Document:

<PAGE>

                                                                   Exhibit 10.18

                            AMENDMENT NO. 5 TO THE
                        VENCOR RETIREMENT SAVINGS PLAN

     This is Amendment No. 5 to the Vencor Retirement Savings Plan (the "Plan")
as amended and restated as of January 1, 1997.

                                    Recital

     WHEREAS, Vencor, Inc. (the "Company") maintains the Plan and has reserved
the right in Section 9.1 of the Plan to amend the Plan from time to time in its
discretion and the Company now wishes to amend the Plan to add a provision
whereby a participant will be deemed to have revoked his salary redirection
election in the event the Company inadvertently ceases to withhold salary
redirection amounts from a participant's pay and the participant does not notify
the Company within 30 days of the first payroll date on which the salary
redirection amount was not withheld from pay that the error occurred.

                                   Amendment

     Section 3.1 of the Plan is hereby amended effective as of the date of
adoption of this Amendment by the addition of a new subparagraph (d) to read in
its entirety as follows:

     (d)  In the event the Employer fails to withhold Participant Salary
     Redirection Contributions pursuant to a Salary Redirection election in
     effect for a Participant for a payroll period, the Participant shall be
     considered to have revoked his Salary Redirection election on the 30th day
     after the pay date on which the Salary Redirection election was first not
     honored. Such revocation shall not be considered to be retroactive. The
     Company shall take such steps as it deems advisable to correct the failure
     to withhold and make Salary Redirection contributions for a Participant for
     the period prior to the effective date of the revocation.

     IN WITNESS WHEREOF, this Amendment No. 5 is hereby adopted this 9/th/ day
of December, 1998.

                              By: /s/ Cecelia A. Hagan
                                  ------------------------------------

                              Title: Vice President of Human Resources
                                     ---------------------------------<PAGE>

                                                                   Exhibit 10.19

                                AMENDMENT NO. 6
                                    TO THE
                        VENCOR RETIREMENT SAVINGS PLAN

     This is Amendment No. 6 to the Vencor Retirement Savings Plan (the "Plan")
as amended and restated as of January 1, 1997.

                                    Recital

     Vencor, Inc. (the "Company") maintains the Plan and has reserved the right
in Section 9.1 of the Plan to amend the Plan from time to time in its discretion
and the Company now wishes to amend the Plan to count past service with Pro Data
Systems, Inc. for purposes of vesting under the Plan effective as of January 1,
1999.

                                   Amendment

     1.  This Amendment shall be effective as of January 1, 1999.

     2.  All Terms used in this Amendment and not otherwise defined herein shall
have the meanings given in the Plan.

     3.  Appendix "A" to the Plan is hereby amended to add to the end of the
Appendix ProData Systems, Inc., so that past service with that company shall be
counted for purposes of vesting service under the Plan.

     IN WITNESS WHEREOF, the company has caused this Amendment No. 6 to be
executed this 2nd day of November, 1998, but effective as of January 1, 1999.

                              VENCOR, INC.

                              By: /s/ Cecelia A. Hagan
                                  ------------------------------------

                              Title: Vice President of Human Resources
                                     ---------------------------------<PAGE>

                                                                   Exhibit 10.20

                            AMENDMENT NO. 7 TO THE
                        VENCOR RETIREMENT SAVINGS PLAN

     This is Amendment No. 7 to the Vencor Retirement Savings Plan (the "Plan")
as amended and restated as of January 1, 1997.

                                    RECITAL

     WHEREAS, Vencor, Inc. (the "Company") maintains the Plan and has reserved
the right in Section 9.1 of the Plan to amend the Plan from time to time in its
discretion. The Company now wishes to amend the Plan to bring Plan's definition
of Compensation into compliance with Section 401(a)(17) of the Code as revised
by the Omnibus Budget Reconciliation Act of 1993 ("OBRA '93"); and to amend the
Plan's Code Section 415 provisions to bring them into compliance with the
requirements of the General Agreement of Tariffs and Trade ("GATT").

                                   AMENDMENTS

     1.   Section 1.10 of the Plan shall be amended by adding the following
sentence at the end of the paragraph, to read as follows:

     For Plan Years beginning on or after January 1, 1994,
     Compensation shall be limited to $150,000, or such higher amount
     determined by the Commissioner of Internal Revenue pursuant to
     Section 401(a)(17) of the Code.

     2.   Notwithstanding any provision of the Plan to the contrary, the
following shall apply:

     Limitation on Benefits. Effective for Plan Years beginning after
     ----------------------
     December 31, 1994, notwithstanding any other provisions of the
     Plan, contributions and other additions with respect to a
     Participant exceed the limitation of Section 415(c) of the Code
     if, when expressed as an annual addition (within the meaning of
     Section 415(c)(2) of the Code to the Participant's Account, such
     annual addition is greater than the lesser of:

          (A) $30,000; or

          (B) 25% of the Participant's compensation (as defined in Section
              415(c)(3) of the Code).
<PAGE>

     IN WITNESS WHEREOF, this Amendment No. 7 is hereby adopted this 9th day of
December, 1998.
                                    By: /s/ Cecelia A. Hagan
                                        --------------------

                                    Title: Vice President of Human Resources
                                           ---------------------------------<PAGE>

                                                                   Exhibit 10.21

                            AMENDMENT NO. 8 TO THE
                        VENCOR RETIREMENT SAVINGS PLAN

This is Amendment No. 8 to the Vencor Retirement Savings Plan (the "plan") as
amended and restated as of January 1, 1997.

                                    RECITAL

WHEREAS, Vencor, Inc. (the "Company") maintains the Plan and has reserved the
right in Section 9.1 of the Plan to amend the Plan from time to time in its
discretion.  The Company now wishes to amend the Plan to clarify the elimination
of the option of receiving a distribution upon the attainment of age 70 l/2
while still employed.

                                  AMENDMENTS

     Section 5.6(c) of the Plan is hereby amended, effective as of December 31,
1998, so that as amended it shall read in its entirety as follows:

     Notwithstanding any other provisions of the Plan, the payment of
     a Participant's benefits hereunder shall begin by payment of a
     lump sum of the entire Accounts of the Participant no later than
     the April l following the calendar year in which the Participant
     has both attained age 70 1/2 and has retired, provided that for
     5% owners as defined in Section 416 of the Code, distribution
     must begin by April 1 following the calendar year in which the
     Participant attains age 70 1/2, regardless of whether the
     Participant has retired; and further provided that a Participant
     who had attained age 70 1/2 on or before December 31, 1998 shall
     have the option to take a lump sum distribution even while
     employed, at the April 1 following attainment of age 70 l/2, if
     the Participant so elects in writing, and, if so elected, shall
     receive a distribution on or before December 31 of the year after
     attainment of age 70 l/2, and again each year thereafter while
     still employed, shall receive a similar distribution of all
     amounts accrued in Accounts of the Participant since the last
     such distribution.

IN WITNESS WHEREOF, this Amendment No. 8 is hereby adopted this 22nd day of
December, 1998.

                              By: /s/ Cecelia A. Hagan
                                  --------------------

                              Title: Vice President of Human Resources
                                     ---------------------------------<PAGE>

                                                                   Exhibit 10.22

                            AMENDMENT NO. 9 TO THE
                        VENCOR RETIREMENT SAVINGS PLAN

     This is Amendment No. 9 to the Vencor Retirement Savings Plan (the "Plan")
as amended and restated as of January 1, 1997, which Amendment shall be
effective as of the dates set forth below.

                                    RECITAL

     WHEREAS, Vencor, Inc. (the "Company") maintains the Plan and has reserved
the right in Section 9.1 of the Plan to amend the Plan from time to time in its
discretion. The Company now wishes to amend the Plan to change how Plan assets
are invested as among the Investment Funds, and to allow a cashout of benefits
of $5,000 or less, rather than $3,500.

                                   AMENDMENT

     1.   Section 4.2(b) of the Plan is hereby amended so that as amended it
shall read in its entirety as follows, effective as of the date set forth
therein:

          (b)  Each Participant shall have the right to direct the
               Committee to invest the cumulative balance in his
               Individual Account attributable to Salary Redirection,
               Prior Plan Salary Redirection Contributions, Prior Plan
               Employer Contributions and current Salary Redirection
               in increments of 10% (25% if elections made prior to
               January 1, 1997, in which case they continue until a
               change is made by the Participant) in the Investment
               Funds provided in Section 4.2(a); provided, however,
               that effective April 1, 1999, no portion of an
               Individual Account may be transferred to the Company
               Stock Fund, and no contributions to Individual Accounts
               made to the Plan with respect to payroll dates on or
               after that date may be directed for investment to the
               Company Stock Fund. All investment directions shall be
               effected as soon as practicable after the end of the
               month, provided the Participant gives the direction by
               identity-secured telephonic instructions (or in writing
               if telephonic instructions are impracticable) no later
               than the 15th day of the month. Neither the Trustee nor
               any other Fiduciary shall be responsible for investment
               losses resulting from a Participant's exercise of
               investment discretion, in accordance with ERISA Section
               404(c).

     2.   Section 4.2(d) of the Plan is hereby amended so that as amended it
shall read in its entirety as follows, effective for Matching Contributions that
relate to Salary Redirection Contributions for pay dates on or after April 1,
1999:
<PAGE>

          (d)  All cumulative and current contributions attributable
               to Employer Contributions (other than contributions in
               a Prior Plan Employer Contribution Account) and the
               Profit Sharing Contribution Account shall be made in
               cash which is invested in the Interest Income Fund.

     3.   All references to "$3,500 or less" or "exceeds $3,500" in Sections
5.7(a), 5.11(b)(4), and 10.5(b) of the Plan are hereby amended to refer to
$5,000 in the place of $3,500, effective September 1, 1999.

     IN WITNESS WHEREOF, this Amendment No. 9 is hereby adopted this _________
day of ___________ 1999.

                                    By /s/ Cecelia A. Hagan
                                       ---------------------------------------

                                    Title: Vice President of Human Resources
                                           -----------------------------------

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00005-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00005-of-00352.parquet"}], [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00005-of-00352.parquet"}], [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00005-of-00352.parquet"}], [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00005-of-00352.parquet"}]]