusive
upon all parties concerned. No member of the Committee shall be liable for any
act or omission (whether or not negligent) taken or omitted in good faith, or
for the exercise of an authority or discretion granted in connection with the
Plan to the Committee, or for the acts or omissions of any other members of the
Committee.

            (d) All costs incurred in connection with the administration and
operation of the Plan shall be paid by the Corporation. Except for the express
obligations of the Corporation under the Plan and under Awards granted in
accordance with the Plan, the Corporation shall have no liability with respect
to any Award, or to any Participant of an Award or any permitted transferee from
any Participant, including, but not limited to, any tax liabilities, capital
losses, or other costs or losses incurred by any Participant or any such
transferee.

      8. Shares Subject to Plan. The maximum aggregate number of Shares which
may be granted under the Plan is 750,000 shares of common stock. The Shares with
respect to which Awards may be made under the Plan may be either authorized and
unissued shares or issued shares heretofore or hereafter reacquired and held as
treasury shares. An Award shall not be considered to have been made under the
Plan with respect to Restricted Stock which is forfeited and new Awards may be
granted under the Plan with respect to the number of Shares as to which such
forfeiture has occurred. No individual may receive Awards under this Plan for
more than 80% of the total number of Shares authorized for issuance under this
Plan.

      9. Participant Rights Under the Plan. No officer, employee or director
shall have a right to be selected as a Participant nor, having been so selected,
to be selected again as a Participant and no officer, employee, director or
other person shall have any claim or right to be granted an Award under the Plan
or under any other incentive or similar plan of the Corporation or any
Affiliate. Neither the Plan nor any action taken thereunder shall be construed
as giving any employee any right to be retained in the employ of the Corporation
or any Affiliate.

      10. Withholding Tax. Upon the termination of any Restricted Period with
respect to an Award (or at any such earlier time, if any, that an election is
made by the Participant under Section 83(b) of the Code, or any successor
provision thereto, to include the value of such shares in taxable income), the
Corporation may withhold from any payment or distribution made under

                                       5
<PAGE>

this Plan sufficient Shares or may withhold or cause to be paid by Participant
sufficient cash to cover any applicable withholding and employment taxes. The
Corporation shall have the right to deduct from all dividends paid with respect
to shares of Restricted Stock the amount of any taxes which the Corporation is
required to withhold with respect to such dividend payments. No discretion or
choice shall be conferred upon any Participant with respect to the form, timing
or method of any such tax withholding.

      11. Amendment, Suspension or Termination. The Board may amend, suspend or
terminate the Plan or any portion thereof at any time, provided, however, that
no such amendment, suspension or termination shall impair the rights of any
Participant, without Participant's consent, in any Award theretofore made
pursuant to the Plan.

      12. Term of Plan. This Plan shall become effective upon the consummation
of the spin-off of the Corporation from Genesis Health Ventures, Inc., subject
to approval of the Shareholders of the Corporation. This Plan shall continue in
effect for a term of ten (10) years unless sooner terminated under Section 11
hereof. Awards may be granted under this Plan prior to the receipt of
shareholder approval; provided that any such Awards are expressly conditioned
upon receipt of shareholder approval and forfeited if Shareholder approval is
not obtained.

      13. Other Provisions.

            (a) The Plan, and all Awards granted hereunder, shall be governed by
and construed in accordance with the laws of the Commonwealth of Pennsylvania.

            (b) The headings of the Sections of the Plan are for convenience of
reference only and shall not effect the interpretation of the Plan.

            (c) All pronouns and similar references in the Plan shall be
construed to be of such number and gender as the context requires or permits.

            (d) If any provision of the Plan is determined to be unenforceable
for any reason, then that provision shall be deemed to have been deleted or
modified to the extent necessary to make it enforceable, and the remaining
provisions of the Plan shall not be affected.

            (e) Neither this Plan nor any Award shall confer upon any officer or
employee any right to continue in the employ of the Corporation.

            (f) The Plan shall be binding upon and inure to the benefit of any
successor, successors or assigns of the Corporation.

            (g) Neither the receipt of an Award nor the delivery of cash,
Shares, or any other amounts pursuant to an Award shall be deemed compensation
for purposes of computing benefits under any retirement plan nor affect any
benefits under any other benefit plan now or hereafter in effect under which the
availability or amount of benefits is related to the level of compensation.

            (h) All notices with respect to the Plan shall be in writing and
shall be hand delivered or sent by certified mail or reputable overnight
delivery service, expenses prepaid.

                                       6
<PAGE>

Notices to the Corporation or the Committee shall be delivered to the
Corporation at 101 East State Street, Kennett Square, Pennsylvania 19348, to the
attention of its General Counsel. Notices to any Participant or holder of Award
Shares shall be sufficient if delivered or sent to such person's address as it
appears in the regular records of the Corporation or its transfer agent.

      14. Amendments.

            Approval Date                        Section Amended
            February 23, 2005                           8

            8. Shares Subject to Plan. The maximum aggregate number of Shares
which may be granted under the Plan is 1,000,000 shares of common stock. The
Shares with respect to which Awards may be made under the Plan may be either
authorized and unissued shares or issued shares heretofore or hereafter
reacquired and held as treasury shares. An Award shall not be considered to have
been made under the Plan with respect to Restricted Stock which is forfeited and
new Awards may be granted under the Plan with respect to the number of Shares as
to which such forfeiture has occurred. No individual may receive Awards under
this Plan for more than 80% of the total number of Shares authorized for
issuance under this Plan.

                                       7
<PAGE>

                                   APPENDIX A

                         GENESIS HEALTHCARE CORPORATION

                            2003 STOCK INCENTIVE PLAN

                           RESTRICTED STOCK AGREEMENT

RS No. __

      An Award of Restricted Stock is hereby awarded on ___________, ____ (the
"Award Date") by Genesis HealthCare Corporation (the "Corporation"), to
___________________ (the "Grantee"), in accordance with the following terms and
conditions, and the conditions contained in the Genesis HealthCare Corporation
2003 Stock Incentive Plan (the "Plan"):

      1. Share Award. The Corporation hereby awards the Grantee ___________
shares (the "Shares") of common stock, par value $0.01 per share ("Common
Stock"), of the Corporation pursuant to the Plan, as the same may from time to
time be amended, and upon the terms and conditions and subject to the
restrictions therein and hereinafter set forth. A copy of the Plan as currently
in effect is incorporated herein by reference and is attached hereto.

      2. Restrictions on Transfer and Restricted Period. During the period (the
"Restricted Period") commencing on the Award Date and terminating on the date
the Shares vest as provided below, the Shares may not be sold, assigned,
transferred, pledged, or otherwise encumbered by the Grantee, except as
hereinafter provided.

      Except as set forth below, the Shares will vest at a rate of ___% of the
initial award per year of Continuous Service (as defined in the Plan) commencing
on the Award Date pursuant to the following schedule:

                                      Amount of
                                    Initial Award
               Date of Vesting          Vested
              -------------------   -------------

              _____________, 200_        __%

      Subject to the restrictions set forth in the Plan, the Committee (as
defined in the Plan) shall have the authority, in its discretion, to accelerate
the time at which any or all of the restrictions shall lapse with respect to any
Shares thereto, or to remove any or all of such restriction, whenever the
Committee may determine that such action is appropriate by reason of changes in
applicable tax or other laws, or other changes in circumstances occurring after
the commencement of the Restricted Period.

<PAGE>

      3. Termination of Service. Except as provided in Section 8 below, if the
Grantee ceases to maintain "Continuous Service" (as defined in the Plan) for any
reason other than death or disability, all Shares which at the time of such
termination of Continuous Service are subject to the restrictions imposed by
Section 2 above shall upon such termination of Continuous Service be forfeited
to the Corporation. If the Grantee ceases to maintain "Continuous Service" (as
defined in the Plan) by reason of death or disability, the Shares then still
subject to restrictions imposed by Section 2 will be free of those restrictions
and shall not be forfeited.

      4. Certificates for the Shares. The Corporation shall issue a certificate
(or certificates) in the name of the Grantee with respect to the Shares, and
shall hold such certificate (or certificates) on deposit for the account of the
Grantee until the expiration of the Restricted Period with respect to the Shares
represented thereby.

      The Grantee further agrees that simultaneously with the execution of the
Agreement, the Grantee shall execute stock powers in favor of the Corporation,
in the form attached hereto as Attachment A, with respect to the Shares and that
the Grantee shall promptly deliver such stock powers to the Corporation.

      The following two paragraphs shall be applicable if, on the Award Date,
the Common Stock subject to such Award has not been registered under the
Securities Act of 1933, as amended, and under applicable state securities laws,
and shall continue to be applicable for so long as such registration has not
occurred:

      The Grantee hereby agrees, warrants and represents that Grantee is
acquiring the Common Stock to be issued pursuant to this Agreement for Grantee's
own account for investment purposes only, and not with a view to, or in
connection with, any resale or other distribution of any of such shares, except
as hereafter permitted. The Grantee further agrees that Grantee will not at any
time make any offer, sale, transfer, pledge or other disposition of such Common
Stock to be issued hereunder without an effective registration statement under
the Securities Act of 1933, as amended, and under any applicable state
securities laws or an opinion of counsel acceptable to the Corporation to the
effect that the proposed transaction will be exempt from such registration. The
Grantee shall execute such instruments, representations, acknowledgments and
agreements as the Corporation may, in its sole discretion, deem advisable to
avoid any violation of federal, state, local or securities exchange rule,
regulation or law.

      The certificates for Common Stock to be issued pursuant to this Agreement
shall bear the following securities legend (the "Securities Legend"):

            The shares represented by this certificate have not been registered
            under the Securities Act of 1933, as amended, or under applicable
            state securities laws. The shares have been acquired for investment
            and may not be offered, sold, transferred, pledged or otherwise
            disposed of without an effective registration statement under the
            Securities Act of 1933, as amended, and under any applicable state
            securities laws or an opinion of counsel acceptable to the
            Corporation that the proposed transaction will be exempt from such
            registration.

                                       A-2
<PAGE>

The Securities Legend shall be removed upon registration of the legended shares
under the Securities Act of 1933, as amended, and under any applicable state
laws or upon receipt of any opinion of counsel acceptable to the Corporation
that said registration is no longer required.

      The sole purpose of the agreements, warranties, representations and legend
set forth in the two immediately preceding paragraphs is to prevent violations
of the Securities Act of 1933, as amended, and any applicable state securities
laws.

      5. Grantee's Rights. Except as otherwise provided herein, the Grantee, as
owner of the Shares, shall have all rights of a shareholder. During any
Restricted Period, the Grantee shall be entitled to vote such Shares as to which
the Restricted Period has not yet lapsed or expired (the "Restricted Shares") in
Grantee's sole discretion, at any annual and special meetings of the
shareholders of the Corporation and at any continuations and adjournments of
such meetings, upon any matters coming before such meetings or adjournments.

      6. Cash Dividends. Cash dividends, if any, paid on the Restricted Shares
shall be held by the Corporation for the account of the Grantee and paid to the
Grantee upon the expiration of the Restricted Period or upon the death or
disability of the Grantee. All such withheld dividends shall earn interest at an
annual rate determined by the Board of Directors of the Corporation (the
"Board").

      7. Expiration of Restricted Period. Upon the lapse or expiration of the
Restricted Period with respect to any portion of the Shares, the Corporation
shall deliver to the Grantee (or in the case of a deceased Grantee, to Grantee's
legal representative) the certificate in respect of such Shares and the related
stock powers held by the Corporation pursuant to Section 4 above. The Shares as
to which the Restricted Period shall have lapsed or expired shall be free of the
restrictions referred to in Section 2 above. Notwithstanding the foregoing, the
Securities Legend described in Section 4 shall continue to be included on the
certificates as long as registration has not occurred.

      8. Adjustments for Changes in Capitalization of the Corporation. In the
event of any change in the outstanding shares of Common Stock by reason of any
reorganization, recapitalization, stock split, stock dividend, combination or
exchange of shares, merger, consolidation, or any change in the corporate
structure of the Corporation or in the shares of Common Stock, the number and
class of Shares covered by this Agreement shall be treated like all other
outstanding shares. Any shares of Common Stock or other securities received, as
a result of the foregoing, by the Grantee with respect to Shares subject to the
restrictions contained in Section 2 above also shall be subject to such
restrictions and the certificate or other instruments representing or evidencing
such shares or securities shall be legended and deposited with the Corporation
in the manner provided in Section 4 above.

      9. Change in Control. If the "Continuous Service" (as defined in the Plan)
of the Grantee is involuntarily terminated for whatever reason, other than for
cause (as defined by the Committee), at any time within 18 months of a "change
in control" (as defined in the Plan), the Restricted Period with respect to all
Shares shall lapse upon such termination and all Shares shall become fully
vested in the Grantee.

                                       A-3
<PAGE>

      10. Delivery and Registration of Shares of Common Stock. The Corporation's
obligation to deliver Shares hereunder shall be conditioned upon the receipt of
a representation as to the investment intention of the Grantee or any other
person to whom such Shares are to be delivered, in such form as the Committee
shall determine to be necessary or advisable to comply with the provisions of
the Securities Act of 1933, as amended, or any other Federal, state or local
securities legislation or regulation. Any representation regarding investment
intent shall become inoperative upon the registration of such shares or other
action eliminating the necessity of such representation under such Securities
Act or other securities regulation.

            The Corporation shall not be required to deliver any Shares under
the Plan prior to (i) the admission of such Shares to listing on the Nasdaq
Stock Market or any stock exchange on which the Shares of Common Stock may then
be listed, and (ii) the completion of such registration or other qualification
of such Shares under any state or federal law, rule or regulation, as the
Committee shall determine to be necessary or advisable.

      11. Plan and Plan Interpretations as Controlling. The Shares hereby
awarded and the terms and conditions herein set forth are subject in all
respects to the terms and conditions of the Plan, which are controlling. All
determinations and interpretations by the Committee shall be binding and
conclusive upon the Grantee or Grantee's legal representatives with regard to
any question arising hereunder or under the Plan.

      12. Grantee Service. Nothing in this Agreement shall limit the right of
the Corporation or any of its Affiliates to terminate the Grantee's service as
an officer, employee, director or otherwise impose upon the Corporation or any
of its Affiliates any obligation to employ or accept the services of the
Grantee.

      13. Withholding and Social Security Taxes. Upon the termination of any
Restricted Period with respect to any Shares (or any such earlier time, if any,
that an election is made under Section 83(b) of the Internal Revenue Code of
1986, as amended (the "Code"), or any successor provision thereto, to include
the value of such Shares in taxable income), the Corporation shall have the
right to withhold from the Grantee's compensation an amount sufficient to
fulfill its or its Affiliate's obligations for any applicable withholding and
employment taxes. Alternatively, the Corporation may require the Grantee to pay
the Corporation the amount of any taxes which the Corporation is required to
withhold with respect to the Shares, or, in lieu thereof, to retain or sell
without notice a sufficient number of Shares to cover the amount required to be
withheld. The Corporation shall withhold from any cash dividends paid on the
Restricted Stock an amount sufficient to cover taxes owed as a result of the
dividend payment. The Corporation's method of satisfying its withholding
obligations shall be solely in the discretion of the Corporation, subject to
applicable federal, state and local laws.

      14. Tax Consequences. Grantee has reviewed with Grantee's own tax advisors
the federal, state, local and foreign tax consequences of this investment and
the transactions contemplated by this Agreement. Grantee is relying solely on
such advisors and not on any statements or representations of Corporation or any
of its agents. Grantee understands that Grantee (and not Corporation) shall be
responsible for Grantee's own tax liability that may arise as a result of this
investment or the transactions contemplated by this Agreement. Grantee
understands that Section 83 of the Code, taxes (as ordinary income) the fair
market value of the

                                      A-4
<PAGE>

Shares as of the date any "restrictions" on the Shares lapse. To the extent that
a grant hereunder is not otherwise an exempt transaction for purposes of Section
16(b) of the Securities and Exchange Act of 1934 (the "1934 Act"), with respect
to officers, directors and 10% shareholders, a "restriction" on the Shares
includes for these purposes the period after the grant of the Shares during
which such officers, directors and 10% shareholders could be subject to suit
under Section 16(b) of the 1934 Act. Alternatively, Grantee understands that
Grantee may elect to be taxed at the time the Shares are granted rather than
when the restrictions on the Shares lapse, or the Section 16(b) period expires,
by filing an election under Section 83(b) of the Code with the I.R.S. within 30
days from the date of grant.

      GRANTEE ACKNOWLEDGES THAT IT IS GRANTEE'S SOLE RESPONSIBILITY AND NOT THE
CORPORATION'S TO FILE TIMELY THE ELECTION AVAILABLE TO GRANTEE UNDER SECTION
83(B) OF THE CODE, EVEN IF GRANTEE REQUESTS THAT THE CORPORATION OR ITS
REPRESENTATIVES MAKE THIS FILING ON GRANTEE'S BEHALF.

      15. Amendment/Choice of Law. This Agreement constitutes the entire
understanding between the Corporation and the Grantee with respect to the
subject matter hereof and no amendment, supplement or waiver of this Agreement,
in whole or in part, shall be binding upon the Corporation unless in writing and
signed by the Chief Executive Officer of the Corporation. This Agreement and the
performances of the parties hereunder shall be construed in accordance with and
governed by the laws of the Commonwealth of Pennsylvania.

      16. Grantee Acceptance. The Grantee shall signify Grantee's acceptance of
the terms and conditions of this Agreement by signing in the space provided
below and signing the attached stock powers and returning a signed copy of this
Agreement and the original attached stock powers to the Corporation. IF A FULLY
EXECUTED COPY HEREOF AND THE ATTACHED STOCK POWERS HAVE NOT BEEN RECEIVED BY
______________ OF THE CORPORATION, THE CORPORATION HAS THE RIGHT TO REVOKE THIS
AWARD, AND AVOID ALL OBLIGATIONS UNDER THIS AGREEMENT.

                  [Remainder of page intentionally left blank]

                                      A-5
<PAGE>

      IN WITNESS WHEREOF, the parties hereto have caused this RESTRICTED STOCK
AGREEMENT to be executed as of the date first above written.

                                       GENESIS HEALTHCARE CORPORATION

                                       By: __________________________
                                           Name:
                                           Title:

                                       ACCEPTED:

                                       ______________________________

                                       ______________________________
                                       (Street Address)

                                       ______________________________
                                       (City, State & Zip Code)

                                      A-6
<PAGE>

                   ATTACHMENT A TO RESTRICTED STOCK AGREEMENT

                                   Stock Power

      For value received, I hereby sell, assign, and transfer to Genesis
HealthCare Corporation (the "Corporation") ____________ shares of the common
stock of the Corporation, standing in my name on the books and records of the
aforesaid Corporation, represented by Certificate No. _____ and do hereby
irrevocably constitute and appoint the Secretary of the Corporation attorney,
with full power of substitution, to transfer this stock on the books and records
of the aforesaid Corporation.

                                       _______________________________

Dated:  ____________

In the presence of:

__________________________________

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