Document:

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                                                                     EXHIBIT 4.2

                      SECOND AMENDMENT TO RIGHTS AGREEMENT

     This Second Amendment (this "Amendment") to the Rights Agreement, dated as
of April 2, 1998 (the "Rights Agreement"), between Omega Worldwide, Inc., a
Maryland corporation (the "Company"), and Equiserve Trust Company N.A.
(successor to First Chicago Trust Company of New York), as Rights Agent, is made
and entered into as of this 1st day of August, 2002.

     WHEREAS, concurrently herewith the Company is entering into (a) that
certain Agreement and Plan of Merger, dated August 1, 2002, by and between Four
Seasons Health Care Limited, a private limited company organized under the laws
of England and Wales ("Four Seasons"), Delta Acquisition I, Inc., a Delaware
corporation ("Delta Acquisition" and, together with Four Seasons, the "Four
Seasons Parties") and the Company, and (b) those certain Tender and Option
Agreements and Irrevocable Proxies, dated as on or about August 1, 2002, among
the Company, the Four Seasons Parties and certain stockholders of the Company,
pursuant to which Four Seasons, through Delta Acquisition, will acquire all of
the issued and outstanding shares of common stock, par value $.10 per share, of
the Company, including the associated preferred share purchase rights issued
pursuant to the Rights Agreement, which are not beneficially owned by the Four
Seasons Parties;

     WHEREAS, concurrently herewith Four Seasons is entering into that certain
Stock Purchase Agreement, dated as of August 1, 2002, among the Four Seasons
Parties and Omega Healthcare Investors, Inc., pursuant to which the Four Seasons
Parties may acquire all of the issued and outstanding shares of Series C
Preferred Stock, par value $1.00 per share, of the Company; and

     WHEREAS, the Board of Directors of the Company has determined to amend the
Rights Agreement as provided herein, pursuant to the authority contained in
Section 27 of the Rights Agreement;

     NOW, THEREFORE, in consideration of the premises and mutual agreements
herein set forth, the Company hereby agrees as follows:

     1.   The definition of "Acquiring Person" as set forth in Section 1 of the
Rights Agreement shall be supplemented to include the following provision at the
end of such definition:

     Notwithstanding the foregoing, if Four Seasons Health Care Limited, a
private limited company organized under the laws of England and Wales ("Four
Seasons"), Delta Acquisition I, Inc., a Delaware corporation ("Delta
Acquisition" and, together with Four Seasons, the "Four Seasons Parties")
purchases or are otherwise deemed to Beneficially Own Common Shares

                                       1

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and/or shares of Series C Preferred Stock, par value $1.00 per share, of the
Company (the "Series C Preferred Shares") solely pursuant to the transactions
contemplated by, and in accordance with the terms and conditions of, that
certain Agreement and Plan of Merger, dated as of August 1, 2002, among the
Company and the Four Season Parties, as amended, supplemented or otherwise
modified from time to time in accordance with the terms thereof (the "Merger
Agreement"), those certain Tender and Option Agreements and Irrevocable
Proxies, dated on or about August 1, 2002, among the Company, the Four Season
Parties and certain stockholders of the Company, as amended, supplemented or
otherwise modified from time to time in accordance with the terms thereof (the
"Tender Agreements"), and the Stock Purchase Agreement, dated as of August 1,
2002, among the Four Seasons Parties and Omega Healthcare Investors, Inc. (the
"Stock Purchase Agreement"), then the Four Seasons Parties (and any Person
deemed to be a Beneficial Owner by reason of beneficial ownership of securities
of the Four Seasons Parties) shall be excluded from this definition of
Acquiring Person under this Agreement.

     2.   Section 3(a) of the Rights Agreement shall be supplemented to include
the following provision at the end of such subsection:

     Notwithstanding the foregoing, if the Four Seasons Parties purchase or are
otherwise deemed to Beneficially Own Common Shares and/or Series C Preferred
Shares solely pursuant to the transactions contemplated by, and in accordance
with the terms and conditions of, the Merger Agreement, the Tender Agreements
and the Stock Purchase Agreement, then such purchase shall not trigger a
Distribution Date under this Agreement.

     3.   Except for the amendments made hereby, the Rights Agreement shall
continue in full force and effect.

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     IN WITNESS WHEREOF, the Company has caused this Second Amendment to the
Rights Agreement to be duly executed and attested, all as of the day and year
first written above.

                                        OMEGA WORLDWIDE, INC.

                                        By:  /s/ John Storey
                                           -------------------------------------
                                        Name:  John Storey
                                             -----------------------------------
                                        Title:  Vice President and Secretary
                                              ----------------------------------

Attest:

By:  /s/ Jeffrey Cohen
    ---------------------------------
Name:  Jeffrey Cohen
      -------------------------------
Title:  Senior Account Manager
       ------------------------------

                                       3<PAGE>
                           July 1, 2002                             EXHIBIT 10.1

                           Mr. Ronald Sharp Elder
[OMEGA                     Chestnuts
 WORLDWIDE                 8 Courtney Place
 INC.                      Cobham
 LOGO]                     Surrey KT11 2BE

                           Dear Ron:

                           You and Omega Worldwide Inc. entered into an
                           employment agreement dated May 1, 2002.  Paragraph
                           2(b) of that agreement provides that you will be
                           eligible for an "initial bonus" for the period
                           January 1, 2002 through June 30, 2002.  This letter
                           confirms our prior agreement that this period will be
                           extended, so that it covers the period January 1,
                           2002 through July 31, 2002.  To reflect this
                           revision, the employment agreement is amended by
                           replacing the phrase "June 30, 2002" with the phrase
                           "July 31, 2002" where the former phrase appears in
                           paragraph 2(b) and paragraph 2(b)(i) of the
                           employment agreement.  If the foregoing reflects your
                           understanding of our agreement, please sign one copy
                           of this letter and return it to me.

                           Very truly yours,
                           Omega Worldwide, Inc.

                           By: /s/ James Eden
                           ------------------
                           Its Chairman

                           The foregoing letter reflects
                           my understanding of my agreement
                           with the Company:

                           /s/ Ronald Sharp Elder
                           ----------------------
                               Ronald Sharp Elder

900 Victors Way            Date: 10th June, 2002
  Suite 345                      ----------
Ann Arbor, MI 48108
Phone: 734-887-0300
Fax: 734-887-0301<PAGE>
                                                                    EXHIBIT 10.2

24 May 2002

Mark Gosling
8 Dane Close
Hartlip
Sittingbourne
Kent ME9 7TN

Dear Mark

REMUNERATION ADJUSTMENTS

Further to our conversation, I am pleased to confirm the following changes to
your remuneration package with Omega (UK) Limited.

With effect from 1 March 2002 your annual salary will increase by 15%. The
pension contribution made by the company to your pension scheme will likewise
be increased by 15%.

The new salary and pension contributions will be used in connection with any
calculation resulting from a trigger of the change of control clause in your
contract.

In addition, you will be awarded an amount of Pound 30,000 on the successful
conclusion of any transaction which results in the sale of Omega Worldwide.
This amount will be excluded from any calculation in regard to the change of
control provisions contained in your contract and will be payable within five
days of closing such a transaction.

All other terms and conditions remain unchanged.

I would be grateful if you could confirm your agreement to these amendments by
singing, dating and returning the enclosed copy of this letter to me in due
course.

Yours sincerely

/s/ Ronald S. Elder

Ronald S Elder
Chief Executive

Signed: /s/ Mark Gosling              Date: 24th May 2002
       --------------------                ----------------------<PAGE>

                                                      EXHIBIT 10.3

24 May 2002

John Storey
93 Dacre Park
Blackheath
London SE13 5BX

Dear John

REMUNERATION ADJUSTMENTS

Further to our conversation, I am pleased to confirm the following changes to
your remuneration package with Omega (UK) Limited.

With effect from 1 March 2002 your annual salary will increase by 15%. The
pension contribution made by the company to your pension scheme will likewise
be increased by 15%.

The new salary and pension contributions will be used in connection with any
calculation resulting from a trigger of the change of control clause in your
contract.

In addition, you will be awarded an amount of pound 30,000 on the successful
conclusion of any transaction which results in the sale of Omega Worldwide.
This amount will be excluded from any calculation in regard to the change of
control provisions contained in your contract and will be payable within five
days of closing such a transaction.

All other terms and conditions remain unchanged.

I would be grateful if you could confirm your agreement to these amendments by
signing, dating and returning the enclosed copy of this letter to me in due
course.

Yours sincerely

/s/ Ronald S. Elder
-----------------------
Ronald S Elder
Chief Executive

Signed: /s/ John Storey                    Date: 24th May 2002
        ------------------                       ----------------

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