GENESIS HEALTH VENTURES INC /PA
8-K/A, 1997-12-23
SKILLED NURSING CARE FACILITIES
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<PAGE>

                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549



                 ===============================================




                                   FORM 8-K/A

                                 AMENDMENT NO. 1
                                       TO
                                 CURRENT REPORT

                     Pursuant to Section 13 or 15(d) of the
                         Securities Exchange Act of 1934




                 ===============================================


       Date of Report (Date of earliest event reported): October 10, 1997



                          Genesis Health Ventures, Inc.
             ------------------------------------------------------
             (Exact name of registrant as specified in its charter)



      Pennsylvania                     1-11666                    06-1132947
- ----------------------------         -----------                -------------
(State or other jurisdiction         (Commission                (IRS Employer
    of incorporation)                File Number)            Identification No.)




                        148 West State Street, Suite 100
                       Kennett Square, Pennsylvania 19348
                       ----------------------------------
                         (Address of principal executive
                          offices, including zip code)





                                  610-444-6350
               --------------------------------------------------
               Registrant's telephone number, including area code


<PAGE>



Item 7 is hereby amended as follows

Item 7.  Financial Statements, Pro Forma Financial Information and Exhibits.

     1.   Financial Statements of business acquired:
          The Multicare Companies, Inc. and Subsidiaries
          (1)  Independent Auditors' Report (1)
          (2)  Consolidated Balance Sheets as of December 31, 1995 and 1996 (1)
          (3)  Consolidated Statements of Operations for the years ended
               December 31, 1994, 1995 and 1996 (1)
          (4)  Consolidated Statements of Stockholders' Equity for the years
               ended December 31, 1994, 1995 and 1996 (1)
          (5)  Consolidated Statements of Cash Flows for the years ended
               December 31, 1994, 1995 and 1996 (1)
          (6)  Notes to Consolidated Financial Statements (1)
          (7)  Unaudited Consolidated Balance Sheet as of September 30, 1997 (2)
          (8)  Unaudited Consolidated Statement of Operations for the three and
               nine months ended September 30, 1997 (2)
          (9)  Unaudited Consolidated Statement of Cash Flows for the nine
               months ended September 30, 1997 (2)
          (10) Unaudited Notes to Consolidated Financial Statements (2)

- -------------------------------
(1)  Incorporated by reference to The Multicare Companies, Inc. Annual report on
     Form 10-K for the period ended December 31, 1996.
(2)  Incorporated by reference to The Multicare Companies, Inc. Quarterly Report
     on Form 10-Q for the period ended September 30, 1997.


         2. Pro Forma Financial Information:



<PAGE>

                 GENESIS HEALTH VENTURES, INC. AND SUBSIDIARIES
             PRO FORMA CONDENSED CONSOLIDATED FINANCIAL INFORMATION
                               SEPTEMBER 30, 1997

The Unaudited Pro Forma Condensed Consolidated Statement of Operations for the
twelve months ended September 30, 1997 gives effect to the following
transactions: (1) the Tender Offer, (2) the Merger (including the Conversion of
Multicare's Convertible Debentures), (3) the sale of the 9% Notes and the
application of proceeds therefrom, (4) the Equity Contributions and the
application of proceeds therefrom, (5) the closing of the Credit Facility and
the application of the proceeds therefrom, (6) the acquisition of the A.D.S
Group ("A.D.S") by Multicare in December 1996 (the "A.D.S Acquisition"), as
though the transaction had occurred as of October 1, 1996 and (7) the Therapy
Sale and the Pharmacy Sale, as though the transactions had occurred as of
October 1, 1996. The Unaudited Pro Forma Condensed Consolidated Balance Sheet
gives effect to each of the foregoing transactions as though each transaction
had occurred as of September 30, 1997. The contract therapy businesses sold by
Multicare to Genesis pursuant to the Therapy Sale were primarily acquired by
Multicare in April 1997; no adjustments have been made in the pro forma
information to reflect the results of operations of the businesses sold in the
Therapy Sale prior to their acquisition by Multicare. The proforma information
should be read in conjunction with the Companies' historical consolidated
financial statements. The columns entitled "Genesis Historical Results " and
"Multicare Historical Results" represents the historical consolidated results of
the respective companies as of September 30, 1997 and for the twelve months then
ended. The column entitled "A.D.S Historical" represents the historical results
of the A.D.S Group from the period of October 1, 1996 through December 31, 1996.
In December 1996, Multicare acquired the A.D.S group and consolidated their
operating results commencing on January 1, 1997.

The pro forma adjustments are based upon available information and certain
assumptions that management believes are reasonable and are described in the
notes accompanying the Unaudited Pro Forma Condensed Consolidated Statement of
Operations and the Unaudited Pro Forma Condensed Consolidated Balance Sheet.
The Unaudited Pro Forma Condensed Consolidated Financial Information is
provided for informational purposes only and does not purport to represent
what the Company's results of operations or financial position would actually
have been had the transactions in fact occurred at such dates or to project
the Company's results of operations or financial position at or for any future
date or period. The Unaudited Pro Forma Condensed Consolidated Financial
Information has been prepared using the purchase method of accounting, whereby
the total cost of the Tender Offer, Merger, Pharmacy Sale and Therapy Sale are
allocated to the tangible and intangible assets acquired and liabilities
assumed based upon their respective fair values at the effective date of the
transactions. Such allocations are based on studies and valuations which have
not yet been completed. Accordingly, the allocations and estimated lives
reflected in the Unaudited Pro Forma Condensed Consolidated Financial
Information are preliminary and subject to revision. However, the Company does
not expect material changes to the allocation of purchase price.



                 GENESIS HEALTH VENTURES, INC. AND SUBSIDIARIES
            UNAUDITED PRO FORMA CONDENSED CONSOLIDATED BALANCE SHEET
                               SEPTEMBER 30, 1997
                                 (In thousands)
<TABLE>
<CAPTION>
                                                                                                                       Pro Forma 
                                                                                                                        Genesis 
                                                                                                                       Multicare
                                                                                                                      Adjusted for
                                                                                                                    Debt Conversion
                                                  Genesis         Multicare       Debt         Transactions          and Pharmacy
                                                 Historical       Historical    Conversion      Adjustments          Therapy Sales
                                                 ----------      ----------    ----------      ------------        ---------------
<S>                                                 <C>              <C>            <C>              <C>                  <C>
Current assets                                 $  352,437        $ 146,254      $     -           $       -           $   498,691
 Property and equipment, net                       578,397         460,800            -             254,000    (3)      1,293,197
 Goodwill, net                                     359,956         171,324            -             690,680 (2)(3)      1,221,960
 Other assets                                      143,323          44,755            -              51,000 (2)(3)        239,078 
                                                ----------        --------      -------           ---------           -----------
 Total assets                                   $1,434,113        $823,133      $     -           $ 995,680           $ 3,252,926 
                                                ==========        ========      =======           =========           ===========
                                                                          
 Current liabilities                              $125,507        $ 94,432      $     -           $       -           $   219,939 
 Long term debt, excluding current maturities      651,667         423,421      (55,420)(1)         792,674 (2)(3)      1,812,342 
 Deferred taxes                                     37,745          42,106            -             101,600(3)            181,451 
 Other liabilities                                  11,173               -            -                   -                11,173 
 Minority interests                                      -               -            -             420,000 (4)           420,000 
 Shareholders' equity                              608,021         263,174       55,420 (1)        (318,594)(3)(4)        608,021 
                                                ----------        --------      -------           ---------           -----------
 Total liabilities and shareholders equity      $1,434,113        $823,133      $     -           $ 995,680           $ 3,252,926 
                                                ==========        ========      =======           =========           ===========
</TABLE>
<PAGE>

See Accompanying Notes to Unaudited Pro Forma Condensed Consolidated Balance 
Sheet  

                 GENESIS HEALTH VENTURES, INC. AND SUBSIDIARIES
                         NOTES TO CONSOLIDATED PROFORMA
                      CONDENSED CONSOLIDATED BALANCE SHEET
                                 (in thousands)

(1) Reflects the conversion of the 7% Senior Subordinated Convertible Debentures
    of Multicare into shares of Multicare common stock in connection with the
    Merger as follows:

        Long-term debt                     (55,420)                   
        Shareholders' Equity                55,420                   

(2) Reflects Genesis' financing of its equity investment in Multicare, the
    purchase prices of the Pharmacy Sale and Therapy Sale and other transaction
    costs. The Genesis equity investment in Multicare is eliminated in
    consolidation.

                                   Transaction     Consolidation           
                                   Adjustments      Elimination       Total
                                   -----------     -------------      -----
        Investment in Multicare      325,000         (325,000)            -   
        Goodwill                      65,000                         65,000 
        Debt Issuance and                               
         Transaction Costs, net       27,000                         27,000 
        Long-term debt               426,000                        426,000 
                                                
    The assets and liabilities of the Multicare pharmacy and therapy businesses
    are reflected in the historical balance sheet of Multicare at September 30,
    1997. Genesis agreed to purchase these businesses in connection with the
    Pharmacy and Therapy Sale. The pro forma effect of the Pharmacy Sale and
    Therapy sale on the consolidated balance sheet of Multicare and Genesis is
    not significant other than the elimination of Multicare's equity in those
    businesses, and the goodwill resulting from the allocation of purchase
    price, which is reflected in footnote 3

(3) Reflects the allocation of purchase price and financing for the Merger as
    follows:
<TABLE>
<CAPTION>
                                     Multicare                   Pharmacy &      Consolidation   
                                    Elimination     Merger     Therapy Sales      Elimination       Total
                                    -----------     ------     -------------     -------------      -----
<S>                                    <C>              <C>         <C>               <C>             <C>     
        Property and Equipment              -       254,000             -                -         254,000 
        Goodwill                     (171,324)      828,504       (31,500)               -         625,680 
        Debt issuance costs, net            -        24,000                                         24,000 
        Deferred taxes                      -       101,600       101,600 
        Long-term debt                      -       440,674       (74,000)               -         366,674 
        Shareholders' equity         (318,594)      745,000            -          (325,000)        101,406 
</TABLE>
    In connection with the allocation of excess purchase price to property and
    equipment, a deferred tax liability of $101,600 has been recorded using an
    effective tax rate of 40% for the difference between the tax and book bases.

    The Consolidation Elimination represents the elimination of Genesis' equity
    contribution in Multicare.

(4) Represents the reclassification of the equity partners' equity interest in
    Multicare of $420,000 from shareholders' equity to minority interests.
<PAGE>


                 GENESIS HEALTH VENTURES, INC. AND SUBSIDIARIES
       UNAUDITED PRO FORMA CONDENSED CONSOLIDATED STATEMENT OF OPERATIONS
                     TWELVE MONTHS ENDED SEPTEMBER 30,1997
                     (In thousands, except per share data)
<TABLE>
<CAPTION>
                                                                                                                
                                                                                                                
                                                                                                                
                                                                                                   ADS           Genesis/ 
                                           Genesis         Multicare            ADS             Pro Forma      Multicare/ADS
                                          Historical       Historical       Historical (1)      Adjustments      Proforma
                                          ----------       ----------       --------------      -----------    -------------
<S>                                      <C>                <C>                <C>              <C>             
 Net Revenues                            $1,099,823         $679,292           $15,544          $     -         $1,794,659
                                                                                                                
 Expenses:                                                                                                      
  Operating Expenses                        858,916          515,576            13,258                           1,387,750
  Corporate, General & Administrative        41,039           31,984             2,047             (125)(2)         74,945
  Special Charge                             15,000                                                                 15,000
  Lease Expense                              28,587           15,929                49              861 (3)         45,426
  Depreciation & Amortization                41,946           27,916               365               15 (4)         70,242

  Interest Expense, Net                      39,103           28,642               535              162 (5)         68,442
                                         ----------         --------           -------          -------         ----------
    Total Expenses                       $1,024,591         $620,047           $16,254          $   913         $1,661,805
                                         ----------         --------           -------          -------         ----------
    Income Before Income Taxes                                                                                  
     and Extraordinary Item              $   75,232         $ 59,245           $  (710)         $  (913)        $  132,854    
                                                                                                                
 Income Tax Expense (Benefit)                27,088           22,152              (273)            (351)            48,616
                                         ----------         --------           -------          -------         ----------
    Income Before Extraordinary Item         48,144           37,093              (437)            (561)            84,238
                                                                                                                
 Extraordinary item                             553            2,219                 -                -              2,772
                                         ----------         --------           -------          -------         ----------
 Net Income                              $   47,591         $ 34,874           $  (437)         $  (561)        $   81,466
                                                                                                                
                                                                                                                
 Primary earnings per share
  before extraordinary item              $     1.35                                                             
 Primary earnings per share              $     1.33                                                             
 Weighted average shares of
  common stock and equivalents               35,643                                                             
                                                                                                                
 Addition to income as a result of
  interest on convertible debt                  303                                                             
                                                                                                                
 Fully diluted earnings per share
  before extraordinary item              $     1.34                                                             
 Fully diluted earnings per share        $     1.32                                                             
 Weighted average shares of
  common stock and equivalents               36,306                                                             

</TABLE>
<PAGE>

(RESTUBBED TABLE)

<TABLE>
<CAPTION>
                                                                                Genesis /               
                                                                               Multicare/              
                                                                             A.D.S  Adjusted         
                                                     Transactions            for Transactions                
                                                      Adjustments              Pro Forma               
                                                      -----------              ---------   
<S>                                                   <C>                      <C>
 Net Revenues                                         $      (0)      (6)      $1,794,659           
                                                            
 Expenses:                                                          
  Operating Expenses                                    (16,469)      (7)       1,371,281               
  Corporate, General & Administrative                   (14,200)      (6)          60,745                      
  Special Charge                                                                   15,000                      
  Lease Expense                                          (3,570)      (8)          41,856                      
  Depreciation & Amortization                            27,021       (9)          97,263                       
  Interest Expense, Net                                  64,962       (8)         133,404 
                                                       --------                ----------
    Total Expenses                                     $ 57,744                $1,720,549                   
                                                       --------                ----------
    Income Before Income Taxes                                                 
     and Extraordinary Item                            $(57,744)               $   75,110                         
                                                                    
 Income Tax Expense (Benefit)                           (20,814)    (10)           27,802                       
                                                       --------                ----------
    Income Before Extraordinary Item                    (36,929)                   47,308                       
                                                                    
 Extraordinary item                                          --                     2,772                     
                                                       --------                ----------
 Net Income                                            $(36,929)               $   44,536               
                                                            
                                                            
 Primary earnings per share
  before extraordinary item                                                    $     1.33               
 Primary earnings per share                                                    $     1.25               
 Weighted average shares of
  common stock and equivalents                                                     35,643               
                                                            
 Addition to income as a result of
  interest on convertible debt                                                        303              
                                                            
 Fully diluted earnings per share
  before extraordinary item                                                   $      1.31               
 Fully diluted earnings per share                                             $      1.23               
 Weighted average shares of
  common stock and equivalents                                                     36,306               

</TABLE>
See Accompanying Notes to Unaudited Pro Forma Condensed Consolidated Statement 
of Operations
<PAGE>

                 GENESIS HEALTH VENTURES, INC. AND SUBSIDIARIES
                         NOTES TO CONSOLIDATED PROFORMA
                CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
                       (in thousands, except share data)


 (1) Represents the historical results of operations of A.D.S from October 1,
     1996 through December 31, 1996. Multicare paid approximately $10,000,
     repaid or assumed approximately $29,800 in debt, financed $51,000 through a
     lease facility and issued 554,973 shares of its common stock for A.D.S.
     Total goodwill approximated $29,900.

 (2) Reflects the elimination of duplicative positions at A.D.S and the
     reduction of professional and accounting fees.

 (3) Reflects the additional lease expense associated with the $51,000 lease
     financing entered into in connection with the A.D.S Acquisition. The lease
     facility was repaid in connection with the Merger.

 (4) Reflects additional depreciation and amortization expense resulting from
     the amortization of goodwill incurred in the A.D.S Acquisition and
     depreciation resulting from the allocation of the purchase price for A.D.S
     to property, plant and equipment. Goodwill is being amortized over periods
     of 25 to 40 years.

 (5) Reflects the additional interest expense on the incremental debt incurred
     in connection with the A.D.S Acquisitions. 

 (6) Represents the net reduction in corporate, general and administrative
     expense due to the elimination of Multicare / A.D.S Proforma corporate,
     general and administrative expense and the incurrence of management fees.
     The management fee, which is charged and recognized by Genesis as operating
     income, is eliminated in the consolidated operating results of Multicare
     and Genesis. As a result of the Mergers, certain corporate employees of
     Multicare are employed by Genesis. The overall reduction in corporate,
     general and administrative expense is the result of anticipated cost
     savings from the elimination of duplicative positions and other costs.

       Multicare                               
               Multicare / A.D.S Pro Forma                     
                       corporate, general and                
                       administrative                             (33,976)
               Management fee                                      35,782 
       Genesis                         
               Corporate, general and                        
                       administrative                              19,776 
               Elimination of management fee                      (35,782)
                                                                 --------
       Total corporate general and                             
               expense                                            (14,200)
                                                                 ========
       Genesis                         
               Management fee                                      35,782 
               Elimination of management fee                      (35,782)
                                                                 --------
       Revenues, net                                                   (0)
                                                                 ======== 
<PAGE>

 (7) In connection with the Merger, Genesis' equity partners in the Multicare
     Transaction will absorb the first $40,000 of operating losses of 
     Multicare. Consequently, $16,469 of estimated losses have been added back
     to other operating expenses.

 (8) Interest and lease expense has been adjusted to reflect the indebtedness
     incurred in connection with the Merger, the Pharmacy Sale, the Therapy Sale
     and the repayment of indebtedness (including the repayment of $54,000 under
     a lease financing facility). The estimated average interest rate for the
     Credit Facility and for the Notes is 8.4% and 9%, respectively.

        Multicare
                Credit Facility                             33,207
                Notes                                       22,500 
                Other debt                                   3,344 
                Multicare / ADS Pro Forma                       
                        interest expense                   (29,874)
        Genesis                         
                Credit Facility                             35,784 
                                                           -------
        Total Interest Expense                              64,962 
                                                           -------
        Lease expense                                       (3,570)
                                                           =======

 (9) The revenues and expenses of the Multicare pharmacy and rehabilitation
     businesses are included in the Multicare historical results for the twelve
     months ended September 30, 1997. With the exception of depreciation and
     amortization, the proforma effect of the Pharmacy Sale and the Therapy Sale
     on operating revenues and expenses is not expected to have a significant
     effect on the consolidated operating results of Multicare and Genesis, as
     those revenues and expenses formerly reflected in the operating results of
     Multicare will be reflected in the results of Genesis. In connection with
     the Merger, Pharmacy Sale and the Therapy Sale, depreciation and have been
     increased by the amortization of goodwill and depreciation resulting from
     the allocation of purchase price. As a result of the Merger, the
     preliminary allocation of the purchase price has resulted in an increase to
     property and equipment ($254,000) and goodwill ($657,180) which are
     amortized over 30 years and 40 years, respectively. The Therapy Sale and
     Pharmacy Sale have preliminarily resulted in additional goodwill of
     approximately $65,000 which is amortized over lives ranging from 20 to 40
     years.
                                                           -------
       Depreciation and amortization                        27,021
                                                           =======

(10) Represents income tax expense at an effective tax rate of 37%. The primary
     difference between expense calculated at statutory rates and the amount
     reflected in the pro forma statements is attributable to non-deductible
     goodwill and the provision for state income taxes.

<PAGE>



         3. Exhibits:

       Exhibit No.          Description
       -----------          -----------

         10.1(3)      Agreement and Plan of Merger dated June 16, 1997 by and
                      among Genesis ElderCare Corp., Genesis ElderCare
                      Acquisition Corp., Genesis Health Ventures, Inc. and The
                      Multicare Companies, Inc.

         10.2(4)      Third Amended and Restated Credit Agreement dated October
                      9, 1997 to Genesis Health Ventures, Inc. from Mellon Bank,
                      N.A., Citicorp USA, Inc., First Union National Bank and
                      NationsBank, N.A.

                                      -1-
<PAGE>
       Exhibit No.          Description
       -----------          -----------

         10.3(4)      Credit Agreement dated October 14, 1997 to The Multicare
                      Companies, Inc. from Mellon Bank, N.A., Citicorp USA,
                      Inc., First Union National Bank and NationsBank, N.A.

         10.4*        Management Agreement dated October 9, 1997 among The
                      Multicare Companies, Inc., Genesis Health Ventures, Inc.
                      and Genesis ElderCare Network Services, Inc.

         10.5(4)      Stockholders' Agreement dated October 9, 1997 among
                      Genesis ElderCare Corp., The Cypress Group L.L.C., TPG
                      Partners II, L.P., Nazem, Inc. and Genesis Health
                      Ventures, Inc.

         10.6(4)      Put/Call Agreement dated October 9, 1997 among The Cypress
                      Group L.L.C., TPG Partners II, L.P., Nazem, Inc. and
                      Genesis Health Ventures, Inc.

         10.7*        Stock Purchase Agreement dated October 10, 1997 among
                      Genesis Health Ventures, Inc., The Multicare Companies,
                      Inc., Concord Health Group, Inc., Horizon Associates,
                      Inc., Institutional Health Care Services, Inc., Care4,
                      L.P., Concord Pharmacy Services, Inc., Compass Health
                      Services, Inc. and Encare of Massachusetts, Inc.

         10.8         Asset Purchase Agreement dated October 10, 1997 among
                      Genesis Health Ventures, Inc., The Multicare Companies,
                      Inc., Health Care Rehab Systems, Inc., Horizon
                      Rehabilitation, Inc., Progressive Rehabilitation Centers,
                      Inc. and Total Rehabilitation Center, L.L.C.

         10.9(3)      Letter Agreement dated June 16, 1997 between Genesis
                      Health Ventures, Inc. and Straus Associates.

         23.1         Consent of Independent Public Accountants
                   
- ----------

*        Previously filed.
(3)      Incorporated by reference to the Tender Offer Statement on Schedule
         14D-1 filed by Genesis ElderCare Corp. and Genesis ElderCare
         Acquisition Corp. on June 20, 1997.
(4)      Incorporated by reference to Amendment No. 7 to the Tender Offer
         Statement on Schedule 14D-1 filed by Genesis ElderCare Corp. and
         Genesis ElderCare Acquisition Corp. on June 20, 1997.

                                      -2-
<PAGE>


                                   SIGNATURES

         Pursuant to the requirements of the Securities Exchange Act of 1934,
the registrant has duly caused this report to be signed on its behalf by the
undersigned hereunto duly authorized.



                           GENESIS HEALTH VENTURES, INC.


                           By: /s/ George V. Hager, Jr.
                               -------------------------------------------------
                               George V. Hager, Jr.
                               Senior Vice President and Chief Financial Officer


Date:  December 22, 1997

<PAGE>


                                  Exhibit 10.8

                  AMENDED AND RESTATED STOCK PURCHASE AGREEMENT

         This Agreement is made this 10th day of October, 1997, by and among
Genesis Health Ventures, Inc., a Pennsylvania corporation, and/or its designee
pursuant to Section 9.2 hereof (the "Buyer"), The Multicare Companies, Inc., a
Delaware corporation, Concord Health Group, Inc., a Delaware corporation,
Horizon Associates, Inc., a West Virginia corporation, and Horizon Medical
Equipment and Supply, Inc., a West Virginia corporation (collectively, the
"Sellers"), and Institutional Health Care Services, Inc., a New Jersey
corporation, Care4, L.P., a Delaware limited partnership, Concord Pharmacy
Services, Inc., a Pennsylvania corporation, Compass Health Services, Inc., a
West Virginia corporation, and Encare of Massachusetts, Inc., a Delaware
corporation (each a "Company" and collectively, the "Companies").

                                   BACKGROUND

         WHEREAS, the Sellers and each of the Companies have agreed to sell and
Buyer has agreed to purchase, all of the issued and outstanding capital stock
and limited partnership interests, whichever is applicable, of each of the
Companies on the terms and conditions provided for in this Agreement.

                                    AGREEMENT

         NOW, THEREFORE, in order to consummate such transactions and in
consideration of the mutual agreements set forth herein, the parties hereto,
intending to be legally bound, agree as follows:

                             ARTICLE 1. DEFINITIONS

         Section 1.1 Definitions. As used in this Agreement, unless otherwise
defined herein or unless the context otherwise requires, the following terms
shall have the following meanings:

         "Agreement" means this Stock Purchase Agreement, all schedules hereto
and all amendments, modifications, and supplements hereto.

         "Buyer" is defined in the preamble hereto.

         "Closing" has the meaning specified in Section 2.2 hereof.


<PAGE>

         "Closing Date" has the meaning specified in Section 2.2 hereof.

         "Company" or "Companies" is defined in the preamble hereto.

         "Encumbrance" means any mortgage, claim, lien, pledge, option, charge,
security interest or other similar interest, easement, judgment or imperfection
of title of any nature whatsoever.

         "Material Adverse Effect" means any change or effect that would or
would reasonably be expected to materially and adversely affect the financial
condition, results of operations, assets or business of each of the Companies,
the each of the Sellers, or Buyer and its subsidiaries taken as a whole, as the
case may be.

         "Merger Agreement" means the Merger Agreement, dated as of June 16,
1997, by and among Genesis ElderCare Corp. (formerly known as Waltz Corp.), a
Delaware corporation, Genesis ElderCare Acquisition Corp. (formerly known as
Waltz Acquisition Corp.), a Delaware corporation, and The Multicare Companies,
Inc. pursuant to which Genesis ElderCare Acquisition Corp. shall merge with and
into The Multicare Companies, Inc.

         "Purchase Price" means Fifty Million Dollars ($50,000,000) to be paid
by Buyer for the Shares in accordance with an allocation to be mutually
determined by the parties.

         "Sellers" is defined in the preamble hereto.

         "Shares" means all of the outstanding capital stock and limited
partnership interests, whichever is applicable, of each of the Companies.

                  ARTICLE 2. SALE OF SHARES AND PURCHASE PRICE

         Section 2.1 Sale of Shares. On the terms and subject to the conditions
set forth in this Agreement, the Sellers shall cause the sale, transfer and
delivery to Buyer, and Buyer shall purchase, on the Closing Date, all right,
title and interest in and to all of the Shares.

         Section 2.2 Closing. The closing of the purchase and sale of the Shares
(the "Closing") shall take place as soon as practicable after the closing under
the Merger Agreement at the offices of Blank Rome Comisky & McCauley, One Logan
Square, Philadelphia, Pennsylvania 19103, or at such other place as shall be
mutually agreeable to the parties hereto (which time and place are designated as
the "Closing Date"), subject to the satisfaction or waiver of the conditions
specified in Article 6; provided, however, that if acceptable to the parties,
the Closing may be effected by facsimile transmission of executed copies of the
documents (including without limitation, this Agreement) delivered at the
Closing and payment of the purchase price specified in Section 2.3 and by
sending original copies of the documents (including without limitation, this
Agreement) delivered at the Closing by reputable overnight delivery service,
postage or delivery charges prepaid, for delivery to the parties at their
respective addresses set forth in Section 9.1 herein by the third business day
following the Closing.


                                       2
<PAGE>
         Section 2.3 Purchase Price. On the Closing Date, Buyer shall pay the
Purchase Price for the Shares. Buyer shall pay the Purchase Price, against
delivery of the certificates and the amended limited partnership agreement,
whichever is applicable, for the Shares required by Section 2.4, by wire
transfer of immediately available funds to such accounts as the Sellers shall
designate. The parties agree to allocate the Purchase Price among the Shares in
a manner to be mutually determined by the parties.

         Section 2.4 Delivery of Certificates, Amended Limited Partnership
Agreement.

                  (i) On the Closing Date, the Sellers and the Companies shall
cause to be delivered to Buyer certificates (with respect to only those
Companies that are corporations) evidencing all of the Shares, duly endorsed in
blank (or in such name as may be designated by Buyer), and accompanied by stock
powers duly executed in blank (or in such name as may be designated by Buyer),
in proper form to transfer all right, title and interest in and to all Shares to
Buyer. Buyer shall have no obligation to purchase any of the Shares unless the
Sellers and the Companies deliver certificates for all of the Shares.

                  (ii) On the Closing Date, the Sellers and the Companies shall
cause to be delivered to Buyer an amended limited partnership agreement (with
respect to only those Companies that are limited partnerships) stating, among
other things, that Buyer is the sole limited partner for the Company that is a
partnership on and as of the Closing Date. Buyer shall have no obligation to
purchase any of the Shares unless the Sellers and the Companies deliver such
amended limited partnership agreement.

                ARTICLE 3. CERTAIN UNDERSTANDINGS AND AGREEMENTS

         Section 3.1 Conduct of Business. From the date of this Agreement to the
Closing Date, the Companies shall, and the Sellers shall cause the Companies to,
conduct their operations according to their ordinary and usual course of
business, to preserve their business organization intact, keep available the
services of their officers and employees and maintain satisfactory relationships
with suppliers, customers and others having business relationships with them.

         Section 3.2 Pre-Closing Access to Properties and Records;
Confidentiality. Between the date hereof and the Closing Date, the Companies
shall, and the Sellers shall cause the Companies to, give authorized
representatives of Buyer, reasonable access to the premises, properties,
contracts, books, records and affairs of the Companies (including reasonable
access to the properties of the Companies for the purposes of conducting a Phase
1 environmental assessment of such properties) and will cause the Companies'
officers to furnish such financial, technical and operating data and other
information pertaining to the Companies' businesses as Buyer shall from time to
time reasonably request.

         Section 3.3 Reasonable Efforts. Subject to the terms and conditions of
this Agreement, each party shall use all commercially reasonable efforts to
take, or cause to be taken, all actions necessary to consummate the transactions
contemplated by this Agreement. The parties shall 



                                       3
<PAGE>

cooperate with one another (a) in determining whether any action by or in
respect of, or filing with, any governmental authority is required, or any
actions, consents, approvals or waivers are required to be obtained from parties
to any contracts and (b) subject to the terms and conditions of this Agreement,
in taking such actions or making any such filings, furnishing information
required in connection therewith and seeking to obtain in a timely fashion any
such actions, consents approvals or waivers.

         Section 3.4 Notice of Certain Events. The Companies and, to the extent
known by it, the Sellers shall give notice to Buyer promptly of:

         (a) any notice of breach or default received subsequent to the date of
this Agreement, or any instrument or agreement to which the Companies or any of
the Sellers is a party or by which it is bound; or

         (b) any suit, action, proceeding or investigation instituted or, to the
Companies' and the Sellers' knowledge, threatened against or affecting any of
the Sellers or Companies subsequent to the date of this Agreement and prior to
the Closing.

         Section 3.5 Section 338(h)(10) Election. With respect to the Buyer's
acquisition of the Shares pursuant to this Agreement, Buyer and the Sellers
shall jointly make a timely election under Section 338(h)(10) of the Internal
Revenue Code of 1986, as amended (the "Code") (and any corresponding elections
under any state or local tax laws) (such elections being hereinafter
collectively referred to as the "338(h)(10) Election"). The Sellers shall
cooperate with Buyer and take such action as may be necessary to cause each of
the Companies to cooperate with Buyer and take any and all action reasonably
necessary or appropriate (including filing such forms, returns, elections,
schedules and other documents as may reasonably be required) to effect and
preserve a timely 338(h)(10) Election in accordance with Code Section 338 and
the applicable regulations thereunder. The allocation of values to the assets of
the Companies shall be in accordance with the allocation set forth in Schedule D
attached hereto. Thereafter, Buyer and the Sellers shall report the sale of the
stock and other equity interests of the Companies pursuant to this Agreement in
a manner which is consistent with the 338(h)(10) Election and shall take no
position contrary thereto or inconsistent therewith in any tax returns in any
discussion with or proceeding before any taxing authority or otherwise. The
Sellers will pay any tax attributable to the making of the Section 338(h)(10)
Election and arising out of a deemed sale of assets as of the Closing.

         Section 3.6 Adjustment of Assets. It is the intention of the parties
that the Companies comprise the institutional pharmacy services companies of
Multicare which have generated year to date annualized revenues of $82.3 million
and EBITDAR of $13.4 million. To the extent that (i) any of the Companies are
not included in the institutional pharmacy services companies which generated
such annualized revenues and EBITDAR or (ii) other entities owned by Seller are
included in such annualized revenues or EBITDAR but are not sold to Buyer
hereunder, the parties agree to make appropriate adjustment of the assets sold
hereunder.

         Section 3.7 Tax Adjustment. To the extent that any taxes are imposed
upon Seller as a result of the sale of the Companies hereunder, Buyer will pay
to Seller the amount of such taxes 



                                       4
<PAGE>

when Seller is required to pay such taxes. To the extent that the sale of
Companies hereunder generates tax losses to Seller, Seller will pay to Buyer the
tax savings realized from such tax losses when Seller receives the benefit from
such tax losses.

               ARTICLE 4. CONDITIONS TO OBLIGATIONS OF EACH PARTY

         The obligations of each party to consummate the transactions
contemplated hereby shall be subject to the fulfillment, at or prior to the
Closing Date, of the following conditions, each of which may be waived by the
parties in writing:

         Section 4.1 No Action or Proceeding. No claim, action, suit or other
proceeding shall be pending or threatened by any public authority or person
before any court, agency or administrative body which creates a substantial
likelihood that the consummation of this Agreement or the transactions
contemplated hereby will be restrained, enjoined or otherwise prevented or that
any material damages will be recovered or other material relief obtained as a
result of the transactions contemplated hereby or as a result of any agreement
entered into in connection with, or as a condition precedent to, the
consummation of the transactions contemplated hereby.

         Section 4.2 Compliance with Law. No provision of any applicable law and
no judgment, injunction, order or decree shall prohibit the Closing. There shall
have been obtained any and all permits, approvals and consents of any
governmental body or agency which Buyer or the Sellers may reasonably deem
necessary so that consummation of the transactions contemplated by this
Agreement will be in compliance in all material respects with the applicable
laws.

         Section 4.3 Hart-Scott-Rodino Requirements. The waiting periods (as
such may be extended by the governmental agencies involved) applicable to the
consummation of the transactions contemplated hereby under the provisions of the
Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended, and the rules
thereunder shall have expired or have been terminated by the appropriate
governmental agency.

         Section 4.4. Regulatory Approvals. Any material approval, permit,
authorization, consent or waiting period of any governmental authority
applicable to (i) the purchase of all of the outstanding shares of common stock,
par value $.01 per share, of Multicare at a purchase price of $28.00 per share
(the "Equity Tender Offer"), (ii) the merger of Genesis ElderCare Acquisition
Corp. with and into Multicare (the "Merger") pursuant to the terms and
conditions of the Merger Agreement or (iii) the ownership or operation by
Multicare, Genesis ElderCare Corp. or Genesis Health Ventures, Inc. of all or a
material portion of the business or assets of Multicare shall have been obtained
or satisfied on terms satisfactory to Genesis ElderCare Corp. in its reasonable
discretion.

                                       5
<PAGE>

                             ARTICLE 5. TERMINATION

         This Agreement may be terminated at any time prior to the Closing Date
as follows:

         (a)  by mutual consent in writing of the parties hereto;

         (b) at any time on or prior to the Closing Date, by either the Buyer,
on the one hand, or the Companies and Sellers, on the other hand, as the case
may be, if the other party(ies) has, in any material respect, breached any
covenant or undertaking contained herein and such breach has not been cured
within thirty days.


                            ARTICLE 6. MISCELLANEOUS

         Section 6.1 Notices. All notices, requests, demands and other
communications hereunder shall be in writing (including telecopy or similar
writing) and shall be given:

                           If to Buyer:

                           Genesis Health Ventures, Inc.
                           148 West State Street
                           Kennett Square, Pennsylvania 19348
                           Attention: Michael R. Walker
                           Telephone: (610) 444-6350
                           Facsimile: (610) 444-7438

                           with a copy to:

                           Blank Rome Comisky & McCauley
                           One Logan Square
                           Philadelphia, Pennsylvania  19103
                           Attention: Stephen E. Luongo, Esq.
                           Telephone:  (215) 569-5500
                           Facsimile:  (215) 569-5555

                           If to the Sellers or Companies:

                           Genesis ElderCare Corp.
                           148 West State Street
                           Kennett Square, Pennsylvania 19348
                           Attention: Michael R. Walker
                           Telephone: (610) 444-6350
                           Facsimile: (610) 444-7438


                                       6
<PAGE>

                           with a copy to:

                           Simpson Thacher & Bartlett
                           425 Lexington Avenue
                           New York, New York 10017-3954
                           Attention: William E. Curbow, Esquire
                           Telephone: (212) 455-2000
                           Facsimile: (212) 455-2502

or to such other address or telecopy number and with such other copies as such
party may hereafter specify for the purpose of notice to the other party. Each
such notice, request, demand or other communication shall be effective (a) if
given by telecopy, when such telecopy is transmitted to the telecopy number
specified in this Section and evidence of receipt is received or (b) if given by
any other means, upon delivery or refusal of delivery at the address specified
in this Section.

         Section 6.2 Assignability; Parties in Interest. This Agreement shall
not be assignable by any of the parties hereto, except that this Agreement shall
be assignable in whole or in part by Buyer to any subsidiary or subsidiaries of
Buyer, provided that no such assignment shall relieve the assignor of its
obligations hereunder. This Agreement shall inure to the benefit of and be
binding upon the parties hereto and their respective successors and permitted
assigns. Except as specifically referred to herein, this Agreement is for the
sole and exclusive benefit of the parties to this Agreement and their successors
and assigns and nothing in this Agreement is intended to confer, expressly or by
implication, upon any other person any legal or equitable rights, remedies or
claims under or by reason of this Agreement.

         Section 6.3 Governing Law; Jurisdiction. This Agreement shall be
governed by, and construed and enforced in accordance with, the laws of the
Commonwealth of Pennsylvania, without regard to conflicts of laws. In any action
between or among any of the parties, whether arising out of this Agreement or
otherwise, (a) each of the parties irrevocably consents to the exclusive
jurisdiction and venue of the federal and state courts located in the
Commonwealth of Pennsylvania; (b) each of the parties irrevocably waives the
right to trial by jury; (c) each of the parties irrevocably consents to service
of process by first class certified mail, return receipt requested, postage
prepaid, to the address at which such party is to receive notice in accordance
with Section 11.1.

         Section 6.4 Counterparts. This Agreement may be executed simultaneously
in one or more counterparts, each of which shall be deemed an original, with the
same effect as if the signatures thereto and hereto were upon the same
instrument. This Agreement shall become effective when each party shall have
received a counterpart signed by the other party.

         Section 6.5 Publicity. The Sellers, the Companies and Buyer agree that
press releases and other announcements with respect to the transactions
contemplated hereby shall be subject to mutual agreement; provided, however,
that Buyer may make such announcements as in the opinion of its counsel, such
party is required to make pursuant to comply with law or the requirements of any
stock exchange or other applicable self-regulatory organization, but in such
event Buyer shall, to the extent 



                                       7
<PAGE>

practicable, give the Sellers and the Companies reasonable prior notice and an
opportunity to comment on the proposed announcement.

         Section 6.6 Complete Agreement. This Agreement, the exhibits hereto and
the schedules and documents delivered pursuant hereto or referred to herein
contain the entire agreement between the parties hereto with respect to the
transactions contemplated herein and supersede all previous negotiations,
commitments and writings.

         Section 6.7 Amendments and Waivers. The parties hereto may (a) extend
the time for the performance of any of the obligations or other acts of the
parties hereto, (b) waive any inaccuracies in the representations and warranties
contained in this Agreement or in any or documents delivered pursuant hereto,
(c) waive compliance with any of the covenants or agreements contained in this
Agreement or (d) amend this Agreement, if and only, in the case of an extension
or amendment, if such action is set forth in a written agreement signed by both
parties, or, in the case of a waiver, if such waiver is signed by the party
against whom the waiver is to be effective.

         Section 6.8 Expenses. Except as specifically provided in this
Agreement, each party shall bear the expenses incurred by it in connection with
the transactions contemplated by this Agreement.

         Section 6.9 Consents. Notwithstanding anything herein to the contrary,
this Agreement shall not constitute an agreement to assign any contract,
license, lease, commitment or other arrangement if an attempted assignment would
constitute a breach thereof. Whenever such consent is required, the Sellers will
use commercially reasonable efforts to cause such consents to be obtained and
Buyer agrees to cooperate with the Sellers and to enter into any reasonable
arrangement designed to provide for Buyer the benefits under such contracts and
agreements.

         Section 6.10 Interpretation. The headings contained in this Agreement
are for reference purposes only and shall not affect in any way the meaning or
interpretation of this Agreement.

         Section 6.11 Severability. Any portion or provision of the Agreement
which is invalid, illegal or unenforceable in any jurisdiction shall, as to that
jurisdiction, be ineffective to the extent of such invalidity, illegality or
unenforceability, without affecting in any way the remaining portions or
provisions hereof in such jurisdiction or, to the extent permitted by law,
rendering that or any other portion or provision of the Agreement invalid,
illegal or unenforceable in any other jurisdiction.

         Section 6.12 Further Assurances. Each party hereto agrees to execute
any and all documents and to perform such other acts as may be necessary or
expedient to further the purposes of this Agreement and the transactions
contemplated hereby.

         Section 6.13. Waiver. The rights and remedies of the parties to this
Agreement are cumulative and not alternative. Neither the failure nor any delay
by any party in exercising any right, power, or privilege under this Agreement
or the documents referred to in this Agreement will operate as a waiver of such
right, power, or privilege, and no single or partial exercise of any such 



                                       8
<PAGE>

right, power, or privilege will preclude any other or further exercise of such
right, power, or privilege or the exercise of any other right, power, or
privilege.

         IN WITNESS WHEREOF, each of the parties hereto has caused this
Agreement to be executed by their respective duly authorized officers as of the
date first above written.

GENESIS HEALTH VENTURES, INC.,      THE MULTICARE COMPANIES, INC.
or its designee

By: /s/ Michael R. Walker           By: /s/ Michael R. Walker
- -------------------------------     -------------------------------
Name: Michael R. Walker             Name: Michael R. Walker
Title: Chairman and Chief           Title: Chairman and Chief 
       Executive Officer                   Executive Officer



CONCORD HEALTH GROUP, INC.          HORIZON ASSOCIATES, INC.

By: /s/ Michael R. Walker           By: /s/ Michael R. Walker
- -------------------------------     -------------------------------
Name: Michael R. Walker             Name: Michael R. Walker
Title: Chairman and Chief           Title: Chairman and Chief 
       Executive Officer                   Executive Officer

INSTITUTIONAL HEALTH CARE         CARE4, L.P.
SERVICES, INC.
                                  By: Institutional Health Care Services, Inc.,
By: /s/ Michael R. Walker               General Partner of Care4, L.P.
- -------------------------------   -------------------------------
Name: Michael R. Walker
Title: Chairman and Chief         By: /s/ Michael R. Walker
       Executive Officer          Name: Michael R. Walker
                                  Title: Chairman and Chief Executive Officer


CONCORD PHARMACY SERVICES, INC.   COMPASS HEALTH SERVICES, INC.
By: /s/ Michael R. Walker         By: /s/ Michael R. Walker
- -------------------------------   -------------------------------
Name: Michael R. Walker           Name: Michael R. Walker
Title: Chairman and Chief         Title: Chairman and Chief 
       Executive Officer                 Executive Officer



ENCARE OF MASSACHUSETTS, INC.     HORIZON MEDICAL EQUIPMENT
                                  AND SUPPLY, INC.
By: /s/ Michael R. Walker
- -------------------------------   -------------------------------
Name: Michael R. Walker           By: /s/ Michael R. Walker
Title: Chairman and Chief         Name: Michael R. Walker
       Executive Officer          Title: Chairman and Chief 
                                         Executive Officer 


<PAGE>

                                  Exhibit 23.1



               Consent of Independent Certified Public Accountants



The Board of Directors
Genesis Health Ventures, Inc.

We hereby consent to the incorporation by reference in the Prospectus
constituting a part of the Registration Statements on Form S-8 which registers
shares of your common stock issued under the Genesis Health Ventures, Inc.
Amended and Restated Employee Stock Option Plan and 1992 Stock Option Plan for
Non-Employee Director of our report dated February 4, 1997, relating to the
consolidated financial statements of The Multicare Companies, Inc. and
Subsidiaries as of December 31, 1996 and for each of the years in the three-year
period ended December 31, 1996 in Amendment No. 1 to Genesis Health Ventures,
Inc.'s current report on Form 8-K/A dated October 10, 1997 filed with the
Securities and Exchange Commission.

We also consent to us being named as "Experts" in the Prospectus.



                                                           KPMG Peat Marwick LLP


Short Hills, New Jersey
December 22, 1997




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