Document:

<PAGE>   1

                              TWELFTH AMENDMENT TO
                      DEBTOR-IN-POSSESSION CREDIT AGREEMENT

                               As of July 19, 2001

                  Reference is made to that certain Debtor-In-Possession Credit
Agreement dated as of January 20, 2000 (as heretofore amended, the "DIP CREDIT
AGREEMENT"), by and among Mariner Health Group, Inc., a Delaware corporation
("MHG"), as debtor and debtor-in-possession, and each of MHG's subsidiaries
listed on the signature pages thereof, each as debtor and debtor-in-possession
(each such subsidiary and MHG individually referred to herein as a "BORROWER"
and, collectively, on a joint and several basis, as the "BORROWERS"); the
Lenders listed on the signature pages thereof; First Union National Bank, as
syndication agent; PNC Capital Markets, Inc. and First Union Securities, Inc.,
as co-arrangers; and PNC Bank, National Association, as collateral agent and
administrative agent (in such capacity, "ADMINISTRATIVE AGENT"), and as an
issuing bank for Letters of Credit thereunder. Capitalized terms used herein
without definition herein shall have the meanings assigned to such terms in the
DIP Credit Agreement and the Borrowing Order.

                  Borrowers and Lenders desire to amend the DIP Credit Agreement
to extend the maturity date of the DIP Credit Agreement. The Lenders are
prepared to do so solely on the terms and conditions herein.

                  NOW, THEREFORE, for and in consideration of the foregoing
premises, the mutual covenants and agreements hereinafter set forth and other
good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the Borrowers and the Lenders hereby agree as follows:

                  The Borrowers and the undersigned Lenders hereby agree that
the definition of "Stated Maturity Date" is hereby amended by deleting the
reference to "July 19, 2001" contained therein and substituting therefor
"December 31, 2001."

                  On and after the Twelfth Amendment Effective Date (as defined
below), each reference in the DIP Credit Agreement to "this Agreement",
"hereunder", "hereof", "herein" or words of like import referring to the DIP
Credit Agreement, and each reference in the other Financing Documents to the
"DIP Credit Agreement", "thereunder", "thereof" or words of like import
referring to the DIP Credit Agreement, shall mean and be a reference to the DIP
Credit Agreement as amended through the date thereof, including by this Twelfth
Amendment to Debtor-In-Possession Credit Agreement (this "TWELFTH AMENDMENT";
the DIP Credit Agreement, as so amended, being the "AMENDED AGREEMENT").

                  Without limiting the generality of the provisions of Section
11.05 of the DIP Credit Agreement, the amendment set forth above shall be
limited precisely as written, and nothing in this Twelfth Amendment shall be
deemed to prejudice any right or remedy that the

<PAGE>   2
Administrative Agent or any Lender may now have or may have in the future under
or in connection with the DIP Credit Agreement or any of such other Financing
Documents. Except as specifically amended by this Twelfth Amendment, the DIP
Credit Agreement and such other Financing Documents shall remain in full force
and effect and are hereby ratified and confirmed.

                  In order to induce Lenders to enter into this Twelfth
Amendment, each Borrower, by its execution of a counterpart of this Twelfth
Amendment, represents and warrants that, subject to obtaining the approval of
the Court to the execution, delivery and performance of this Twelfth Amendment,
(a) such Borrower has the corporate or other power and authority and all
material Governmental Approvals required to enter into this Twelfth Amendment
and to carry out the transactions contemplated by, and perform its obligations
under, the Amended Agreement, (b) the execution and delivery of this Twelfth
Amendment and the performance of the Amended Agreement have been duly authorized
by all necessary corporate or other action on the part of such Borrower, (c) the
execution and delivery by such Borrower of this Twelfth Amendment and the
performance by such Borrower of the Amended Agreement do not and will not
contravene, or violate, any Applicable Laws (including an applicable order of
the Court) or any provision of its Organizational Documents, or constitute a
default under any agreement or other instrument binding upon it (which default,
in the case of such instruments or agreements, would give rise to rights
enforceable on a post-Petition Date basis) or result in or require the
imposition of any Liens (other than the Liens created by the Collateral
Documents) on any of its assets, (d) the execution and delivery by such Borrower
of this Twelfth Amendment and the performance by such Borrower of the Amended
Agreement do not and will not require any action by or in respect of, or filing
with, any governmental body, agency or official, (e) this Twelfth Amendment and
the Amended Agreement have been duly executed and delivered by such Borrower and
constitute the valid and binding obligations of such Borrower, enforceable in
accordance with their respective terms, except as may be limited by general
principles of equity, and (f) after giving effect to this Twelfth Amendment, no
event has occurred and is continuing or will result from the consummation of the
transactions contemplated by this Twelfth Amendment that would constitute a
Default.

                  This Twelfth Amendment may be executed in any number of
counterparts and by different parties hereto in separate counterparts, each of
which when so executed and delivered shall be deemed an original, but all such
counterparts together shall constitute but one and the same instrument. This
Twelfth Amendment shall become effective (the date of such effectiveness being
the "TWELFTH AMENDMENT EFFECTIVE DATE") as of July 19, 2001 provided the
following conditions shall have been met: (a) the Borrowers and each of the
Lenders shall have executed counterparts of this Twelfth Amendment and the
Borrowers and the Administrative Agent shall have received written or telephonic
notification of such execution and authorization of delivery thereof, (b) the
Administrative Agent shall have received from the Borrowers, for distribution to
the undersigned Lenders in accordance with their respective Percentages, an
amendment fee of 1% of the aggregate Tranche A Commitments of such Lenders after
giving effect to this Twelfth Amendment, (c) PNC Bank, National Association, as
administrative agent under the Existing Credit Facilities (the "PREPETITION
AGENT"), shall have received an adequate protection payment from the Borrower an
amount to be agreed to by the Borrowers and the Prepetition Agent, for the
ratable benefit of each of the Existing Lenders, in partial satisfaction of the
Prepetition Indebtedness due under the Existing Credit Facilities (to be applied
by the Prepetition Agent in accordance with the terms of the Existing Credit
Facilities), (d) the Court
Agent

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<PAGE>   3
shall have entered an order, in form and substance satisfactory to the Lenders,
approving this Twelfth Amendment, the amendment fee and the adequate protection
payment referenced above, and (e) the Administrativeshall have received evidence
satisfactory to it that all outstanding statements of O'Melveny & Myers LLP,
Buchanan Ingersoll, P.C., Houlihan Lokey Howard & Zukin and Deloitte Consulting,
L.L.C. that are received by MHG prior to 12:00 Noon (New York City time) on July
13, 2001 have been paid in full.

                  THIS TWELFTH AMENDMENT AND THE RIGHTS AND OBLIGATIONS OF THE
PARTIES HEREUNDER SHALL BE GOVERNED BY, AND SHALL BE CONSTRUED AND ENFORCED IN
ACCORDANCE WITH, THE INTERNAL LAWS OF THE STATE OF NEW YORK (INCLUDING WITHOUT
LIMITATION SECTION 5-1401 OF THE GENERAL OBLIGATIONS LAW OF THE STATE OF NEW
YORK), WITHOUT REGARD TO CONFLICTS OF LAWS PRINCIPLES.

                  [Remainder of page intentionally left blank]

                                       3
<PAGE>   4
<TABLE>
<S>                                            <C>
BORROWERS:                                     MARINER HEALTH GROUP, INC.
                                               AID & ASSISTANCE, INC.
                                               BEECHWOOD HERITAGE RETIREMENT COMMUNITY, INC.
                                               BRIDE BROOK NURSING & REHABILITATION CENTER,
                                                    INC.
                                               COMPASS PHARMACY SERVICES, INC.
                                               COMPASS PHARMACY SERVICES OF MARYLAND, INC.
                                               COMPASS PHARMACY SERVICES OF TEXAS, INC.
                                               CYPRESS NURSING FACILITY, INC.
                                               LONG RIDGE NURSING AND REHABILITATION CENTER,
                                                    INC.
                                               LONGWOOD REHABILITATION CENTER, INC.
                                               MARINER HEALTH AT BONIFAY, INC.
                                               MARINER HEALTH CARE, INC.
                                               MARINER HEALTH CARE OF ATLANTIC SHORES, INC.
                                               MARINER HEALTH CARE OF DELAND, INC.
                                               MARINER HEALTH CARE OF FORT WAYNE, INC.
                                               MARINER HEALTH CARE OF GREATER LAUREL, INC.
                                               MARINER HEALTH CARE OF INVERNESS, INC.
                                               MARINER HEALTH CARE OF LAKE WORTH, INC.
                                               MARINER HEALTH CARE OF MACCLENNY, INC.
                                               MARINER HEALTH CARE OF METROWEST, INC.
                                               MARINER HEALTH CARE OF NASHVILLE, INC.
                                               MARINER HEALTH CARE OF NORTH HILLS, INC.
                                               MARINER HEALTH CARE OF ORANGE CITY, INC.
                                               MARINER HEALTH CARE OF PALM CITY, INC.
                                               MARINER HEALTH CARE OF PINELLAS POINT, INC.
                                               MARINER HEALTH CARE OF PORT ORANGE, INC.
                                               MARINER HEALTH CARE OF SOUTHERN CONNECTICUT,
                                                    INC.
                                               MARINER HEALTH CARE OF TOLEDO, INC.
                                               MARINER HEALTH CARE OF TUSKAWILLA, INC.
                                               MARINER HEALTH CARE OF WEST HILLS, INC.
                                               MARINER HEALTH CENTRAL, INC.
                                               MARINER HEALTH HOME CARE, INC.
                                               MARINER HEALTH OF FLORIDA, INC.
                                               MARINER HEALTH OF JACKSONVILLE, INC.
                                               MARINER HEALTH OF MARYLAND, INC.
                                               MARINER HEALTH OF ORLANDO, INC.
                                               MARINER HEALTH OF PALMETTO, INC.
                                               MARINER HEALTH OF SEMINOLE COUNTY, INC.
                                               MARINER HEALTH OF TAMPA, INC.
                                               MARINER HEALTH RESOURCES, INC.
                                               MARINER PHYSICIAN SERVICES, INC.
                                               MARINER PRACTICE CORPORATION
                                               MARINER - REGENCY HEALTH PARTNERS, INC.
                                               MARINERSELECT STAFFING SOLUTIONS, INC.
                                               MARINER SUPPLY SERVICES, INC.
                                               MEDREHAB, INC.
</TABLE>

                                       S-1
<PAGE>   5
<TABLE>
<S>                                            <C>
                                               MEDREHAB OF INDIANA, INC.
                                               MEDREHAB OF LOUISIANA, INC.
                                               MEDREHAB OF MISSOURI, INC.
                                               MERRIMACK VALLEY NURSING & REHABILITATION
                                                    CENTER, INC.
                                               METHUEN NURSING & REHABILITATION CENTER, INC.
                                               MHC REHAB. CORP.
                                               MHC TRANSPORTATION, INC.
                                               MYSTIC NURSING & REHABILITATION CENTER, INC.
                                               NATIONAL HEALTH STRATEGIES, INC.
                                               PARK TERRACE NURSING & REHABILITATION CENTER,
                                                    INC.
                                               PENDLETON NURSING & REHABILITATION CENTER, INC.
                                               PINNACLE CARE CORPORATION
                                               PINNACLE CARE CORPORATION OF HUNTINGTON
                                               PINNACLE CARE CORPORATION OF NASHVILLE
                                               PINNACLE CARE CORPORATION OF SENECA
                                               PINNACLE CARE CORPORATION OF SUMTER
                                               PINNACLE CARE CORPORATION OF WILLIAMS BAY
                                               PINNACLE CARE CORPORATION OF WILMINGTON
                                               PINNACLE CARE MANAGEMENT CORPORATION
                                               PINNACLE PHARMACEUTICALS, INC.
                                               PINNACLE PHARMACEUTICAL SERVICES, INC.
                                               PINNACLE REHABILITATION, INC.
                                               PINNACLE REHABILITATION OF MISSOURI, INC.
                                               PRISM CARE CENTERS, INC.
                                               PRISM HEALTH GROUP, INC.
                                               PRISM HOME CARE COMPANY, INC.
                                               PRISM HOME CARE, INC.
                                               PRISM HOME HEALTH SERVICES, INC.
                                               PRISM HOSPITAL VENTURES, INC.
                                               PRISM REHAB SYSTEMS, INC.
                                               REGENCY HEALTH CARE CENTER OF SEMINOLE COUNTY,
                                                    INC.
                                               SASSAQUIN NURSING & REHABILITATION CENTER, INC.
                                               TAMPA MEDICAL ASSOCIATES, INC.
                                               THE OCEAN PHARMACY, INC.
                                               TRI-STATE HEALTH CARE, INC.
                                               WINDWARD HEALTH CARE, INC.

                                               BY:
                                                    --------------------------------------------------
                                                     Boyd P. Gentry
                                                     Vice President for each of the foregoing Borrowers
</TABLE>

                                      S-2
<PAGE>   6
<TABLE>
<S>                                           <C>
                                               IHS REHAB PARTNERSHIP, LTD.

                                               BY:   MARINER HEALTH CARE OF NASHVILLE, INC., its
                                                     General Partner

                                                     By:
                                                        ---------------------------------------------
                                                     Name:
                                                     Title:

                                               MARINER HEALTH PROPERTIES IV, LTD.

                                               BY:   MARINER HEALTH OF FLORIDA, INC., its General
                                                     Partner

                                                     By:
                                                        ---------------------------------------------
                                                     Name:
                                                     Title:

                                               MARINER HEALTH PROPERTIES VI, LTD.

                                               BY:   MARINER HEALTH OF FLORIDA, INC., its General
                                                     Partner

                                                     By:
                                                        ---------------------------------------------
                                                     Name:
                                                     Title:

                                               SEVENTEENTH STREET ASSOCIATES LIMITED PARTNERSHIP

                                               BY:   TRI-STATE HEALTH CARE, INC., its General Partner

                                                     By:
                                                        ---------------------------------------------
                                                     Name:
                                                     Title:

</TABLE>

                                      S-3
<PAGE>   7

<TABLE>
<S>                                            <C>
                                               ALLEGIS HEALTH AND LIVING CENTER AT HERITAGE
                                                    HARBOUR, L.L.C.

                                               BY:   MARINER HEALTH OF MARYLAND, INC., its General
                                                      Partner

                                                     By:
                                                        ------------------------------------------
                                                     Name:
                                                     Title:
</TABLE>

                                      S-4
<PAGE>   8

<TABLE>
<S>                                            <C>
AGENTS AND LENDERS:                            PNC BANK, NATIONAL ASSOCIATION,
                                               Individually as a Continuing Lender and as
                                               Administrative Agent, Collateral Agent and LC Issuing
                                               Bank

                                               By:
                                                  -----------------------------------------------------
                                               Name:
                                               Title:
</TABLE>

                                      S-5
<PAGE>   9

<TABLE>
<S>                                            <C>
                                               FIRST UNION NATIONAL BANK,
                                               individually as a Continuing Lender and as Syndication
                                               Agent

                                               By:
                                                  -----------------------------------------------------
                                               Name:
                                               Title:
</TABLE>

                                      S-6

<PAGE>   10
<TABLE>
<S>                                            <C>
                                               CREDIT LYONNAIS NEW YORK BRANCH,
                                               individually as a Continuing Lender

                                               By:
                                                   -------------------------------
                                               Name:
                                               Title:
</TABLE>

                                      S-7
<PAGE>   11

<TABLE>
<S>                                            <C>
                                               BANK AUSTRIA CREDITANSTALT CORPORATE FINANCE,
                                               INC.
                                               individually as a Continuing Lender

                                               By:
                                                  ------------------------------------------
                                               Name:
                                               Title:

                                               By:
                                                  ------------------------------------------
                                               Name:
                                               Title:

                                      S-8
</TABLE><PAGE>   1

                                FOURTH AMENDMENT
                             TO REVOLVING CREDIT AND
                               GUARANTY AGREEMENT

                  FOURTH AMENDMENT, dated as of June 26, 2001 (the "Amendment"),
to the REVOLVING CREDIT AND GUARANTY AGREEMENT, dated as of January 18, 2000,
among MARINER POST-ACUTE NETWORK, INC., a Delaware corporation (the "Borrower"),
a debtor and debtor-in-possession under Chapter 11 of the Bankruptcy Code, the
Guarantors named therein (the "Guarantors"), THE CHASE MANHATTAN BANK, a New
York banking corporation ("Chase"), each of the other financial institutions
party thereto (together with Chase, the "Banks") and THE CHASE MANHATTAN BANK,
as Agent for the Banks (in such capacity, the "Agent"):

                              W I T N E S S E T H:

                  WHEREAS, the Borrower, the Guarantors, the Banks and the Agent
are parties to that certain Revolving Credit and Guaranty Agreement, dated as of
January 18, 2000, as amended by the First Amendment to Revolving Credit and
Guaranty Agreement dated as of February 16, 2000, the Second Amendment to
Revolving Credit and Guaranty Agreement dated as of March 20, 2000 and the Third
Amendment to Revolving Credit and Guaranty Agreement dated as of January 11,
2001 (as the same may be further amended, modified or supplemented from time to
time, the "Credit Agreement"); and

                  WHEREAS, the Borrower and the Guarantors have requested that
from and after the Effective Date (as hereinafter defined) of this Amendment,
the Credit Agreement be amended subject to and upon the terms and conditions set
forth herein;

                  NOW, THEREFORE, in consideration of the foregoing premises,
the mutual covenants hereinafter set forth and other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, it
is agreed by the parties as follows:

         1.       As used herein all terms that are defined in the Credit
Agreement shall have the same meanings herein.

         2.       Section 1.01 of the Credit Agreement is hereby amended by
inserting the following new definitions in appropriate alphabetical order:

                  "Fourth Amendment" shall mean the Fourth Amendment to
                  Revolving Credit and Guaranty Agreement, dated as of June 26,
                  2001.

                  "Second Amending Order" shall have the meaning set forth in
                  paragraph 8 of the Fourth Amendment.

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<PAGE>   2
         3.       The definition of the term "Maturity Date" set forth in
Section 1.01 of the Credit Agreement is hereby amended in its entirety to read
as follows:

                  "Maturity Date" shall mean December 31, 2001.

         4.       Section 6.04 of the Credit Agreement is hereby amended in its
entirety to read as follows:

         6.04.    CAPITAL EXPENDITURES.

                  (a)      Make Capital Expenditures (other than Special Capital
         Expenditures) in excess of (i) $22,000,000 during the Borrower's fiscal
         year ending September 30, 2001, and (ii) $6,000,000 during the three
         (3)-month period ending December 31, 2001.

                  (b)      Make Special Capital Expenditures in excess of (i)
         $5,650,000 during the Borrower's fiscal year ending September 30, 2001,
         and (ii) $1,000,000 during the three (3)-month period ending December
         31, 2001.

                  (c)      In the case of any Health Care Facility that is
         leased from, or subject to a lien in favor of, a Real Estate Financier,
         make Capital Expenditures or Special Capital Expenditures other than
         for normal routine maintenance or as required to maintain applicable
         Health Care Permits.

         As used in this section, the following terms shall have the meanings
         specified below:

                           "APS"    shall mean American Pharmaceutical Services,
         Inc. and its Subsidiaries.

                           "LTAC's" shall mean the long-term acute care
         facilities listed as such on Exhibit A to the Fourth Amendment.

                           "Omega Facilities" shall mean the facilities listed
         as such on Exhibit A to the Fourth Amendment.

                           "Special Capital Expenditures" shall mean, during any
         period, any Capital Expenditures incurred during such period by the
         Borrower or any Guarantor relating to the Omega Facilities, the LTAC's
         or APS, or in connection with Health Care Facilities identified by the
         Borrower in the Three-Year Business Plan to be sold or otherwise
         disposed of, or to settlements with creditors approved by

                                       2
<PAGE>   3

         the Bankruptcy Court, to the extent that the amount of such Capital
         Expenditures was not included in the Borrower's Three-Year Business
         Plan.

                           "Three-Year Business Plan" shall mean Borrower's
         three-year business plan delivered to the Agent, revised as of May 31,
         2000.

         5.       Section 6.05 of the Credit Agreement is hereby amended by
inserting the following dates and the following amounts at the end of the table
set forth therein:

<TABLE>
                  <S>                       <C>
                  "September 30, 2001       $51,670,000
                  October 31, 2001          $58,329,000
                  November 30, 2001         $64,988,000
                  December 31, 2001         $71,647,000
</TABLE>

         6.       Section 6.14 of the Credit Agreement is hereby amended by
deleting the dates "June 30, 2001", "July 31, 2001" and "August 31, 2001" and
the percentages set opposite such dates appearing in the table set forth therein
and inserting in lieu thereof the following:

<TABLE>
                  <S>                       <C>
                  "June 30, 2001            85.2%
                  July 31, 2001             85.2%
                  August 31, 2001           85.3%
                  September 30, 2001        85.3%
                  October 31, 2001          85.5%
                  November 30, 2001         85.5%
                  December 31, 2001         85.5%"
</TABLE>

         7.       Clause (j) of Section 7.01 of the Credit Agreement is hereby
amended by inserting the parenthetical phrase "(other than pursuant to the First
Amending Order and the Second Amending Order)" immediately following the words
"modifying either of the Orders" appearing at the end thereof.

         8.       Except as set forth in the following sentence, this Amendment
shall not become effective until the date (the "Effective Date") on which (i)
this Amendment shall have been executed by the Borrower, the Guarantors, the
Banks and the Agent, and the Agent shall have received evidence satisfactory to
it of such execution, (ii) the Borrower shall have paid to the Agent, for the
respective account of the Banks, an amendment fee in an aggregate amount equal
to $400,000, and (iii) the Bankruptcy Court shall have entered an order
satisfactory in form and substance to the Agent (the "Second Amending Order")
authorizing the terms of this Amendment (including the payment of the fees
provided for in clause (ii) of this paragraph). Notwithstanding anything to the
contrary set forth in the preceding sentence, the amendment of Section 6.04 of
the Credit Agreement appearing in paragraph 4 above shall become effective on
the date on which the condition set forth in clause (i) of the preceding
sentence shall have been satisfied (except that the word "Banks" in such clause
shall be read as "Required Banks" solely for purposes of this sentence), and
irrespective of whether the conditions described in clauses (ii) and (iii) of
the preceding sentence have been satisfied.

                                       3
<PAGE>   4
         9.       Except to the extent hereby amended, the Credit Agreement and
each of the Loan Documents remain in full force and effect and are hereby
ratified and affirmed.

         10.      The Borrower agrees that its obligations set forth in Section
10.05 of the Credit Agreement shall extend to the preparation, execution and
delivery of this Amendment, including the reasonable fees and disbursements of
special counsel to the Agent.

         11.      This Amendment shall be limited precisely as written and shall
not be deemed (a) to be a consent granted pursuant to, or a waiver or
modification of, any other term or condition of the Credit Agreement or any of
the instruments or agreements referred to therein or (b) to prejudice any right
or rights which the Agent or the Banks may now have or have in the future under
or in connection with the Credit Agreement or any of the instruments or
agreements referred to therein. Whenever the Credit Agreement is referred to in
the Credit Agreement or any of the instruments, agreements or other documents or
papers executed or delivered in connection therewith, such reference shall be
deemed to mean the Credit Agreement as modified by this Amendment.

         12.      This Amendment may be executed in any number of counterparts
and by the different parties hereto in separate counterparts, each of which when
so executed and delivered shall be deemed to be an original and all of which
taken together shall constitute but one and the same instrument.

         13.      This Amendment shall be governed by, and construed in
accordance with, the laws of the State of New York.

                                       4
<PAGE>   5
                  IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be duly executed as of the day and the year first written.

                                    BORROWER:

                                    MARINER POST-ACUTE NETWORK, INC.

                                    By:
                                       ----------------------------------------
                                             Name:
                                             Title:

                                    GUARANTORS:

                                    AMERICAN MEDICAL INSURANCE
                                    BILLING SERVICES, INC.
                                    AMERICAN PHARMACEUTICAL SERVICES, INC.
                                    AMERICAN REHABILITY SERVICES, INC.
                                    AMERICAN-CAL MEDICAL SERVICES, INC.
                                    AMERRA PROPERTIES, INC.
                                    AMS GREEN TREE, INC.
                                    AMS PROPERTIES, INC.
                                    APS HOLDING COMPANY, INC.
                                    APS PHARMACY MANAGEMENT, INC.
                                    BRIAN CENTER HEALTH & RETIREMENT/
                                      ALLEGHANY, INC.
                                    BRIAN CENTER HEALTH & RETIREMENT/
                                      BASTIAN, INC.
                                    BRIAN CENTER HEALTH & RETIREMENT/
                                      TAMPA, INC.
                                    BRIAN CENTER HEALTH & RETIREMENT/
                                      WALLACE, INC.
                                    BRIAN CENTER MANAGEMENT CORPORATION
                                    BRIAN CENTER NURSING CARE/AUSTELL, INC.
                                    BRIAN CENTER NURSING CARE/FINCASTLE, INC.
                                    BRIAN CENTER NURSING CARE/HICKORY, INC.
                                    BRIAN CENTER OF ASHEBORO, INC.
                                    BRIAN CENTER OF CENTRAL COLUMBIA, INC.
                                    CAMBRIDGE BEDFORD, INC.
                                    CAMBRIDGE EAST, INC.
                                    CAMBRIDGE NORTH, INC.
                                    CAMBRIDGE SOUTH, INC.
                                    CLINTONAIRE NURSING HOME, INC.
                                    CONNERWOOD HEALTHCARE, INC.

                                       5
<PAGE>   6
                                    CORNERSTONE HEALTH MANAGEMENT COMPANY
                                    CRESTMONT HEALTH CENTER, INC.
                                    DEVCON HOLDING COMPANY
                                    EH ACQUISITION CORP.
                                    EH ACQUISITION CORP. II
                                    EH ACQUISITION CORP. III
                                    EVERGREEN HEALTHCARE LTD., L.P.
                                    EVERGREEN HEALTHCARE,  INC.
                                    FRENCHTOWN NURSING HOME, INC.
                                    GC SERVICES, INC.
                                    GCI BELLA VITA, INC.
                                    GCI CAMELLIA CARE CENTER, INC.
                                    GCI COLTER VILLAGE, INC.
                                    GCI EAST VALLEY MEDICAL &
                                      REHABILITATION CENTER,  INC.
                                    GCI FAITH NURSING HOME, INC.
                                    GCI HEALTH CARE CENTERS, INC.
                                    GCI JOLLEY ACRES, INC.
                                    GCI PALM COURT, INC.
                                    GCI PRINCE GEORGE, INC.
                                    GCI REHAB, INC.
                                    GCI SPRINGDALE VILLAGE, INC.
                                    GCI THERAPIES, INC.
                                    GCI VILLAGE GREEN, INC.
                                    GCI-CAL THERAPIES COMPANY
                                    GCI-WISCONSIN PROPERTIES, INC.
                                    GRANCARE HOME HEALTH SERVICES, INC.
                                    GRANCARE OF MICHIGAN, INC.
                                    GRANCARE OF NORTH CAROLINA, INC.
                                    GRANCARE OF NORTHERN CALIFORNIA, INC.
                                    GRANCARE SOUTH CAROLINA, INC.
                                    GRANCARE, INC.
                                    HAWK'S-PERIMETER, INC.
                                    HERITAGE NURSING HOME, INC.
                                    HERITAGE OF LOUISIANA, INC.
                                    HMI CONVALESCENT CARE, INC.
                                    HOSPICE ASSOCIATES OF AMERICA, INC.
                                    HOSTMASTERS, INC.
                                    INTERNATIONAL HEALTH CARE MANAGEMENT, INC.
                                    INTERNATIONAL X-RAY, INC.
                                    LC MANAGEMENT COMPANY
                                    LCA OPERATIONAL HOLDING COMPANY
                                    LCR, INC.
                                    LIVING CENTERS - EAST, INC.
                                    LIVING CENTERS - PHCM, INC.

                                       6
<PAGE>   7
                                    LIVING CENTERS - ROCKY MOUNTAIN, INC.
                                    LIVING CENTERS - SOUTHEAST DEVELOPMENT
                                      CORPORATION
                                    LIVING CENTERS - SOUTHEAST, INC.
                                    LIVING CENTERS DEVELOPMENT COMPANY
                                    LIVING CENTERS HOLDING COMPANY
                                    LIVING CENTERS LTCP DEVELOPMENT COMPANY
                                    LIVING CENTERS OF TEXAS, INC.
                                    MADONNA NURSING CENTER, INC.
                                    MED-THERAPY REHABILITATION SERVICES, INC.
                                    MIDDLEBELT NURSING HOME, INC.
                                    MIDDLEBELT-HOPE NURSING HOME, INC.
                                    NAN-DAN CORP.
                                    NATIONAL HERITAGE REALTY, INC.
                                    NIGHTINGALE EAST NURSING CENTER, INC.
                                    OMEGA/INDIANA CARE CORP.
                                    PROFESSIONAL HEALTH CARE MANAGEMENT, INC.
                                    PROFESSIONAL RX SYSTEMS, INC.
                                    REHABILITY HEALTH SERVICES, INC.
                                    RENAISSANCE MENTAL HEALTH CENTER, INC.
                                    ST. ANTHONY NURSING HOME, INC.
                                    SUMMIT HOSPITAL HOLDINGS, INC.
                                    SUMMIT HOSPITAL OF EAST GEORGIA, INC.
                                    SUMMIT HOSPITAL OF SOUTHEAST ARIZONA, INC.
                                    SUMMIT HOSPITAL OF SOUTHEAST TEXAS, INC.
                                    SUMMIT HOSPITAL OF SOUTHWEST
                                    LOUISIANA, INC.
                                    SUMMIT HOSPITAL OF WEST GEORGIA, INC.
                                    SUMMIT INSTITUTE FOR PULMONARY
                                    MEDICINE AND REHABILITATION, INC.
                                    SUMMIT INSTITUTE OF AUSTIN, INC.
                                    SUMMIT INSTITUTE OF WEST MONROE, INC.

                                       7
<PAGE>   8

                                    SUMMIT MEDICAL HOLDINGS, LTD.
                                    SUMMIT MEDICAL MANAGEMENT, INC.

                                    By:
                                       ----------------------------------------
                                             Name:
                                             Title:

                                    THE CHASE MANHATTAN BANK,
                                             INDIVIDUALLY AND AS AGENT

                                    By:
                                       ----------------------------------------
                                             Name:
                                             Title:

                                    BANK OF AMERICA, N.A.

                                    By:
                                       ----------------------------------------
                                             Name:
                                             Title:

                                    SRV-HIGHLAND, INC.

                                    By:
                                       ----------------------------------------
                                             Name:
                                             Title:

                                    GLENEAGLES TRADING LLC

                                    By:
                                       ----------------------------------------
                                             Name:
                                             Title:

                                    GENERAL ELECTRIC CAPITAL CORPORATION

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                       8
<PAGE>   9

                                    FOOTHILL CAPITAL CORPORATION

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    GOLDMAN SACHS CREDIT PARTNERS L.P.

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    BHF (USA) CAPITAL CORPORATION

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    BDC FINANCE L.L.C.

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    HELLER HEALTHCARE FINANCE, INC.

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    BAYERISCHE HYPO- UND VEREINSBANK AG NEW
                                    YORK BRANCH

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                       9
<PAGE>   10

                                    MUIRFIELD TRADING LLC

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    KEMPER FLOATING RATE FUND

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                    TORONTO DOMINION (NEW YORK), INC.

                                    By:
                                       ----------------------------------------
                                      Name:
                                      Title:

                                       10
<PAGE>   11
                          EXHIBIT A TO FOURTH AMENDMENT

Omega Facilities

<TABLE>
<CAPTION>
         Name of Facility                            Subsidiary Lessee/Operator
         ----------------                            --------------------------
<S>                                                  <C>
1.       Cambridge South Healthcare Center           Cambridge South, Inc.
         Beverly Hills, MI

2.       Clinton-Aire Healthcare Center              ClintonAire Nursing Home,
         Clinton Township, MI                        Inc.

3.       Crestmont Health Care Center                Crestmont Health Center,
         Fenton, MI                                  Inc.

4.       Heritage Manor Nursing Center               Heritage Nursing Home, Inc.
         Flint, MI

5.       Nightingale Healthcare Center               Nightingale East Nursing
         Warren, MI                                  Center, Inc.

6.       Hope Healthcare Center                      Middlebelt-Hope Nursing
         Westland, MI                                Home, Inc.

7.       Bedford Villa Healthcare Center             Cambridge Bedford, Inc.
         Southfield, MI

8.       Cambridge East Healthcare Center            Cambridge East, Inc.
         Madison Heights, MI

9.       Cambridge North Healthcare Center           Cambridge North, Inc.
         Clawson, MI

10.      Brian Center Health and Rehabilitation
         Center - Statesville                                  PHCM
         Statesville, NC

11.      Brian Center Health and Rehabilitation
         Center - Goldsboro                                    PHCM
</TABLE>

<PAGE>   12
<TABLE>
<S>                                                  <C>
         GOLDSBORO, NC

12.      Brian Center Health and Rehabilitation
         Center -Durham                                       PHCM
         Durham, NC

13.      Frenchtown Healthcare Center                Frenchtown Nursing Home,
         Monroe, MI (SOLD 2/1/01)                    Inc.

14.      St. Anthony Health Care Center              St. Anthony Nursing Home,
         Warren, MI (SOLD 2/1/01)                    Inc.

15.      Madonna Healthcare Center                   Madonna Nursing Home, Inc.
         Detroit, MI (SOLD 2/1/01)

16.      Middlebelt Healthcare Center                Middlebelt Nursing Home,
         Livonia, MI (SOLD 2/1/01)                   Inc.
</TABLE>

LTAC'S

<TABLE>
<CAPTION>
         Name of Facility                            Subsidiary Lessee/Operator
         ----------------                            --------------------------
<S>      <C>                                         <C>
1.       Summit Hospital of Northeast                Summit Institute of West Monroe,
         Louisiana, West Monroe, LA                  Inc.

2.       Summit Hospital of Northwest                Summit Institute for Pulmonary
         Louisiana, Bossier City, LA                 Medicine and Rehabilitation, Inc.

3.       Summit Hospital of Southwest                Summit Hospital of Southwest
         Louisiana, Sulphur, LA                      Louisiana, Inc.

4.       Summit Hospital of Southeast                Summit Hospital of Southwest
         Arizona, Inc., Tucson, AZ                   Arizona, Inc.

5.       Specialty Hospital of Houston               Cornerstone Health Management
         Houston, TX                                 Company

6.       Specialty Hospital of Houston               Cornerstone Health Management
         (Clear Lakes Campus),Houston, TX            Company

7.       Specialty Hospital of Austin                Cornerstone Health Management
         Houston, TX                                 Company

8.       Specialty Hospital of Austin                Cornerstone Health Management
         (St. David's Campus), Austin, TX            Company
</TABLE>

<PAGE>   13

<TABLE>
<S>                                                  <C>
9.       Specialty Hospital of Austin                Cornerstone Health Management
         (North Austin Medical Center),              Company
         Austin, TX

10.      Summit Hospital of Central Texas,           Summit Institute of Austin, Inc.
         Austin, TX

11.      Specialty Hospital of New Orleans           Cornerstone Health Management
         New Orleans, LA                             Company

12.      Compass Hospital of Dallas                  Summit Medical Management, Inc.
         De Soto, TX

13.      Compass Hospital of San Antonio             Summit Medical Management, Inc.
         San Antonio, TX

14.      Specialty Hospital of Mahoning              Cornerstone Health Management
         Valley, Youngstown, OH                      Company

15.      Specialty Hospital of Lorain,               Mariner Specialty Hospital Group
         Lorain, OH

16.      Compass Hospital of Phoenix                 Summit Medical Management, Inc.
         Phoenix, AZ
</TABLE>

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00028-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00028-of-00352.parquet"}]]