Document:

EXHIBIT 10.46.2

                  FIRST AMENDMENT TO CONVERTIBLE NOTE AGREEMENT
                         AND CONVERTIBLE PROMISSORY NOTE

     This First  Amendment  to that certain  Convertible  Note  Agreement  dated
August 8, 2000 (the "Credit Agreement") and that certain Convertible  Promissory
Note dated  August 8, 2000 (the  "Note") is made and entered into as of the 21st
day of January, 2002 by and between CareCentric, Inc. (formerly known as Simione
Central Holdings, Inc.) ("Borrower") and Barrett C. O'Donnell ("O'Donnell").

                                   WITNESSETH:

     WHEREAS,  Borrower  and  O'Donnell  entered into the Credit  Agreement  and
Borrower executed the Note in favor of O'Donnell;

     WHEREAS,  the parties desire to amend certain terms of the Credit Agreement
and the Note on the terms and conditions set forth herein;

     NOW,  THEREFORE,  in  consideration  of the premises and mutual  agreements
herein contained, and for other good and valuable consideration, the receipt and
adequacy of which are hereby acknowledged, the parties hereto agree as follows:

     1.   Exhibit A to the Credit Agreement, which is the Note, shall be amended
          by this First Amendment without requiring re-execution of the Note, as
          follows:

          (a)  The first  sentence of the first  paragraph  of the Note shall be
               amended  by  deleting  at the end  thereof  of the  phrase  "nine
               percent (9%) per annum" and inserting in lieu thereof: "at a rate
               per annum equal to the Prime Rate plus two percent  (2%).  `Prime
               Rate' means the fluctuating prime rate of interest established by
               Wainwright  Bank & Trust Company from time to time whether or not
               such rate shall be otherwise published."

          (b)  After the second sentence of the first paragraph of the Note, the
               following  sentence  shall be added:  "However,  for the calendar
               quarters  ending in the year 2002,  one-half of accrued  interest
               shall be payable  at the end of each  calendar  quarter,  and the
               balance  shall be due and  payable at  December  31,  2003 at the
               choice  of  Lender,  either  (a)  in  cash  promptly,  or  (b) by
               conversion  to an  "obligation"  under the terms of this Note and
               the Agreement (as  referenced  below)  through the delivery of an
               appropriate promissory note."

          (c)  Clause (i) of the second sentence of the fourth  paragraph of the
               Note shall be deleted and the following shall be inserted in lieu
               thereof:  "the Prime Rate plus two  percent  (2%)  interest  rate
               described  in the first  paragraph  above shall be increased to a
               rate per annum equal to the Prime Rate plus five percent (5%) for
               as  long  as the  Event  of  Default  continues".

<PAGE>

     2.   Except as specifically  amended hereby or otherwise agreed,  the terms
          and conditions of and obligations  created under the Credit  Agreement
          and the Note are hereby  ratified  and  confirmed  and shall remain in
          full force and effect according to their terms.

     3.   This  First  Amendment  shall  not  waive  nor be  deemed to waive nor
          otherwise  affect in any manner  whatsoever the effect,  the terms and
          conditions of that certain  Subordination  Agreement  dated as of July
          2000 by and between O'Donnell and Wainwright Bank & Trust Company.

     4.   This First  Amendment  may be executed in any number of  counterparts,
          each of which when so executed and delivered shall be an original, but
          all of which shall constitute one and the same instrument. Delivery of
          an executed  counterpart to this First  Amendment by telecopy shall be
          effective as an original and shall constitute a representation that an
          original will be delivered.

     5.   This First  Amendment  and the rights and  obligations  of the parties
          under this First  Amendment  shall be governed by, and  construed  and
          interpreted  in  accordance  with,  the laws of the State of Delaware,
          without reference to conflicts of law.

     IN WITNESS WHEREOF,  each of the parties hereto has caused a counterpart of
this First  Amendment  to be duly  executed  and  delivered as of the date first
above written.

                                    BORROWER:

                                    CARECENTRIC, INC.

                                    By:  /s/ John R. Festa
                                         --------------------------------------
                                         John R. Festa, President

                                    LENDER:

                                    /s/ Barrett C. O'Donnell
                                    --------------------------------------------
                                    Barrett C. O'Donnell<PAGE>

                   [LETTERHEAD OF AMF BOWLING WORLDWIDE, INC.]

                                                                  Exhibit 10.7

August 8, 2001

Mr. Frederick C. Kraegel                               Roland Smith
9 Dilton Court                                         President
Richmond, Virginia 23233                               Chief Executive Officer

[LOGO]
 AMF

Dear Fred:

I am very pleased to confirm our offer for you to join AMF as Senior Vice
President and Chief Administrative Officer reporting directly to me.

You will start on August 13, 2001 and will be compensated at an annualized
salary of $275,000 or $10,576.92 on a bi-weekly basis. In addition you will be
entitled to an annual incentive of 50% of your annual salary based upon mutually
agreed to key result areas and company performance. This bonus will be prorated
for the number of months that you work in 2001. In addition, you will be
entitled to receive six months severance if your employment is terminated
without cause prior to the consummation of the Chapter 11 proceeding.

You will be eligible for all full time employee benefits to include medical,
dental, long and short term insurance, life and accidental life insurance,
variable annuity matching plan, 3 weeks vacation, holiday and personal day pay,
executive physicals and financial planning.

You will have three direct reports; Chris Caesar, Chief Financial Officer; Al
Cornish, Vice President Human Resources and John Fottrell, Vice President
Information Technology. We agreed that your responsibilities will include
assisting Chris and myself in the successful completion of the Chapter 11
proceedings; serving as a mentor to Chris Caesar in his development as the Chief
Financial Officer and providing oversight and counsel to the Human Resources
and Information Technology Departments.

I have enclosed two copies of this letter. Please sign one and fax a copy to Al
Cornish, Vice President Human Resources at (804) 730-6686. Also, please provide
the original signed copy to Al in due course for our records. Should you have
any questions, please feel free to call Al Cornish at (804) 730-6620 to discuss.

The Immigration and Naturalization Act of 1987 requires that you provide the
proper documentation verifying your ability to work in the United States. Please
be sure to bring two (2) forms of identification with you on your first day.

         AMF Always Means Fun!(TM)

<PAGE>

This letter is intended to only outline the salary and benefits available to you
as an AMF Bowling Worldwide, Inc. employee and should not be considered an
employment contract. AMF Bowling Worldwide, Inc. is an at-will employer and as
such you or the company may terminate your employment at any time.

Fred, I am very excited to have someone with your background, experience and
leadership capability join AMF. I look forward to working closely with you as we
make AMF everything it can be.

Best Regards,

/s/ Roland Smith
    Roland Smith

/s/ Fred Kraegel      August 9, 2001
------------------    ---------------
Fred Kraegel          Date

<PAGE>

                   [LETTERHEAD OF AMF BOWLING WORLDWIDE, INC.]

April 25, 2002

Mr. Frederick G. Kraegel                                 Roland Smith
9 Dilton Court                                           President
Richmond, Virginia 23233                                 Chief Executive Officer

[LOGO]
 AMF

Dear Fred,

This letter is to serve as an addendum to your original August 8, 2001
employment letter. There have been several changes in you status that I felt
needed to be confirmed in writing.

1. Title: Executive Vice President and Chief Administrative Officer

2. Salary: As of January 28, 2002, your salary was increased to $288,000.

3. Senior Management Supplemental Benefits, Tier 1: You are eligible for all of
   benefits covered in the attached supplement.

4. Direct Reports: Your direct reports continue to be Chris Caesar and John
   Fottrell and also now include Dan McCormack (Legal) and Mark Hatcher (Real
   Estate).

I believe your August 8, 2001 letter and this addendum cover your present
employment agreement with AMF Bowling Worldwide, Inc. Please sign the bottom of
this addendum and return to Wayne.

Best Regards,

/s/ Roland Smith
Roland Smith
President and Chief Executive Officer

/s/ Frederick G. Kraegel          April 30, 2002
------------------------          --------------
Frederick G. Kraegel              Date

Cc:       Wayne Tennent

     AMF Always Means Fun!(TM)<PAGE>

                                                                  EXECUTION COPY

                                                                    EXHIBIT 10.1
                                                                    ------------

                       AMENDMENT NO. 2 TO CREDIT AGREEMENT
                       -----------------------------------

                                              Dated as of March 29, 2002

          This AMENDMENT NO. 2 ("Amendment") amends that certain CREDIT
AGREEMENT dated as of November 30, 2000, as amended by that certain Amendment to
Credit Agreement dated as of October 31, 2001 (the "Credit Agreement") among
MASSEY ENERGY COMPANY (the "Borrower"), A.T. MASSEY COAL COMPANY, INC., the
lenders party thereto (collectively, the "Lenders"), CITIBANK, N.A., as
administrative agent for the Lenders (in such capacity "Administrative Agent"),
PNC BANK, NATIONAL ASSOCIATION, as syndication agent, and FIRST UNION NATIONAL
BANK, as documentation agent. Terms not otherwise defined herein are used herein
as defined in the Credit Agreement.

                             PRELIMINARY STATEMENTS

     WHEREAS, the Required Lenders have agreed to amend certain provisions of
the Credit Agreement on the terms set forth herein.

     NOW, THEREFORE, the parties hereto agree as follows:

          SECTION 1. Amendment.  Subject to the satisfaction of the conditions
                     ---------
precedent specified in Section 2 hereof, the Credit Agreement shall be amended
as follows:

          (a)  Section 1.01 is hereby amended by deleting in its entirety the
definition of "Applicable Margin" contained therein and replacing it with the
following:

               "Applicable Margin" means, for Eurodollar Loans, an interest rate
                -----------------
     per annum equal at all times to, (i) 0.400% for each day during a Level I
     Period; (ii) 0.550% for each day during a Level II Period; (iii) 0.900% for
     each day during a Level III Period; (iv) 1.000% for each day during a Level
     IV Period; (v) 1.200% for each day during a Level V Period; and (vi) 1.400%
     for each day during a Level VI Period.

          (b)  Section 5.07 is hereby amended by deleting clause (a) therein it
in its entirety and replacing it with the following:

               "(a) The Borrower will maintain a ratio of Consolidated Debt to
     Consolidated EBITDA, as determined on the last day of each fiscal quarter,
     for the four fiscal quarters ending on such day, of not more than (i) 4.0
     to 1.0, for the fiscal quarters ending March 31, 2002 and June 30, 2002,
     (ii) 3.5 to 1.0, for the fiscal quarter ending September 30, 2002, (iii)
     3.0 to 1.0 for the fiscal quarter ending December 31, 2002, and (iv) 2.75
     to 1.0 for the fiscal quarters ending after December 31, 2002."

          (c)  Section 5.07 is hereby amended by deleting clause (b) therein it
in its entirety and replacing it with the following:

               "(b) The Borrower shall maintain a Consolidated Interest Coverage
     Ratio, as determined on the last day of each fiscal quarter, for the four
     fiscal quarters ending on such day, of not less than (i) 4.25 to 1.0, for
     the fiscal quarters ending March 31, 2002, June 30, 2002 and September 30,
     2002, (ii) 4.5 to 1.0, for the fiscal quarter ending December 31, 2002, and
     (iii) 4.75 to 1.0, for the fiscal quarters ending after December 31, 2002."

<PAGE>

           SECTION 2. Conditions to Effectiveness. This Amendment shall become
                      ---------------------------
effective as of the date above first written when, and only when, the
Administrative Agent shall have received counterparts of this Amendment executed
by the Required Lenders.

           SECTION 3. Representations and Warranties. The representations and
                      ------------------------------
warranties contained in Article IV of the Credit Agreement are true and correct
in all material respects as of the date hereof, other than with respect to any
such representation or warranty that speaks as of a date certain, in which case
such representation or warranty is true and correct as of such date.

           SECTION 4. Costs and Expenses. The Borrower hereby agrees to pay on
                      ------------------
demand all costs and expenses of the Administrative Agent in connection with the
preparation, execution, delivery and administration of this Amendment
(including, without limitation, the reasonable fees and expenses of counsel for
the Administrative Agent) in accordance with the terms of Section 10.03(a)(ii)
of the Credit Agreement.

           SECTION 5. No Event of Default. No Event of Default has occurred and
                      -------------------
is continuing as of the date hereof.

           SECTION 6. Effect on the Credit Agreement. Except as specifically
                      ------------------------------
amended herein, the Credit Agreement and the other documents delivered
thereunder are, and shall continue to be, in full force and effect and are
hereby in all respects ratified and confirmed.

           SECTION 7. Execution in Counterparts. This Amendment may be executed
                      -------------------------
in any number of counterparts and by different parties hereto in separate
counterparts, each of which when so executed shall be deemed to be an original
and all of which taken together shall constitute one and the same agreement.
Delivery of an executed counterpart of a signature page to this Amendment by
facsimile shall be effective as delivery of an original counterpart of this
Amendment.

           SECTION 8. Governing Law. This Amendment shall be governed by, and
                      -------------
construed in accordance with, the laws of the State of New York.

                  [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

                                        2

<PAGE>

           IN WITNESS WHEREOF, the parties hereto have caused this Amendment to
be duly executed by their respective authorized officers as of the day and year
first above written.

                                    MASSEY ENERGY COMPANY, as Borrower

                                    By: _______________________________________
                                        Name:   Baxter F. Phillips, Jr.
                                        Title:  Vice President and Treasurer

                                    By: _______________________________________
                                         Name:  Jeffrey M. Jarosinski
                                         Title: Vice President-Finance and
                                         Chief Financial Officer

                                    A.T. MASSEY COAL COMPANY, INC., as Guarantor

                                    By: _______________________________________
                                         Name:  Baxter F. Phillips, Jr.
                                         Title: Vice President and Treasurer

                                        3

<PAGE>

                                   CITIBANK, N.A. as Administrative Agent and as
                                   Lender

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   PNC BANK, NATIONAL ASSOCIATION

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   FIRST UNION NATIONAL BANK

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   WESTDEUTSCHE LANDESBANK GIROZENTRALE

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   BANK ONE, NA

                                   By:__________________________________________
                                      Name:
                                      Title:

                                        4

<PAGE>

                                   THE ROYAL BANK OF SCOTLAND PLC

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   BRANCH BANKING AND TRUST COMPANY

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   THE BANK OF NEW YORK

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   DRESDNER BANK LATEINAMERIKA AG MIAMI AGENCY

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   WACHOVIA BANK, N.A.

                                   By:__________________________________________
                                      Name:
                                      Title:

                                        5

<PAGE>

                                   AUSTRALIA AND NEW ZEALAND BANKING GROUP
                                   LIMITED

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   MELLON BANK N.A.

                                   By:__________________________________________
                                      Name:
                                      Title:

                                   BANK HAPOALIM

                                   By:__________________________________________
                                      Name:
                                      Title:

                                        6

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