Document:

<PAGE>   1
Exhibit 10.1                                       Loan Number 99-407

                       SECOND AMENDMENT TO LOAN DOCUMENTS

         This SECOND AMENDMENT TO LOAN DOCUMENTS (this "Amendment") is made this
20th day of September, 2000, among HELLER HEALTHCARE FINANCE, INC., a Delaware
corporation formerly known as HCFP FUNDING, INC. ("Lender") and BALANCED CARE
CORPORATION, a Delaware corporation (referred to herein as "Guarantor"), and
BALANCED CARE REALTY AT STATE COLLEGE, INC., a Delaware corporation, BALANCED
CARE REALTY AT ALTOONA, INC., a Delaware corporation, BALANCED CARE REALTY AT
LEWISTOWN, INC., a Delaware corporation, BALANCED CARE REALTY AT READING, INC.,
a Delaware corporation, BALANCED CARE REALTY AT BERWICK, INC., a Delaware
corporation, BALANCED CARE REALTY AT PECKVILLE, INC., a Delaware corporation,
BALANCED CARE REALTY AT SCRANTON, INC., a Delaware corporation, BALANCED CARE
REALTY AT MARTINSBURG, INC., a Delaware corporation, BALANCED CARE REALTY AT
MAUMELLE, INC., a Delaware corporation, BALANCED CARE REALTY AT SHERWOOD, INC.,
a Delaware corporation, BALANCED CARE REALTY AT MOUNTAIN HOME, INC., a Delaware
corporation, and BALANCED CARE REALTY AT MANSFIELD, INC., a Delaware corporation
(collectively referred to herein as "Outlook Pointe Borrowers"), and BCC AT
DARLINGTON, INC., a Delaware corporation, BALANCED CARE AT EYERS GROVE, INC., a
Delaware corporation, BALANCED CARE AT BUTLER, INC., a Delaware corporation,
BALANCED CARE AT SARVER, INC., a Delaware corporation, and BALANCED CARE AT
NORTH RIDGE, INC., a Delaware corporation (collectively referred to herein as
"BCC Borrowers"). The Outlook Pointe Borrowers and BCC Borrowers are
collectively referred to herein as "Borrowers."

                                    RECITALS:

         A. Lender has made available to BCC Borrowers a revolving credit
facility in the maximum principal amount of Twelve Million and No/100 Dollars
($12,000,000) (the "Revolving Credit Facility") subject to the terms and
conditions contained in a Loan and Security Agreement dated April 22, 1999, as
amended by an Amendment No. 1 to Loan and Security Agreement dated July 1, 1999
(the "First Amendment"), an Amendment No. 2 to Loan and Security Agreement dated
July 29, 1999 (the "Second Amendment"), and an Amendment No. 3 to Loan and
Security Agreement dated December 31, 1999 (the "Third Amendment"), all among
the Lender and BCC Borrowers (as well as other entities that have since been
released from the terms and conditions of the Loan and Security Agreement as
amended). The Loan and Security Agreement, as amended by the First Amendment,
the Second Amendment, and the

<PAGE>   2

Third Amendment, is referred to herein as the "Loan and Security Agreement." The
Loan and Security Agreement and all other loan documents executed in connection
with the Loan and Security Agreement and the Revolving Credit Facility are
collectively referred to herein as the "Revolving Credit Facility Loan
Documents."

         B. Lender has also made a loan (the "Outlook Pointe Loan") of
Thirty-Two Million and No/100 Dollars ($32,000,000.00) to Outlook Pointe
Borrowers subject to the terms and conditions contained in a Loan Agreement
dated December 30, 1999, between Lender and Outlook Pointe Borrowers (the Loan
Agreement, including all exhibits thereto and the Senior Housing Rider of even
date therewith, as amended from time to time, is referred to herein as the "Loan
Agreement"). The Outlook Pointe Loan is evidenced by a Promissory Note A of even
date with the Loan Agreement in the original principal amount of Twenty-Five
Million Six Hundred Thousand and No/100 Dollars ($25,600,000.00) ("Note A") and
by a Subordinated Promissory Note B of even date with the Loan Agreement in the
original principal amount of Six Million Four Hundred Thousand and No/100
Dollars ($6,400,000.00) ("Note B") (Note A and Note B and all amendments thereto
and substitutions therefor are hereinafter referred to collectively as the
"Note").

         C. As additional security for the Outlook Pointe Loan, Guarantor has
executed and delivered a Guaranty dated December 30, 1999, in favor of Lender
(as amended from time to time, the "Guaranty").

         D. Also in connection with the Outlook Pointe Loan, Guarantor and
Outlook Pointe Borrowers have executed and delivered a Hazardous Materials
Indemnity Agreement dated December 30, 1999, in favor of Lender (as amended from
time to time, the "Environmental Indemnity"). The Loan Agreement, the Guaranty,
and the Environmental Indemnity, the New Note (as defined below), together with
all mortgages, deeds of trust and other documents and instruments executed and
delivered by one or more of the Outlook Pointe Borrowers or the Guarantor in
connection the Outlook Pointe Loan, are collectively referred to herein as the
"Outlook Pointe Loan Documents," and the Outlook Pointe Loan Documents,
collectively with the Revolving Credit Facility Loan Documents, are referred to
herein as the "Loan Documents." Capitalized terms used herein without definition
shall have the meanings provided in the Loan Agreement.

         E. Also in connection with the Outlook Pointe Loan, Lender, Guarantor,
Outlook Pointe Borrowers, and various other

                                      -2-
<PAGE>   3

entities have entered into a Subordination Agreement dated April 18, 2000 (the
"Subordination Agreement"), addressing debt that is junior to the Outlook Pointe
Loan.

         F. On or about April 27, 2000, Lender increased the Outlook Pointe Loan
to Thirty-Seven Million and No/100 Dollars ($37,000,000.00) (the "Amended
Loan"), as evidenced by an Amended and Restated Promissory Note A dated April
27, 2000 in the original principal amount of Thirty Million Six Hundred Thousand
and No/100 Dollars ($30,600,000.00) ("Amended Note A"), and an Amended and
Restated Subordinated Promissory Note B dated April 27, 2000 in the original
principal amount of Six Million Four Hundred Thousand and No/100 Dollars
($6,400,000.00) ("Amended Note B"), and amendments to the mortgages and deeds of
trust constituting Outlook Pointe Loan Documents dated April 27, 2000 (the
"Outlook Pointe Mortgages"). In connection with the Amended Loan, BCC Borrowers
have executed and delivered to Lender amendments to the mortgages and deeds of
trust constituting Revolving Credit Facility Loan Documents dated April 27, 2000
(the "Revolving Credit Facility Mortgages").

         G. Lender has agreed to increase the Amended Loan by Five Million and
No/100 Dollars ($5,000,000.00) (the "New Funds") to Forty-Two Million and No/100
Dollars ($42,000,000.00) (the "Loan") and in consideration thereof requires
Borrowers and Guarantor to enter into this Amendment amending the Loan
Documents. In conjunction with this Amendment, Outlook Pointe Borrowers have
executed and delivered to Lender a Second Amended and Restated Promissory Note A
in the original principal amount of Amended Note A (the "New Note A"), a Second
Amended and Restated Subordinated Promissory Note B in the original principal
amount of Amended Note B (the "New Note B"), and a Promissory Note C in the
original principal amount of Five Million and No/100 Dollars ($5,000,000.00)
(the "New Note C") (said amended and restated promissory notes and New Note C
collectively referred to herein as the "New Note"), and amendments to the
Outlook Pointe Mortgages all of even date herewith. In conjunction with this
Amendment, BCC Borrowers have executed and delivered to Lender amendments to the
Revolving Credit Facility Mortgages all of even date herewith.

         NOW, THEREFORE, in consideration of the foregoing recitals and the
mutual conditions and agreements contained herein, and for other good and
valuable consideration (the receipt and sufficiency of which are hereby
acknowledged), Lender, the Borrowers and Guarantor hereby agree as follows:

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         1. Conditions Precedent. Lender's obligation to disburse the New Funds
is subject to satisfaction of all of the following conditions:

                  A. Lender shall have received the following documents, all in
form and substance reasonably satisfactory to Lender:

                  (i) this Amendment;

                  (ii) the New Note; and

                  (iii) amendments to the Outlook Pointe Mortgages and the
Revolving Credit Facility Mortgages (the "Mortgage Amendments").

                  B. Borrower shall have paid Lender a commitment fee in the
amount of One Hundred Thousand and No/100 Dollars ($100,000.00), which
commitment fee shall be nonrefundable and shall be deemed fully earned upon
receipt;

                  C. Lender shall have received such opinions of counsel to
Borrowers and Guarantor as Lender may reasonably require; and

                  D. Lender shall have received such other items as Lender may
reasonably require.

         2. Payment of Expenses. At the time of Lender's disbursement of the New
Funds, Outlook Pointe Borrowers shall pay all Expenses (as defined below)
incurred by Lender in connection with the transaction contemplated by this
Amendment, including without limitation, Lender's expenses incurred in the
negotiation and documentation related to the New Funds and this Amendment. For
the purposes hereof "Expenses" means all reasonable expenditures and expenses
that may be paid or incurred by or on behalf of Lender, including attorneys'
fees (of outside and inside counsel), engineers' fees, accountants' fees,
independent consultants' fees (including environmental consultants), all costs
and expenses incurred in connection with any of the foregoing fees and expenses,
Lender's out-of-pocket costs and expenses related to any audit or inspection of
the Project (as defined in the Loan Agreement), stamp taxes, mortgage taxes,
intangibles taxes, and costs for procuring any abstracts of title, title
searches, lien and UCC searches, and examination, title insurance policies and
endorsements, Torrens' Certificates (if applicable), and similar data and
assurances with respect to title as Lender may deem reasonably necessary.

                                      -4-
<PAGE>   5

         3. The New Funds shall not constitute Gross Revenue for purposes of
calculating Net Cash Flow under the Loan Agreement, nor shall any Expenses,
commitment fees or other expenses incurred by the Outlook Pointe Borrowers in
connection with the loan of the New Funds constitute an "operating expense" for
purposes of calculating Net Cash Flow.

         4. Notwithstanding any provision of the Loan Documents to the contrary,
no collateral for any of the Loan Documents shall be released until the Loan has
been repaid in full.

         5. The following new Section 1.10 (Additional Exit Fee) and Section
1.11 (Reserve) shall be added immediately following Section 1.9 of the Loan
Agreement:

                  Section 1.10. Additional Exit Fee. As additional consideration
         for making the additional loan evidenced by New Note C, Borrower shall,
         on the date payment in full of New Note C is made, pay to Lender an
         amount (the "Additional Exit Fee") equal to Six Hundred Thousand and
         No/100 Dollars ($600,000.00); provided, however, that Borrower shall
         not be required to pay Lender the Additional Exit Fee if the New Note C
         has been repaid in full on or before October 31, 2000. At Lender's
         discretion, Lender may pay or prepay the Additional Exit Fee by making
         an advance under the Revolving Credit Facility Loan Documents in such
         amount at any time after November 1, 2000, if New Note C is not repaid
         in full by October 31, 2000.

                  Section 1.11. Reserve. On the date that the proceeds of New
         Note C are disbursed, Lender shall disburse an amount (the "Reserve")
         equal to Two Million Five Hundred Thousand and No/100 Dollars
         ($2,500,000.00) of such proceeds into a reserve account in Lender's
         name with a financial institution acceptable to Lender (the "Reserve
         Account"). The funds in the Reserve Account may be commingled with the
         general funds of Lender and shall not be deemed to be held in trust for
         the benefit of Borrower. Lender shall credit for Borrower's account
         interest on the funds in the Reserve Account, which interest shall
         accrue monthly at the money market account rate of interest announced
         from time to time by the financial institution holding the Reserve. At
         Lender's sole discretion, a disbursement from the Reserve Account may
         be made to cure past due interest or other defaults

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<PAGE>   6

         under the Loan Documents. In the event Lender cures a default under the
         Loan Documents with funds from the Reserve Account, such default shall
         be deemed cured for all purposes. (For example, if Lender disburses a
         sum from the Reserve Account sufficient to pay all past due interest on
         the New Note, the interest payment default shall be deemed cured for
         all purposes.) In addition, so long as no Event of Default then exists,
         Lender shall permit Borrower to apply all funds remaining in the
         Reserve Account (the Reserve plus interest thereon) to repay the New
         Note C provided that the New Note C is repaid on or before November 15,
         2000. Consequently, the funds in the Reserve Account shall only be used
         to pay interest, principal and any other amounts due Lender, or to
         satisfy any obligations owed to Lender, under the Loan Documents,
         including but not limited to payment of the Additional Exit Fee.

         6. All references to the "Loan" in the Outlook Pointe Loan Documents,
including without limitation the Guaranty and Environmental Indemnity, shall
include the loan of the New Funds hereunder.

         7. All references in the Loan Documents to any of the Outlooke Pointe
Loan Documents shall mean the applicable Outlook Pointe Loan Document, as
amended hereby and by the Mortgage Amendments, or the New Note, as applicable.
All references in the Outlooke Pointe Loan Documents to the Note shall mean the
New Note.

         8. All references in the Loan Documents to any of the Revolving Credit
Facility Loan Documents shall mean the applicable Revolving Credit Facility Loan
Document as amended hereby and by the Mortgage Amendments.

         9. Except as expressly provided herein, in the New Note and in the
Mortgage Amendments, the Loan Documents (including without limitation the
Guaranty, Environmental Indemnity, Subordination Agreement, and the undated
Consent Form with attached letter dated February 16, 2000, to Lender and Heller
Financial, Inc. from Guarantor) shall remain unmodified and in full force and
effect and are hereby ratified and confirmed as amended by this Amendment.

         10. The provisions of this Amendment that pertain to the Outlook Pointe
Loan, the Outlook Pointe Loan Documents, and the Outlook Pointe Borrowers shall
be governed by and construed in accordance with the internal laws of the State
of Illinois.

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<PAGE>   7

The provisions of this Amendment that pertain to the Revolving Credit Facility,
the Revolving Credit Facility Loan Documents, and the BCC Borrowers shall be
governed by and construed in accordance with the internal laws of the State of
Maryland.

                         [signatures on following pages]

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<PAGE>   8

         IN WITNESS WHEREOF, the parties hereto have executed this Amendment or
have caused this Amendment to be executed by their duly authorized
representatives as of the date first above written.

                                   OUTLOOK POINTE BORROWERS:

                                   BALANCED CARE REALTY AT STATE
                                   COLLEGE, INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT ALTOONA,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT LEWISTOWN,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT READING,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT BERWICK,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                      -8-
<PAGE>   9

                                   BALANCED CARE REALTY AT PECKVILLE,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT SCRANTON,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT MARTINSBURG,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT MAUMELLE,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT SHERWOOD,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE REALTY AT MOUNTAIN
                                   HOME, INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                      -9-
<PAGE>   10

                                   BALANCED CARE REALTY AT MANSFIELD,
                                   INC., a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BCC BORROWERS:

                                   BCC AT DARLINGTON, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT EYERS GROVE, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT BUTLER, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT SARVER, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT NORTH RIDGE, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                      -10-
<PAGE>   11

                                   GUARANTOR:

                                   BALANCED CARE CORPORATION,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Senior Vice President and Legal
                                   Counsel & Assistant Secretary

                                      -11-
<PAGE>   12

                                   LENDER:

                                   HELLER HEALTHCARE FINANCE, INC.,
                                   a Delaware corporation formerly known as
                                   HCFP FUNDING, INC.

                                   By/s/Kevin J. McMeen
                                   Name Kevin J. McMeen
                                   Its SVP

                  Accepted and agreed to on the date first set forth above.

                                   MANAGERS OF PROJECTS:

                                   BCC AT STATE COLLEGE, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   TC REALTY OF ALTOONA, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   TC REALTY OF LEWISTOWN, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                      -12-
<PAGE>   13

                                   TC REALTY OF READING, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   TC REALTY OF BERWICK, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BLACK BOX OF PECKVILLE, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   TC REALTY CORPORATION III,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT MARTINSBURG, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                      -13-
<PAGE>   14

                                   BALANCED CARE AT MAUMELLE, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT SHERWOOD, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   BALANCED CARE AT MOUNTAIN HOME, INC.,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                   TC REALTY CORPORATION II,
                                   a Delaware corporation

                                   By/s/Robin L. Barber
                                   Printed Name Robin L. Barber
                                   Its Vice President and Secretary

                                      -14-<PAGE>   1

Exhibit 10.2                                                  Loan No. 99-407

                           SECOND AMENDED AND RESTATED
                                PROMISSORY NOTE A

$30,600,000.00                                                September 20, 2000

1.       Promise to Pay.

         FOR VALUE RECEIVED, BALANCED CARE REALTY AT STATE COLLEGE, INC., a
Delaware corporation, BALANCED CARE REALTY AT ALTOONA, INC., a Delaware
corporation, BALANCED CARE REALTY AT LEWISTOWN, INC., a Delaware corporation,
BALANCED CARE REALTY AT READING, INC., a Delaware corporation, BALANCED CARE
REALTY AT BERWICK, INC., a Delaware corporation, BALANCED CARE REALTY AT
PECKVILLE, INC., a Delaware corporation, BALANCED CARE REALTY AT SCRANTON, INC.,
a Delaware corporation, BALANCED CARE REALTY AT MARTINSBURG, INC., a Delaware
corporation, BALANCED CARE REALTY AT MAUMELLE, INC., a Delaware corporation,
BALANCED CARE REALTY AT SHERWOOD, INC., a Delaware corporation, BALANCED CARE
REALTY AT MOUNTAIN HOME, INC., a Delaware corporation and BALANCED CARE REALTY
AT MANSFIELD, INC., a Delaware corporation (collectively "Maker"), each of which
has its address c/o Balanced Care Corporation, 1215 Manor Drive, Mechanicsburg,
Pennsylvania 17055, Attention: Clint Fegan, Chief Financial Officer, jointly and
severally promises to pay to the order of HELLER HEALTHCARE FINANCE, INC., a
Delaware corporation, and its successors and assigns ("Holder") the sum of
Thirty Million Six Hundred Thousand and No/100 Dollars ($30,600,000.00),
together with all other amounts added thereto pursuant to this Second Amended
and Restated Promissory Note A ("this Note") or otherwise payable to Holder
under the Loan Documents (as hereinafter defined), including, but not limited
to, the "Exit Fee" as defined and set forth in the Loan Agreement (as
hereinafter defined) (or so much thereof as may from time to time be
outstanding), together with interest thereon as hereinafter set forth, all
payable in lawful money of the United States of America (collectively, the
"Loan"). Payments shall be made to Holder at 500 West Monroe Street, Attention:
Real Estate Financial Services, Chicago, Illinois 60661 (or such other address
as Holder may hereafter designate in writing to Maker).

         This Note is secured by, among other things, the Mortgages encumbering
the Project. This Note, the Second Amended and Restated Subordinated Promissory
Note B made by Maker in favor of Holder dated the date hereof in the original
principal amount of Six Million Four Hundred Thousand and No/100 Dollars

<PAGE>   2

($6,400,000.00) ("Note B"), the Promissory Note C made by Maker in favor of
Holder dated the date hereof in the original principal amount of Five Million
and No/100 Dollars ($5,000,000.00) ("Note C"), the Mortgages, the Loan Agreement
dated December 30, 1999, between Maker and Holder, as amended by the Amendment
to Loan Documents dated April 27, 2000 between Maker and Holder and the Second
Amendment to Loan Documents of even date herewith between Maker and Holder (as
so amended, the "Loan Agreement") and any other documents evidencing or securing
the Loan or executed in connection therewith, and any modification, renewal or
extension of any of the foregoing are collectively called the "Loan Documents".
Except as otherwise provided herein, capitalized terms used in this Note shall
have the same meanings as are assigned to such terms in the Loan Agreement.

         This Note amends, restates and replaces in its entirety that certain
Amended and Restated Promissory Note A dated April 27, 2000 in the principal
amount of Thirty Thousand Six Hundred Thousand and No/100 Dollars
($30,600,000.00) made by Maker in favor of Holder (the "Original Note"). The
execution and delivery of this Note shall not be deemed to be a novation of the
indebtedness outstanding under the Original Note, but instead such indebtedness
shall remain outstanding and now be evidenced by and repaid in accordance with
this Note.

2.       Interest.

         So long as no Event of Default (as hereinafter defined) exists,
interest shall accrue on the principal balance hereof from time to time
outstanding and Maker shall pay interest thereon at a rate equal to a floating
rate per annum equal to three and seventy-five hundredths percent (3.75%) plus
the Base Rate (the aggregate rate referred to as the "Interest Rate"). "Base
Rate" shall mean the rate published each business day in the Wall Street Journal
for notes maturing three (3) months after issuance under the caption "Money
Rates, London Interbank Offered Rates (LIBOR)". The Interest Rate for each
calendar month shall be fixed based upon the Base Rate published prior to and in
effect on the first (1st) business day of such month; provided, however, the
Interest Rate from and including the date hereof through December 31, 1999 shall
be fixed based upon the Base Rate in effect on December 30, 1999. Interest shall
be calculated based on a 360 day year and charged for the actual number of days
elapsed.

                                      -2-
<PAGE>   3

3.       Payment.

                  (a) Commencing on February 1, 2000, Maker shall pay interest
         computed at the Interest Rate monthly in arrears on the first (1st) day
         of each month; provided, however, interest for the period from and
         after the date hereof through December 31, 1999, shall be paid in
         advance on the date hereof.

                  (b) In addition to monthly payments of interest, commencing
         November 20, 2000, and on the twentieth (20th) day after the end of
         each calendar month thereafter until the Repayment Date, Maker shall
         pay Holder one hundred percent (100%) of the Excess Cash Flow
         corresponding to such calendar month then ended, to be applied in
         repayment of the principal balance hereof.

                  (c) This Note shall be due and payable on or before December
         31, 2001, or any earlier date on which this Note shall be required to
         be paid in full, whether by acceleration or otherwise (the "Maturity
         Date").

4.       Intentionally Omitted.

5.       Prepayment.

         Maker may prepay this Note in full or in part at any time; provided
Maker gives Holder at least thirty (30) days prior written notice thereof and
pays the Exit Fee (as defined in the Loan Agreement) then due Lender.

6.       Exit Fee.

         As additional consideration for entering into the Loan Agreement and
making the Loan pursuant thereto, Borrower shall pay to Holder the Final Exit
Fee and, if applicable, the Proportionate Exit Fees, all as provided in the Loan
Agreement.

7.       Default.

         7.1. Events of Default.

         Any of the following shall constitute an "Event of Default" under this
Note: (a) failure to pay any amounts owed pursuant to this Note, Note B or Note
C within ten (10) calendar days after such payment is due; or (b) the occurrence
of any

                                      -3-
<PAGE>   4

default under any of the other Loan Documents, which, continues uncured default
beyond any applicable grace or cure period.

         7.2. Remedies.

         So long as an Event of Default remains outstanding: (a) interest shall
accrue at a rate equal to the Interest Rate plus four percent (4%) per annum
(the "Default Rate"); (b) Holder may, at its option and without notice (such
notice being expressly waived), declare this Note immediately due and payable;
and (c) Holder may pursue all rights and remedies available under the Mortgages
or any other Loan Documents. Holder's rights, remedies and powers, as provided
in this Note and the other Loan Documents, are cumulative and concurrent, and
may be pursued singly, successively or together against Maker, any guarantor of
the Loan, the security described in the Loan Documents, and any other security
given at any time to secure the payment hereof, all at the sole discretion of
Holder. Additionally, Holder may resort to every other right or remedy available
at law or in equity without first exhausting the rights and remedies contained
herein, all in Holder's sole discretion. Failure of Holder, for any period of
time or on more than one occasion, to exercise its option to accelerate the
Maturity Date shall not constitute a waiver of the right to exercise the same at
any time during the continued existence of any Event of Default or any
subsequent Event of Default.

         If any attorney is engaged: (i) to collect the Loan or any sums due
under the Loan Documents, whether or not legal proceedings are thereafter
instituted by Holder; (ii) to represent Holder in any bankruptcy,
reorganization, receivership or other proceedings affecting creditors' rights
and involving a claim under this Note; (iii) to protect the liens of any
Mortgage or any of the Loan Documents; (iv) to represent Holder in any other
proceedings whatsoever in connection with any Mortgage or any of the Loan
Documents including post judgment proceedings to enforce any judgment related to
the Loan Documents; or (v) in connection with seeking an out-of-court workout or
settlement of any of the foregoing, then Maker shall pay to Holder all
reasonable costs, attorneys' fees and expenses in connection therewith, in
addition to all other amounts due hereunder.

8.       Late Charge.

         If payments of principal or interest due under this Note, or any other
amounts due under the other Loan Documents, are not timely made and remain
overdue for a period of ten (10) days, Maker, without notice or demand by
Holder, promptly shall pay an

                                      -4-
<PAGE>   5

amount ("Late Charge") equal to four percent (4%) of each delinquent payment.

9.       Governing Law; Severability.

         This Note shall be governed by and construed in accordance with the
internal laws of the State of Illinois. The invalidity, illegality or
unenforceability of any provision of this Note shall not affect or impair the
validity, legality or enforceability of the remainder of this Note, and to this
end, the provisions of this Note are declared to be severable.

10.      Waiver.

         Maker, for itself and all endorsers, guarantors and sureties of this
Note, and their respective heirs, legal representatives, successors and assigns,
hereby waives presentment for payment, demand, notice of nonpayment, notice of
dishonor, protest of any dishonor, notice of protest and protest of this Note,
and all other notices in connection with the delivery, acceptance, performance,
default or enforcement of the payment of this Note, and agrees that their
respective liability shall be unconditional and without regard to the liability
of any other party and shall not be in any manner affected by any indulgence,
extension of time, renewal, waiver or modification granted or consented to by
Holder. Maker, for itself and all endorsers, guarantors and sureties of this
Note and their respective heirs, legal representatives, successors and assigns,
hereby consents to every extension of time, renewal, waiver or modification that
may be granted by Holder with respect to the payment or other provisions of this
Note, and to the release of any makers, endorsers, guarantors or sureties, and
their heirs, legal representatives, successors and assigns, and of any
collateral given to secure the payment hereof, or any part hereof, with or
without substitution, and agrees that additional makers, endorsers, guarantors
or sureties and their heirs, legal representatives, successors and assigns, may
become parties hereto without notice to Maker or to any endorser, guarantor or
surety and without affecting the liability of any of them.

11.      Security, Application of Payments.

         This Note is secured by the liens, encumbrances and obligations created
hereby and by the other Loan Documents and the terms and provisions of the other
Loan Documents are hereby incorporated herein. Payments will be applied, at
Holder's option, first to any fees, expenses or other costs Maker is obligated
to pay under this Note or the other Loan Documents, second to current interest
due on this Note, third to any past due

                                      -5-
<PAGE>   6

interest payable under this Note, fourth to current interest due on Note B,
fifth to any past due interest payable under Note B, sixth to interest payable
under Note C, seventh to the outstanding principal balance of this Note, eighth
to the outstanding principal balance of Note B, ninth to the outstanding
principal balance of Note C, and tenth to the Exit Fee and the Additional Exit
Fee; provided, however, that all interest on and the principal amount of Note C
(and the Additional Exit Fee, if any) may be prepaid in whole or in part at any
time, and the foregoing application of payments shall not apply, if Borrower
designates in its notice required under Section 5 of Note C in connection with
the prepayment of sums due under Note C that such prepayments should be applied
solely to amounts due under Note C.

12.      Miscellaneous.

         12.1. Amendments.

         This Note may not be terminated or amended orally, but only by a
termination or amendment in writing signed by Holder and Maker.

         12.2. Lawful Rate of Interest.

         In no event whatsoever shall the amount of interest paid or agreed to
be paid to Holder pursuant to this Note or any of the Loan Documents exceed the
highest lawful rate of interest permissible under applicable law. If, from any
circumstances whatsoever, fulfillment of any provision of this Note and the
other Loan Documents shall involve exceeding the lawful rate of interest which a
court of competent jurisdiction may deem applicable hereto ("Excess Interest"),
then ipso facto, the obligation to be fulfilled shall be reduced to the highest
lawful rate of interest permissible under such law and if, for any reason
whatsoever, Holder shall receive, as interest, an amount which would be deemed
unlawful under such applicable law, such interest shall be applied to the Loan
(whether or not due and payable), and not to the payment of interest, or
refunded to Maker if such Loan has been paid in full. Neither Maker nor any
guarantor, endorser or surety nor their heirs, legal representatives, successors
or assigns shall have any action against Holder for any damages whatsoever
arising out of the payment or collection of any such Excess Interest.

         12.3. Captions.

         The captions of the Paragraphs of this Note are for convenience of
reference only and shall not be deemed to modify, explain, enlarge or restrict
any of the provisions hereof.

                                      -6-
<PAGE>   7

         12.4. Notices.

         Notices shall be given under this Note in conformity with the terms and
conditions of the Loan Agreement.

         12.5. Intentionally Omitted.

         12.6. Time of Essence.

         Time is of the essence of this Note and the performance of each of the
covenants and agreements contained herein.

13.      Intentionally Omitted.

14.      Sale of Loan.

         Holder, at any time and without the consent of Maker, may grant
participations in or sell, transfer, assign and convey all or any portion of its
right, title and interest in and to the Loan, this Note, the Mortgages and the
other Loan Documents, any guaranties given in connection with the Loan and any
collateral given to secure the Loan.

15.      Consent to Jurisdiction.

         MAKER HEREBY CONSENTS TO THE JURISDICTION OF ANY STATE OR FEDERAL COURT
LOCATED WITHIN THE COUNTY OF COOK, STATE OF ILLINOIS AND IRREVOCABLY AGREES
THAT, SUBJECT TO HOLDER'S ELECTION, ALL ACTIONS OR PROCEEDINGS ARISING OUT OF OR
RELATING TO THIS NOTE OR THE OTHER LOAN DOCUMENTS SHALL BE LITIGATED IN SUCH
COURTS. MAKER EXPRESSLY SUBMITS AND CONSENTS TO THE JURISDICTION OF THE
AFORESAID COURTS AND WAIVES ANY DEFENSE OF FORUM NON CONVENIENS. MAKER HEREBY
WAIVES PERSONAL SERVICE OF ANY AND ALL PROCESS AND AGREES THAT ALL SUCH SERVICE
OF PROCESS MAY BE MADE UPON MAKER BY CERTIFIED OR REGISTERED MAIL, RETURN
RECEIPT REQUESTED, ADDRESSED TO MAKER, AT THE ADDRESS SET FORTH IN THIS NOTE AND
SERVICE SO MADE SHALL BE COMPLETE TEN (10) DAYS AFTER THE SAME HAS BEEN POSTED.

16.      Jury Trial Waiver.

         MAKER, AND HOLDER BY ITS ACCEPTANCE OF THIS NOTE, HEREBY WAIVE THEIR
RESPECTIVE RIGHTS TO A TRIAL BY JURY IN ANY ACTION OR PROCEEDING BASED UPON, OR
RELATED TO, THE SUBJECT MATTER OF THIS NOTE AND THE BUSINESS RELATIONSHIP THAT
IS BEING ESTABLISHED. THIS WAIVER IS KNOWINGLY, INTENTIONALLY AND VOLUNTARILY
MADE BY MAKER AND BY HOLDER, AND MAKER ACKNOWLEDGES THAT NEITHER HOLDER NOR ANY
PERSON ACTING ON BEHALF OF HOLDER HAS MADE ANY REPRESENTATIONS OF FACT TO INDUCE
THIS WAIVER OF TRIAL BY

                                      -7-
<PAGE>   8

JURY OR HAS TAKEN ANY ACTIONS WHICH IN ANY WAY MODIFY OR NULLIFY ITS EFFECT.
MAKER AND HOLDER ACKNOWLEDGE THAT THIS WAIVER IS A MATERIAL INDUCEMENT TO ENTER
INTO A BUSINESS RELATIONSHIP, THAT MAKER AND HOLDER HAVE ALREADY RELIED ON THIS
WAIVER IN ENTERING INTO THIS NOTE AND THAT EACH OF THEM WILL CONTINUE TO RELY ON
THIS WAIVER IN THEIR RELATED FUTURE DEALINGS. MAKER AND HOLDER FURTHER
ACKNOWLEDGE THAT THEY HAVE BEEN REPRESENTED (OR HAVE HAD THE OPPORTUNITY TO BE
REPRESENTED) IN THE SIGNING OF THIS NOTE AND IN THE MAKING OF THIS WAIVER BY
INDEPENDENT LEGAL COUNSEL.

                         [signatures on following pages]

                                      -8-
<PAGE>   9

         IN WITNESS WHEREOF, Maker has executed this Note or has caused the same
to be executed by its duly authorized representatives as of the date first set
forth above.

                                 MAKER:

                                 BALANCED CARE REALTY AT STATE
                                 COLLEGE, INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT ALTOONA,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT LEWISTOWN,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT READING,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT BERWICK,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT PECKVILLE,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                      -9-
<PAGE>   10

                                 BALANCED CARE REALTY AT SCRANTON,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT MARTINSBURG,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT MAUMELLE,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT SHERWOOD,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT MOUNTAIN
                                 HOME, INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                 BALANCED CARE REALTY AT MANSFIELD,
                                 INC., a Delaware corporation

                                 By/s/Robin L. Barber
                                 Printed Name Robin L. Barber
                                 Its Vice President and Secretary

                                      -10-

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