HEALTH CARE & RETIREMENT CORP / DE
10-K, 1998-02-23
SKILLED NURSING CARE FACILITIES
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<PAGE>   1
                                      
                                  FORM 10-K
                                      
                      SECURITIES AND EXCHANGE COMMISSION
                            WASHINGTON, D.C. 20549
                                      
 (Mark One)
    [X]   ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
                       SECURITIES EXCHANGE ACT OF 1934
                 For the fiscal year ended December 31, 1997
                                     OR
    [ ]   TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
                       SECURITIES EXCHANGE ACT OF 1934

                     COMMISSION FILE NUMBER:    1-10858

                   HEALTH CARE AND RETIREMENT CORPORATION
           (Exact name of registrant as specified in its charter)

          DELAWARE                                    34-1687107
(State or other jurisdiction of                   (IRS Employer
incorporation or organization)                    Identification No.)

ONE SEAGATE, TOLEDO, OHIO                             43604-2616
(Address of principal executive offices)              (Zip Code)


REGISTRANT'S TELEPHONE NUMBER, INCLUDING AREA CODE:   (419) 252-5500

SECURITIES REGISTERED PURSUANT TO SECTION 12(b) OF THE ACT:

                                         Name of each exchange
     Title of each class                  on which registered
    --------------------                 ---------------------
COMMON STOCK, $.01 PAR VALUE             NEW YORK STOCK EXCHANGE

     SECURITIES REGISTERED PURSUANT TO SECTION 12(g) OF THE ACT:   NONE

Indicate by check mark whether the registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the
registrant was required to file such reports), and (2) has been subject to such
filing requirements for the past 90 days.
                                          Yes  X    No
                                             -----    -----

Indicate by check mark if disclosure of delinquent filers pursuant to
Item 405 of Regulation S-K is not contained herein, and will not be contained,
to the best of the registrant's knowledge, in definitive proxy or information
statements incorporated by reference in Part III of this Form 10-K or any
amendment to this Form 10-K  [X]

Based on the closing price of $39.6875 per share on January 30, 1998, the
aggregate market value of the registrant's voting stock held by non-affiliates
was $1,718,184,191.  Solely for purposes of this computation, the registrant's
directors and executive officers have been deemed to be affiliates.  Such
treatment is not intended to be, and should not be construed to be, an
admission by the registrant or such directors and officers that all of such
persons are "affiliates", as that term is defined under the Securities Act of
1934.

  The number of shares of Common Stock, $.01 par value, of Health Care and
  Retirement Corporation outstanding as of January 30, 1998 was 44,553,984.

                     DOCUMENTS INCORPORATED BY REFERENCE

The following document is incorporated herein by reference in the Part
indicated:


     Specific portions of the registrant's Proxy Statement for the Annual
     Stockholders' Meeting to be held May 5, 1998 are incorporated by reference
     in Part III.



<PAGE>   2

                              TABLE OF CONTENTS
                                      
<TABLE>
<CAPTION>

PART I
<S>  <C>                                                                    <C>
     ITEM 1. BUSINESS ........................................................2
     ITEM 2. PROPERTIES ......................................................8
     ITEM 3. LEGAL PROCEEDINGS ...............................................9
     ITEM 4. SUBMISSION OF MATTERS                                        
             TO A VOTE OF SECURITY HOLDERS ...................................9

PART II

     ITEM 5. MARKET FOR REGISTRANT'S COMMON STOCK
             AND RELATED STOCKHOLDER MATTERS .................................9

     ITEM 6. SELECTED FINANCIAL DATA ........................................10

     ITEM 7. MANAGEMENT'S DISCUSSION AND ANALYSIS
             OF FINANCIAL CONDITION AND RESULTS
             OF OPERATIONS ..................................................11

     ITEM 8. FINANCIAL STATEMENTS AND
             SUPPLEMENTARY DATA .............................................16

     ITEM 9. CHANGES IN AND DISAGREEMENTS
             WITH ACCOUNTANTS ON ACCOUNTING
             AND FINANCIAL DISCLOSURE .......................................36

PART III

     ITEM 10. DIRECTORS AND EXECUTIVE
              OFFICERS OF THE REGISTRANT ....................................36

     ITEM 11. EXECUTIVE COMPENSATION ........................................38

     ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL
              OWNERS AND MANAGEMENT .........................................38

     ITEM 13. CERTAIN RELATIONSHIPS AND RELATED
              TRANSACTIONS ..................................................38

PART IV

     ITEM 14. EXHIBITS, FINANCIAL STATEMENT SCHEDULES,
              AND REPORTS ON FORM 8-K .......................................39

SIGNATURES ..................................................................43

EXHIBITS ...................................................................E-1
</TABLE>
                                      
                                      
                                      1
                                      
<PAGE>   3
                                      
                                      
                                    PART I
                                      
ITEM 1.  BUSINESS

GENERAL DEVELOPMENT OF BUSINESS

Health Care and Retirement Corporation ("HCR" or the "Company") is a provider 
of a range of health care services, including long term care, subacute
medical care, rehabilitation therapy, home health care, pharmacy services and
management services for subacute care, rehabilitation therapy, vision care and
eye surgery.  The most significant portion of HCR's business is long term care.
The Company operates 129 nursing centers with 16,700 beds located in 16 states. 
The Company owns 121 of the centers, with 93 operating under the Heartland
name.  At December 31, 1997, HCR operated 63 medical specialty units with more
than 2,200 beds, within its nursing centers.  Medical specialty units provide
subacute medical care, intensive rehabilitation programs or Alzheimer's care
programs.

MileStone Healthcare Inc., acquired in January 1997 and a wholly owned
subsidiary, is a leading provider of program management services for subacute
care and acute rehabilitation programs in hospitals and skilled nursing
centers, and comprehensive outpatient rehabilitation facilities (CORFs).  These
services are provided in 53 subacute and rehabilitation units and 10 CORFs
located in 14 states at December 31, 1997.

Heartland Rehabilitation Services, Inc., a wholly owned subsidiary, provides
rehabilitation therapy in HCR centers, skilled centers of others, hospitals and
outpatient therapy clinics serving the midwest and mid-Atlantic states, Texas
and Florida.  This subsidiary expanded its operations by acquiring or opening
22 clinics in 1997, making a total of 73 outpatient clinics at December 31,
1997.

The executive offices of the Company are located at One SeaGate, Toledo, Ohio
43604-2616.  Its telephone number is (419) 252-5500.

NARRATIVE DESCRIPTION OF BUSINESS

Long Term Care Services

The Company generally provides comprehensive long term care services to patients
in all of its centers.  These services include three basic types of care.

     Skilled Nursing Care.  The Company operates 124 long term care centers
which provide health care services emphasizing skilled nursing care. Registered
nurses, licensed practical nurses and certified nursing assistants provide
services prescribed by the patient's attending physician, including
administration of medications and injections on a 24-hour basis.  Licensed
therapists provide physical, speech, occupational and respiratory therapy for
patients recovering from strokes, heart attacks, orthopedic conditions or other
illnesses, injuries or disabilities.  In addition, the centers provide daily
dietary services, social services, therapeutic recreational activities,


                                      
                                      2
                                      


<PAGE>   4


housekeeping and laundry services.  Dentistry, podiatry, psychological
counseling, laboratory, pharmacy and X-ray services are available.

     Assisted Living Services.  Three of the Company's centers and 19 units in
other HCR centers are dedicated to providing assisted living or personal care
services.  These services, which are less intensive than the Company's skilled
nursing care, assist patients with the general activities of daily living such
as dressing, bathing and meal preparation.

     Residential or Retirement Care.  Two of the Company's centers are
dedicated to providing residential services to residents with greater
independence and less demanding health needs than the patients in the Company's
other centers.  These retirement centers provide general supervision and a
protected environment, including room, board and planned social activities.

Specialty Medical Services

In certain centers specialized nursing or rehabilitative care is provided for
patients whose medical problems are more acute or require more sophisticated
treatment.  These specialty services include the following programs.

     Subacute Medical Care and Rehabilitation Programs.  These programs are
provided in specialized units with specially trained staff, appropriate
equipment and increased involvement by physician specialists.  Working closely
with patients, families and insurers, interdisciplinary teams develop
comprehensive, individualized patient care plans that target the essential
medical and functional discharge objectives.  Programs for medically complex
patients cover post-coronary surgery care, oncology, pain management,
infectious disease treatment, peritoneal and hemo dialysis and complex wound
care.  Rehabilitation programs promote recovery from major surgery, stroke,
amputation, joint replacement, head injury or general neurologic or orthopedic
conditions.

     Alzheimer's Care Programs.  Specialized care and programming are provided
by trained staff in a growing number of HCR centers for persons who have
Alzheimer's or related disorders.  Education and support are also provided to
families of these patients.

Health Care Services

HCR provides rehabilitation therapy in its centers, skilled centers of others,
hospitals and 73 outpatient clinics.  The home health care business specializes
in all levels of home health, hospice care and rehabilitation therapy from 33
offices.  HCR entered into long-term agreements that provide capital and
management services to physician practices, specializing in vision care and
refractive eye surgery.  Management services are also provided to 53 subacute
care and acute rehabilitation programs in hospitals and skilled nursing centers
and 10 comprehensive outpatient rehabilitation facilities.  HCR owns 50% of a
partnership, Heartland Healthcare Services, which provides high quality
pharmaceutical products to long term care centers and institutional pharmacies.


                                      
                                      3
                                      


<PAGE>   5


Labor

Labor costs account for approximately 63% of the Company's operating expenses
and the Company competes with other health care providers for the services of
nurses and other professional and nonprofessional health care workers.  In the
past, the health care industry has periodically experienced shortages of
nurses.  Although the Company does not currently have a staffing shortage nor
does it foresee one given structural changes in the supply and demand for
nurses, a shortage of nurses or other health care workers in the geographic
areas in which the Company operates could adversely affect the ability of the
Company to attract and retain qualified personnel and could increase its
operating costs.

Customers

There are no individual customers or related group of customers which account
for a significant portion of the Company's revenue.  The Company does not
expect that the possible loss of a single customer or group of related
customers would have a material adverse effect.

Certain classes of patients rely on a common source of funds for payment of the
cost of their care.  The following table reflects the allocation of such
revenue sources among Medicare, Medicaid and private pay and other sources for
the last three years.


<TABLE>
<CAPTION>
                            1997    1996    1995
                           ------  ------  ------
     <S>                   <C>     <C>     <C>
     Medicaid              29.9%   32.5%   33.6%
     Medicare              26.2%   27.4%   28.2%
     Private pay & other   43.9%   40.1%   38.2%
                           ------  ------  ------
                           100.0%  100.0%  100.0%
                           ======  ======  ======
</TABLE>


Private pay and other sources include commercial insurance, individual
patients' own funds, managed care plans and the Veterans Administration.
Although payment rates vary among these sources, such rates are largely
determined by market forces and costs.

The government reimbursement programs such as Medicare and Medicaid prescribe,
by regulation, the billing methods and amounts which may be charged and
reimbursed for the care of patients covered by such programs.  The Medicare
program is generally a cost-based reimbursement program.  The Medicaid programs
differ from state to state and generally reimburse the Company under
prospective rate methodologies.  The Balanced Budget Act of 1997 (Balanced
Budget Act) signed into law on August 5, 1997, changes the Medicare
reimbursement methodology to a prospective payment system effective with cost
reporting periods beginning after July 1, 1998 and, among other things, repeals
the federal payment standard for Medicaid nursing facilities after October 1,
1997, thereby granting states greater flexibility in establishing payment
rates. There can be no assurance that these changes or any future changes or
any future health care legislation will not adversely affect HCR's business.


                                      
                                      4
                                      


<PAGE>   6




Regulation and Licenses

The federal government and all states in which the Company operates regulate,
license or certify various aspects of the Company's business.   Long term care
centers are subject to periodic inspection by governmental and other
authorities to assure continued compliance with various requirements such as
resident rights, admission, discharge and transfer rights, quality of life,
quality of care, nursing, dietary, rehabilitation, dental and pharmacy
services, administration, physical environment, infection control, resident
assessment and resident behavior and facility practices.  These reviews and
inspections may affect either the license to operate a long term care facility
or the eligibility to participate in the Medicare and Medicaid programs.  The
failure to maintain or renew any required regulatory licenses or certifications
could prevent the Company from offering its existing services at the
non-complying facility.

In general, state licenses are renewable annually.  At December 31, 1997, the
Company had valid licenses at all centers where such licenses were necessary
for continued operation and the Company expects that pending license renewals
will be favorably completed.  It is possible that, as a result of alleged
deficiencies observed during an inspection or review, the license at a center
could be placed on a provisional or conditional status or the Medicaid or
Medicare certification could be subject to termination unless a resurvey
determines that the alleged deficiencies were corrected or substantial progress
toward correction was achieved.  At December 31, 1997 no centers had received
final notices or determinations that Medicare and/or Medicaid certifications
would be terminated.  At December 31, 1997, the Company had one center
operating under a provisional or conditional license.  As of December 31,
1997, the Company had 114 Medicaid certified facilities and 124 Medicare
certified facilities.

Changes in federal regulations from the Omnibus Budget Reconciliation Act of
1987 became effective July 1, 1995.  These federal regulations affect the
survey process for nursing facilities and the authority of state survey
agencies and the Health Care Financing Administration to impose sanctions on
facilities based upon noncompliance with requirements for participation in the
Medicare and Medicaid programs.  Sanctions can include temporary management,
denial of payment for new admissions, denial of payment for all residents,
civil fines of $50 to $10,000 per day of violation, closure of the facility,
directed plans of correction and directed in-service training. The Company has
adopted policies and procedures which are designated to facilitate the
Company's compliance with the regulations, although, there can be no assurance
that, in the future, the Company will not have sanctions imposed, including
civil fines, for alleged violations of the requirements.

Government reimbursement programs such as Medicare and Medicaid are subject 
to statutory and regulatory changes, rate adjustments, administrative
rulings and interpretations and processing delays by fiscal intermediaries, all
of which could materially decrease the rate of payments to the Company for its
services and supplies rendered to patients covered by such programs.  In
addition, under the retrospective reimbursement system used by the Medicare
program and the Medicaid programs in certain states in which the Company
operates, the Company receives interim payments



                                      5
                                      
                                      
                                      
<PAGE>   7


during the year for patient care services based on each center's expected
reimbursable cost.  Based on the submission of year end cost reports and
routine audits, the amount of reimbursement can be adjusted in favor of the
Company or the program.

The Company is also subject to federal and state laws which govern financial 
and other arrangements involving healthcare providers.  Such laws include 
the illegal remuneration provisions of the Social Security Act, which
make it a felony to solicit, receive, offer to pay or pay any kickback, bribe
or rebate in return for referring a person for any item or service or in return
for purchasing, leasing, ordering or arranging for any good, facility, service
or item paid by federal health care programs.  The Office of the Inspector
General of the Department of Health and Human Services, the Department of
Justice and other federal agencies interpret these fraud and abuse provisions
liberally and enforce them aggressively.  The recently enacted Balanced Budget
Act also includes numerous health fraud provisions, including:  increased
mandatory exclusion periods for multiple health fraud convictions and permanent
exclusion for those convicted of three health care-related crimes; authority
for the Secretary to refuse to enter into Medicare agreements with convicted
felons; new civil money penalties for contracting with an excluded provider or
violating the federal anti-kickback statute; and an expansion of the mandatory
and permissive exclusions added by the Health Insurance Portability and
Accountability Act of 1996 to substantially any federal health care program. 
In addition, some states restrict certain business relationships between
physicians and other providers of healthcare services.  Many states prohibit
business corporations from providing, or holding themselves out as providers
of, medical care.  Possible sanctions for violation of any of these
restrictions or prohibitions include loss of licensure or eligibility to
participate in reimbursement programs (including Medicare and Medicaid), asset
forfeitures and civil and criminal penalties.  These laws vary from state to
state, are often vague and have seldom been interpreted by the courts or
regulatory agencies.  A civil action to exclude a provider from the Medicaid
and/or Medicare programs may be brought.  There are also other civil and
criminal statutes applicable to nursing facilities and other health care
providers, such as those governing false claims.  The Company believes it is in
compliance with all of the foregoing statutes and regulations.  The Company
maintains a corporate compliance program to facilitate its compliance with
applicable statutes and regulations.  However, there can be no assurance that
government officials responsible for enforcing these statutes will not assert
that the Company or certain transactions in which the Company is involved are
in violation of these statutes.

Competitive Conditions

The long term care industry is highly fragmented and the Company competes
primarily on a local and regional basis with many long term care providers,
some of whom may own as few as a single nursing center.  In addition the
Company competes with alternative types of health care providers such as home
health care, adult day care centers, and hospitals which convert underutilized
acute care capacity to skilled nursing facilities.  Although the Company has
129 centers in 16 states, competitive factors are dominated by local or
regional characteristics.


                                      
                                      6
                                      



<PAGE>   8



The ability of the Company to compete successfully varies from location to
location depending on a number of factors, including the number of competing
centers in the local market, the types of services available, quality of care,
reputation, age and appearance of each center and the cost of care in each
locality. In general, the Company seeks to compete in each market by
establishing a reputation within the local community for quality and caring
health services, attractive and comfortable facilities and the provision of
specialized health care.

Cautionary Statements

Statements contained in this Annual Report on Form 10-K which are not
historical facts are "forward-looking statements" within the meaning of the
Private Securities Litigation Reform Act of 1995 (the Act).  In addition, the
Company, through its senior management, from time to time makes forward-looking
oral and written public statements concerning the Company's expected future
operations and performance and other developments.  The following cautionary
statements are being made pursuant to the provisions of the Act with the
intention of obtaining the benefits of the safe harbor provisions of the Act.

HCR cautions investors that any forward-looking statements made by the Company
are necessarily estimates reflecting the Company's best judgement based upon
current information, and involve known and unknown risks and uncertainties and
other factors that may cause actual future results to differ materially from
the estimates in the forward-looking statements.  Such factors include
legislative, regulatory or other changes in the  healthcare industry at either
or both the federal or state levels, changes in reimbursement for the Company's
services by governmental or private payors and the Company's ability to respond
to such regulatory and/or reimbursement changes, competition, the Company's
ability to recruit and retain competent management and other personnel, the
Company's ability to negotiate satisfactory arrangements with third-party
payors, the Company's ability to successfully integrate acquisitions, general
conditions in the economy and capital markets, and other factors set forth 
herein or identified from time to time in the Company's Securities and Exchange 
Commission filings and in other public announcements.

Employees

As of December 31, 1997, the Company has approximately 22,000 full and
part-time employees.  Approximately  2,600 of the employees are salaried and
the remainder are paid on an hourly basis. Approximately 2,200 of the employees
are members of labor unions.


                                      
                                      7
                                      
                                      

<PAGE>   9


ITEM 2.  PROPERTIES

The principal properties of the registrant and its subsidiaries, which are of
material importance to the conduct of its business, consist of 129 long term
care centers located in 16 states, 73 outpatient therapy clinics located in
Ohio, New Jersey, Virginia, Kentucky and Florida, and 33 home health care
offices located in Michigan, Ohio, Indiana, Illinois and Florida.  All of the
outpatient clinics and home health care offices are leased.

While each long term care center is unique, the average center is approximately
40,000 square feet in size and provides 120 semi-private licensed beds.  The
centers are predominately single story structures with brick or stucco facades,
dry wall partitions and attractive interior finishes.  Common areas include
dining, therapy, personal care and activities rooms, resident and visitor
lounges, as well as administrative offices and employee lounges.  The Company
believes that all of its centers have been well maintained and are suitable for
the conduct of its business.  For the year ended December 31, 1997,
approximately 89% of the beds were utilized.

The following table shows the number and location of centers and beds operated
by the Company as of December 31, 1997.

<TABLE>
<CAPTION>
                               Number of Centers
                             --------------------
                               Owned     Leased    Number of Beds
                             ---------  ---------  --------------
              <S>            <C>            <C>        <C>
              Ohio                  31 (1)                  3,489
              Florida               19       6              3,298
              Michigan              23       1              3,090
              Texas                  8                      1,357
              Pennsylvania           7       1              1,127
              West Virginia          7                        940
              Wisconsin              5                        826
              Illinois               7                        618
              Maryland               3                        519
              South Carolina         4                        481
              Virginia               2                        214
              Tennessee              1                        211
              Kentucky               1                        200
              Indiana                1                        120
              New Jersey             1                        106
              Missouri               1                         98
                                   ---     ---             ------
                                   121       8             16,694
                                   ===     ===             ======
</TABLE>


The Company subleases space for its corporate offices in Toledo, Ohio from
Owens-Illinois, Inc.

  (1)  Some or all of the property at two centers in Ohio are subject to
       liens which encumber the properties in an aggregate amount of
       approximately $1,655,000.



                                      
                                      8
                                      


<PAGE>   10


ITEM 3.  LEGAL PROCEEDINGS

There are no material pending legal proceedings other than litigation arising
in the ordinary course of business for which the Company has insurance
coverage.  The Company does not believe the results of such litigation, even if
the outcome were unfavorable to the Company, would have a material adverse
effect on its financial position.

ITEM 4.  SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS

Not applicable.

                                   PART II

ITEM 5.  MARKET FOR REGISTRANT'S COMMON STOCK AND RELATED STOCKHOLDER MATTERS

The Company's common stock is listed under the symbol "HCR" on the New York
Stock Exchange which is the principal market on which the stock is traded.

The range of market prices by quarter in trading on the New York Stock Exchange
for 1996 and 1997 is shown below.  The prices are adjusted to reflect a 3-for-2
stock split effected in 1996 by the payment of a 50% stock dividend on June 5
to stockholders of record on May 21, 1996.


<TABLE>
<CAPTION>
                                      Low       High
                                      ---       ---
     <S>                            <C>       <C>
     1996
         First Quarter              $22.4167  $27.4167
         Second Quarter             $23.2500  $26.6250
         Third Quarter              $21.7500  $26.0000
         Fourth Quarter             $23.8750  $29.2500

     1997
         First Quarter              $25.0000  $30.7500
         Second Quarter             $27.7500  $34.8750
         Third Quarter              $32.9375  $38.3750
         Fourth Quarter             $35.5000  $42.5000
</TABLE>


No cash dividends have been declared or paid on the common stock.

The number of stockholders of record on January 31, 1998 was 308.  More than
98% of the outstanding shares were registered in the name of Depository Trust
Company, or CEDE, which held such shares on behalf of 224 brokerage firms,
banks and other financial institutions.  The shares attributed to these
financial institutions, in turn, represented the interests of more than 15,000
unidentified beneficial owners.


                                      
                                      9
                                      


<PAGE>   11

<TABLE>
<CAPTION>

ITEM 6.  SELECTED FINANCIAL DATA
- --------------------------------
FIVE-YEAR FINANCIAL HISTORY                     1997             1996             1995              1994       1993
                                                ----             ----             ----              ----       ----
<S>                                           <C>               <C>               <C>               <C>       <C>
                                                        (In thousands, except per share and other data)
Results of Operations
- ---------------------
Revenues                                      $891,963          $782,023          $713,469          $615,103  $559,344
Expenses:
 Operating                                     705,867           625,331           575,462           492,990   450,720
 General and administrative                     34,983            32,182            30,440            29,897    27,747
 Depreciation and amortization                  37,395            30,677            25,973            21,283    18,567
                                              --------          --------          --------          --------  --------
                                               778,245           688,190           631,875           544,170   497,034
                                              --------          --------          --------          --------  --------
Income from operations                         113,718            93,833            81,594            70,933    62,310
Interest expense, net                          (15,339)          (10,415)           (9,835)           (8,662)   (9,490)
Equity in earnings of partnership                2,806             1,500               531
                                              --------          --------          --------          --------  --------
Income before taxes and cumulative effect      101,185            84,918            72,290            62,271    52,820
Income taxes                                    31,064            25,475            21,687            20,238    18,751
                                              --------          --------          --------          --------  --------
Income before cumulative effect                 70,121            59,443            50,603            42,033    34,069
Cumulative effect as of December 31,
 1992 of change in the method of
 accounting for income taxes                                                                                     1,430
                                              --------          --------          --------          --------  --------
Net income                                    $ 70,121          $ 59,443          $ 50,603          $ 42,033  $ 35,499
                                              ========          ========          ========          ========  ========
Earnings per share - basic:
Income before cumulative effect               $   1.57          $   1.30          $   1.08          $   0.88  $   0.70
Cumulative effect of accounting change                                                                            0.03
                                              --------          --------          --------          --------  --------
Net income                                    $   1.57          $   1.30          $   1.08          $   0.88  $   0.73
                                              ========          ========          ========          ========  ========
Earnings per share - diluted:
Income before cumulative effect               $   1.51          $   1.24          $   1.03          $   0.84  $   0.68
Cumulative effect of accounting change                                                                            0.03
                                              --------          --------          --------          --------  --------
Net income                                    $   1.51          $   1.24          $   1.03          $   0.84  $   0.71
                                              ========          ========          ========          ========  ========
Cash provided by operating activities         $ 72,611          $ 91,475          $ 59,519          $ 74,557  $ 60,668

Financial Position
- ------------------
Total assets                                  $936,351          $802,784          $729,191          $671,430  $635,994
Working capital                                 49,427            22,539            14,391            20,154    11,411
Long-term debt                                 292,951           202,295           159,082           149,028   155,500
Stockholders' equity                           434,006           393,034           374,430           344,501   316,919

Financial Measurements (Unaudited)
- ----------------------------------
Income from operations as a percent
 of revenues                                      12.7%             12.0%             11.4%             11.5%     11.1%
Income before cumulative effect as a
 percent of revenues                               7.9               7.6               7.1               6.8       6.1
Net debt-to-capital ratio                         40.1              34.1              29.8              26.6      32.1

Other Data (Unaudited)
- ----------------------
Number of facilities                               129               128               127               129       124
Number of licensed beds                         16,694            16,534            16,366            16,605    15,942
Percentage of occupied beds                         89%               89%               90%               91%       92%
Number of employees                             22,000            20,000            18,500            16,500    16,000
</TABLE>


The earnings per share amounts prior to 1997 have been restated as required to
comply with Statement of Financial Accounting Standards No. 128, "Earnings Per
Share."  All per share data have been adjusted to reflect the 3-for-2 stock
split effected in the form of a dividend in 1996.


                                       
                                      10
                                       
                                       

<PAGE>   12



ITEM 7.  MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL
CONDITION AND RESULTS OF OPERATIONS

FINANCIAL CONDITION

DECEMBER 31, 1997 AND 1996

Health Care and Retirement Corporation (HCR or Company) paid $55,028,000 in
1997 for the acquisition of various businesses, including a privately held
company, MileStone Healthcare, Inc., and contingent consideration related to
prior year acquisitions.  The businesses acquired provide rehabilitation
therapy services and program management services for comprehensive medical
rehabilitation and subacute care.  The acquisitions were accounted for under
the purchase method of accounting.  HCR acquired assets of $12,000,000, assumed
liabilities of $21,000,000 and recorded $64,000,000 of intangible assets.
Certain of these agreements contain a provision for additional consideration
contingent upon the future financial results of the business.  The maximum
contingent consideration related to 1997 and prior acquisitions aggregates
$54,288,000 and will, if earned, be paid over the next five years and treated
as additions to the purchase price of the businesses.

Property and equipment increased $50,238,000 as a result of renovations and
capital improvements to existing facilities, the construction of a 180-bed
facility in Ann Arbor, Michigan, that opened in June, 1997 and the partial
construction of a 120-bed facility near Milwaukee, Wisconsin, scheduled for
completion in the third quarter of 1998.

There was no valuation allowance related to the deferred tax assets at December
31, 1997 and 1996, as the assets could be realized through the reversal of
existing taxable temporary differences.

RESULTS OF OPERATIONS - OVERVIEW

HCR is a provider of a range of health care services, including long term care,
subacute medical care, rehabilitation therapy, home health care, pharmacy
services and management services for subacute care, rehabilitation therapy,
vision care and eye surgery.  The most significant portion of HCR's business
relates to long term care, operating 129 centers in 16 states with more than
half located in Ohio, Michigan and Florida.  The major factors influencing
HCR's financial performance are acquisitions, consistently high occupancy rates
in the Company's centers, and continued improvement in the percentage of
revenue from Medicare, private pay and insured patients.

Growth in the core business continues with the construction of new facilities,
including a 165-bed facility in West Bloomfield, Michigan, in December 1996 and
180-bed facility in Ann Arbor, Michigan, in June 1997.  HCR is expanding the
number of medical specialty units within its new facilities as well as its
existing long term care centers that provide subacute medical care,
rehabilitation programs or Alzheimer's care programs.  During 1997, HCR added 5
medical specialty units, bringing the total to 63 units with more than 2,200
beds at December 31, 1997, compared to 58 units with 1,800 beds and 56 units
with 1,700 beds at December 31, 1996 and 1995, respectively.

                                      
                                      
                                      11
                                      


<PAGE>   13



HCR has developed an integrated health care network from acquisitions,
management agreements and a partnership.

MileStone Healthcare, Inc., acquired in January 1997 and a wholly owned
subsidiary, is a leading provider of program management services for subacute
care and acute rehabilitation programs in hospitals and skilled nursing
centers, and comprehensive outpatient rehabilitation facilities (CORFs).  These
services are provided in 53 subacute and rehabilitation units and 10 CORFs
located in 14 states at December 31, 1997.

Heartland Rehabilitation Services, Inc., a wholly owned subsidiary, provides
rehabilitation therapy in long term care centers of HCR, skilled centers of
others, hospitals and outpatient therapy clinics serving the midwestern and
mid-Atlantic states, Texas and Florida.  This subsidiary expanded its
operations by acquiring or opening 22 clinics in 1997, 32 clinics in 1996 and
16 clinics in 1995, making a total of 73 outpatient clinics at December 31,
1997.

HCR Home Health Care and Hospice, Inc., a wholly owned subsidiary, specializes
in all levels of home health, hospice care and rehabilitation therapy with
offices located in Ohio, Michigan, Indiana and Florida.  This subsidiary
acquired 2 offices in 1996 and 31 offices in 1995, making a total of 33 offices
at December 31, 1997.

Vision Management Services, Inc., a majority owned subsidiary, and RVA
Management Services, Inc., a wholly owned subsidiary, entered into long-term
management contracts in 1996 and 1995 with physician practices in the
midwestern states, specializing in vision care and refractive eye surgery.  The
Company receives a management fee equal to a certain percentage of operating
income as defined by the agreements.

In 1994 HCR formed a partnership with Omnicare, Inc., a leading provider of
institutional pharmacy services.  Each of the companies has a 50% share in the
partnership, Heartland Healthcare Services, which provides high quality
pharmaceutical products on a cost-effective basis to long term care centers and
institutional pharmacies.  HCR accounts for the partnership under the equity
method of accounting.

YEAR ENDED DECEMBER 31, 1997 COMPARED TO YEAR ENDED DECEMBER 31, 1996

Revenue increased $109,940,000 or 14% from the prior year.  Of the increase,
60% related to the acquisition of various businesses in 1996 and 1997.  The
remaining increases were due to mix changes and improved per diem rates,
resulting from more specialized care, such as subacute medical care and
rehabilitative services for more acutely ill patients.  The occupancy levels
were 89% in 1996 and 1997.  The mix of revenue from Medicare, private pay and
insured patients increased from 68% in 1996 to 70% in 1997, primarily due to
the growth in revenue from acquisitions.

Operating expenses increased $80,536,000 or 13%.  Of the increase, 60% related
to the acquisition of various businesses in 1996 and 1997.  The remaining
increases were related to labor costs and general increases in other expenses.
Labor costs, excluding those related to the acquisitions, represented 27% of
the increase due to the average wage rate increases as well as growth in the
staffing levels related to medical specialty units, rehabilitative services and
home health care.


                                      
                                      12
                                      
                                      

<PAGE>   14


General and administrative expense approximated 4% of revenue in 1996 and 1997.
The increase in depreciation of $3,285,000 related to the capital expenditures
during 1996 and 1997 for new facilities, renovations and capital improvements.
Amortization increased $3,433,000 due to the intangible assets recorded in
connection with acquisitions in 1996 and 1997.  The increase in interest
expense of $5,405,000 was attributable to higher debt levels.  The equity in
earnings of the partnership increased as a result of the growth in supplying
pharmaceutical needs of HCR centers and Omnicare pharmacies.

HCR does not believe that inflation has had a material impact on the results of
operations.

YEAR ENDED DECEMBER 31, 1996 COMPARED TO YEAR ENDED DECEMBER 31, 1995

Revenue increased $68,554,000 or 10% from the prior year.  Of the increase, 59%
related to the acquisition of various businesses in 1995 and 1996.  The
remaining increases were due to mix changes and improved per diem rates,
resulting from more specialized care, such as subacute medical care and
rehabilitative services for more acutely ill patients.  The occupancy levels
were 90% in 1995 and 89% in 1996.  The mix of revenue from Medicare, private
pay and insured patients increased from 66% in 1995 to 68% in 1996, primarily
due to the growth in revenue from rehabilitation services.

Operating expenses increased $49,869,000 or 9%.  Of the increase, 70% related
to the acquisition of various businesses in 1995 and 1996.  The remaining
increases were related to labor costs and general increases in other expenses.
Labor costs, excluding those related to the acquisitions, represented 28% of
the increase due to the average wage rate increases as well as growth in the
staffing levels related to medical specialty units, rehabilitative services and
home health care.

General and administrative expense, which approximated 4% of revenue in 1995
and 1996, increased $1,742,000 from the prior year.  The increase in
depreciation of $4,155,000 related to the capital expenditures during 1995 and
1996 for renovations, capital improvements and medical specialty units.
Amortization increased $549,000 due to the intangible assets generated from the
various acquisitions in 1995 and 1996.  The increase in interest expense of
$1,139,000 was attributable to higher debt levels.  The equity in earnings of
the partnership increased as a result of internal expansion and an acquisition
in 1996.

HCR does not believe that inflation has had a material impact on the results of
operations.

NEW ACCOUNTING STANDARD

In June 1997, the Financial Accounting Standards Board issued Statement No.
131, "Disclosures about Segments of an Enterprise and Related Information" (FAS
131), which is effective December 31, 1998, with interim disclosures beginning
in 1999.  Comparative information for prior years is required to be restated.
This Statement requires public business enterprises to report certain
information about operating segments, their products and services, the
geographic areas in which they operate, and their major customers.  The
operating segments should be based on the structure of the enterprise's
internal organization whose operating results are regularly reviewed by the
company's chief operating decision maker to make decisions about resources to
be allocated to the segment and assess its performance.  Management has not
determined the effect, if any, of FAS 131 on the consolidated financial 
statements.


                                      
                                      13
                                      
                                      

<PAGE>   15


CAPITAL RESOURCES AND LIQUIDITY

During 1997, HCR satisfied its cash requirements from a combination of cash
generated from operating activities and borrowing under a bank credit
agreement.  HCR used the cash principally for capital expenditures, acquisition
of businesses, repayment of debt and the purchase of HCR common stock.  At
December 31, 1997, the Company maintained $7,455,000 in cash and cash
equivalents, of which $2,700,000 was invested in short-term investments.

Cash used in investing activities amounted to $105,160,000 in 1997.
Expenditures for property and equipment consisted of $39,862,000 for
renovations, capital improvements and information systems, and $9,670,000 for
the construction of a 180-bed facility in Ann Arbor, Michigan, which was
completed in the second quarter, and the start of construction of a 120-bed
facility near Milwaukee, Wisconsin.  As part of the diversification into other
health care services, HCR acquired various businesses and paid contingent
consideration for prior years' acquisitions for a total of $55,028,000 in 1997.

Net cash provided by financing activities amounted to $37,615,000.  The
increase in debt under the credit agreement of $92,600,000 was partially used
to repay other long-term debt of $20,667,000 which included debt assumed in the
first quarter acquisitions and to purchase 1,139,100 shares of HCR stock for
$38,113,000.  As of December 31, 1997, a total of 6,264,650 HCR shares have
been purchased, pursuant to the authority to purchase up to 8,000,000 HCR
shares through December 31, 1998.

During 1997, a major portion of HCR's credit agreement was extended for another
year in accordance with a provision under which HCR may annually request an
extension of the commitment and, if the lenders agree, the maturity of the
agreement will be extended for an additional year.  At December 31, 1997, the
credit agreement permitted HCR to borrow up to $325,000,000 through August 2,
2001; then the borrowing capacity is reduced to $295,000,000 through August 2,
2002.  HCR had borrowed $285,000,000 and issued letters of credit totalling
$12,359,000, which left a remaining unused borrowing capacity of $27,641,000 at
December 31, 1997.  The letters of credit benefit certain third party insurers
and relate to recorded liabilities.  HCR had obligations under noncancellable
operating leases totalling $37,283,000 at December 31, 1997.

HCR believes that its cash flow from operations will be sufficient to cover
debt payments, future capital expenditures and operating needs.  It is likely
that HCR will pursue growth from acquisitions, partnerships and other ventures
which would be funded from excess cash from operations, credit available under
the bank credit agreement and other financing arrangements that are normally
available in the marketplace.

                                      
                                      
                                      14
                                      


<PAGE>   16


OTHER

HCR is in the process of changing substantially all of its information systems
related to financial reporting and benefits to accommodate its growth strategy.
These information systems are anticipated to be operational by the end of the
first quarter of 1999 and will be Year 2000 compatible.  The estimated costs of
these systems is expected to be less than $15 million.  Most of these costs
will be capitalized and amortized over a five to twelve year period.

HCR has a Year 2000 task force which is determining the extent to which it is
vulnerable to any third party failures to remediate their own Year 2000 issues.
The task force is having, and will continue to have, formal communications with
all of the Company's significant suppliers and large customers to determine the
extent, if any, and the remedies, if needed, to which the Company's interface
systems are vulnerable.  There can be no guarantee that the systems of other
companies on which the Company's systems rely will be timely converted and
would not have an adverse effect on HCR's systems.


                                      
                                      15
                                      
                                      

<PAGE>   17


ITEM 8.  FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

<TABLE>
<CAPTION>
                                                                     Page
                                                                     ----
<S>                                                                  <C>
Report of Ernst & Young LLP Independent Auditors                      17
Consolidated Balance Sheets                                           18
Consolidated Statements of Income                                     19
Consolidated Statements of Cash Flows                                 20
Consolidated Statements of Stockholders' Equity                       21
Notes to Consolidated Financial Statements                            22
Supplementary Data (Unaudited) - Summary of Quarterly Results         35
</TABLE>


                                      
                                      16
                                      
                                      

<PAGE>   18


REPORT OF ERNST & YOUNG LLP INDEPENDENT AUDITORS





The Board of Directors and Stockholders
Health Care and Retirement Corporation

We have audited the accompanying consolidated balance sheets of Health Care and
Retirement Corporation and subsidiaries (HCR) as of December 31, 1997 and 1996,
and the related consolidated statements of income, stockholders' equity and
cash flows for each of the three years in the period ended December 31, 1997.
Our audits also included the financial statement schedule listed in the Index
at Item 14.  These financial statements and schedule are the responsibility of
the Company's management.  Our responsibility is to express an opinion on these
financial statements and schedule based on our audits.

We conducted our audits in accordance with generally accepted auditing
standards.  Those standards require that we plan and perform the audit to
obtain reasonable assurance about whether the financial statements are free of
material misstatement.  An audit includes examining, on a test basis, evidence
supporting the amounts and disclosures in the financial statements.  An audit
also includes assessing the accounting principles used and significant
estimates made by management, as well as evaluating the overall financial
statement presentation.  We believe that our audits provide a reasonable basis
for our opinion.

In our opinion, the financial statements referred to above present fairly, in
all material respects, the consolidated financial position of HCR and
subsidiaries at December 31, 1997 and 1996, and the consolidated results of
their operations and their cash flows for each of the three years in the period
ended December 31, 1997, in conformity with generally accepted accounting
principles.  Also, in our opinion, the related financial statement schedule,
when considered in relation to the basic financial statements taken as a whole,
presents fairly in all material respects the information set forth therein.

                                                               ERNST & YOUNG LLP


Toledo, Ohio
January 27, 1998

                                      
                                      
                                      17
                                      
                                      

<PAGE>   19

                    HEALTH CARE AND RETIREMENT CORPORATION
                                      
                         CONSOLIDATED BALANCE SHEETS

<TABLE>
<CAPTION>
                                                                                   December 31
                                                                                   -----------
                                                                             1997                  1996
                                                                             ----                  ----
<S>                                                                        <C>                   <C>
                                                                          (In thousands, except share data)
ASSETS
Current assets:
 Cash and cash equivalents                                                 $  7,455              $  2,389
 Receivables, less allowances for
  doubtful accounts of $19,184 and $13,335                                  138,049               114,777
 Prepaid expenses                                                             5,408                10,023
 Deferred income taxes                                                       19,839                19,801
                                                                           --------              --------
Total current assets                                                        170,751               146,990

Net property and equipment                                                  552,973               533,457
Intangible assets, net of amortization of $13,764 and $7,602:
 Goodwill                                                                   102,078                43,664
 Other                                                                       32,124                32,472
Other assets                                                                 78,425                46,201
                                                                           --------              --------
Total assets                                                               $936,351              $802,784
                                                                           ========              ========

LIABILITIES AND STOCKHOLDERS' EQUITY
Current liabilities:
 Accounts payable                                                          $ 36,580              $ 32,218
 Employee compensation and benefits                                          36,855                34,425
 Accrued insurance liabilities                                               17,873                23,943
 Other accrued liabilities                                                   29,162                32,448
 Long-term debt due within one year                                             854                 1,417
                                                                           --------              --------
Total current liabilities                                                   121,324               124,451

Long-term debt                                                              292,951               202,295
Deferred income taxes                                                        67,276                66,798
Other liabilities                                                            20,794                16,206

Stockholders' equity:
 Preferred stock, $.01 par value, 5,000,000 shares authorized
 Common stock, $.01 par value, 80,000,000 shares authorized,
 48,860,406 shares issued                                                       489                   489
 Capital in excess of par value                                             273,325               268,036
 Retained earnings                                                          275,519               210,306
                                                                           --------              --------
                                                                            549,333               478,831
 Less treasury stock, at cost (4,637,597 and 3,999,541 shares)             (115,327)              (85,797)
                                                                           --------              --------
Total stockholders' equity                                                  434,006               393,034
                                                                           --------              --------
Total liabilities and stockholders' equity                                 $936,351              $802,784
                                                                           ========              ========
</TABLE>

                                       
                            See accompanying notes.
                                       
                                      18
                                       
                                       


<PAGE>   20
                                      
                    HEALTH CARE AND RETIREMENT CORPORATION
                                      
                      CONSOLIDATED STATEMENTS OF INCOME
                                      

<TABLE>
<CAPTION>
                                               Year ended December 31
                                               ----------------------
                                           1997            1996            1995
                                           ----            ----            ----
<S>                                      <C>             <C>             <C>
                                         (In thousands, except per share amounts)

Revenues                                 $891,963        $782,023        $713,469

Expenses:
 Operating                                705,867         625,331         575,462
 General and administrative                34,983          32,182          30,440
 Depreciation and amortization             37,395          30,677          25,973
                                         --------        --------        --------
                                          778,245         688,190         631,875
                                         --------        --------        --------

Income from operations                    113,718          93,833          81,594
Interest expense                          (17,203)        (11,798)        (10,659)
Interest income                             1,864           1,383             824
Equity in earnings of partnership           2,806           1,500             531
                                         --------        --------        --------

Income before income taxes                101,185          84,918          72,290
Income taxes                               31,064          25,475          21,687
                                         --------        --------        --------

Net income                               $ 70,121        $ 59,443        $ 50,603
                                         ========        ========        ========

Earnings per share:
 Basic                                   $   1.57        $   1.30        $   1.08
 Diluted                                 $   1.51        $   1.24        $   1.03
</TABLE>
                            See accompanying notes.
                                       
                                      19
                                       



<PAGE>   21

                    HEALTH CARE AND RETIREMENT CORPORATION

                    CONSOLIDATED STATEMENTS OF CASH FLOWS


<TABLE>
<CAPTION>
                                                                           Year ended December 31
                                                                            ----------------------
                                                                       1997         1996         1995
                                                                       ----         ----         ----  
                                                                               (In thousands)
<S>                                                                   <C>            <C>        <C>
OPERATING ACTIVITIES
Net income                                                            $70,121      $59,443      $50,603
Adjustments to reconcile net income to net                                                    
 cash provided by operating activities:                                                       
 Depreciation and amortization                                         37,709       32,020       27,630
 Provision for bad debts                                               10,644        8,073        5,288
 Deferred income taxes                                                  3,537        2,750        4,391
 Equity in earnings of partnership                                     (2,806)      (1,500)        (531)
 Gain from sale of property and equipment                                                        (1,538)
 Changes in assets and liabilities,                                                           
  excluding businesses acquired:                                                              
  Receivables                                                         (23,656)     (21,835)     (17,307)
  Prepaid expenses and other assets                                   (24,770)       4,110      (18,137)
  Accounts payable                                                      3,172       (1,683)      (1,013)
  Employee compensation and benefits                                    2,507        4,227        2,800
  Accrued insurance and other liabilities                              (3,847)       5,870        7,333
                                                                     --------     --------     --------
Total adjustments                                                       2,490       32,032        8,916
                                                                     --------     --------     --------
                                                                                              
Net cash provided by operating activities                              72,611       91,475       59,519
                                                                     --------     --------     --------
                                                                                              
INVESTING ACTIVITIES                                                                          
Purchases and construction of property                                                        
 and equipment                                                        (49,532)     (51,901)     (33,877)
Proceeds from sale of property and equipment                                                      5,486
Cash paid to acquire businesses                                       (55,028)     (36,548)     (35,236)
Investment in partnership                                                (600)      (3,945)      (1,975)
                                                                     --------     --------     --------
Net cash used in investing activities                                (105,160)     (92,394)     (65,602)
                                                                     --------     --------     --------
                                                                                              
FINANCING ACTIVITIES                                                                          
Net borrowings under bank credit agreement                             92,600       42,400       14,000
Principal payments of long-term debt                                  (20,667)      (1,896)      (4,950)
Proceeds from exercise of stock options                                 3,795        2,573        3,084
Purchase of common stock for treasury                                 (38,113)     (47,511)     (28,161)
                                                                     --------     --------     --------
Net cash provided by (used in) financing activities                    37,615       (4,434)     (16,027)
                                                                     --------     --------     --------
                                                                                              
Net increase (decrease) in cash                                         5,066       (5,353)     (22,110)
Cash and cash equivalents at beginning of year                          2,389        7,742       29,852
                                                                     --------     --------     --------
Cash and cash equivalents at end of year                              $ 7,455      $ 2,389      $ 7,742
                                                                     ========     ========     ========
</TABLE>

                                       
                            See accompanying notes.
                                       
                                       20
                                       

<PAGE>   22


                    HEALTH CARE AND RETIREMENT CORPORATION

               CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY


<TABLE>
<CAPTION>
                                                      Capital                                        Total  
                                                     in Excess                                      Stock-  
                                         Common       of Par          Retained        Treasury      holders 
                                         Stock         Value          Earnings         Stock         Equity 
                                         -----         -----          --------         ------        ------
                                                           (In thousands, except share data)
<S>                                       <C>        <C>              <C>              <C>          <C>
Balance at January 1, 1995                $326       $259,863         $107,266       $(22,954)       $344,501

   Vesting of restricted stock                          1,012                                           1,012
   Purchase of treasury stock
    (1,483,500 shares)                                                                (28,161)        (28,161)
   Exercise of stock options (522,675
    shares issued from treasury shares)                                 (3,336)         6,530           3,194
   Tax benefit from restricted stock
    and exercise of stock options                       3,281                                           3,281
   Net income                                                           50,603                         50,603
                                         ------      --------         --------       --------        --------
Balance at December 31, 1995                326       264,156          154,533        (44,585)        374,430

   Vesting of restricted stock                          1,012                                           1,012
   Purchase of treasury stock
    (1,939,400 shares)                                                                (47,511)        (47,511)
   Exercise of stock options (370,939
    shares issued from treasury shares)                                 (3,670)         6,299           2,629
   Tax benefit from restricted stock
    and exercise of stock options                       3,031                                           3,031
   Effect of 50% stock distribution         163          (163)
   Net income                                                           59,443                         59,443
                                         ------      --------         --------       --------        --------
Balance at December 31, 1996                489       268,036          210,306        (85,797)        393,034

   Purchase of treasury stock
    (1,149,897 shares, including 10,797
    shares from employees)                                                            (38,510)        (38,510)
   Exercise of stock options (511,841
    shares issued from treasury shares)                                 (4,908)         8,980           4,072
   Tax benefit from exercise
    of stock options                                    5,289                                           5,289
   Net income                                                           70,121                         70,121
                                         ------      --------         --------       --------        --------
Balance at December 31, 1997               $489      $273,325         $275,519      $(115,327)       $434,006
                                         ======      ========         ========      =========        ========
</TABLE>


                            See accompanying notes.

                                      21


<PAGE>   23


                     HEALTH CARE AND RETIREMENT CORPORATION

                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


1.   ACCOUNTING POLICIES

NATURE OF OPERATIONS
Health Care and Retirement Corporation (HCR or Company) is a provider of a
range of health care services, including long term care, subacute medical care,
rehabilitation therapy, home health care, pharmacy services and management
services for subacute care, rehabilitation therapy, vision care and eye
surgery.  The most significant portion of HCR's business relates to long term
care, operating 129 centers in 16 states with more than half located in Ohio,
Michigan and Florida.  Within HCR's centers, there are 63 medical specialty
units which provide subacute medical care, rehabilitation programs or
Alzheimer's care programs.  HCR provides rehabilitation therapy in nursing
centers of HCR and others, and 73 outpatient therapy clinics serving the
midwestern and mid-Atlantic states, Texas and Florida.  The home health care
business specializes in all levels of home health, hospice care and
rehabilitation therapy from 33 offices located in Ohio, Michigan, Indiana,
Illinois and Florida.  HCR owns 50% of a pharmacy partnership that provides
pharmaceutical products to long term care centers and pharmacies.  Management
services are provided to 53 subacute care and acute rehabilitation programs in
hospitals and skilled nursing centers and 10 comprehensive outpatient
rehabilitation facilities (CORFs) located in 14 states.  HCR has entered into
long-term agreements that provide capital and management services to physician
practices in the midwestern states, specializing in vision care and refractive
eye surgery.

BASIS OF PRESENTATION
The consolidated financial statements include the accounts of HCR and its
majority owned subsidiaries.  Significant intercompany accounts and
transactions have been eliminated in consolidation.  HCR's 50% ownership
investment in a pharmacy partnership is recorded under the equity method.

USE OF ESTIMATES
The preparation of financial statements in conformity with generally accepted
accounting principles requires management to make estimates and assumptions
that affect the amounts reported in the financial statements and accompanying
notes.  Actual results could differ from those estimates.

CASH EQUIVALENTS
Investments with a maturity of three months or less when purchased are
considered cash equivalents for purposes of the statements of cash flows.

RECEIVABLES AND REVENUES
Revenues are recognized when the related patient services are provided.
Receivables and revenues are stated at amounts estimated by management to be
the net realizable value.


                                      22



<PAGE>   24


PROPERTY AND EQUIPMENT
Property and equipment is recorded at cost.  Depreciation is provided on the
straight-line method over the estimated useful lives of the assets, generally 5
to 10 years for equipment and furnishings and 20 to 40 years for buildings and
improvements.

INTANGIBLE ASSETS
Goodwill and other intangible assets of businesses acquired are amortized by
the straight-line method over periods ranging from 5 to 15 years for noncompete
agreements, 40 years for management contracts which represent the related term
of the contracts and 40 years for goodwill.  Deferred financing costs are
amortized to interest expense over the life of the related borrowings, using
the interest method.

IMPAIRMENT OF LONG-LIVED ASSETS
The carrying value of long-lived and intangible assets is reviewed quarterly to
determine if facts and circumstances suggest that the assets may be impaired or
that the amortization period may need to be changed.  HCR considers external
factors relating to each asset, including contract changes, local market
developments, national health care trends and other publicly available
information.  If these external factors and the projected undiscounted cash
flows of the company over the remaining amortization period indicate that the
asset will not be recoverable, the carrying value will be adjusted to the
estimated fair value.  As of December 31, 1997, HCR does not believe there is
any indication that the carrying value or the amortization period of its assets
needs to be adjusted.

INVESTMENT IN LIFE INSURANCE
Investment in corporate owned life insurance policies is recorded net of policy
loans in other assets.  The net life insurance expense, which includes premiums
and interest on cash surrender borrowings, net of all increases in cash
surrender values, is included in operating expenses.

INCOME TAXES
HCR accounts for income taxes under the liability method as required by
Statement of Financial Accounting Standards No. 109, "Accounting for Income
Taxes."  HCR and its subsidiaries file a consolidated federal income tax
return.

TREASURY STOCK
HCR records the purchase of its common stock for treasury at cost.  Differences
between the proceeds for reissuance of treasury stock and the cost of the
treasury stock, based on the first-in, first-out method, are charged to
retained earnings.

STOCK BASED COMPENSATION
Stock options are granted for a fixed number of shares to employees with an
exercise price equal to the fair value of the shares at the date of grant.  HCR
accounts for the stock option grants in accordance with APB Opinion No. 25,
"Accounting for Stock Issued to Employees," and, accordingly, recognizes no
compensation expense for the stock options.



                                       23



<PAGE>   25

EARNINGS PER SHARE 
Effective December 31, 1997, HCR changed its method of computing
earnings per share (EPS) as required by Statement of Financial Accounting
Standards No. 128 "Earnings Per Share" (FAS 128).  FAS 128 replaced the
previously reported primary and fully diluted EPS with basic and diluted EPS. 
Basic EPS is computed by dividing net income (income available to common
stockholders) by the weighted-average number of common shares outstanding
during the period. The computation of diluted EPS is similar to basic EPS
except that the number of shares is increased to include the number of
additional common shares that would have been outstanding if the dilutive
potential common shares had been issued.  Dilutive potential common shares for
HCR include shares issuable upon exercise of HCR's nonqualified stock options
and restricted stock that has not vested.  EPS amounts for prior periods have
been restated.

NEW ACCOUNTING STANDARD
In June 1997, the Financial Accounting Standards Board issued Statement No.
131, "Disclosures about Segments of an Enterprise and Related Information" (FAS
131), which is effective December 31, 1998, with interim disclosures beginning
in 1999.  Comparative information for prior years is required to be restated.
This Statement requires public business enterprises to report certain
information about operating segments, their products and services, the
geographic areas in which they operate, and their major customers.  The
operating segments should be based on the structure of the enterprise's
internal organization whose operating results are regularly reviewed by the
company's chief operating decision maker to make decisions about resources to
be allocated to the segment and assess its performance.  Management has not
determined the effect, if any, of FAS 131 on the consolidated financial
statements.

2.   EARNINGS PER SHARE

The calculation of earnings per share (EPS) is as follows:

<TABLE>
<CAPTION>
                                                1997       1996       1995
                                                ----       ----       ----
   <S>                                        <C>        <C>        <C>
                                                 (In thousands, except EPS)
   Numerator:
      Net income (income available to common
       stockholders)                            $70,121    $59,443    $50,603

   Denominator:
      Denominator for basic EPS - weighted-
       average shares                            44,548     45,708     46,833
      Effect of dilutive securities:
         Stock options                            1,967      2,127      2,130
                                                -------    -------    -------
      Denominator for diluted EPS - adjusted
       weighted-average shares and assumed
       conversions                               46,515     47,835     48,963
                                                =======    =======    =======

   Basic EPS                                      $1.57      $1.30      $1.08
   Diluted EPS                                    $1.51      $1.24      $1.03
</TABLE>



                                       24


<PAGE>   26


Options to purchase shares of HCR common stock were outstanding but were not
included in the computation of diluted EPS because the options' exercise price
was greater than the average market price of the common shares as follows:
408,275 shares granted in December 1997 at $39.44 for the 1997 calculation,
370,550 shares granted in December 1996 at $27.75 for the 1996 calculation and
455,700 shares granted in November 1995 at $21.50 for the 1995 calculation.
Restricted stock awards of 339,500 shares in 1997 were not included in the
computation of diluted EPS because the effect would be antidilutive.

3.   ACQUISITIONS

HCR paid $55,028,000, $36,548,000 and $35,236,000 in 1997, 1996 and 1995,
respectively, for the acquisition of various businesses, including home health
care, rehabilitation therapy and management services agreements for subacute
care, rehabilitation therapy, vision care and eye surgery. The acquisitions
were accounted for under the purchase method of accounting.  In 1997 HCR
acquired assets of $12,000,000, assumed liabilities of $21,000,000 and recorded
$64,000,000 of intangible assets.  HCR also recorded intangible assets of
$34,100,000 and $32,225,000 in 1996 and 1995, respectively.  Certain of these
agreements contain a provision for additional consideration contingent upon the
future financial results of the business.  The maximum contingent consideration
aggregates $54,288,000 and will, if earned, be paid over the next five years
and treated as additions to the purchase price of the businesses.  The results
of operations of the acquired businesses are included in the consolidated
statements of income from the date of acquisition.  The pro forma consolidated
results of operations would not be materially different from the amounts
reported in 1997 and 1996.

4.   REVENUES

HCR receives reimbursement under the federal Medicare program and various state
Medicaid programs.  Revenues under these programs totalled $500,000,000,
$469,000,000 and $437,000,000 for the years ended December 31, 1997, 1996 and
1995, respectively.  Medicare and certain Medicaid program revenues are subject
to audit and retroactive adjustment by government representatives.  In the
opinion of management, any differences between the net revenue recorded and
final determination will not materially affect the consolidated financial
statements.  Net third party settlements receivable amounted to $8,972,000 and
$11,381,000 at December 31, 1997 and 1996, respectively.  There were no
non-governmental receivables which represented amounts in excess of 10% of
total receivables at December 31, 1997 and 1996.



                                      25




<PAGE>   27

5.   PROPERTY AND EQUIPMENT

<TABLE>
<CAPTION>

Property and equipment consists of the following:
                                                  1997      1996
                                                  ----      ----  
<S>                                             <C>       <C>
                                                  (In thousands)

Land and improvements                           $ 66,966  $ 63,154
Buildings and improvements                       476,687   450,496
Equipment and furnishings                        131,958   111,124
Construction in progress                          14,846    15,445
                                                --------  --------
                                                 690,457   640,219
Less accumulated depreciation                    137,484   106,762
                                                --------  --------
Net property and equipment                      $552,973  $533,457
                                                ========  ========
</TABLE>


Depreciation expense amounted to $30,747,000, $27,462,000 and $23,307,000 for
the years ended December 31, 1997, 1996 and 1995, respectively.

6.   LONG-TERM DEBT


<TABLE>
<CAPTION>
Long-term debt consists of the following:
                                                  1997      1996   
                                                  ----      ----   
  <S>                                           <C>       <C>      
                                                   (In thousands)     
Debt under the Credit Agreement                 $285,000  $192,400 
Real estate mortgage and installment notes         1,234     2,046 
Industrial development revenue bonds               3,130     3,290 
Capital lease obligations (see Note 7)             4,441     5,976 
                                                --------  -------- 
                                                 293,805   203,712 
Less amounts due within one year                     854     1,417 
                                                --------  -------- 
                                                $292,951  $202,295 
                                                ========  ======== 

</TABLE>


At December 31, 1997, HCR has an unsecured credit agreement with a group of
banks (the Credit Agreement) which provides for an extendible $325,000,000
revolving loan commitment through August 2, 2001, then the borrowing capacity
is reduced to $295,000,000 through August 2, 2002.  The Credit Agreement
includes a provision under which HCR may annually request an extension of the
commitment and, if the lenders agree, the maturity of the agreement will be
extended for an additional year.  The amount available for additional direct
borrowing and letters of credit was $27,641,000 at December 31, 1997.

Loans under the Credit Agreement bear interest at variable rates which reflect,
at the election of the Company, either the agent bank's base lending rate, an
increment of .225% to .55% over Eurodollar indices depending on the quarterly
performance of a key ratio, or rates offered by any of the participating banks
under bid procedures.  The average interest rate on loans under the Credit
Agreement was 6.19% and 5.94% at December 31, 1997 and 1996, respectively.  A
commitment fee is charged on unused credit availability ranging from an annual
rate of .08% to .20% depending on the quarterly performance of a key ratio.



                                      26



<PAGE>   28

The Credit Agreement contains various covenants, restrictions and events of
default.  Among other things, these provisions require HCR to maintain certain
financial ratios and restrict its ability to incur indebtedness, create liens
or dispose of assets in excess of specified levels.

The real estate mortgage notes and certain industrial development revenue bonds
are collateralized by real estate.  Amounts under these facilities are payable
monthly at varying interest rates from 9.75% to 11.58%.  Maturities range from
2000 to 2008.

Long-term debt maturities for the five years subsequent to December 31, 1997
are as follows: 1998 - $854,000; 1999 - $1,006,000; 2000 - $962,000; 2001 -
$590,000 and  2002 - $285,642,000.

Capitalized interest costs amounted to $436,000, $655,000 and $257,000 for the
years ended December 31, 1997, 1996 and 1995, respectively.

Interest paid amounted to $16,206,000, $10,496,000 and $9,794,000 for the years
ended December 31, 1997, 1996 and 1995, respectively.

7.   LEASES

HCR leases certain property and equipment under both operating and capital
leases, which expire at various dates to 2036.  Certain of the facility leases
contain purchase options.  The cost and accumulated amortization of property
and equipment under capital leases were:


<TABLE>
<CAPTION>
                                                 1997     1996
                                                 ----     ----  
<S>                                            <C>      <C>
                                                (In thousands)
Land and improvements                          $ 1,330  $ 1,426
Buildings and improvements                      15,636   18,975
Equipment and furnishings                        2,580    3,016
                                               -------  -------
                                                19,546   23,417
Less accumulated amortization                    1,509    1,480
                                               -------  -------
                                               $18,037  $21,937
                                               =======  =======
</TABLE>


                                      27



<PAGE>   29


Payments under noncancellable operating leases, minimum lease payments and the
present value of net minimum lease payments under capital leases as of December
31, 1997 are as follows:


<TABLE>
<CAPTION>
                                                Operating  Capital
                                                 Leases    Leases
                                                ---------  -------
<S>                                               <C>        <C>
                                                    (In thousands)
                                                    
1998                                              $ 8,779     $449
1999                                                8,003      453
2000                                                6,567      456
2001                                                5,519      461
2002                                                4,521      465
Later years                                         3,894   11,540
                                                  -------   ------
Total minimum lease payments                      $37,283   13,824
                                                  =======
                                                    
Less amount representing interest                            9,383
                                                            ------
                                                    
Present value of net minimum                        
 lease payments (included in                        
 long-term debt - see Note 6)                               $4,441
                                                            ======
</TABLE>


Rental expense was $11,476,000, $9,361,000 and $7,704,000 for the years ended
December 31, 1997, 1996 and 1995, respectively.

8.   INCOME TAXES

The provision for income taxes consists of the following:


<TABLE>
<CAPTION>
                                  1997        1996       1995
                                  ----        ----       ----   
<S>                              <C>       <C>           <C>
                                          (In thousands)
Current:                       
 Federal                         $25,541    $21,025    $15,809    
 State and local                   1,986      1,700      1,487    
                                 -------    -------    -------    
                                  27,527     22,725     17,296    
                                                                  
Deferred:                                                         
 Federal                           2,993      2,327      3,715    
 State and local                     544        423        676    
                                 -------    -------    -------    
                                   3,537      2,750      4,391    
                                 -------    -------    -------    
                                 $31,064    $25,475    $21,687    
                                 =======    =======    =======    
</TABLE>


                                      
                                       28




<PAGE>   30

The reconciliation of the amount computed by applying the statutory federal
income tax rate to income before income taxes to the provision for income taxes
is as follows:


<TABLE>
<CAPTION>
                                             1997        1996         1995
                                             ----        ----         ----  
<S>                                         <C>      <C>             <C>
                                                     (In thousands)
Income taxes computed at statutory rate     $35,415     $29,721      $25,302
Differences resulting from:                                        
 State and local income taxes                 1,644       1,380        1,406
 Corporate owned life insurance              (6,455)     (5,620)      (5,329)
 Other                                          460          (6)         308
                                            -------     -------      -------
Provision for income taxes                  $31,064     $25,475      $21,687
                                            =======     =======      =======
</TABLE>


Under FAS 109, deferred income taxes reflect the net tax effects of temporary
differences between the carrying amounts of assets and liabilities for
financial reporting purposes and the amount used for income tax purposes.
Significant components of HCR's federal and state deferred tax assets and
liabilities are as follows:


<TABLE>
<CAPTION>
                                                         1997     1996
                                                         ----     ----  
<S>                                                     <C>      <C>
                                                        (In thousands)
Net current deferred tax assets:                       
 Allowances for receivables and settlements              $8,523   $6,710
 Accrued insurance reserves                               6,927    9,214
 Employee compensation and benefits                       5,195    5,066
 Other                                                     (806)  (1,189)
                                                        -------  -------
                                                        $19,839  $19,801
                                                        =======  =======
                                                       
Net noncurrent deferred tax liabilities:               
 Fixed asset bases and depreciation differences         $69,712  $66,008
 Pension receivable                                       5,984    5,388
 Deferred compensation                                   (5,118)  (3,312)
 Life insurance                                          (1,561)  (1,184)
 Noncompete agreements                                   (1,404)  (1,404)
 Other                                                     (337)   1,302
                                                        -------  -------
                                                        $67,276  $66,798
                                                        =======  =======
</TABLE>


Income taxes payable amounted to $17,250,000 and $19,601,000 at December 31,
1997 and 1996, respectively.  Income taxes paid amounted to $24,986,000,
$18,380,000 and $13,623,000 for the years ended December 31, 1997, 1996 and
1995, respectively.

9.   STOCK PLANS

HCR has stock option plans for key employees and for outside directors
which authorize the grant of options for up to 8,199,000 and 300,000 shares,
respectively.  There were 1,936,687 and 2,297,634 shares available for future
grant at December 31, 1997 and 1996, respectively. Generally, the exercise
price of each option equals the market price of HCR's stock on the date of
grant and an option's maximum term is ten years.  The options for key employees
vest at the end of three years and the options for outside directors vest 
immediately.



                                      29



<PAGE>   31

In accordance with Statement of Financial Accounting Standards No. 123, 
"Accounting for Stock-Based Compensation" (FAS 123), HCR has elected to apply 
Accounting Principles Board Opinion No. 25, "Accounting for Stock Issued to 
Employees," and related interpretations in accounting for its plans and
accordingly, did not recognize compensation expense for options granted in
1997,1996 and 1995.  If HCR had accounted for its 1997, 1996 and 1995 options
under the fair value method of FAS 123, net income and earnings per share would
have been reduced to the pro forma amounts indicated below:


<TABLE>
<CAPTION>
                                      1997         1996         1995
                                      ----         ----         ----
<S>                                   <C>          <C>          <C>
Net income - as reported             $70,121      $59,443      $50,603  
Net income - pro forma               $68,531      $58,558      $50,373  
                                                                        
Earnings per share - as reported:                                       
  Basic                                $1.57        $1.30        $1.08  
  Diluted                              $1.51        $1.24        $1.03  
Earnings per share - pro forma:                                         
  Basic                                $1.54        $1.28        $1.08  
  Diluted                              $1.47        $1.23        $1.03  
</TABLE>

The pro forma effect on net income for 1997, 1996 and 1995 is not       
representative of the pro forma effect on net income in future years, because
it does not take into consideration pro forma compensation expense related to
grants prior to 1995.  The pro forma effect will not be fully reflected until
1998.

The fair value of each option grant is estimated on the date of grant using a   
Black-Scholes option pricing model with the following weighted average
assumptions used for grants in 1997, 1996 and 1995, respectively:  dividend
yield of 0% for all years; expected volatility of 20% in all years; risk-free
interest rates of 5.92%, 5.95% and 5.78%; and expected lives of 5.7, 5.9 and
5.7 years.  The weighted average fair value of options granted is $13.01, $9.45
and $7.10 per share in 1997, 1996 and 1995, respectively.  The option valuation
model was developed for use in estimating the fair value of traded options
which have no vesting restrictions and are fully transferable.  In addition,
option valuation models require the input of highly subjective assumptions
including the expected stock price volatility.  Since HCR's stock options have
characteristics significantly different from those of traded options, and since
variations in the subjective input assumptions can materially affect the fair
value estimate, in management's opinion, the existing models do not necessarily
provide a reliable single measure of the fair value of its employee stock
options.



                                      30


<PAGE>   32

Information regarding these option plans for 1995, 1996 and 1997 is as follows:


<TABLE>
<CAPTION>
                                                               Weighted   
                                                                Average   
                                                               Exercise   
                                                  Shares         Price    
                                                  ------       --------   
<S>                                               <C>          <C>        
Options outstanding at
  January 1, 1995                               5,170,156        $7.60 
Options granted                                   491,700       $21.31 
Options forfeited                                (111,187)      $11.49 
Options exercised                                (522,675)       $5.90 
                                                ---------              
                                                                       
Options outstanding at                                                 
  December 31, 1995                             5,027,994        $9.03 
Options granted                                   406,550       $27.40 
Options forfeited                                 (77,400)      $16.34 
Options exercised                                (370,939)       $6.94 
                                                ---------              
                                                                       
Options outstanding at                                                 
  December 31, 1996                             4,986,205       $10.57 
Options granted                                   455,072       $38.77 
Options forfeited                                 (94,125)      $21.58 
Options exercised                                (511,841)       $7.80 
                                                ---------              
                                                                       
Options outstanding at                                                 
  December 31, 1997                             4,835,311       $13.31 
                                                =========      
Options exercisable at                                                 
  December 31, 1995                             3,098,807        $6.42 
  December 31, 1996                             3,781,167        $6.86 
  December 31, 1997                             3,701,561        $8.23       
</TABLE> 
                                                                             
The following tables summarize information about options outstanding        
and options exercisable at December 31, 1997:                
              
                                                                             
<TABLE>
<CAPTION>
                              Options Outstanding
                              -------------------
                                                     Weighted
                                         Weighted    Average
 Range of                                Average     Remaining
 Exercise                   Number       Exercise   Contractual
  Prices                  Outstanding     Price        Life
  ------                  -----------    --------   -----------
<S>                        <C>            <C>        <C>
 $5 - $10                   2,874,614      $5.82        4.0
$10 - $20                     747,250     $15.21        6.4
$20 - $30                     759,273     $24.52        8.4
$30 - $40                     454,174     $38.78        9.7
                            ---------                      
                            4,835,311     $13.31        5.5
                           ==========   
</TABLE>


                                      31



<PAGE>   33

<TABLE>
<CAPTION>

                         Options Exercisable
                         -------------------

                                      Weighted
Range of                               Average
Exercise                  Number      Exercise
Prices                  Exercisable    Price
- ----------              -----------  ----------
<S>                     <C>          <C>                  
 $5 - $10                2,874,614       $5.82           
$10 - $20                  743,650      $15.23           
$20 - $30                   37,398      $23.90           
$30 - $40                   45,899      $32.97           
                        ----------                       
                         3,701,561       $8.23           
                        ==========                       
</TABLE>


HCR  has a restricted stock plan for corporate officers and certain key
senior management employees which authorizes up to 1,392,866 restricted shares
to be issued.  During 1991 corporate officers were issued 892,866 restricted
shares that vested 20% of the shares each year.  During 1997 executive officers
and key senior management employees were awarded 339,500 restricted shares
contingent upon the achievement during 1997 of certain performance-based
criteria.  Such criteria were met at December 31, 1997. The restricted stock
will be issued in early 1998 after certification by the Board of Directors that
the criteria were achieved.  The restrictions associated with the restricted
stock will lapse as of December 31, 2000 for key senior management employees and
the later of December 31, 2000 or retirement for corporate officers.

Compensation expense related to stock options granted in October, 1991 and 
restricted stock was $450,000, $1,010,000 and $1,221,000 for the years ended
December 31, 1997, 1996 and 1995, respectively.

10.  EMPLOYEE BENEFIT PLANS

HCR has a qualified, defined benefit pension plan (Pension Plan) with benefits
based on compensation and length of service.  The Pension Plan was amended in
1994 to freeze all future benefits under the plan.  The Pension Plan covered
substantially all full-time employees as of December 31, 1994.


<TABLE>
<CAPTION>
The funded status of the Pension Plan is as follows:
                                                         1997       1996
                                                         ----       ----        
                                                         (In thousands)
<S>                                                  <C>          <C>
Actuarial present value of benefit obligations:
      Vested                                          $  16,795   $  18,216 
      Nonvested                                             996       2,517 
                                                      ---------   --------- 
Accumulated benefit obligation                        $  17,791   $  20,733 
                                                      =========   ========= 
                                                                            
Projected benefit obligation                          $  17,791   $  20,733 
Plan assets at fair value                                37,922      33,295 
                                                      ---------   --------- 
Plan assets in excess of                                                    
 projected benefit obligation                           (20,131)    (12,562) 
Unrecognized net gain (loss)                              4,632      (1,254) 
                                                      ---------   --------- 
Prepaid pension cost at end of year                   $ (15,499)  $ (13,816) 
                                                      =========   ========= 
</TABLE>



                                      32


<PAGE>   34


The components of the net pension income for the Pension Plan are as follows:

<TABLE>
<CAPTION>
                                                     1997      1996        1995                                        
                                                     ----      ----        ----                                        
                                                             (In thousands)                                            
<S>                                               <C>        <C>          <C>
Interest cost on projected benefit obligation      $  1,266   $  1,507    $  1,381                                      
Actual return on plan assets                         (6,445)    (4,146)     (6,776)                                      
Net amortization and deferral                         3,496      1,165       3,998                                      
                                                   --------   --------    --------                                      
Net pension income                                 $ (1,683)  $ (1,474)   $ (1,397)                                      
                                                   ========   ========    ========                                      
</TABLE>


The actuarial present value of benefit obligations is based on a discount rate
of 7.5% at December 31, 1997 and 1996.  The freezing of future pension benefits
during 1994 eliminated any future salary increases from the computation
effective December 31, 1994.  The expected long-term rate of return on assets
is 10% for 1997 and 1996.  Plan assets include commingled funds with
investments in marketable equity securities, international equity securities
and government and corporate debt securities.

HCR has a Senior Executive Retirement Plan (SERP) which is a non-qualified plan
designed to provide pension benefits and life insurance for corporate officers
(15 employees).  Pension benefits are based on compensation and length of
service.  The benefits under the SERP are provided from a combination of the
benefits to which the corporate officers are entitled under the Pension Plan
and from life insurance policies that are owned by the corporate officers who
have assigned the corporate interest (HCR's share of premiums paid) in the
policies to HCR.  HCR's share of the cash surrender value of the policies was
$14,200,000 and $11,879,000 at December 31, 1997 and 1996, respectively, and
was included in other assets.  The accrued and unfunded liability was
$3,683,000 and $2,697,000 at December 31, 1997 and 1996, respectively, and was
included in other long-term liabilities.

HCR maintains a savings program qualified under Section 401(k) of the Internal
Revenue Code (401(k)) which allows an eligible employee the opportunity to
invest in the 401(k)'s various investment funds.  In order to maintain the
qualified status of the 401(k), it was amended to exclude highly compensated
employees after December 31, 1992.  In conjunction with this amendment, HCR
adopted the Senior Management Savings Plan (SMSP) which is a non-qualified,
unfunded deferred compensation program designed to provide essentially the same
benefits as the 401(k).

HCR contributes an amount equal to one-half of the participant's 401(k)
contributions up to a maximum matching contribution of 2% or 3% of the
participant's base salary depending on the participant's date of employment.
Company matching contributions to the 401(k) amounted to $1,510,000, $1,172,000
and $898,000 for the years ended December 31, 1997, 1996 and 1995,
respectively.  The increase in matching contributions was due to additional
employees from acquisitions and the participation of previously ineligible
employees.

                                      33


<PAGE>   35

Under the SMSP, HCR accrues an amount equal to one-half of the participant's
SMSP salary deferral up to a maximum matching amount of 3% of the participant's
compensation, as defined, and accrues the earnings calculated on each
participant's unit investments.  HCR's expense for the matching amount and the
earnings amounted to $2,539,000, $1,180,000 and $1,220,000 for the years ended
December 31, 1997, 1996 and 1995, respectively.  The increase in expense
relates primarily to growth in earnings on the unit investments.

11.  FAIR VALUE OF FINANCIAL INSTRUMENTS

The carrying amount and fair value of the financial instruments are as follows:


<TABLE>
<CAPTION>
                                         1997               1996
                                   -----------------  -----------------
                                   Carrying   Fair    Carrying   Fair
                                    Amount    Value    Amount    Value
                                   --------  -------  --------  -------
<S>                                <C>       <C>      <C>       <C>
                                             (In thousands)
                                  
Cash and cash equivalents           $ 7,455  $ 7,455   $ 2,389  $ 2,389
Long-term debt, excluding         
capitalized leases                  289,364  289,989   197,736  198,279
</TABLE>


The carrying amount of cash and cash equivalents is equal to its fair value due
to the short maturity of the investments.

The carrying amount of the long-term debt, excluding capitalized lease
obligations, approximates its fair value due to the significant amount of
variable rate, long-term debt.  The fair value is estimated using discounted
cash flow analyses, based on HCR's current incremental borrowing rates.

12.  STOCKHOLDER RIGHTS PLAN

On May 2, 1995, the Board of Directors of HCR declared a dividend of one right
for each outstanding share of HCR's common stock.  An exercisable right, under
certain circumstances, will entitle the holder to purchase from the Company one
one-hundredth of a share of Series A Junior Participating Preferred Stock for
an exercise price of $100, subject to adjustment.  The rights expire on May 2,
2005.  Such rights will not be exercisable nor transferable apart from the
common stock until ten days after a person or group acquires 15% of HCR's
common stock or initiates a tender offer or exchange offer that would result in
ownership of 15% of HCR's common stock.  In the event that HCR is merged, and
its common stock is exchanged or converted, the rights will entitle the holders
to buy shares of the acquirer's common stock at a 50% discount.  Under certain
other circumstances, the rights can become rights to purchase HCR's common
stock at a 50% discount.  The rights may be redeemed by HCR for one cent per
right at any time prior to the first date that a person or group acquires a
beneficial ownership of 15% of HCR's common stock.



                                       34


<PAGE>   36


                    HEALTH CARE AND RETIREMENT CORPORATION

                        SUPPLEMENTARY DATA (UNAUDITED)

                         SUMMARY OF QUARTERLY RESULTS




<TABLE>
<CAPTION>
                                      Year ended December 31, 1997
                                      ----------------------------    
                          First      Second      Third       Fourth      Year
                          -----     -------      -----       ------      ----  
                                  (In thousands, except per share amounts)
<S>                     <C>          <C>         <C>         <C>       <C>
Revenues                 $213,912    $220,356    $226,606    $231,089  $891,963
Income from operations     26,923      28,209      29,310      29,276   113,718
Net income                 16,324      17,219      18,151      18,427    70,121

Earnings per share:
 Basic                      $0.37       $0.39       $0.41       $0.41     $1.57
 Diluted                    $0.35       $0.37       $0.39       $0.40     $1.51
</TABLE>



<TABLE>
<CAPTION>
                                      Year ended December 31, 1996
                                      ----------------------------    
                          First      Second      Third       Fourth      Year
                          -----     -------      -----       ------      ----  
 <S>                     <C>       <C>         <C>         <C>         <C>
 Revenues                $187,645    $194,267    $199,205    $200,906  $782,023
 Income from operations    22,235      22,895      24,192      24,511    93,833
 Net income                13,931      14,630      15,232      15,650    59,443

 Earnings per share:
  Basic                     $0.30       $0.32       $0.34       $0.35     $1.30
  Diluted                   $0.29       $0.30       $0.32       $0.33     $1.24
</TABLE>



The 1996 and first three quarters of 1997 earnings per share amounts have been
restated to comply with Statement of Financial Accounting Standards No. 128,
"Earnings Per Share."

                                       35


<PAGE>   37

ITEM 9.  CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON
ACCOUNTING AND FINANCIAL DISCLOSURE

None

                                   PART III

ITEM 10.  DIRECTORS AND EXECUTIVE OFFICERS OF THE REGISTRANT

Information on directors of the Registrant is incorporated herein by reference
under the heading "Election of Directors" in the Registrant's Proxy Statement
which will be filed pursuant to Regulation 14A with the Commission prior to
April 30, 1998.  The names, ages, offices and positions held during the last
five years of each of the Company's executive officers and other corporate
officers is set forth below.

                              EXECUTIVE OFFICERS

<TABLE>
<CAPTION>

NAME                 AGE  OFFICE AND EXPERIENCE
- ----                 ---  ---------------------
<S>                  <C>  <C>
PAUL A. ORMOND       48   Chairman of the Board, President and Chief Executive
                          Officer of HCR since August 1991 and President and
                          Chief Executive Officer of Health Care and Retirement
                          Corporation of America (HCRA), a subsidiary of the
                          Company, since October 1991.  Member of Class I of
                          the Board of Directors of the Company, with a term
                          expiring in 1998.

M. KEITH WEIKEL      59   Senior Executive Vice President and Chief Operating
                          Officer of HCR since August 1991 and Senior Executive
                          Vice President and Chief Operating Officer of HCRA
                          since October 1991.  Member of Class III of the Board
                          of Directors of the Company, with a term expiring in
                          2000.

GEOFFREY G. MEYERS   53   Executive Vice President, Chief Financial Officer and
                          Treasurer of HCR since August 1991 and Executive Vice
                          President and Chief Financial Officer of HCRA since
                          October 1991.  Member of Class II of the Board of
                          Directors of the Company, with a term expiring in
                          1999.

R. JEFFREY BIXLER    52   Vice President and General Counsel of HCR and HCRA
                          since November 1991 and Secretary of HCR and HCRA
                          since December 1991.
</TABLE>


                                       36


<PAGE>   38

<TABLE>
<CAPTION>

<S>                  <C>  <C>
NANCY A. EDWARDS     47   Vice President and General Manager of Central
                          Division of HCR and HCRA since December 1993;
                          Assistant Vice President and General Manager of HCRA
                          from June 1993 to December 1993; and Florida Regional
                          Manager of HCRA from October 1991 to June 1993.

JEFFREY W. FERGUSON  49   Vice President and General Manager of Midwest
                          Division of HCR and HCRA since February 1995; Vice
                          President and Director of Marketing of HCR from
                          August 1991 to February 1995; and Vice President and
                          Director of Marketing of HCRA from October 1991 to
                          February 1995.

SPENCER C. MOLER     50   Vice President and Controller of HCR since August
                          1991 and Controller and Treasurer of HCRA since
                          October 1991.

F. JOSEPH SCHMITT    49   Vice President and General Manager of Southern
                          Division of HCR and HCRA since December 1993 and
                          Florida Senior Regional Manager of HCRA from October
                          1991 to December 1993.

PAUL G. SIEBEN       51   Vice President and Director of Development and
                          Construction of HCR since August 1991 and Vice
                          President and Director of Development and
                          Construction of HCRA since October 1991.


                      OTHER CORPORATE OFFICERS


J. SUSAN HINES        44   Vice President and Director of Medical Specialty
                           Programs of HCR and HCRA since December 1996; Vice
                           President and Director of Clinical Services and
                           Specialty Programs of HCR and HCRA from May 1993 to
                           December 1996; Assistant Vice President for Clinical
                           Services and Specialty Programs of HCRA from April
                           1993 to May 1993; and Assistant Vice President and
                           Director of Professional Services of HCRA from
                           October 1991 to April 1993.

WILLIAM H. KINSCHNER  50   Vice President and Director of Management Support
                           Services of HCR since December 1995; Vice President
                           and Director of Planning of HCR and HCRA from May
                           1993 to December 1995; Vice President and Director
                           of Planning and Reimbursement of HCR from August
                           1991 to May 1993;  and Vice President and Director
                           of Planning and Reimbursement of HCRA from October 
                           1991 to May 1993.
</TABLE>


                                       37


<PAGE>   39

<TABLE>
<CAPTION>
<S>               <C>  <C>
BARRY A. LAZARUS  46   Vice President and Director of Reimbursement of HCR and
                       HCRA since May 1993 and Executive Vice President for
                       AmCorps, Inc. from February 1992 to May 1993.

WADE B. O'BRIAN   54   Vice President and Director of Human Resources and Labor
                       Relations of HCR since August 1991 and Vice President
                       and Director of Human Resources and Labor Relations of
                       HCRA since October 1991.

JOYCE C. SMITH    53   Vice President and Director of Professional Services of
                       HCR and HCRA since December 1995; Assistant Vice
                       President and Director of Professional Services of HCRA
                       from June 1994 to December 1995; Director of
                       Professional Services of HCRA from April 1994 to June
                       1994; Manager of Nursing Services of HCRA from April
                       1993 to April 1994; and Manager of Quality Standards of
                       HCRA from October 1991 to April 1993.
</TABLE>


ITEM 11.  EXECUTIVE COMPENSATION

Information on executive compensation is incorporated herein by reference under
the heading "Executive Compensation" in the Registrant's Proxy Statement which
will be filed with the Commission prior to April 30, 1998.


ITEM 12.  SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND
MANAGEMENT

Information on security ownership of certain beneficial owners is incorporated
herein by reference under the heading "Security Ownership of Certain Management
and Beneficial Owners" in the Registrant's Proxy Statement which will be filed
with the Commission prior to April 30, 1998.

ITEM  13.  CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS

Information on certain relationships and related transactions is incorporated
herein by reference under the heading "Election of Directors" in the
Registrant's Proxy Statement which will be filed with the Commission prior to
April 30, 1998.

                                       38


<PAGE>   40

                                    PART IV

ITEM 14.  EXHIBITS, FINANCIAL STATEMENT SCHEDULES, AND REPORTS ON
FORM 8-K

LIST OF FINANCIAL STATEMENTS AND FINANCIAL STATEMENT SCHEDULES

The following consolidated financial statements of Health Care and Retirement
Corporation and subsidiaries are filed as part of this Form 10-K in Item 8 on
the pages indicated:

<TABLE>
<CAPTION>
                                                                      Page
                                                                      ----
      <S>                                                             <C>
      Report of Ernst & Young LLP Independent Auditors                17
      Consolidated Balance Sheets - December 31, 1997 and 1996        18
      Consolidated Statements of Income -
         Years ended December 31, 1997, 1996 and 1995                 19
      Consolidated Statements of Cash Flows -
         Years ended December 31, 1997, 1996 and 1995                 20
      Consolidated Statements of Stockholders' Equity -
         Years ended December 31, 1997, 1996 and 1995                 21
      Notes to Consolidated Financial Statements - December 31, 1997  22
</TABLE>


The following consolidated financial statement schedule of Health Care and
Retirement Corporation and subsidiaries is included in this Form 10-K on page
40:

     Schedule II  Valuation and Qualifying Accounts

All other schedules for which provision is made in the applicable accounting
regulation of the Securities and Exchange Commission are not required under the
related instructions or are inapplicable and therefore have been omitted.

                                       39




<PAGE>   41


                     HEALTH CARE AND RETIREMENT CORPORATION

                SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS
                                 (In thousands)


<TABLE>
<CAPTION>
                                              Charged             Additions
                                  Balance at  to Costs   Deduc-     From      Balance
                                  Beginning     and      tions    Acquisi-   at End of
                                  of Period   Expenses  (Note 1)    tions     Period
                                  ----------  --------  --------  ---------  ---------
<S>                                 <C>         <C>       <C>       <C>        <C>
Year ended December 31, 1997:
Deducted from asset accounts:
 Allowance for doubtful accounts     $13,335   $10,644  $(5,935)     $1,140    $19,184
                                     =======   =======  ========     ======    =======

Year ended December 31, 1996:
Deducted from asset accounts:
 Allowance for doubtful accounts     $11,485    $8,073  $(7,516)     $1,293    $13,335
                                     =======    ======  ========     ======    =======

Year ended December 31, 1995:
Deducted from asset accounts:
 Allowance for doubtful accounts     $11,882    $5,288  $(6,229)       $544    $11,485
                                     =======    ======  ========       ====    =======
</TABLE>

(1)  Uncollectible accounts written off, net of recoveries.


                                      40


<PAGE>   42

EXHIBITS

<TABLE>
<CAPTION>

S-K Item 601
     No.                               Document
- -------------
<S>             <C>
 3.1        --  Certificate of Incorporation of Health Care and Retirement
                Corporation (filed as Exhibit 4.1 to the Registrant's
                Registration Statement on Form S-1,
                File No. 33-42535 and incorporated herein by reference).
 3.2        --  By-laws of Health Care and Retirement Corporation (filed as
                Exhibit 4.2 to the Registrant's Registration Statement on Form
                S-1, File No. 33-42535 and incorporated herein by reference).
 4          --  Amended and Restated Credit Agreement among Health Care and
                Retirement Corporation, various lenders and Continental Bank,
                as agent, dated as of August 2, 1994 (filed as Exhibit 4 to the
                Registrant's Quarterly Report on Form 10-Q for the quarter
                ended June 30, 1994 and incorporated herein by reference).
 4.1        --  First Amendment to the Amended and Restated Credit Agreement
                among Health Care and Retirement Corporation, various lenders
                and Bank of America National Trust and Savings Association, as
                agent, dated as of July 7, 1995 (filed as Exhibit 4 to the
                Registrant's Quarterly Report on Form 10-Q for the quarter
                ended June 30, 1995 and incorporated herein by reference).
 4.2        --  Third Amendment to the Amended and Restated Credit Agreement
                among Health Care and Retirement Corporation, various lenders
                and Bank of America National Trust and Savings Association, as
                agent, dated as of January 24, 1997 (filed as Exhibit 4.2 to
                the Registrant's Annual Report on Form 10-K for the year ended
                December 31, 1996 and incorporated herein by reference).
 10.1       --  Stock Purchase Agreement and amendment among HCR, HCRC Inc.,
                O-I Health Care Holding Corp. and Owens-Illinois, Inc. dated as
                of August 30, 1991 (filed as Exhibit 10.1 and 10.1(a) to the
                Registrant's Registration Statement on Form S-1, File No.
                33-42535 and incorporated herein by reference).
 10.2       --  Form of Annual Incentive Award Plan (filed as Exhibit 10.2 to
                the Registrant's Registration Statement on Form S-1, File No.
                33-42535 and incorporated herein by reference).
 10.3       --  Performance Award Plan (filed on pages A1 to A4 of the
                Registrant's Proxy Statement dated March 22, 1994 in connection
                with its Annual Meeting held on May 3, 1994 and incorporated
                herein by reference).
 10.4       --  Amended Stock Option Plan for Key Employees (filed as Exhibit 4
                to the Registrant's Registration Statement on Form S-8, File
                No. 33-83324 and incorporated herein by reference).
 10.5       --  Revised form of Non-Qualified Stock Option Agreement between
                HCR and various Key Employees participating in the Stock Option
                Plan for Key Employees (filed as Exhibit 4.7 to the
                Registrant's Registration Statement on Form S-8, File
                No.33-48885 and incorporated herein by reference).
 10.6       --  Amended Restricted Stock Plan (filed on pages A1 to A9 of the
                Registrant's Proxy Statement dated March 25, 1997 in 
                connection with its Annual Meeting held on May 6, 1997 and 
                incorporated herein by reference).
</TABLE>

                                      
                                      41
                                      
                                      
<PAGE>   43

<TABLE>
<CAPTION>

<S>              <C>
 10.7        --  Revised form of Restricted Stock Plan Agreement between HCR 
                 and officers participating in Restricted Stock Plan (filed as 
                 Exhibit 10.7(a) to the Registrant's Registration Statement on 
                 Form S-1, File No. 33-42535 and incorporated herein by 
                 reference).
 10.8        --  Form of Employment Agreement between HCRA and remaining 
                 executive officers (filed as Exhibit 10.13 to the Registrant's 
                 Registration Statement on Form S-1, File No. 33-42535 and 
                 incorporated herein by reference).
*10.9        --  Form of Second Amended Employment Agreement between HCRA, HCR
                 and Paul A. Ormond.
*10.10       --  Form of Second Amended Employment Agreement between HCRA, HCR
                 and M. Keith Weikel.
*10.11       --  Form of Second Amended Employment Agreement between HCRA, HCR
                 and Geoffrey G. Meyers.
*10.12       --  Form of Second Amended Employment Agreement between HCRA, HCR
                 and R. Jeffrey Bixler.
 10.13       --  Stock Option Plan for Outside Directors (filed as Exhibit 4.4 
                 to the Registrant's Registration Statement on Form S-8, File 
                 No. 33-48885 and incorporated herein by reference).
 10.14       --  Form of Non-Qualified Stock Option Agreement between HCR and 
                 various outside directors participating in Stock Option Plan 
                 for Outside Directors (filed as Exhibit 4.6 to the 
                 Registrant's Registration Statement on Form S-8, File No, 
                 33-48885 and incorporated herein by reference).
 10.15       --  Executive Officer Deferred Compensation Plan dated December 
                 18, 1991 (filed as Exhibit 10.12 to the Registrant's Annual 
                 Report on Form 10-K for the period ended December 31, 1991 and 
                 incorporated herein by reference).
 10.16       --  Form of Indemnification Agreement between HCR and various 
                 officers and directors (filed as Exhibit 10.9 to the 
                 Registrant's Registration Statement on Form S-1, File No. 
                 33-42535 and incorporated herein by reference).
 10.17       --  Senior Executive Retirement Plan dated October 1, 1992 (filed 
                 as Exhibit 10.15 to the Registrant's Annual Report on Form 
                 10-K for the year ended December 31, 1992 and incorporated 
                 herein by reference).
 10.18       --  Senior Management Savings Plan dated December 17, 1992 (filed 
                 as Exhibit 10.16 to the Registrant's Annual Report on Form 
                 10-K for the year ended December 31, 1992 and incorporated 
                 herein by reference).
*21          --  Subsidiaries of the Registrant
*23          --  Consent of Independent Auditors
*27          --  Financial Data Schedule for the year ended December 31, 1997
</TABLE>


REPORTS ON FORM 8-K

There were no reports on Form 8-K filed by the Registrant during the fourth
quarter ended December 31, 1997.
____________
* Filed herewith.


                                      42
                                       
                                       
<PAGE>   44

                                   SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange
Act of 1934, the Registrant has duly caused this report to be signed on its
behalf by the undersigned, thereunto duly authorized.

                               HEALTH CARE AND RETIREMENT CORPORATION
                               (Registrant)

                               by /s/ R. Jeffrey Bixler
                                 ---------------------------------------------
                                 R. Jeffrey Bixler
                                 Vice President, General Counsel and Secretary

DATE:  February 17, 1998



                                      43
                                      
                                      
                                      
<PAGE>   45


Pursuant to the requirements of the Securities Exchange Act of 1934, this
report has been signed below by the following persons on behalf of Health Care
and Retirement Corporation and in the capacities and on the date indicated.


     SIGNATURE            TITLE
     ---------            -----

  /s/ John J. Clair, Jr.
- ------------------------
John J. Clair, Jr.        Director

  /s/ Joseph H. Lemieux
- ------------------------
Joseph H. Lemieux         Director

  /s/ Geoffrey G. Meyers
- ------------------------
Geoffrey G. Meyers        Executive Vice President, Chief Financial Officer and
                          Treasurer; Director (Principal Financial Officer)

  /s/ Spencer C. Moler
- ------------------------
Spencer C. Moler          Vice President and Controller (Principal Accounting
                          Officer)

  /s/ Paul A. Ormond
- ------------------------
Paul A. Ormond            Chairman of the Board of Directors, President and
                          Chief Executive Officer (Principal Executive Officer)

  /s/ Robert G. Siefers
- ------------------------
Robert G. Siefers         Director

  /s/ M. Keith Weikel
- ------------------------
M. Keith Weikel           Senior Executive Vice President and Chief Operating 
                          Officer; Director


  /s/ Thomas L. Young
- ---------------------
Thomas L. Young           Director


DATE:   February 17, 1998

                                       44




<PAGE>   46

                                EXHIBIT INDEX



<TABLE>
<CAPTION>

     Exhibit
     Number   Description
     -------  -----------
     <S>      <C>
      10.9    Form of Second Amended Employment Agreement between
              HCRA, HCR and Paul A. Ormond.

      10.10   Form of Second Amended Employment Agreement between
              HCRA, HCR and M. Keith Weikel.

      10.11   Form of Second Amended Employment Agreement between
              HCRA, HCR and Geoffrey G. Meyers.

      10.12   Form of Second Amended Employment Agreement between
              HCRA, HCR and R. Jeffrey Bixler.

      21      Subsidiaries of the Registrant

      23      Consent of Independent Auditors

      27      Financial Data Schedule for the year ended December 31, 1997
</TABLE>



                                      45



<PAGE>   1
                                                                    EXHIBIT 10.9

                     SECOND AMENDED EMPLOYMENT AGREEMENT
                                      

     This SECOND AMENDED EMPLOYMENT AGREEMENT ("Agreement"), effective as of
April 1, 1997 between HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA, an
Ohio corporation (the "Company"), HEALTH CARE AND RETIREMENT CORPORATION, a
Delaware corporation and sole stockholder of the Company ("HCR) and PAUL A.
ORMOND ("Employee"), supersedes and replaces all prior employment agreements
between the parties hereto.

                                   RECITALS

A.   The Company has agreed to employ Employee in the position and at the base
     rate of pay set forth on Schedule I.

B.   The Company has further agreed to provide severance benefits to Employee
     upon a termination of Employee's employment resulting from certain
     specified events.

C.   The Company wishes to insure that its senior executives and other key
     employees are not practically disabled from discharging their duties in
     respect to a proposed or actual transaction involving a Change in Control.

D.   The Company desires to assure itself of both present and future
     continuity of management and desires to establish certain minimum
     severance benefits for certain of its senior executive officers and other
     key employees, including Employee, applicable in the event of a Change in
     Control.

                                    EVENTS

     In consideration of the foregoing, and for other good and valuable
consideration, the receipt and adequacy of which is hereby acknowledged,
Employee and the Company hereby agree as follows:

     1. CERTAIN DEFINED TERMS.  The following terms have the meanings set forth
below:

          (a)  "Accounting Firm" is defined in Section 10(b).

          (b)  "Aggregate Cash Compensation" means the sum of Base Pay and
     Employee's cash bonuses pursuant to the Company's Annual Incentive Plan
     and Performance Award Plan as in effect at any time of determination.

          (c)  "Base Pay" means Employee's annual base salary as in effect at
     any time of determination.

          (d)  "Board" means the Board of Directors of HCR.

          (e)  "Cause" means Employee's financial dishonesty, fraud in the
     performance of his duties, willful failure to perform assigned duties
     hereunder or the commission of a felony.

          (f)  "Change in Control" means the occurrence during the Protected
     Term of any of the following events:



<PAGE>   2


                 (i) HCR is merged, consolidated or reorganized into or with
            another corporation or other legal person, and as a result of such
            merger, consolidation or reorganization less than sixty-five
            percent of the combined voting power of the then outstanding
            securities of such resulting corporation or person immediately
            after such transaction are held in the aggregate by the holders of
            Voting Stock of HCR immediately prior to such transaction;

                 (ii) HCR sells or otherwise transfers all or substantially all
            of its assets to another corporation or other legal person, and as
            a result of such sale or transfer less than sixty-five percent of
            the combined voting power of the then outstanding Voting Stock of
            such corporation or person immediately after such sale or transfer
            is held in the aggregate by the holders of Voting Stock of HCR
            immediately prior to such sale or transfer;

                 (iii) There is a report filed on Schedule 13D or Schedule
            14D-1 (or any successor schedule, form or report), each as
            promulgated pursuant to the Exchange Act, disclosing that any
            person (as the term "person" is used in Section 13(d)(3) or Section
            14(d)(2) of the Exchange Act) has become the beneficial owner (as
            the term "beneficial owner" is defined under Rule 13d-3 or any
            successor rule or regulation promulgated under the Exchange Act) of
            15% or more of the then outstanding Voting Stock of HCR;

                 (iv) HCR files a report or proxy statement with the Securities
            and Exchange Commission pursuant to the Exchange Act disclosing in
            response to Form 8-K or Schedule 14A (or any successor schedule,
            form or report or item therein) that a Change in Control of HCR has
            occurred or will occur in the future pursuant to any then existing
            contract or transaction; or

                 (v) If, during any consecutive twelve month period,
            individuals who at the beginning of any such period constitute the
            Directors cease for any reason to constitute at least a majority
            thereof, provided, however, that for purposes of this clause (v)
            each Director who is first elected, or first nominated for election
            by HCR's stockholders, by a vote of at least one-half of the
            Directors (or a committee thereof) then still in office who were
            Directors at the beginning of any such period will be deemed to
            have been a Director at the beginning of such period.

          Notwithstanding the foregoing provisions of Sections 1(f)(iii) or
1(f)(iv), unless otherwise determined in a specific case by majority vote of
the Board, a "Change in Control" shall not be deemed to have occurred for
purposes of Sections 1(f)(iii) or 1(f)(iv) solely because (1) HCR, (2) any
Subsidiary (including, without limitation, the Company) or (3) any employee
stock ownership plan or any other employee benefit plan of HCR or any
Subsidiary either files or becomes obligated to file a report or a proxy
statement under or in response to Schedule 13D, Schedule 14D-1, Form 8-K or
Schedule 14A (or any successor schedule, form or report or item therein) under
the Exchange Act disclosing beneficial ownership by it of shares of Voting
Stock of HCR, whether in excess of 15% or otherwise, or because HCR reports
that a change in control of HCR has occurred or will occur in the future by     
reason of such beneficial ownership.

          (g)  "Competing Business" shall mean any person, corporation or other
entity engaged in the United States of America in providing long-term care,
skilled nursing or rehabilitative services or selling or attempting to sell or
providing or attempting to provide any 


                                      2

<PAGE>   3


other product or service which is the same as or similar to products or
services sold or provided by the Company within the last 2 years prior to
termination of Employee's employment hereunder.

          (h)  "Continuation Period" means the thirty-six months immediately
     following the Termination Date.

          (i)  "Director" means a member of the Board.

          (j)  "Employee Benefits" means the perquisites and benefits as
     provided under any and all employee retirement income and welfare benefit
     policies, plans, programs or arrangements in which Employee is entitled
     to participate at any time of determination, including, without
     limitation, any stock option, stock purchase, stock appreciation,
     savings, pension, supplemental employee retirement, or other retirement
     income or welfare benefit, deferred compensation, incentive compensation,
     group or other life, health, medical/hospital or other insurance (whether
     funded by actual insurance or self-insured by the Company), disability,
     salary continuation, expense reimbursement and other employee benefit
     policies.

          (k)  "Exchange Act" means the Securities Exchange Act of 1934, as
     amended.

          (l)  "Excise Tax" is defined in Section 10(a).

          (m)  "Gross-Up Payment" is defined in Section 10(a).

          (n)  "ISO" is defined in Section 10(a).

          (o)  "Payment" is defined in Section 10(a).

          (p)  "Protected Term" means the period commencing as of the date
     hereof and expiring as of the close of business on March 31, 2000;
     provided, however, that: (i) commencing on April 1, 1998 and each April 1
     thereafter, the term of this Agreement will automatically be extended for
     an additional year unless, not later than December 31 of the immediately
     preceding year, the Company or Employee shall have given notice that it
     or Employee, as the case may be, does not wish to have the Protected Term
     extended; and (ii) except as otherwise provided in the last sentence of
     Section 12, if, prior to a Change in Control, Employee ceases for any  
     reason to be an employee of the Company, thereupon without further action
     the Protected Term shall be deemed to have expired and Sections 8, 10, 11
     and 14(a) and the last sentence of Section 12 of this Agreement and the
     portion of any other provision of this Agreement that incorporates such
     provisions will immediately terminate and be of no further effect.  For
     purposes of this Section 1(p), Employee shall not be deemed to have
     ceased to be an employee of the Company by reason of the transfer of
     Employee's employment between or among HCR and the Company or any other
     Subsidiary.

          (q)  "Severance Period" means the period of time commencing on the
     date of the occurrence of a Change in Control and continuing until the
     earliest of (i) the third anniversary of the occurrence of the Change in
     Control (ii) Employee's death, or (ii) Employee's attainment of age 65.

          (r)  "Severance Benefits" are defined in Section 8(b).



                                      3
<PAGE>   4


          (s)  "Subsidiary" means any entity in which HCR directly or
     indirectly beneficially owns 50% or more of the then outstanding Voting
     Stock.

          (t)  "Termination Date" means the effective date of Employee's
     termination of employment with the Company; provided that for purposes of
     this Section 1(t), Employee shall not be deemed to have ceased to be an
     employee of the Company by reason of the transfer of Employee's
     employment between or among HCR and the Company or any other Subsidiary.

          (u)  "Underpayment" is defined in Section 10(a).

          (v)  "Voting Stock" means securities entitled to vote generally in
     the election of directors.

     2.   SALARY AND POSITION.  Employee's Base Pay and job title shown on
Schedule I are correct as of the date hereof and in accordance with Employee's
understanding.

     3.   AT-WILL EMPLOYMENT.  Employee's employment with the Company is not for
any specified term and may be terminated by Employee or by the Company at any
time for any reason, with or without Cause.

     4.   NO OTHER AGREEMENTS.  Except as specifically set forth herein and in
Schedule II attached hereto, Employee represents and warrants that there are no
other written or oral agreements, understandings or commitments relating to
Employee's future employment, work assignments, compensation (including
compensation upon termination), benefits, or any other term or condition of
employment.

     5.   ENTIRE AGREEMENT.  This Agreement and the agreements listed in 
Schedule II attached hereto constitute the complete agreement between Employee
and the Company regarding any and all aspects of their employment relationship
and supersede any and all prior written or oral agreements, understandings or
commitments.  Employee understands that no representative of the Company has
been authorized to enter into any agreement, understanding or commitment with
Employee which is inconsistent in any way with the terms of this Agreement.

     6.   PROHIBITION AGAINST AMENDMENT.  Employee's Base Pay may be modified by
the Company at any time in its sole discretion.  The retirement and benefit
plans set forth in Schedule II attached hereto in which Employee is entitled to
participate may be improved, reduced or terminated by the Company at any time
in its sole discretion; provided, however, that no vested or accrued benefit
shall be adversely affected.  No term set forth in this Agreement, including
without limitation the terms set forth in Section 3 hereof, may be modified in
any way except by a written agreement signed by Employee and by an authorized
representative of the Company which expressly states the intention of the
parties to modify the terms of this Agreement.

     7.   SEVERANCE PAYMENT NOT FOLLOWING A CHANGE IN CONTROL.  Except as
provided in Section 8:

          (a)  Upon the termination of Employee's employment as a result of
     Employee's electing to resign his employment or to retire without the
     consent of the Company, no payments shall be required or made pursuant to
     this Section 7.


                                      4

<PAGE>   5

          (b)  Upon the termination of Employee's employment by the Company for
     Cause, no payments shall be required or made pursuant to this Section 7.

          (c)  Upon the termination of Employee's employment by the Company for
     any reason other than for Cause or disability, the Company shall continue
     payment of Employee's Base Pay, at the rate then in effect on the
     Termination Date, for a period of two years after such Termination Date.
     The Company shall give thirty (30) days written notice of any such
     termination which notice shall specify the Termination Date.

          (d)  Upon the termination of Employee's employment as a result of the
     death of Employee, the Company shall continue payment of Employee's Base
     Pay, at the rate then in effect on the Termination Date, for a period of
     two years after such Termination Date; provided, however, that such
     payments shall be offset by any survivor benefits, excluding life
     insurance proceeds, received by Employee's spouse or other designated
     beneficiary under the Company's plans, programs and policies.

          (e)  Upon the termination of Employee's employment as a result of his
     becoming unable to perform his duties due to a disability as established
     by the award of long-term disability benefits under the Company's
     long-term disability plan, the Company may terminate Employee's
     employment by giving Employee thirty (30) days written notice of its
     intention to terminate.  In such event, Company shall continue payment of
     Employee's Base Pay, at the rate then in effect on the Termination Date,
     for a period of two years after such Termination Date; provided, however,
     that such payments shall be offset by any disability benefits received by
     Employee, or his legal guardian, under the Company's plans, programs and
     policies.

          (f)  Notwithstanding anything to the contrary contained in this
     Section 7, upon the termination of Employee's employment for any reason
     other than pursuant to Section 8, whether voluntarily or involuntarily
     and whether with or without Cause, Employee shall be entitled to the
     payments provided for hereunder and such rights as he otherwise has under
     the Company's Restricted Stock Plan and the Company's Stock Option Plan
     in the circumstances of his particular termination.

     8.   TERMINATION FOLLOWING A CHANGE IN CONTROL.

          (a)  Eligibility for Severance Benefits.

                 (i) If, during the Severance Period, Employee's employment is
            terminated by the Company other than for Cause and other than as a
            result of his death or disability pursuant to Section 7(d) or (e),
            Employee shall be entitled to the Severance Benefits.

                 (ii) Following the consummation of a Change in Control,
            Employee may elect, within the 60-day period following the
            occurrence of one of the following events, to terminate employment
            with the Company and receive the Severance Benefits (pursuant to
            written notice to the Board specifying the effective date of such
            termination which shall not be earlier than the date of the Board's
            receipt of such notice and shall not be later than the end of such
            60-day period):


                                      5


<PAGE>   6

                       (A) Failure to elect or reelect or otherwise to maintain
                  Employee in the office or position, or a substantially
                  equivalent office or position, of or with the Company or
                  successor, as the case may be, which Employee held
                  immediately prior to a Change in Control, or the removal of
                  Employee as a Director (or as a member of the board of
                  directors of any successor thereto) if Employee shall have
                  been a Director immediately prior to the Change in Control;

                       (B) The occurrence of any of the following:

                             (I) a significant adverse change in the nature or
                        scope of the authorities, powers, functions,
                        responsibilities or duties attached to the position
                        with the Company or successor, as the case may be,
                        which Employee held immediately prior to the Change in
                        Control;

                             (II) a reduction in Employee's Base Pay as in
                        effect immediately prior to the Change in Control;

                             (III) a material reduction in the scope or value
                        of Employee Benefits as in effect immediately prior to
                        a Change in Control; or

                             (IV) any material breach of this Agreement by the
                        Company or any successor thereto,

                        which situation is not remedied within 10 calendar days
                        after written notice to the Board (or the board of any
                        successor) from Employee;

                       (C) The liquidation, dissolution, merger, consolidation
                  or reorganization of the Company or transfer of all or
                  substantially all of its business and/or assets, unless the
                  surviving or successor entity, if other than the Company (by
                  liquidation, merger, consolidation, reorganization, transfer
                  or otherwise), to which all or substantially all of such
                  business and/or assets have been transferred (directly or by
                  operation of law) assumes all duties and obligations of the
                  Company under this Agreement pursuant to Section 16(a); or

                       (D) The Company or any successor, as the case may be, by
                  which Employee is employed relocates its principal executive
                  offices, or requires Employee to have his principal location
                  of work changed, to any location which increases by more than
                  25 miles Employee's commute to such location immediately
                  prior to the Change in Control, or requires Employee to
                  travel away from his office in the course of discharging his
                  responsibilities or duties hereunder at least 20% more (in
                  terms of aggregate days in any calendar year or in any
                  calendar quarter when annualized for purposes of comparison
                  to any prior year) than the average of such time that was
                  required of Employee in the three full years immediately
                  prior to the Change of Control without, in either case, his
                  prior written consent.


                                      6

<PAGE>   7



                 (iii) If Employee elects to terminate employment with the
            Company or any successor, as the case may be, for any reason, or
            without reason, during such portion of the 180-day period
            immediately following the first anniversary of the occurrence of
            any Change in Control that falls within the Severance Period,
            Employee shall be entitled to the Severance Benefits.

          (b)  Severance Benefits.  If, following the occurrence of a Change in
     Control, Employee's employment with the Company is terminated pursuant to
     Section 8(a)(i), (ii) or (iii), the Company will pay to Employee the
     following amounts within five business days after the Termination Date
     and will provide to Employee the following benefits (collectively, the
     "Severance Benefits"):

                 (i) A lump sum payment equal to three times the highest
            Aggregate Cash Compensation paid or payable to Employee for any of
            the three calendar years preceding the year in which the
            Termination Date occurs or for the year in which the Termination
            Date occurs if the Termination Date occurs after the end of the
            first quarter; for purposes of this Section 8(b)(i), if the
            Company's financial performance for the year-to-date period
            preceding the Termination Date is consistent with budgeted levels
            (as certified by the Compensation Committee) then the Aggregate
            Cash Compensation for the year in which the Termination Date occurs
            shall be assumed to be equal to the sum of: (A) the Employee's Base
            Pay, (B) the Employee's Annual Incentive Plan bonus payable for the
            year in which the Termination Date occurs, calculated by
            multiplying the product of the Employee's Base Pay and the
            Employee's bonus percentage by 150%, and (C) the Employee's
            Performance Award Plan award payable for the award period ending
            with the year in which the Termination Date occurs as if the
            earnings per share growth rate for such year were assumed to be the
            actual growth rate for the year-to-date period prior to the
            Termination Date;

                 (ii) During the Continuation Period:

                       (A) the Company will arrange to provide Employee with
                  group medical, dental and vision benefits substantially
                  similar to those which Employee was receiving or entitled to
                  receive immediately prior to the Change in Control; and

                       (B) the Company (or successor) will provide Employee the
                  use of office space, furnishings and secretarial support
                  services comparable to those provided to Employee immediately
                  prior to the Change in Control;

                       If and to the extent that any benefit described in
                  Section 8(b)(ii)(A) is not or cannot be paid or provided
                  under any policy, plan program or arrangement of the Company,
                  then the Company will pay or provide for the payment to
                  Employee, his dependents and beneficiaries, of such Employee
                  Benefits in any manner selected by the Company.  Without
                  otherwise limiting the purposes or effect of Section 8,
                  Employee Benefits otherwise receivable by Employee pursuant
                  to Section 8(b)(ii)(A) will be reduced to the extent
                  comparable welfare benefits are actually received by Employee
                  from another employer during the Continuation Period, and any
                  such benefits received by Employee shall be reported by
                  Employee to the Company.



                                      7

<PAGE>   8


                 (iii) The Company shall take whatever action is necessary to
            fund completely any split-dollar life insurance arrangement
            maintained by the Company for the benefit of Employee, effective as
            of the Termination Date and based upon Employee's service through
            the end of the Continuation Period;

                 (iv) Effective as of the Termination Date, Employee will be
            credited with service with the Company for an additional 36 months
            for the purpose of determining service credits and benefits due and
            payable to Employee under the Company's retirement income,
            supplemental retirement and other benefit plans of the Company
            applicable to Employee, his dependents or his beneficiaries
            immediately prior to the Change in Control; and

                 (v) Employee shall be permitted to elect to defer receipt of
            amounts payable to him, if any, under the Company's Senior
            Management Savings Plan and Senior Management Savings Plan for
            Corporate Officers until any date not later than the expiration of
            the Continuation Period.

          (c)  Without limiting the rights of Employee at law or in equity, if
     the Company fails to make any payment or provide any benefit required to
     be made or provided under this Section 8 on a timely basis, the Company
     will pay interest on the amount or value thereof at an annualized rate of
     interest equal to the so-called composite "prime rate" as quoted from
     time to time during the relevant period in the Midwest Edition of The
     Wall Street Journal.  Any change in such prime rate will be effective on
     and as of the date such change is so published.

          (d)  Notwithstanding any other provision hereof, the parties'
     respective rights and obligations under this Section 8 and under Section
     11 will survive:

                 (i) any termination or expiration of this Agreement following
            a Change in Control prior to the expiration of the Protected Term;
            and

                 (ii) the termination of Employee's employment for any reason
            whatsoever following a Change in Control prior to the expiration of
            the Protected Term.

     9.   NO SET-OFF; NO MITIGATION OBLIGATION.  The Company hereby acknowledges
that it will be difficult and may be impossible (a) for Employee to find
reasonably comparable employment following the Termination Date; and (b) to
measure the amount of damages which Employee may suffer as a result of
termination of employment hereunder.  In addition, the Company acknowledges
that its severance pay plans applicable to corporate officers do not provide
for mitigation, offset or reduction of any severance payment received
thereunder.  Accordingly, the payment of the severance compensation by the
Company to Employee in accordance with the terms of this Agreement is hereby
acknowledged by the Company to be reasonable and will be liquidated damages,
and Employee will not be required to mitigate the amount of any payment
provided for in this Agreement by seeking other employment or otherwise, nor
will any profits, income, earnings or other benefits from any source whatsoever
create any mitigation, offset, reduction or any other obligation on the part of
Employee hereunder or otherwise, except as expressly provided in Sections 7(d)
and (e) and the last sentence of Section 8 (b)(ii).



                                      8
<PAGE>   9


     10.  CERTAIN ADDITIONAL PAYMENTS BY THE COMPANY.

          (a)  Anything in this Agreement to the contrary notwithstanding, in
     the event that a Change in Control occurs prior to the expiration of the
     Protected Term and it shall be determined (as hereafter provided) that
     any payment or distribution by the Company or any of its affiliates to or
     for the benefit of Employee, whether paid or payable or distributed or
     distributable pursuant to the terms of this Agreement or otherwise
     pursuant to or by reason of any other agreement, policy, plan, program or
     arrangement, including without limitation any stock option, stock
     appreciation right or similar right, or the lapse or termination of any
     restriction on or the vesting or exercisability of any of the foregoing
     (collectively, a "Payment"), would be subject to the excise tax imposed
     by Section 4999 of the Internal Revenue Code (or any successor provision
     thereto) by reason of being considered "contingent on a change in
     ownership or control" of the Company, within the meaning of Section 280G
     of the Internal Revenue Code (or any successor provision thereto) or to
     any similar tax imposed by state or local law, or any interest or
     penalties with respect to such tax (such tax or taxes, together with any
     such interest and penalties, being hereafter collectively referred to as
     the "Excise Tax"), then Employee shall be entitled to receive an
     additional payment or payments (collectively, a "Gross-Up Payment");
     provided, however, that no Gross-up Payment shall be made with respect to
     the Excise Tax, if any, attributable to: (i) any incentive stock option,
     as defined by Section 422 of the Internal Revenue Code ("ISO"), granted
     prior to the execution of this Agreement; or (ii) any stock appreciation
     or similar right, whether or not limited, granted in tandem with any ISO
     described in clause (i).  The Gross-Up Payment shall be in an amount such
     that, after payment by Employee of all taxes, including any Excise Tax
     (and including any interest or penalties imposed with respect to such
     taxes), imposed upon the Gross-Up Payment, Employee retains an amount of
     the Gross-Up Payment equal to the Excise Tax imposed upon the Payment.

          (b)  Subject to the provisions of Section 10(f) hereof, all
     determinations required to be made under this Section 10, including
     whether an Excise Tax is payable by Employee and the amount of such
     Excise Tax and whether a Gross-Up Payment is required to be paid by the
     Company to Employee and the amount of such Gross-Up Payment, if any,
     shall be made by a nationally recognized accounting firm (the "Accounting
     Firm") selected by the Company.  The Company shall direct the Accounting
     Firm to submit its determination and detailed supporting calculations to
     both the Company and Employee within thirty (30) calendar days after any
     Termination Date arising pursuant to Section 8(a).  If the Accounting
     Firm determines that any Excise Tax is payable by Employee, the Company
     shall pay the required Gross-Up Payment to Employee within five (5)
     business days after receipt of such determination.  If the Accounting
     Firm determines that no Excise Tax is payable by Employee, it shall, at
     the same time as it makes such determination, furnish the Company and
     Employee an opinion that Employee has substantial authority not to report
     any Excise Tax on his federal, state or local income or other tax return.
     As a result of the uncertainty in the application of Section 4999 of the
     Internal Revenue Code (or any successor provision thereto) and the
     possibility of similar uncertainty regarding applicable state or local
     tax law at the time of any determination by the Accounting Firm
     hereunder, it is possible that a Gross-Up Payment which will not have
     been made by the Company should have been made (an "Underpayment"),
     consistent with the calculations required to be made hereunder.  In the
     event that the Company exhausts or fails to pursue its remedies pursuant
     to Section 10(f) hereof and Employee thereafter is required to make a
     payment of any Excise Tax, Employee shall direct the Accounting Firm to
     determine the amount of the Underpayment that has occurred and to submit
     its determination and detailed supporting calculations to both the
     Company and Employee as promptly as possible.  Any such 


                                      9

<PAGE>   10


     Underpayment shall be promptly paid by the Company to, or for the
     benefit of, Employee within five business days after receipt of such
     determination and calculations.

          (c)  The Company and Employee shall each provide the Accounting Firm
     access to and copies of any books, records and documents in the possession
     of the Company or Employee, as the case may be, reasonably requested by
     the Accounting Firm, and otherwise cooperate with the Accounting Firm in
     connection with the preparation and issuance of the determination and
     calculations contemplated by Section 10(b) hereof. Except as contemplated
     by Sections 10(f) or 10(g), any final determination by the Accounting Firm
     as to the amount of the Gross-Up Payment shall be binding upon the Company
     and Employee.

          (d)  The federal, state and local income or other tax returns filed by
     Employee shall be prepared and filed on a consistent basis with the
     determinations of the Accounting Firm with respect to the Excise Tax
     payable by Employee.  Employee shall make proper payment of the amount of
     any Excise Payment, and at the request of the Company, provide to the
     company true and correct copies (with any amendments ) of his federal
     income tax return as filed with the Internal Revenue Service and
     corresponding state and local tax returns, if relevant, as filed with the
     applicable taxing authority, and such other documents reasonably requested
     by the Company, evidencing such payment.  If prior to the filing of
     Employee's federal income tax return, or corresponding state or local tax
     return, if relevant, the Accounting Firm determines that the amount of the
     Gross-Up Payment should be reduced, Employee shall within five business
     days pay to the Company the amount of such reduction.

          (e)  The fees and expenses of the Accounting Firm for its services in
     connection with the determinations and calculations contemplated by
     Section 10(b) hereof shall be borne by the Company.

          (f)  Employee shall notify the Company in writing of any claim by the
     Internal Revenue Service or any other taxing authority that, if
     successful, would require the payment by the Company of a Gross-Up
     Payment.  Such notification shall be given as promptly as practicable but
     no later than 10 business days after Employee actually receives notice of
     such claim and Employee shall further apprise the Company of the nature of
     such claim and the date on which such claim is requested to be paid (in
     each case, to the extent known by Employee).  Employee shall not pay such
     claim prior to the earlier of: (i) the expiration of the ten (10) calendar
     day period following the date on which he gives such notice to the
     Company; and (ii) the date that any payment of such amount with respect to
     such claim is due.  If the Company notifies Employee in writing prior to
     the expiration of such period that it desires to contest such claim,
     Employee shall:

                       (A) provide the Company with any written records or
                  documents in his possession relating to such claim reasonably
                  requested by the Company;

                       (B) take such action in connection with contesting such
                  claim as the Company shall reasonably request in writing from
                  time to time, including  without limitation accepting legal
                  representation with respect to such claim by an attorney
                  competent in respect of the subject matter and reasonably
                  selected by the Company;



                                      10

<PAGE>   11


                       (C) cooperate with the Company in good faith in order
                  effectively to contest such claim; and

                       (D) permit the Company to participate in any proceedings
                  relating to such claim;

     provided, however, that the Company shall bear and pay directly all
     costs and expenses (including interest and penalties) incurred in
     connection with such contest and shall indemnify and hold harmless
     Employee, on an after-tax basis, for and against any Excise Tax or income
     tax, including interest and penalties with respect thereto, imposed as a
     result of such representation and payment of costs and expenses.  Without
     limiting the foregoing provisions of this Section 10(f), the Company shall
     control all proceedings taken in connection with the contest of any claim
     contemplated by this Section 10(f) and, at its sole option, may pursue or
     forego any and all administrative appeals, proceedings, hearings and
     conferences with the taxing authority in respect of such claim (provided,
     however, that Employee may participate therein at his own cost and
     expense) and may, at its option, either direct Employee to pay the tax
     claimed and sue for refund or contest the claim in any permissible manner,
     and Employee agrees to prosecute such contest to a determination before
     any administrative tribunal, in a court of initial jurisdiction and in one
     or more appellate courts, as the Company shall determine; provided,
     however, that if the Company directs Employee to pay the tax claimed and
     sue for a refund, the Company shall advance the amount of such payment to
     Employee on an interest-free basis and shall indemnify and hold Employee
     harmless, on an after tax basis, from any Excise Tax or income or other
     tax, including interest or penalties with respect thereto, imposed with
     respect to such advance; and provided, further, however, that any
     extension of the statute of limitations relating to payment of taxes for
     the taxable year of Employee with respect to which the contested amount is
     claimed to be due is limited solely to such contested amount. 
     Furthermore, the Company's control of any such contested claim shall be
     limited to issues with respect to which a Gross-Up Payment would be
     payable hereunder and Employee shall be entitled to settle or contest, as
     the case may be, any other issue raised by the Internal Revenue Service or
     any other taxing authority.

          (g)  If, after the receipt by Employee of any amount advanced by the
     Company pursuant to Section 10(f) hereof, Employee receives any refund
     with respect to such claim, Employee shall (subject to the Company's
     complying with the requirements of Section 10(f) hereof) promptly pay to
     the Company the amount of such refund (together with any interest paid or
     credited thereon after any taxes applicable thereto).  If, after the
     receipt by Employee of any amount advanced by the Company pursuant to
     Section 10(f) hereof, a determination is made that Employee shall not be
     entitled to any refund with respect to such claim and the Company does not
     notify Employee in writing of its intent to contest such denial or refund
     prior to the expiration of 30 calendar days after such determination, then
     such advance shall be forgiven and shall not be required to be repaid and
     the amount of any such advance shall offset, to the extent thereof, the
     amount of Gross-Up Payment required to be paid by the Company to Employee
     pursuant to this Section 10.

     11.  LEGAL FEES AND EXPENSES.  It is the intent of the Company that
Employee not be required to incur legal fees and the related expenses
associated with the interpretation, enforcement or defense of Employee's rights
under Section 8 of this Agreement by litigation or otherwise because the cost
and expense thereof would substantially detract from the benefits intended to
be extended to Employee hereunder.  Accordingly, if the Company fails to comply
with any of its obligations under this 



                                      11


<PAGE>   12



Agreement or in the event that the Company or any other person takes any 
action to declare this Agreement void or unenforceable, or institutes any
litigation or other action or proceeding designed to deny, or to recover from,
Employee the benefits provided or intended to be provided to Employee
hereunder, the Company irrevocably authorizes Employee from time to time to
retain counsel of Employee's choice, at the expense of the Company as hereafter
provided, to advise and represent Employee in connection with any such
interpretation, enforcement or defense, including, without limitation, the
initiation or defense of any litigation or other legal action, whether by or
against the Company or any Director, officer, stockholder or other person
affiliated with the Company, in any jurisdiction. Without respect to whether
Employee prevails, in whole or in part, in connection with any of the
foregoing, the Company will pay and be solely financially responsible for any
and all reasonable attorneys' and related fees and expenses by Employee in
connection with any of the foregoing.

     12.  EMPLOYMENT RIGHTS: TERMINATION PRIOR TO CHANGE IN CONTROL.  Nothing
expressed or implied in this Agreement will create any right or duty on the
part of the Company or Employee to have Employee remain in the employment of
the Company prior to or following any Change in Control.  Any termination of
employment of Employee by the Company other than for Cause or by reason of his
death or disability pursuant to Sections 7(b), (d) or (e) during the period
beginning on the date that is sixty (60) days prior to the date of the first
public announcement by the Company of the potential occurrence of an event that
would constitute a Change in Control and ending on the date of consummation of
such Change in Control shall be deemed to be a termination of Employee after a
Change in Control for purposes of this Agreement.

     13.  NON-COMPETITION/NON-SOLICITATION.

          (a)  Covenant Not to Compete.  Employee covenants and agrees that 
     during the period of Employee's employment hereunder and for a period of 
     one (1) year following the termination of Employee's employment, 
     including without limitation termination by the Company for cause or 
     without cause, Employee shall not, in the United States of America, 
     engage, directly or indirectly, whether as principal or as agent, officer,
     director, employee, consultant, shareholder or otherwise, alone or in 
     association with any other person, corporation or other entity, in any 
     Competing Business.

          (b)  Non-Solicitation of Customers.  Employee agrees that during his
     employment with the Company he shall not, directly or indirectly, solicit
     the business of, or do business with, any customer or prospective
     customer of the Company for any business purpose other than for the
     benefit of the Company.  Employee further agrees that for one (1) year
     following termination of his employment with the Company, including
     without limitation termination by the Company for cause or without cause,
     Employee shall not, directly or indirectly, solicit the business of, or
     do business with, any customers or prospective customers of the Company.

          (c)  Non-Solicitation of Employees.  Employee agrees that, during his
     employment with the Company and for one (1) year following termination of
     Employee's employment with the Company, including without limitation
     termination by the Company for cause or without cause, Employee shall
     not, directly or indirectly, solicit or induce, or attempt to solicit or
     induce, any employee of the Company to leave the employment of the
     Company for any reason whatsoever, or hire any employee of the Company
     except into the employment of the Company.

     14.  VESTING OF OPTIONS AND RESTRICTED STOCK; EMPLOYEE BENEFITS.


                                      12

<PAGE>   13



          (a)  Upon the consummation of a Change in Control prior to the
     expiration of the Protected Term,

                 (i) all options to purchase Company stock then held by
            Employee shall be fully vested and exercisable in full as of such
            date;

                 (ii) all shares of restricted Company stock issuable to
            Employee under outstanding restricted stock awards made to Employee
            prior to the date of such Change in Control shall be issued to
            Employee as of such date; and

                 (iii) the restrictions applicable to all shares of restricted
            stock then held by Employee (including shares issued pursuant to
            subsection (ii) above) shall lapse as of such date.

          (b)  Except as otherwise expressly provided herein, no termination of
     Employee's employment with the Company will affect any rights which
     Employee may have pursuant to any agreement, policy, plan, program or
     arrangement of the Company providing Employee Benefits.

     15.  WITHHOLDING OF TAXES.  The Company may withhold from any amounts
payable under this Agreement all federal, state, city or other taxes as the
Company is required to withhold pursuant to any law or governmental regulation
or ruling.

     16.  SUCCESSORS AND BINDING AGREEMENT.

          (a)  The Company will require all successors (whether direct or
     indirect, by purchase, merger, consolidation, reorganization or
     otherwise) to any substantial portion of the business or assets of the
     Company, by agreement in form and substance satisfactory to Employee,
     jointly and severally expressly to assume and agree to perform this
     Agreement in the same manner and to the same extent the Company would be
     required to perform if no such succession had taken place.  This
     Agreement will be binding upon and inure to the benefit of the Company
     and any successor to the Company, including without limitation any
     persons acquiring directly or indirectly all or substantially all of the
     business or assets of the Company whether by purchase, merger,
     consolidation, reorganization or otherwise (and such successor shall
     thereafter be deemed the "Company" for the purposes of this Agreement),
     but will not otherwise be assignable, transferable or delegable by the
     Company.

          (b)  This Agreement will inure to the benefit of and be enforceable
     by Employee's personal or legal representatives, executors,
     administrators, successors, heirs, distributees and legatees.

          (c)  This Agreement is personal in nature and neither of the parties
     hereto shall, without the consent of the other, assign, transfer or
     delegate this Agreement or any rights or obligations hereunder except as
     expressly provided in Sections 16(a) and 16(b) hereof.  Without limiting
     the generality or effect of the foregoing, Employee's right to receive
     payments hereunder will not be assignable, transferable or delegable,
     whether by pledge, creation of a security interest, or otherwise, other
     than by a transfer by Employee's will or by the laws of descent and
     distribution and, in the event of any attempted assignment or transfer
     contrary to this Section 16(c), the Company shall have no liability to
     pay any amount so attempted to be assigned, transferred or delegated.



                                      13


<PAGE>   14


     17.  NOTICES.  For all purposes of this Agreement, all communications,
including without limitation notices, consents, requests or approvals, required
or permitted to be given hereunder will be in writing and will be deemed to
have been duly given when hand delivered or dispatched by electronic facsimile
transmission (with receipt thereof orally confirmed), or five business days
after having been mailed by United States registered or certified mail, return
receipt requested, postage prepaid, or three business days after having been
sent by a nationally recognized overnight courier service such as Federal
Express or UPS, addressed to the Company (to the attention of the Secretary of
the Company) at its principal executive office and to Employee at his principal
residence, or to such other address as any party may have furnished to the
other in writing and in accordance herewith, except that notices of changes of
address shall be effective only upon receipt.

     18.  GOVERNING LAW.  The validity, interpretation, construction and
performance of this Agreement will be governed by and construed in accordance
with the substantive laws of the State of Delaware, without giving effect to
the principles of conflict of laws of such State.

     19.  VALIDITY.  If any provision of this Agreement or the application of
any provision hereof to any person or circumstances is held invalid,
unenforceable or otherwise illegal, the remainder of this Agreement and the
application of such provision to any other person or circumstances will not be
affected, and the provision so held to be invalid, unenforceable or otherwise
illegal will be reformed to the extent (and only to the extent) necessary to
make it enforceable, valid or legal.

     20.  MISCELLANEOUS.  No waiver by either party hereto at any time of any
breach by the other party hereto or compliance with any condition or provision
of this Agreement to be performed by such other party will be deemed a waiver
of similar or dissimilar provisions or conditions at the same or at any prior
or subsequent time.  No agreements or representations, oral or otherwise,
expressed or implied with respect to the subject matter hereof have been made
by either party which are not set forth expressly in this Agreement.
References to Sections are to references to Sections of this Agreement.

     21.  COUNTERPARTS.  This Agreement may be executed in one or more
counterparts, each of which will be deemed to be an original but all of which
together will constitute one and the same agreement.

     22.  TITLES.  Titles are provided herein for convenience only and are not
to serve as a basis for interpretation or construction of this Agreement.




                                      14
<PAGE>   15


     IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the date first above written.

                                            THE COMPANY:
      
                                            HEALTH CARE AND RETIREMENT
                                            CORPORATION OF AMERICA


                                            By: 
                                               --------------------------------
                                            Its:   
                                               --------------------------------


                                            HEALTH CARE AND RETIREMENT
                                            CORPORATION



                                            By: 
                                               --------------------------------
                                            Its:   
                                               --------------------------------

                                            EMPLOYEE:

                                            -----------------------------------
                                            Paul A. Ormond




                                      15

<PAGE>   16

                                      
                                  SCHEDULE I


     Employee:           Paul A. Ormond

     Current Base Rate:  $510,000

     Job Titles:         Chairman, President and Chief Executive Officer










<PAGE>   17
                                      
                                      
                                 SCHEDULE II


Annual Incentive Plan
Performance Award Plan
Stock Option Plan
Amended Restricted Stock Plan
Salary Retirement Plan (prior to January 1, 1993)
Stock Purchase and Savings Program (prior to January 1, 1993)
Senior Executive Retirement Plans
Supplemental Offset Plan
Excess and Supplemental Benefit Plans
Corporate Officer and Senior Executive Life Insurance Program
Senior Management Savings Plan
Senior Management Savings Plan For Corporate Officers
Such other benefit plans and arrangements as the Company provides, from time to
time, to salaried employees generally participation in which is approved by the
President.



<PAGE>   1
                                                                   EXHIBIT 10.10
                     SECOND AMENDED EMPLOYMENT AGREEMENT


     This SECOND AMENDED EMPLOYMENT AGREEMENT ("Agreement"), effective as of
April 1, 1997 between HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA, an
Ohio corporation (the "Company"), HEALTH CARE AND RETIREMENT CORPORATION, a
Delaware corporation and sole stockholder of the Company ("HCR) and M. KEITH
WEIKEL ("Employee"), supersedes and replaces all prior employment agreements
between the parties hereto.

                                   RECITALS

A.   The Company has agreed to employ Employee in the position and at the base
     rate of pay set forth on Schedule I.

B.   The Company has further agreed to provide severance benefits to Employee
     upon a termination of Employee's employment resulting from certain
     specified events.

C.   The Company wishes to insure that its senior executives and other key
     employees are not practically disabled from discharging their duties in
     respect to a proposed or actual transaction involving a Change in Control.

D.   The Company desires to assure itself of both present and future
     continuity of management and desires to establish certain minimum
     severance benefits for certain of its senior executive officers and other
     key employees, including Employee, applicable in the event of a Change in
     Control.

                                    EVENTS

     In consideration of the foregoing, and for other good and valuable
consideration, the receipt and adequacy of which is hereby acknowledged,
Employee and the Company hereby agree as follows:

     1. CERTAIN DEFINED TERMS.  The following terms have the meanings set forth
below:

           (a) "Accounting Firm" is defined in Section 10(b).

           (b) "Aggregate Cash Compensation" means the sum of Base Pay and
      Employee's cash bonuses pursuant to the Company's Annual Incentive Plan
      and Performance Award Plan as in effect at any time of determination.

           (c) "Base Pay" means Employee's annual base salary as in effect at
      any time of determination.

           (d) "Board" means the Board of Directors of HCR.

           (e) "Cause" means Employee's financial dishonesty, fraud in the
      performance of his duties, willful failure to perform assigned duties
      hereunder or the commission of a felony.

           (f) "Change in Control" means the occurrence during the Protected
      Term of any of the following events:



<PAGE>   2


                 (i) HCR is merged, consolidated or reorganized into or with
            another corporation or other legal person, and as a result of such
            merger, consolidation or reorganization less than sixty-five
            percent of the combined voting power of the then outstanding
            securities of such resulting corporation or person immediately
            after such transaction are held in the aggregate by the holders of
            Voting Stock of HCR immediately prior to such transaction;

                 (ii) HCR sells or otherwise transfers all or substantially all
            of its assets to another corporation or other legal person, and as
            a result of such sale or transfer less than sixty-five percent of
            the combined voting power of the then outstanding Voting Stock of
            such corporation or person immediately after such sale or transfer
            is held in the aggregate by the holders of Voting Stock of HCR
            immediately prior to such sale or transfer;

                 (iii) There is a report filed on Schedule 13D or Schedule
            14D-1 (or any successor schedule, form or report), each as
            promulgated pursuant to the Exchange Act, disclosing that any
            person (as the term "person" is used in Section 13(d)(3) or Section
            14(d)(2) of the Exchange Act) has become the beneficial owner (as
            the term "beneficial owner" is defined under Rule 13d-3 or any
            successor rule or regulation promulgated under the Exchange Act) of
            15% or more of the then outstanding Voting Stock of HCR;

                 (iv) HCR files a report or proxy statement with the Securities
            and Exchange Commission pursuant to the Exchange Act disclosing in
            response to Form 8-K or Schedule 14A (or any successor schedule,
            form or report or item therein) that a Change in Control of HCR has
            occurred or will occur in the future pursuant to any then existing
            contract or transaction; or

                 (v) If, during any consecutive twelve month period,
            individuals who at the beginning of any such period constitute the
            Directors cease for any reason to constitute at least a majority
            thereof, provided, however, that for purposes of this clause (v)
            each Director who is first elected, or first nominated for election
            by HCR's stockholders, by a vote of at least one-half of the
            Directors (or a committee thereof) then still in office who were
            Directors at the beginning of any such period will be deemed to
            have been a Director at the beginning of such period.

           Notwithstanding the foregoing provisions of Sections 1(f)(iii) or
      1(f)(iv), unless otherwise determined in a specific case by majority vote
      of the Board, a "Change in Control" shall not be deemed to have occurred
      for purposes of Sections 1(f)(iii) or 1(f)(iv) solely because (1) HCR,
      (2) any Subsidiary (including, without limitation, the Company) or (3)
      any employee stock ownership plan or any other employee benefit plan of
      HCR or any Subsidiary either files or becomes obligated to file a report
      or a proxy statement under or in response to Schedule 13D, Schedule
      14D-1, Form 8-K or Schedule 14A (or any successor schedule, form or
      report or item therein) under the Exchange Act disclosing beneficial
      ownership by it of shares of Voting Stock of HCR, whether in excess of
      15% or otherwise, or because HCR reports that a change in control of HCR
      has occurred or will occur in the future by reason of such beneficial
      ownership.

           (g) "Competing Business" shall mean any person, corporation or other
      entity engaged in the United States of America in providing long-term
      care, skilled nursing or rehabilitative services or selling or attempting
      to sell or providing or attempting to provide any 


                                      
                                      2



<PAGE>   3


      other product or service which is the same as or similar to products or
      services sold or provided by the Company within the last 2 years prior to
      termination of Employee's employment hereunder.

           (h) "Continuation Period" means the thirty-six months immediately
      following the Termination Date.

           (i) "Director" means a member of the Board.

           (j) "Employee Benefits" means the perquisites and benefits as
      provided under any and all employee retirement income and welfare benefit
      policies, plans, programs or arrangements in which Employee is entitled
      to participate at any time of determination, including, without
      limitation, any stock option, stock purchase, stock appreciation,
      savings, pension, supplemental employee retirement, or other retirement
      income or welfare benefit, deferred compensation, incentive compensation,
      group or other life, health, medical/hospital or other insurance (whether
      funded by actual insurance or self-insured by the Company), disability,
      salary continuation, expense reimbursement and other employee benefit
      policies.

           (k) "Exchange Act" means the Securities Exchange Act of 1934, as
      amended.

           (l) "Excise Tax" is defined in Section 10(a).

           (m) "Gross-Up Payment" is defined in Section 10(a).

           (n) "ISO" is defined in Section 10(a).

           (o) "Payment" is defined in Section 10(a).

           (p) "Protected Term" means the period commencing as of the date
      hereof and expiring as of the close of business on March 31, 2000;
      provided, however, that: (i) commencing on April 1, 1998 and each April 1
      thereafter, the term of this Agreement will automatically be extended for
      an additional year unless, not later than December 31 of the immediately
      preceding year, the Company or Employee shall have given notice that it
      or Employee, as the case may be, does not wish to have the Protected Term
      extended; and (ii) except as otherwise provided in the last sentence of
      Section 12, if, prior to a Change in Control, Employee ceases for any
      reason to be an employee of the Company, thereupon without further action
      the Protected Term shall be deemed to have expired and Sections 8, 10, 11
      and 14(a) and the last sentence of Section 12 of this Agreement and the
      portion of any other provision of this Agreement that incorporates such
      provisions will immediately terminate and be of no further effect.  For
      purposes of this Section 1(p), Employee shall not be deemed to have
      ceased to be an employee of the Company by reason of the transfer of
      Employee's employment between or among HCR and the Company or any other
      Subsidiary.

           (q) "Severance Period" means the period of time commencing on the
      date of the occurrence of a Change in Control and continuing until the
      earliest of (i) the third anniversary of the occurrence of the Change in
      Control (ii) Employee's death, or (ii) Employee's attainment of age 65.

           (r) "Severance Benefits" are defined in Section 8(b).



                                      3

<PAGE>   4


           (s) "Subsidiary" means any entity in which HCR directly or
      indirectly beneficially owns 50% or more of the then outstanding Voting
      Stock.

           (t) "Termination Date" means the effective date of Employee's
      termination of employment with the Company; provided that for purposes of
      this Section 1(t), Employee shall not be deemed to have ceased to be an
      employee of the Company by reason of the transfer of Employee's
      employment between or among HCR and the Company or any other Subsidiary.

           (u) "Underpayment" is defined in Section 10(a).

           (v) "Voting Stock" means securities entitled to vote generally in
      the election of directors.

     2. SALARY AND POSITION.  Employee's Base Pay and job title shown on
Schedule I are correct as of the date hereof and in accordance with Employee's
understanding.

     3. AT-WILL EMPLOYMENT.  Employee's employment with the Company is not for
any specified term and may be terminated by Employee or by the Company at any
time for any reason, with or without Cause.

     4. NO OTHER AGREEMENTS.  Except as specifically set forth herein and in
Schedule II attached hereto, Employee represents and warrants that there are no
other written or oral agreements, understandings or commitments relating to
Employee's future employment, work assignments, compensation (including
compensation upon termination), benefits, or any other term or condition of
employment.

     5. ENTIRE AGREEMENT.  This Agreement and the agreements listed in Schedule
II attached hereto constitute the complete agreement between Employee and the
Company regarding any and all aspects of their employment relationship and
supersede any and all prior written or oral agreements, understandings or
commitments.  Employee understands that no representative of the Company has
been authorized to enter into any agreement, understanding or commitment with
Employee which is inconsistent in any way with the terms of this Agreement.

     6. PROHIBITION AGAINST AMENDMENT.  Employee's Base Pay may be modified by
the Company at any time in its sole discretion.  The retirement and benefit
plans set forth in Schedule II attached hereto in which Employee is entitled to
participate may be improved, reduced or terminated by the Company at any time
in its sole discretion; provided, however, that no vested or accrued benefit
shall be adversely affected.  No term set forth in this Agreement, including
without limitation the terms set forth in Section 3 hereof, may be modified in
any way except by a written agreement signed by Employee and by an authorized
representative of the Company which expressly states the intention of the
parties to modify the terms of this Agreement.

     7. SEVERANCE PAYMENT NOT FOLLOWING A CHANGE IN CONTROL.  Except as
provided in Section 8:

           (a) Upon the termination of Employee's employment as a result of
      Employee's electing to resign his employment or to retire without the
      consent of the Company, no payments shall be required or made pursuant to
      this Section 7.



                                      4
<PAGE>   5


           (b) Upon the termination of Employee's employment by the Company for
      Cause, no payments shall be required or made pursuant to this Section 7.

           (c) Upon the termination of Employee's employment by the Company for
      any reason other than for Cause or disability, the Company shall continue
      payment of Employee's Base Pay, at the rate then in effect on the
      Termination Date, for a period of one year after such Termination Date.
      The Company shall give thirty (30) days written notice of any such
      termination which notice shall specify the Termination Date.

           (d) Upon the termination of Employee's employment as a result of the
      death of Employee, the Company shall continue payment of Employee's Base
      Pay, at the rate then in effect on the Termination Date, for a period of
      one year after such Termination Date; provided, however, that such
      payments shall be offset by any survivor benefits, excluding life
      insurance proceeds, received by Employee's spouse or other designated
      beneficiary under the Company's plans, programs and policies.

           (e) Upon the termination of Employee's employment as a result of his
      becoming unable to perform his duties due to a disability as established
      by the award of long-term disability benefits under the Company's
      long-term disability plan, the Company may terminate Employee's
      employment by giving Employee thirty (30) days written notice of its
      intention to terminate.  In such event, Company shall continue payment of
      Employee's Base Pay, at the rate then in effect on the Termination Date,
      for a period of one year after such Termination Date; provided, however,
      that such payments shall be offset by any disability benefits received by
      Employee, or his legal guardian, under the Company's plans, programs and
      policies.

           (f) Notwithstanding anything to the contrary contained in this
      Section 7, upon the termination of Employee's employment for any reason
      other than pursuant to Section 8, whether voluntarily or involuntarily
      and whether with or without Cause, Employee shall be entitled to the
      payments provided for hereunder and such rights as he otherwise has under
      the Company's Restricted Stock Plan and the Company's Stock Option Plan
      in the circumstances of his particular termination.

      8. TERMINATION FOLLOWING A CHANGE IN CONTROL.

           (a) Eligibility for Severance Benefits.

                 (i) If, during the Severance Period, Employee's employment is
            terminated by the Company other than for Cause and other than as a
            result of his death or disability pursuant to Section 7(d) or (e),
            Employee shall be entitled to the Severance Benefits.

                 (ii) Following the consummation of a Change in Control,
            Employee may elect, within the 60-day period following the
            occurrence of one of the following events, to terminate employment
            with the Company and receive the Severance Benefits (pursuant to
            written notice to the Board specifying the effective date of such
            termination which shall not be earlier than the date of the Board's
            receipt of such notice and shall not be later than the end of such
            60-day period):



                                      5
<PAGE>   6


                       (A) Failure to elect or reelect or otherwise to maintain
                  Employee in the office or position, or a substantially
                  equivalent office or position, of or with the Company or
                  successor, as the case may be, which Employee held
                  immediately prior to a Change in Control, or the removal of
                  Employee as a Director (or as a member of the board of
                  directors of any successor thereto) if Employee shall have
                  been a Director immediately prior to the Change in Control;

                       (B) The occurrence of any of the following:

                             (I) a significant adverse change in the nature or
                        scope of the authorities, powers, functions,
                        responsibilities or duties attached to the position
                        with the Company or successor, as the case may be,
                        which Employee held immediately prior to the Change in
                        Control;

                             (II) a reduction in Employee's Base Pay as in
                        effect immediately prior to the Change in Control;

                             (III) a material reduction in the scope or value
                        of Employee Benefits as in effect immediately prior to
                        a Change in Control; or

                             (IV) any material breach of this Agreement by the
                        Company or any successor thereto,

                        which situation is not remedied within 10 calendar days
                        after written notice to the Board (or the board of any
                        successor) from Employee;

                       (C) The liquidation, dissolution, merger, consolidation
                  or reorganization of the Company or transfer of all or
                  substantially all of its business and/or assets, unless the
                  surviving or successor entity, if other than the Company (by
                  liquidation, merger, consolidation, reorganization, transfer
                  or otherwise), to which all or substantially all of such
                  business and/or assets have been transferred (directly or by
                  operation of law) assumes all duties and obligations of the
                  Company under this Agreement pursuant to Section 16(a); or

                       (D) The Company or any successor, as the case may be, by
                  which Employee is employed relocates its principal executive
                  offices, or requires Employee to have his principal location
                  of work changed, to any location which increases by more than
                  25 miles Employee's commute to such location immediately
                  prior to the Change in Control, or requires Employee to
                  travel away from his office in the course of discharging his
                  responsibilities or duties hereunder at least 20% more (in
                  terms of aggregate days in any calendar year or in any
                  calendar quarter when annualized for purposes of comparison
                  to any prior year) than the average of such time that was
                  required of Employee in the three full years immediately
                  prior to the Change of Control without, in either case, his
                  prior written consent.


                                      6



<PAGE>   7


                 (iii) If Employee elects to terminate employment with the
            Company or any successor, as the case may be, for any reason, or
            without reason, during such portion of the 180-day period
            immediately following the first anniversary of the occurrence of
            any Change in Control that falls within the Severance Period,
            Employee shall be entitled to the Severance Benefits.

           (b) Severance Benefits.  If, following the occurrence of a Change in
      Control, Employee's employment with the Company is terminated pursuant to
      Section 8(a)(i), (ii) or (iii), the Company will pay to Employee the
      following amounts within five business days after the Termination Date
      and will provide to Employee the following benefits (collectively, the
      "Severance Benefits"):

                 (i) A lump sum payment equal to three times the highest
            Aggregate Cash Compensation paid or payable to Employee for any of
            the three calendar years preceding the year in which the
            Termination Date occurs or for the year in which the Termination
            Date occurs if the Termination Date occurs after the end of the
            first quarter; for purposes of this Section 8(b)(i), if the
            Company's financial performance for the year-to-date period
            preceding the Termination Date is consistent with budgeted levels
            (as certified by the Compensation Committee) then the Aggregate
            Cash Compensation for the year in which the Termination Date occurs
            shall be assumed to be equal to the sum of: (A) the Employee's Base
            Pay, (B) the Employee's Annual Incentive Plan bonus payable for the
            year in which the Termination Date occurs, calculated by
            multiplying the product of the Employee's Base Pay and the
            Employee's bonus percentage by 150%, and (C) the Employee's
            Performance Award Plan award payable for the award period ending
            with the year in which the Termination Date occurs as if the
            earnings per share growth rate for such year were assumed to be the
            actual growth rate for the year-to-date period prior to the
            Termination Date;

                 (ii) During the Continuation Period:

                       (A) the Company will arrange to provide Employee with
                  group medical, dental and vision benefits substantially
                  similar to those which Employee was receiving or entitled to
                  receive immediately prior to the Change in Control; and

                       (B) the Company (or successor) will provide Employee the
                  use of office space, furnishings and secretarial support
                  services comparable to those provided to Employee immediately
                  prior to the Change in Control;

                       If and to the extent that any benefit described in
                  Section 8(b)(ii)(A) is not or cannot be paid or provided
                  under any policy, plan program or arrangement of the Company,
                  then the Company will pay or provide for the payment to
                  Employee, his dependents and beneficiaries, of such Employee
                  Benefits in any manner selected by the Company.  Without
                  otherwise limiting the purposes or effect of Section 8,
                  Employee Benefits otherwise receivable by Employee pursuant
                  to Section 8(b)(ii)(A) will be reduced to the extent
                  comparable welfare benefits are actually received by Employee
                  from another employer during the Continuation Period, and any
                  such benefits received by Employee shall be reported by
                  Employee to the Company.



                                      7


<PAGE>   1
                                                                   EXHIBIT 10.11

                      SECOND AMENDED EMPLOYMENT AGREEMENT


     This SECOND AMENDED EMPLOYMENT AGREEMENT ("Agreement"), effective as of
April 1, 1997 between HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA, an
Ohio corporation (the "Company"), HEALTH CARE AND RETIREMENT CORPORATION, a
Delaware corporation and sole stockholder of the Company ("HCR) and GEOFFREY G.
MEYERS ("Employee"), supersedes and replaces all prior employment agreements
between the parties hereto.

                                    RECITALS

A.   The Company has agreed to employ Employee in the position and at the base
     rate of pay set forth on Schedule I.

B.   The Company has further agreed to provide severance benefits to Employee
     upon a termination of Employee's employment resulting from certain
     specified events.

C.   The Company wishes to insure that its senior executives and other key
     employees are not practically disabled from discharging their duties in
     respect to a proposed or actual transaction involving a Change in Control.

D.   The Company desires to assure itself of both present and future
     continuity of management and desires to establish certain minimum
     severance benefits for certain of its senior executive officers and other
     key employees, including Employee, applicable in the event of a Change in
     Control.

                                     EVENTS

     In consideration of the foregoing, and for other good and valuable
consideration, the receipt and adequacy of which is hereby acknowledged,
Employee and the Company hereby agree as follows:

     1. CERTAIN DEFINED TERMS.  The following terms have the meanings set forth
below:

           (a) "Accounting Firm" is defined in Section 10(b).

           (b) "Aggregate Cash Compensation" means the sum of Base Pay and
      Employee's cash bonuses pursuant to the Company's Annual Incentive Plan
      and Performance Award Plan as in effect at any time of determination.

           (c) "Base Pay" means Employee's annual base salary as in effect at
      any time of determination.

           (d) "Board" means the Board of Directors of HCR.

           (e) "Cause" means Employee's financial dishonesty, fraud in the
      performance of his duties, willful failure to perform assigned duties
      hereunder or the commission of a felony.

           (f) "Change in Control" means the occurrence during the Protected
      Term of any of the following events:



<PAGE>   2

                 (i) HCR is merged, consolidated or reorganized into or with
            another corporation or other legal person, and as a result of such
            merger, consolidation or reorganization less than sixty-five
            percent of the combined voting power of the then outstanding
            securities of such resulting corporation or person immediately
            after such transaction are held in the aggregate by the holders of
            Voting Stock of HCR immediately prior to such transaction;

                 (ii) HCR sells or otherwise transfers all or substantially all
            of its assets to another corporation or other legal person, and as
            a result of such sale or transfer less than sixty-five percent of
            the combined voting power of the then outstanding Voting Stock of
            such corporation or person immediately after such sale or transfer
            is held in the aggregate by the holders of Voting Stock of HCR
            immediately prior to such sale or transfer;

                 (iii) There is a report filed on Schedule 13D or Schedule
            14D-1 (or any successor schedule, form or report), each as
            promulgated pursuant to the Exchange Act, disclosing that any
            person (as the term "person" is used in Section 13(d)(3) or Section
            14(d)(2) of the Exchange Act) has become the beneficial owner (as
            the term "beneficial owner" is defined under Rule 13d-3 or any
            successor rule or regulation promulgated under the Exchange Act) of
            15% or more of the then outstanding Voting Stock of HCR;

                 (iv) HCR files a report or proxy statement with the Securities
            and Exchange Commission pursuant to the Exchange Act disclosing in
            response to Form 8-K or Schedule 14A (or any successor schedule,
            form or report or item therein) that a Change in Control of HCR has
            occurred or will occur in the future pursuant to any then existing
            contract or transaction; or

                 (v) If, during any consecutive twelve month period,
            individuals who at the beginning of any such period constitute the
            Directors cease for any reason to constitute at least a majority
            thereof, provided, however, that for purposes of this clause (v)
            each Director who is first elected, or first nominated for election
            by HCR's stockholders, by a vote of at least one-half of the
            Directors (or a committee thereof) then still in office who were
            Directors at the beginning of any such period will be deemed to
            have been a Director at the beginning of such period.

            Notwithstanding the foregoing provisions of Sections 1(f)(iii) or
      1(f)(iv), unless otherwise determined in a specific case by majority vote
      of the Board, a "Change in Control" shall not be deemed to have occurred
      for purposes of Sections 1(f)(iii) or 1(f)(iv) solely because (1) HCR,
      (2) any Subsidiary (including, without limitation, the Company) or (3)
      any employee stock ownership plan or any other employee benefit plan of
      HCR or any Subsidiary either files or becomes obligated to file a report
      or a proxy statement under or in response to Schedule 13D, Schedule
      14D-1, Form 8-K or Schedule 14A (or any successor schedule, form or
      report or item therein) under the Exchange Act disclosing beneficial
      ownership by it of shares of Voting Stock of HCR, whether in excess of
      15% or otherwise, or because HCR reports that a change in control of HCR
      has occurred or will occur in the future by reason of such beneficial
      ownership.

            (g) "Competing Business" shall mean any person, corporation or other
      entity engaged in the United States of America in providing long-term
      care, skilled nursing or rehabilitative services or selling or attempting
      to sell or providing or attempting to provide any 



                                      2
<PAGE>   3

      other product or service which is the same as or similar to products or   
      services sold or provided by the Company within the last 2 years prior to
      termination of Employee's employment hereunder.

           (h) "Continuation Period" means the thirty-six months immediately
      following the Termination Date.

           (i) "Director" means a member of the Board.

           (j) "Employee Benefits" means the perquisites and benefits as
      provided under any and all employee retirement income and welfare benefit
      policies, plans, programs or arrangements in which Employee is entitled
      to participate at any time of determination, including, without
      limitation, any stock option, stock purchase, stock appreciation,
      savings, pension, supplemental employee retirement, or other retirement
      income or welfare benefit, deferred compensation, incentive compensation,
      group or other life, health, medical/hospital or other insurance (whether
      funded by actual insurance or self-insured by the Company), disability,
      salary continuation, expense reimbursement and other employee benefit
      policies.

           (k) "Exchange Act" means the Securities Exchange Act of 1934, as
      amended.

           (l) "Excise Tax" is defined in Section 10(a).

           (m) "Gross-Up Payment" is defined in Section 10(a).

           (n) "ISO" is defined in Section 10(a).

           (o) "Payment" is defined in Section 10(a).

           (p) "Protected Term" means the period commencing as of the date
      hereof and expiring as of the close of business on March 31, 2000;
      provided, however, that: (i) commencing on April 1, 1998 and each April 1
      thereafter, the term of this Agreement will automatically be extended for
      an additional year unless, not later than December 31 of the immediately
      preceding year, the Company or Employee shall have given notice that it
      or Employee, as the case may be, does not wish to have the Protected Term
      extended; and (ii) except as otherwise provided in the last sentence of
      Section 12, if, prior to a Change in Control, Employee ceases for any
      reason to be an employee of the Company, thereupon without further action
      the Protected Term shall be deemed to have expired and Sections 8, 10, 11
      and 14(a) and the last sentence of Section 12 of this Agreement and the
      portion of any other provision of this Agreement that incorporates such
      provisions will immediately terminate and be of no further effect.  For
      purposes of this Section 1(p), Employee shall not be deemed to have
      ceased to be an employee of the Company by reason of the transfer of
      Employee's employment between or among HCR and the Company or any other
      Subsidiary.

           (q) "Severance Period" means the period of time commencing on the
      date of the occurrence of a Change in Control and continuing until the
      earliest of (i) the third anniversary of the occurrence of the Change in
      Control (ii) Employee's death, or (ii) Employee's attainment of age 65.

           (r) "Severance Benefits" are defined in Section 8(b).


                                      3
<PAGE>   4

           (s) "Subsidiary" means any entity in which HCR directly or
      indirectly beneficially owns 50% or more of the then outstanding Voting
      Stock.

           (t) "Termination Date" means the effective date of Employee's
      termination of employment with the Company; provided that for purposes of
      this Section 1(t), Employee shall not be deemed to have ceased to be an
      employee of the Company by reason of the transfer of Employee's
      employment between or among HCR and the Company or any other Subsidiary.

           (u) "Underpayment" is defined in Section 10(a).

           (v) "Voting Stock" means securities entitled to vote generally in
      the election of directors.

      2. SALARY AND POSITION.  Employee's Base Pay and job title shown on
Schedule I are correct as of the date hereof and in accordance with Employee's
understanding.

      3. AT-WILL EMPLOYMENT.  Employee's employment with the Company is not for
any specified term and may be terminated by Employee or by the Company at any
time for any reason, with or without Cause.

      4. NO OTHER AGREEMENTS.  Except as specifically set forth herein and in
Schedule II attached hereto, Employee represents and warrants that there are no
other written or oral agreements, understandings or commitments relating to
Employee's future employment, work assignments, compensation (including
compensation upon termination), benefits, or any other term or condition of
employment.

      5. ENTIRE AGREEMENT.  This Agreement and the agreements listed in Schedule
II attached hereto constitute the complete agreement between Employee and the
Company regarding any and all aspects of their employment relationship and
supersede any and all prior written or oral agreements, understandings or
commitments.  Employee understands that no representative of the Company has
been authorized to enter into any agreement, understanding or commitment with
Employee which is inconsistent in any way with the terms of this Agreement.

      6. PROHIBITION AGAINST AMENDMENT.  Employee's Base Pay may be modified by
the Company at any time in its sole discretion.  The retirement and benefit
plans set forth in Schedule II attached hereto in which Employee is entitled to
participate may be improved, reduced or terminated by the Company at any time
in its sole discretion; provided, however, that no vested or accrued benefit
shall be adversely affected.  No term set forth in this Agreement, including
without limitation the terms set forth in Section 3 hereof, may be modified in
any way except by a written agreement signed by Employee and by an authorized
representative of the Company which expressly states the intention of the
parties to modify the terms of this Agreement.

      7. SEVERANCE PAYMENT NOT FOLLOWING A CHANGE IN CONTROL.  Except as
provided in Section 8:

           (a) Upon the termination of Employee's employment as a result of
      Employee's electing to resign his employment or to retire without the
      consent of the Company, no payments shall be required or made pursuant to
      this Section 7.



                                      4
<PAGE>   5

           (b) Upon the termination of Employee's employment by the Company for
      Cause, no payments shall be required or made pursuant to this Section 7.

           (c) Upon the termination of Employee's employment by the Company for
      any reason other than for Cause or disability, the Company shall continue
      payment of Employee's Base Pay, at the rate then in effect on the
      Termination Date, for a period of one year after such Termination Date.
      The Company shall give thirty (30) days written notice of any such
      termination which notice shall specify the Termination Date.

           (d) Upon the termination of Employee's employment as a result of the
      death of Employee, the Company shall continue payment of Employee's Base
      Pay, at the rate then in effect on the Termination Date, for a period of
      one year after such Termination Date; provided, however, that such
      payments shall be offset by any survivor benefits, excluding life
      insurance proceeds, received by Employee's spouse or other designated
      beneficiary under the Company's plans, programs and policies.

           (e) Upon the termination of Employee's employment as a result of his
      becoming unable to perform his duties due to a disability as established
      by the award of long-term disability benefits under the Company's
      long-term disability plan, the Company may terminate Employee's
      employment by giving Employee thirty (30) days written notice of its
      intention to terminate.  In such event, Company shall continue payment of
      Employee's Base Pay, at the rate then in effect on the Termination Date,
      for a period of one year after such Termination Date; provided, however,
      that such payments shall be offset by any disability benefits received by
      Employee, or his legal guardian, under the Company's plans, programs and
      policies.

           (f) Notwithstanding anything to the contrary contained in this
      Section 7, upon the termination of Employee's employment for any reason
      other than pursuant to Section 8, whether voluntarily or involuntarily
      and whether with or without Cause, Employee shall be entitled to the
      payments provided for hereunder and such rights as he otherwise has under
      the Company's Restricted Stock Plan and the Company's Stock Option Plan
      in the circumstances of his particular termination.

      8. TERMINATION FOLLOWING A CHANGE IN CONTROL.

           (a) Eligibility for Severance Benefits.

                 (i) If, during the Severance Period, Employee's employment is
            terminated by the Company other than for Cause and other than as a
            result of his death or disability pursuant to Section 7(d) or (e),
            Employee shall be entitled to the Severance Benefits.

                 (ii) Following the consummation of a Change in Control,
            Employee may elect, within the 60-day period following the
            occurrence of one of the following events, to terminate employment
            with the Company and receive the Severance Benefits (pursuant to
            written notice to the Board specifying the effective date of such
            termination which shall not be earlier than the date of the Board's
            receipt of such notice and shall not be later than the end of such
            60-day period):


                                      5
<PAGE>   6

                       (A) Failure to elect or reelect or otherwise to maintain
                  Employee in the office or position, or a substantially
                  equivalent office or position, of or with the Company or
                  successor, as the case may be, which Employee held
                  immediately prior to a Change in Control, or the removal of
                  Employee as a Director (or as a member of the board of
                  directors of any successor thereto) if Employee shall have
                  been a Director immediately prior to the Change in Control;

                       (B) The occurrence of any of the following:

                             (I) a significant adverse change in the nature or
                        scope of the authorities, powers, functions,
                        responsibilities or duties attached to the position
                        with the Company or successor, as the case may be,
                        which Employee held immediately prior to the Change in
                        Control;

                             (II) a reduction in Employee's Base Pay as in
                        effect immediately prior to the Change in Control;

                             (III) a material reduction in the scope or value
                        of Employee Benefits as in effect immediately prior to
                        a Change in Control; or

                             (IV) any material breach of this Agreement by the
                        Company or any successor thereto,

                        which situation is not remedied within 10 calendar days
                        after written notice to the Board (or the board of any
                        successor) from Employee;

                       (C) The liquidation, dissolution, merger, consolidation
                  or reorganization of the Company or transfer of all or
                  substantially all of its business and/or assets, unless the
                  surviving or successor entity, if other than the Company (by
                  liquidation, merger, consolidation, reorganization, transfer
                  or otherwise), to which all or substantially all of such
                  business and/or assets have been transferred (directly or by
                  operation of law) assumes all duties and obligations of the
                  Company under this Agreement pursuant to Section 16(a); or

                       (D) The Company or any successor, as the case may be, by
                  which Employee is employed relocates its principal executive
                  offices, or requires Employee to have his principal location
                  of work changed, to any location which increases by more than
                  25 miles Employee's commute to such location immediately
                  prior to the Change in Control, or requires Employee to
                  travel away from his office in the course of discharging his
                  responsibilities or duties hereunder at least 20% more (in
                  terms of aggregate days in any calendar year or in any
                  calendar quarter when annualized for purposes of comparison
                  to any prior year) than the average of such time that was
                  required of Employee in the three full years immediately
                  prior to the Change of Control without, in either case, his
                  prior written consent.




                                      6
<PAGE>   7

                 (iii) If Employee elects to terminate employment with the
            Company or any successor, as the case may be, for any reason, or
            without reason, during such portion of the 180-day period
            immediately following the first anniversary of the occurrence of
            any Change in Control that falls within the Severance Period,
            Employee shall be entitled to the Severance Benefits.

           (b) Severance Benefits.  If, following the occurrence of a Change in
      Control, Employee's employment with the Company is terminated pursuant to
      Section 8(a)(i), (ii) or (iii), the Company will pay to Employee the
      following amounts within five business days after the Termination Date
      and will provide to Employee the following benefits (collectively, the
      "Severance Benefits"):

                 (i) A lump sum payment equal to three times the highest
            Aggregate Cash Compensation paid or payable to Employee for any of
            the three calendar years preceding the year in which the
            Termination Date occurs or for the year in which the Termination
            Date occurs if the Termination Date occurs after the end of the
            first quarter; for purposes of this Section 8(b)(i), if the
            Company's financial performance for the year-to-date period
            preceding the Termination Date is consistent with budgeted levels
            (as certified by the Compensation Committee) then the Aggregate
            Cash Compensation for the year in which the Termination Date occurs
            shall be assumed to be equal to the sum of: (A) the Employee's Base
            Pay, (B) the Employee's Annual Incentive Plan bonus payable for the
            year in which the Termination Date occurs, calculated by
            multiplying the product of the Employee's Base Pay and the
            Employee's bonus percentage by 150%, and (C) the Employee's
            Performance Award Plan award payable for the award period ending
            with the year in which the Termination Date occurs as if the
            earnings per share growth rate for such year were assumed to be the
            actual growth rate for the year-to-date period prior to the
            Termination Date;

                 (ii) During the Continuation Period:

                       (A) the Company will arrange to provide Employee with
                  group medical, dental and vision benefits substantially
                  similar to those which Employee was receiving or entitled to
                  receive immediately prior to the Change in Control; and

                       (B) the Company (or successor) will provide Employee the
                  use of office space, furnishings and secretarial support
                  services comparable to those provided to Employee immediately
                  prior to the Change in Control;

                       If and to the extent that any benefit described in
                  Section 8(b)(ii)(A) is not or cannot be paid or provided
                  under any policy, plan program or arrangement of the Company,
                  then the Company will pay or provide for the payment to
                  Employee, his dependents and beneficiaries, of such Employee
                  Benefits in any manner selected by the Company.  Without
                  otherwise limiting the purposes or effect of Section 8,
                  Employee Benefits otherwise receivable by Employee pursuant
                  to Section 8(b)(ii)(A) will be reduced to the extent
                  comparable welfare benefits are actually received by Employee
                  from another employer during the Continuation Period, and any
                  such benefits received by Employee shall be reported by
                  Employee to the Company.



                                      7
<PAGE>   8

                 (iii) The Company shall take whatever action is necessary to
            fund completely any split-dollar life insurance arrangement
            maintained by the Company for the benefit of Employee, effective as
            of the Termination Date and based upon Employee's service through
            the end of the Continuation Period;

                 (iv) Effective as of the Termination Date, Employee will be
            credited with service with the Company for an additional 36 months
            for the purpose of determining service credits and benefits due and
            payable to Employee under the Company's retirement income,
            supplemental retirement and other benefit plans of the Company
            applicable to Employee, his dependents or his beneficiaries
            immediately prior to the Change in Control; and

                 (v) Employee shall be permitted to elect to defer receipt of
            amounts payable to him, if any, under the Company's Senior
            Management Savings Plan and Senior Management Savings Plan for
            Corporate Officers until any date not later than the expiration of
            the Continuation Period.

            (c) Without limiting the rights of Employee at law or in equity, if
      the Company fails to make any payment or provide any benefit required to
      be made or provided under this Section 8 on a timely basis, the Company
      will pay interest on the amount or value thereof at an annualized rate of
      interest equal to the so-called composite "prime rate" as quoted from
      time to time during the relevant period in the Midwest Edition of The
      Wall Street Journal.  Any change in such prime rate will be effective on
      and as of the date such change is so published.

            (d) Notwithstanding any other provision hereof, the parties'
      respective rights and obligations under this Section 8 and under Section
      11 will survive:

                 (i) any termination or expiration of this Agreement following
            a Change in Control prior to the expiration of the Protected Term;
            and

                 (ii) the termination of Employee's employment for any reason
            whatsoever following a Change in Control prior to the expiration of
            the Protected Term.

      9. NO SET-OFF; NO MITIGATION OBLIGATION.  The Company hereby acknowledges
that it will be difficult and may be impossible (a) for Employee to find
reasonably comparable employment following the Termination Date; and (b) to
measure the amount of damages which Employee may suffer as a result of
termination of employment hereunder.  In addition, the Company acknowledges
that its severance pay plans applicable to corporate officers do not provide
for mitigation, offset or reduction of any severance payment received
thereunder.  Accordingly, the payment of the severance compensation by the
Company to Employee in accordance with the terms of this Agreement is hereby
acknowledged by the Company to be reasonable and will be liquidated damages,
and Employee will not be required to mitigate the amount of any payment
provided for in this Agreement by seeking other employment or otherwise, nor
will any profits, income, earnings or other benefits from any source whatsoever
create any mitigation, offset, reduction or any other obligation on the part of
Employee hereunder or otherwise, except as expressly provided in Sections 7(d)
and (e) and the last sentence of Section 8 (b)(ii).



                                      8
<PAGE>   9

      10. CERTAIN ADDITIONAL PAYMENTS BY THE COMPANY.

           (a) Anything in this Agreement to the contrary notwithstanding, in
      the event that a Change in Control occurs prior to the expiration of the
      Protected Term and it shall be determined (as hereafter provided) that
      any payment or distribution by the Company or any of its affiliates to or
      for the benefit of Employee, whether paid or payable or distributed or
      distributable pursuant to the terms of this Agreement or otherwise
      pursuant to or by reason of any other agreement, policy, plan, program or
      arrangement, including without limitation any stock option, stock
      appreciation right or similar right, or the lapse or termination of any
      restriction on or the vesting or exercisability of any of the foregoing
      (collectively, a "Payment"), would be subject to the excise tax imposed
      by Section 4999 of the Internal Revenue Code (or any successor provision
      thereto) by reason of being considered "contingent on a change in
      ownership or control" of the Company, within the meaning of Section 280G
      of the Internal Revenue Code (or any successor provision thereto) or to
      any similar tax imposed by state or local law, or any interest or
      penalties with respect to such tax (such tax or taxes, together with any
      such interest and penalties, being hereafter collectively referred to as
      the "Excise Tax"), then Employee shall be entitled to receive an
      additional payment or payments (collectively, a "Gross-Up Payment");
      provided, however, that no Gross-up Payment shall be made with respect to
      the Excise Tax, if any, attributable to: (i) any incentive stock option,
      as defined by Section 422 of the Internal Revenue Code ("ISO"), granted
      prior to the execution of this Agreement; or (ii) any stock appreciation
      or similar right, whether or not limited, granted in tandem with any ISO
      described in clause (i).  The Gross-Up Payment shall be in an amount such
      that, after payment by Employee of all taxes, including any Excise Tax
      (and including any interest or penalties imposed with respect to such
      taxes), imposed upon the Gross-Up Payment, Employee retains an amount of
      the Gross-Up Payment equal to the Excise Tax imposed upon the Payment.

           (b) Subject to the provisions of Section 10(f) hereof, all
      determinations required to be made under this Section 10, including
      whether an Excise Tax is payable by Employee and the amount of such
      Excise Tax and whether a Gross-Up Payment is required to be paid by the
      Company to Employee and the amount of such Gross-Up Payment, if any,
      shall be made by a nationally recognized accounting firm (the "Accounting
      Firm") selected by the Company.  The Company shall direct the Accounting
      Firm to submit its determination and detailed supporting calculations to
      both the Company and Employee within thirty (30) calendar days after any
      Termination Date arising pursuant to Section 8(a).  If the Accounting
      Firm determines that any Excise Tax is payable by Employee, the Company
      shall pay the required Gross-Up Payment to Employee within five (5)
      business days after receipt of such determination.  If the Accounting
      Firm determines that no Excise Tax is payable by Employee, it shall, at
      the same time as it makes such determination, furnish the Company and
      Employee an opinion that Employee has substantial authority not to report
      any Excise Tax on his federal, state or local income or other tax return.
      As a result of the uncertainty in the application of Section 4999 of the
      Internal Revenue Code (or any successor provision thereto) and the
      possibility of similar uncertainty regarding applicable state or local
      tax law at the time of any determination by the Accounting Firm
      hereunder, it is possible that a Gross-Up Payment which will not have
      been made by the Company should have been made (an "Underpayment"),
      consistent with the calculations required to be made hereunder.  In the
      event that the Company exhausts or fails to pursue its remedies pursuant
      to Section 10(f) hereof and Employee thereafter is required to make a
      payment of any Excise Tax, Employee shall direct the Accounting Firm to
      determine the amount of the Underpayment that has occurred and to submit
      its determination and detailed supporting calculations to both the
      Company and Employee as promptly as possible.  Any such 


                                      9
<PAGE>   10

      Underpayment shall be promptly paid by the Company to, or for the benefit 
      of, Employee within five business days after receipt of such
      determination and calculations.

           (c) The Company and Employee shall each provide the Accounting Firm
      access to and copies of any books, records and documents in the
      possession of the Company or Employee, as the case may be, reasonably
      requested by the Accounting Firm, and otherwise cooperate with the
      Accounting Firm in connection with the preparation and issuance of the
      determination and calculations contemplated by Section 10(b) hereof.
      Except as contemplated by Sections 10(f) or 10(g), any final
      determination by the Accounting Firm as to the amount of the Gross-Up
      Payment shall be binding upon the Company and Employee.

           (d) The federal, state and local income or other tax returns filed
      by Employee shall be prepared and filed on a consistent basis with the
      determinations of the Accounting Firm with respect to the Excise Tax
      payable by Employee.  Employee shall make proper payment of the amount of
      any Excise Payment, and at the request of the Company, provide to the
      company true and correct copies (with any amendments ) of his federal
      income tax return as filed with the Internal Revenue Service and
      corresponding state and local tax returns, if relevant, as filed with the
      applicable taxing authority, and such other documents reasonably
      requested by the Company, evidencing such payment.  If prior to the
      filing of Employee's federal income tax return, or corresponding state or
      local tax return, if relevant, the Accounting Firm determines that the
      amount of the Gross-Up Payment should be reduced, Employee shall within
      five business days pay to the Company the amount of such reduction.

           (e) The fees and expenses of the Accounting Firm for its services in
      connection with the determinations and calculations contemplated by
      Section 10(b) hereof shall be borne by the Company.

           (f) Employee shall notify the Company in writing of any claim by the
      Internal Revenue Service or any other taxing authority that, if
      successful, would require the payment by the Company of a Gross-Up
      Payment.  Such notification shall be given as promptly as practicable but
      no later than 10 business days after Employee actually receives notice of
      such claim and Employee shall further apprise the Company of the nature
      of such claim and the date on which such claim is requested to be paid
      (in each case, to the extent known by Employee).  Employee shall not pay
      such claim prior to the earlier of: (i) the expiration of the ten (10)
      calendar day period following the date on which he gives such notice to
      the Company; and (ii) the date that any payment of such amount with
      respect to such claim is due.  If the Company notifies Employee in
      writing prior to the expiration of such period that it desires to contest
      such claim, Employee shall:

                       (A) provide the Company with any written records or
                  documents in his possession relating to such claim reasonably
                  requested by the Company;

                       (B) take such action in connection with contesting such
                  claim as the Company shall reasonably request in writing from
                  time to time, including  without limitation accepting legal
                  representation with respect to such claim by an attorney
                  competent in respect of the subject matter and reasonably
                  selected by the Company;



                                      10
<PAGE>   11

                       (C) cooperate with the Company in good faith in order
                  effectively to contest such claim; and

                       (D) permit the Company to participate in any proceedings
                  relating to such claim;

      provided, however, that the Company shall bear and pay directly all costs
      and expenses (including interest and penalties) incurred in connection
      with such contest and shall indemnify and hold harmless Employee, on an
      after-tax basis, for and against any Excise Tax or income tax, including
      interest and penalties with respect thereto, imposed as a result of such
      representation and payment of costs and expenses.  Without limiting the
      foregoing provisions of this Section 10(f), the Company shall control all
      proceedings taken in connection with the contest of any claim
      contemplated by this Section 10(f) and, at its sole option, may pursue or
      forego any and all administrative appeals, proceedings, hearings and
      conferences with the taxing authority in respect of such claim (provided,
      however, that Employee may participate therein at his own cost and
      expense) and may, at its option, either direct Employee to pay the tax
      claimed and sue for refund or contest the claim in any permissible
      manner, and Employee agrees to prosecute such contest to a determination
      before any administrative tribunal, in a court of initial jurisdiction
      and in one or more appellate courts, as the Company shall determine;
      provided, however, that if the Company directs Employee to pay the tax
      claimed and sue for a refund, the Company shall advance the amount of
      such payment to Employee on an interest-free basis and shall indemnify
      and hold Employee harmless, on an after tax basis, from any Excise Tax or
      income or other tax, including interest or penalties with respect
      thereto, imposed with respect to such advance; and provided, further,
      however, that any extension of the statute of limitations relating to
      payment of taxes for the taxable year of Employee with respect to which
      the contested amount is claimed to be due is limited solely to such
      contested amount.  Furthermore, the Company's control of any such
      contested claim shall be limited to issues with respect to which a
      Gross-Up Payment would be payable hereunder and Employee shall be
      entitled to settle or contest, as the case may be, any other issue raised
      by the Internal Revenue Service or any other taxing authority.

           (g) If, after the receipt by Employee of any amount advanced by the
      Company pursuant to Section 10(f) hereof, Employee receives any refund
      with respect to such claim, Employee shall (subject to the Company's
      complying with the requirements of Section 10(f) hereof) promptly pay to
      the Company the amount of such refund (together with any interest paid or
      credited thereon after any taxes applicable thereto).  If, after the
      receipt by Employee of any amount advanced by the Company pursuant to
      Section 10(f) hereof, a determination is made that Employee shall not be
      entitled to any refund with respect to such claim and the Company does
      not notify Employee in writing of its intent to contest such denial or
      refund prior to the expiration of 30 calendar days after such
      determination, then such advance shall be forgiven and shall not be
      required to be repaid and the amount of any such advance shall offset, to
      the extent thereof, the amount of Gross-Up Payment required to be paid by
      the Company to Employee pursuant to this Section 10.

      11. LEGAL FEES AND EXPENSES.  It is the intent of the Company that
Employee not be required to incur legal fees and the related expenses
associated with the interpretation, enforcement or defense of Employee's rights
under Section 8 of this Agreement by litigation or otherwise because the cost
and expense thereof would substantially detract from the benefits intended to
be extended to Employee hereunder.  Accordingly, if the Company fails to comply
with any of its obligations under this 


                                      11
<PAGE>   12

Agreement or in the event that the Company or any other person takes any action 
to declare this Agreement void or unenforceable, or institutes any litigation
or other action or proceeding designed to deny, or to recover from, Employee
the benefits provided or intended to be provided to Employee hereunder, the
Company irrevocably authorizes Employee from time to time to retain counsel of
Employee's choice, at the expense of the Company as hereafter provided, to
advise and represent Employee in connection with any such interpretation,
enforcement or defense, including, without limitation, the initiation or
defense of any litigation or other legal action, whether by or against the
Company or any Director, officer, stockholder or other person affiliated with
the Company, in any jurisdiction. Without respect to whether Employee prevails,
in whole or in part, in connection with any of the foregoing, the Company will
pay and be solely financially responsible for any and all reasonable attorneys'
and related fees and expenses by Employee in connection with any of the
foregoing.

      12. EMPLOYMENT RIGHTS: TERMINATION PRIOR TO CHANGE IN CONTROL.  Nothing
expressed or implied in this Agreement will create any right or duty on the
part of the Company or Employee to have Employee remain in the employment of
the Company prior to or following any Change in Control.  Any termination of
employment of Employee by the Company other than for Cause or by reason of his
death or disability pursuant to Sections 7(b), (d) or (e) during the period
beginning on the date that is sixty (60) days prior to the date of the first
public announcement by the Company of the potential occurrence of an event that
would constitute a Change in Control and ending on the date of consummation of
such Change in Control shall be deemed to be a termination of Employee after a
Change in Control for purposes of this Agreement.

      13. NON-COMPETITION/NON-SOLICITATION.

           (a) Covenant Not to Compete.  Employee covenants and agrees that
      during the period of Employee's employment hereunder and for a period of
      one (1) year following the termination of Employee's employment,
      including without limitation termination by the Company for cause or
      without cause, Employee shall not, in the United States of America,
      engage, directly or indirectly, whether as principal or as agent,
      officer, director, employee, consultant, shareholder or otherwise, alone
      or in association with any other person, corporation or other entity, in
      any Competing Business.

           (b) Non-Solicitation of Customers.  Employee agrees that during his
      employment with the Company he shall not, directly or indirectly, solicit
      the business of, or do business with, any customer or prospective
      customer of the Company for any business purpose other than for the
      benefit of the Company.  Employee further agrees that for one (1) year
      following termination of his employment with the Company, including
      without limitation termination by the Company for cause or without cause,
      Employee shall not, directly or indirectly, solicit the business of, or
      do business with, any customers or prospective customers of the Company.

           (c) Non-Solicitation of Employees.  Employee agrees that, during his
      employment with the Company and for one (1) year following termination of
      Employee's employment with the Company, including without limitation
      termination by the Company for cause or without cause, Employee shall
      not, directly or indirectly, solicit or induce, or attempt to solicit or
      induce, any employee of the Company to leave the employment of the
      Company for any reason whatsoever, or hire any employee of the Company
      except into the employment of the Company.

      14. VESTING OF OPTIONS AND RESTRICTED STOCK; EMPLOYEE BENEFITS.



                                      12
<PAGE>   13


            (a) Upon the consummation of a Change in Control prior to the
      expiration of the Protected Term,

                 (i) all options to purchase Company stock then held by
            Employee shall be fully vested and exercisable in full as of such
            date;

                 (ii) all shares of restricted Company stock issuable to
            Employee under outstanding restricted stock awards made to Employee
            prior to the date of such Change in Control shall be issued to
            Employee as of such date; and

                 (iii) the restrictions applicable to all shares of restricted
            stock then held by Employee (including shares issued pursuant to
            subsection (ii) above) shall lapse as of such date.

            (b) Except as otherwise expressly provided herein, no termination of
      Employee's employment with the Company will affect any rights which
      Employee may have pursuant to any agreement, policy, plan, program or
      arrangement of the Company providing Employee Benefits.

      15. WITHHOLDING OF TAXES.  The Company may withhold from any amounts
payable under this Agreement all federal, state, city or other taxes as the
Company is required to withhold pursuant to any law or governmental regulation
or ruling.

      16. SUCCESSORS AND BINDING AGREEMENT.

            (a) The Company will require all successors (whether direct or
      indirect, by purchase, merger, consolidation, reorganization or
      otherwise) to any substantial portion of the business or assets of the
      Company, by agreement in form and substance satisfactory to Employee,
      jointly and severally expressly to assume and agree to perform this
      Agreement in the same manner and to the same extent the Company would be
      required to perform if no such succession had taken place.  This
      Agreement will be binding upon and inure to the benefit of the Company
      and any successor to the Company, including without limitation any
      persons acquiring directly or indirectly all or substantially all of the
      business or assets of the Company whether by purchase, merger,
      consolidation, reorganization or otherwise (and such successor shall
      thereafter be deemed the "Company" for the purposes of this Agreement),
      but will not otherwise be assignable, transferable or delegable by the
      Company.

            (b) This Agreement will inure to the benefit of and be enforceable
      by Employee's personal or legal representatives, executors,
      administrators, successors, heirs, distributees and legatees.

            (c) This Agreement is personal in nature and neither of the parties
      hereto shall, without the consent of the other, assign, transfer or
      delegate this Agreement or any rights or obligations hereunder except as
      expressly provided in Sections 16(a) and 16(b) hereof.  Without limiting
      the generality or effect of the foregoing, Employee's right to receive
      payments hereunder will not be assignable, transferable or delegable,
      whether by pledge, creation of a security interest, or otherwise, other
      than by a transfer by Employee's will or by the laws of descent and
      distribution and, in the event of any attempted assignment or transfer
      contrary to this Section 16(c), the Company shall have no liability to
      pay any amount so attempted to be assigned, transferred or delegated.


                                      13
<PAGE>   14

     17. NOTICES.  For all purposes of this Agreement, all communications,
including without limitation notices, consents, requests or approvals, required
or permitted to be given hereunder will be in writing and will be deemed to
have been duly given when hand delivered or dispatched by electronic facsimile
transmission (with receipt thereof orally confirmed), or five business days
after having been mailed by United States registered or certified mail, return
receipt requested, postage prepaid, or three business days after having been
sent by a nationally recognized overnight courier service such as Federal
Express or UPS, addressed to the Company (to the attention of the Secretary of
the Company) at its principal executive office and to Employee at his principal
residence, or to such other address as any party may have furnished to the
other in writing and in accordance herewith, except that notices of changes of
address shall be effective only upon receipt.

     18. GOVERNING LAW.  The validity, interpretation, construction and
performance of this Agreement will be governed by and construed in accordance
with the substantive laws of the State of Delaware, without giving effect to
the principles of conflict of laws of such State.

     19. VALIDITY.  If any provision of this Agreement or the application of
any provision hereof to any person or circumstances is held invalid,
unenforceable or otherwise illegal, the remainder of this Agreement and the
application of such provision to any other person or circumstances will not be
affected, and the provision so held to be invalid, unenforceable or otherwise
illegal will be reformed to the extent (and only to the extent) necessary to
make it enforceable, valid or legal.

     20. MISCELLANEOUS.  No waiver by either party hereto at any time of any
breach by the other party hereto or compliance with any condition or provision
of this Agreement to be performed by such other party will be deemed a waiver
of similar or dissimilar provisions or conditions at the same or at any prior
or subsequent time.  No agreements or representations, oral or otherwise,
expressed or implied with respect to the subject matter hereof have been made
by either party which are not set forth expressly in this Agreement.
References to Sections are to references to Sections of this Agreement.

     21. COUNTERPARTS.  This Agreement may be executed in one or more
counterparts, each of which will be deemed to be an original but all of which
together will constitute one and the same agreement.

     22. TITLES.  Titles are provided herein for convenience only and are not
to serve as a basis for interpretation or construction of this Agreement.




                                      14
<PAGE>   15

     IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the date first above written.

                                      THE COMPANY:                           
                                                                             
                                      HEALTH CARE AND RETIREMENT             
                                      CORPORATION OF AMERICA                 
                                                                             
                                                                             
                                      By:  _______________________________   
                                                                             
                                      Its:   _____________________________   
                                                                             
                                                                             
                                      HEALTH CARE AND RETIREMENT             
                                      CORPORATION                            
                                                                             
                                                                             
                                      By:  _______________________________   
                                                                             
                                      Its:   _____________________________   
                                                                             
                                      EMPLOYEE:                              
                                                                             
                                      ____________________________________   
                                      Geoffrey G. Meyers                     





                                      15
<PAGE>   16
                                   SCHEDULE I



Employee:             Geoffrey G. Meyers

Current Base Rate:    $234,000

Job Titles:           Executive Vice President, Chief Financial Officer,
                      Treasurer and Assistant Secretary














<PAGE>   17
                                 SCHEDULE II


Annual Incentive Plan
Performance Award Plan
Stock Option Plan
Amended Restricted Stock Plan
Salary Retirement Plan (prior to January 1, 1993)
Stock Purchase and Savings Program (prior to January 1, 1993)
Senior Executive Retirement Plans
Supplemental Offset Plan
Excess and Supplemental Benefit Plans
Corporate Officer and Senior Executive Life Insurance Program
Senior Management Savings Plan
Senior Management Savings Plan For Corporate Officers
Such other benefit plans and arrangements as the Company provides, from time to
time, to salaried employees generally participation in which is approved by the
President.












<PAGE>   1
                                                                   EXHIBIT 10.12

                      SECOND AMENDED EMPLOYMENT AGREEMENT


     This SECOND AMENDED EMPLOYMENT AGREEMENT ("Agreement"), effective as of
April 1, 1997 between HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA, an
Ohio corporation (the "Company"), HEALTH CARE AND RETIREMENT CORPORATION, a
Delaware corporation and sole stockholder of the Company ("HCR) and R. JEFFREY
BIXLER ("Employee"), supersedes and replaces all prior employment agreements
between the parties hereto.

                                    RECITALS

A.   The Company has agreed to employ Employee in the position and at the base
     rate of pay set forth on Schedule I.

B.   The Company has further agreed to provide severance benefits to Employee
     upon a termination of Employee's employment resulting from certain
     specified events.

C.   The Company wishes to insure that its senior executives and other key
     employees are not practically disabled from discharging their duties in
     respect to a proposed or actual transaction involving a Change in Control.

D.   The Company desires to assure itself of both present and future
     continuity of management and desires to establish certain minimum
     severance benefits for certain of its senior executive officers and other
     key employees, including Employee, applicable in the event of a Change in
     Control.

                                     EVENTS

     In consideration of the foregoing, and for other good and valuable
consideration, the receipt and adequacy of which is hereby acknowledged,
Employee and the Company hereby agree as follows:

     1. CERTAIN DEFINED TERMS.  The following terms have the meanings set forth
below:

           (a) "Accounting Firm" is defined in Section 10(b).

           (b) "Aggregate Cash Compensation" means the sum of Base Pay and
      Employee's cash bonuses pursuant to the Company's Annual Incentive Plan
      and Performance Award Plan as in effect at any time of determination.

           (c) "Base Pay" means Employee's annual base salary as in effect at
      any time of determination.

           (d) "Board" means the Board of Directors of HCR.

           (e) "Cause" means Employee's financial dishonesty, fraud in the
      performance of his duties, willful failure to perform assigned duties
      hereunder or the commission of a felony.

           (f) "Change in Control" means the occurrence during the Protected
      Term of any of the following events:

<PAGE>   2

                 (i) HCR is merged, consolidated or reorganized into or with
            another corporation or other legal person, and as a result of such
            merger, consolidation or reorganization less than sixty-five
            percent of the combined voting power of the then outstanding
            securities of such resulting corporation or person immediately
            after such transaction are held in the aggregate by the holders of
            Voting Stock of HCR immediately prior to such transaction;

                 (ii) HCR sells or otherwise transfers all or substantially all
            of its assets to another corporation or other legal person, and as
            a result of such sale or transfer less than sixty-five percent of
            the combined voting power of the then outstanding Voting Stock of
            such corporation or person immediately after such sale or transfer
            is held in the aggregate by the holders of Voting Stock of HCR
            immediately prior to such sale or transfer;

                 (iii) There is a report filed on Schedule 13D or Schedule
            14D-1 (or any successor schedule, form or report), each as
            promulgated pursuant to the Exchange Act, disclosing that any
            person (as the term "person" is used in Section 13(d)(3) or Section
            14(d)(2) of the Exchange Act) has become the beneficial owner (as
            the term "beneficial owner" is defined under Rule 13d-3 or any
            successor rule or regulation promulgated under the Exchange Act) of
            15% or more of the then outstanding Voting Stock of HCR;

                 (iv) HCR files a report or proxy statement with the Securities
            and Exchange Commission pursuant to the Exchange Act disclosing in
            response to Form 8-K or Schedule 14A (or any successor schedule,
            form or report or item therein) that a Change in Control of HCR has
            occurred or will occur in the future pursuant to any then existing
            contract or transaction; or

                 (v) If, during any consecutive twelve month period,
            individuals who at the beginning of any such period constitute the
            Directors cease for any reason to constitute at least a majority
            thereof, provided, however, that for purposes of this clause (v)
            each Director who is first elected, or first nominated for election
            by HCR's stockholders, by a vote of at least one-half of the
            Directors (or a committee thereof) then still in office who were
            Directors at the beginning of any such period will be deemed to
            have been a Director at the beginning of such period.

            Notwithstanding the foregoing provisions of Sections 1(f)(iii) or
      1(f)(iv), unless otherwise determined in a specific case by majority vote
      of the Board, a "Change in Control" shall not be deemed to have occurred
      for purposes of Sections 1(f)(iii) or 1(f)(iv) solely because (1) HCR,
      (2) any Subsidiary (including, without limitation, the Company) or (3)
      any employee stock ownership plan or any other employee benefit plan of
      HCR or any Subsidiary either files or becomes obligated to file a report
      or a proxy statement under or in response to Schedule 13D, Schedule
      14D-1, Form 8-K or Schedule 14A (or any successor schedule, form or
      report or item therein) under the Exchange Act disclosing beneficial
      ownership by it of shares of Voting Stock of HCR, whether in excess of
      15% or otherwise, or because HCR reports that a change in control of HCR
      has occurred or will occur in the future by reason of such beneficial
      ownership.

            (g) "Competing Business" shall mean any person, corporation or other
      entity engaged in the United States of America in providing long-term
      care, skilled nursing or rehabilitative services or selling or attempting
      to sell or providing or attempting to provide any 


                                      2
<PAGE>   3

      other product or service which is the same as or similar to products or   
      services sold or provided by the Company within the last 2 years prior to
      termination of Employee's employment hereunder.

           (h) "Continuation Period" means the thirty-six months immediately
      following the Termination Date.

           (i) "Director" means a member of the Board.

           (j) "Employee Benefits" means the perquisites and benefits as
      provided under any and all employee retirement income and welfare benefit
      policies, plans, programs or arrangements in which Employee is entitled
      to participate at any time of determination, including, without
      limitation, any stock option, stock purchase, stock appreciation,
      savings, pension, supplemental employee retirement, or other retirement
      income or welfare benefit, deferred compensation, incentive compensation,
      group or other life, health, medical/hospital or other insurance (whether
      funded by actual insurance or self-insured by the Company), disability,
      salary continuation, expense reimbursement and other employee benefit
      policies.

           (k) "Exchange Act" means the Securities Exchange Act of 1934, as
      amended.

           (l) "Excise Tax" is defined in Section 10(a).

           (m) "Gross-Up Payment" is defined in Section 10(a).

           (n) "ISO" is defined in Section 10(a).

           (o) "Payment" is defined in Section 10(a).

           (p) "Protected Term" means the period commencing as of the date
      hereof and expiring as of the close of business on March 31, 2000;
      provided, however, that: (i) commencing on April 1, 1998 and each April 1
      thereafter, the term of this Agreement will automatically be extended for
      an additional year unless, not later than December 31 of the immediately
      preceding year, the Company or Employee shall have given notice that it
      or Employee, as the case may be, does not wish to have the Protected Term
      extended; and (ii) except as otherwise provided in the last sentence of
      Section 12, if, prior to a Change in Control, Employee ceases for any
      reason to be an employee of the Company, thereupon without further action
      the Protected Term shall be deemed to have expired and Sections 8, 10, 11
      and 14(a) and the last sentence of Section 12 of this Agreement and the
      portion of any other provision of this Agreement that incorporates such
      provisions will immediately terminate and be of no further effect.  For
      purposes of this Section 1(p), Employee shall not be deemed to have
      ceased to be an employee of the Company by reason of the transfer of
      Employee's employment between or among HCR and the Company or any other
      Subsidiary.

           (q) "Severance Period" means the period of time commencing on the
      date of the occurrence of a Change in Control and continuing until the
      earliest of (i) the third anniversary of the occurrence of the Change in
      Control (ii) Employee's death, or (ii) Employee's attainment of age 65.

           (r) "Severance Benefits" are defined in Section 8(b).




                                      3

<PAGE>   4
           (s) "Subsidiary" means any entity in which HCR directly or
      indirectly beneficially owns 50% or more of the then outstanding Voting
      Stock.

           (t) "Termination Date" means the effective date of Employee's
      termination of employment with the Company; provided that for purposes of
      this Section 1(t), Employee shall not be deemed to have ceased to be an
      employee of the Company by reason of the transfer of Employee's
      employment between or among HCR and the Company or any other Subsidiary.

           (u) "Underpayment" is defined in Section 10(a).

           (v) "Voting Stock" means securities entitled to vote generally in
      the election of directors.

      2. SALARY AND POSITION.  Employee's Base Pay and job title shown on
Schedule I are correct as of the date hereof and in accordance with Employee's
understanding.

      3. AT-WILL EMPLOYMENT.  Employee's employment with the Company is not for
any specified term and may be terminated by Employee or by the Company at any
time for any reason, with or without Cause.

      4. NO OTHER AGREEMENTS.  Except as specifically set forth herein and in
Schedule II attached hereto, Employee represents and warrants that there are no
other written or oral agreements, understandings or commitments relating to
Employee's future employment, work assignments, compensation (including
compensation upon termination), benefits, or any other term or condition of
employment.

      5. ENTIRE AGREEMENT.  This Agreement and the agreements listed in Schedule
II attached hereto constitute the complete agreement between Employee and the
Company regarding any and all aspects of their employment relationship and
supersede any and all prior written or oral agreements, understandings or
commitments.  Employee understands that no representative of the Company has
been authorized to enter into any agreement, understanding or commitment with
Employee which is inconsistent in any way with the terms of this Agreement.

      6. PROHIBITION AGAINST AMENDMENT.  Employee's Base Pay may be modified by
the Company at any time in its sole discretion.  The retirement and benefit
plans set forth in Schedule II attached hereto in which Employee is entitled to
participate may be improved, reduced or terminated by the Company at any time
in its sole discretion; provided, however, that no vested or accrued benefit
shall be adversely affected.  No term set forth in this Agreement, including
without limitation the terms set forth in Section 3 hereof, may be modified in
any way except by a written agreement signed by Employee and by an authorized
representative of the Company which expressly states the intention of the
parties to modify the terms of this Agreement.

      7. SEVERANCE PAYMENT NOT FOLLOWING A CHANGE IN CONTROL.  Except as
provided in Section 8:

           (a) Upon the termination of Employee's employment as a result of
      Employee's electing to resign his employment or to retire without the
      consent of the Company, no payments shall be required or made pursuant to
      this Section 7.


                                      4
<PAGE>   5

           (b) Upon the termination of Employee's employment by the Company for
      Cause, no payments shall be required or made pursuant to this Section 7.

           (c) Upon the termination of Employee's employment by the Company for
      any reason other than for Cause or disability, the Company shall continue
      payment of Employee's Base Pay, at the rate then in effect on the
      Termination Date, for a period of one year after such Termination Date.
      The Company shall give thirty (30) days written notice of any such
      termination which notice shall specify the Termination Date.

           (d) Upon the termination of Employee's employment as a result of the
      death of Employee, the Company shall continue payment of Employee's Base
      Pay, at the rate then in effect on the Termination Date, for a period of
      one year after such Termination Date; provided, however, that such
      payments shall be offset by any survivor benefits, excluding life
      insurance proceeds, received by Employee's spouse or other designated
      beneficiary under the Company's plans, programs and policies.

           (e) Upon the termination of Employee's employment as a result of his
      becoming unable to perform his duties due to a disability as established
      by the award of long-term disability benefits under the Company's
      long-term disability plan, the Company may terminate Employee's
      employment by giving Employee thirty (30) days written notice of its
      intention to terminate.  In such event, Company shall continue payment of
      Employee's Base Pay, at the rate then in effect on the Termination Date,
      for a period of one year after such Termination Date; provided, however,
      that such payments shall be offset by any disability benefits received by
      Employee, or his legal guardian, under the Company's plans, programs and
      policies.

           (f) Notwithstanding anything to the contrary contained in this
      Section 7, upon the termination of Employee's employment for any reason
      other than pursuant to Section 8, whether voluntarily or involuntarily
      and whether with or without Cause, Employee shall be entitled to the
      payments provided for hereunder and such rights as he otherwise has under
      the Company's Restricted Stock Plan and the Company's Stock Option Plan
      in the circumstances of his particular termination.

      8. TERMINATION FOLLOWING A CHANGE IN CONTROL.

           (a) Eligibility for Severance Benefits.

                 (i) If, during the Severance Period, Employee's employment is
            terminated by the Company other than for Cause and other than as a
            result of his death or disability pursuant to Section 7(d) or (e),
            Employee shall be entitled to the Severance Benefits.

                 (ii) Following the consummation of a Change in Control,
            Employee may elect, within the 60-day period following the
            occurrence of one of the following events, to terminate employment
            with the Company and receive the Severance Benefits (pursuant to
            written notice to the Board specifying the effective date of such
            termination which shall not be earlier than the date of the Board's
            receipt of such notice and shall not be later than the end of such
            60-day period):


                                      5
<PAGE>   6

                       (A) Failure to elect or reelect or otherwise to maintain
                  Employee in the office or position, or a substantially
                  equivalent office or position, of or with the Company or
                  successor, as the case may be, which Employee held
                  immediately prior to a Change in Control, or the removal of
                  Employee as a Director (or as a member of the board of
                  directors of any successor thereto) if Employee shall have
                  been a Director immediately prior to the Change in Control;

                       (B) The occurrence of any of the following:

                             (I) a significant adverse change in the nature or
                        scope of the authorities, powers, functions,
                        responsibilities or duties attached to the position
                        with the Company or successor, as the case may be,
                        which Employee held immediately prior to the Change in
                        Control;

                             (II) a reduction in Employee's Base Pay as in
                        effect immediately prior to the Change in Control;

                             (III) a material reduction in the scope or value
                        of Employee Benefits as in effect immediately prior to
                        a Change in Control; or

                             (IV) any material breach of this Agreement by the
                        Company or any successor thereto,

                        which situation is not remedied within 10 calendar days
                        after written notice to the Board (or the board of any
                        successor) from Employee;

                       (C) The liquidation, dissolution, merger, consolidation
                  or reorganization of the Company or transfer of all or
                  substantially all of its business and/or assets, unless the
                  surviving or successor entity, if other than the Company (by
                  liquidation, merger, consolidation, reorganization, transfer
                  or otherwise), to which all or substantially all of such
                  business and/or assets have been transferred (directly or by
                  operation of law) assumes all duties and obligations of the
                  Company under this Agreement pursuant to Section 16(a); or

                       (D) The Company or any successor, as the case may be, by
                  which Employee is employed relocates its principal executive
                  offices, or requires Employee to have his principal location
                  of work changed, to any location which increases by more than
                  25 miles Employee's commute to such location immediately
                  prior to the Change in Control, or requires Employee to
                  travel away from his office in the course of discharging his
                  responsibilities or duties hereunder at least 20% more (in
                  terms of aggregate days in any calendar year or in any
                  calendar quarter when annualized for purposes of comparison
                  to any prior year) than the average of such time that was
                  required of Employee in the three full years immediately
                  prior to the Change of Control without, in either case, his
                  prior written consent.



                                      6
<PAGE>   7

                 (iii) If Employee elects to terminate employment with the
            Company or any successor, as the case may be, for any reason, or
            without reason, during such portion of the 180-day period
            immediately following the first anniversary of the occurrence of
            any Change in Control that falls within the Severance Period,
            Employee shall be entitled to the Severance Benefits.

            (b) Severance Benefits.  If, following the occurrence of a Change in
      Control, Employee's employment with the Company is terminated pursuant to
      Section 8(a)(i), (ii) or (iii), the Company will pay to Employee the
      following amounts within five business days after the Termination Date
      and will provide to Employee the following benefits (collectively, the
      "Severance Benefits"):

                 (i) A lump sum payment equal to three times the highest
            Aggregate Cash Compensation paid or payable to Employee for any of
            the three calendar years preceding the year in which the
            Termination Date occurs or for the year in which the Termination
            Date occurs if the Termination Date occurs after the end of the
            first quarter; for purposes of this Section 8(b)(i), if the
            Company's financial performance for the year-to-date period
            preceding the Termination Date is consistent with budgeted levels
            (as certified by the Compensation Committee) then the Aggregate
            Cash Compensation for the year in which the Termination Date occurs
            shall be assumed to be equal to the sum of: (A) the Employee's Base
            Pay, (B) the Employee's Annual Incentive Plan bonus payable for the
            year in which the Termination Date occurs, calculated by
            multiplying the product of the Employee's Base Pay and the
            Employee's bonus percentage by 150%, and (C) the Employee's
            Performance Award Plan award payable for the award period ending
            with the year in which the Termination Date occurs as if the
            earnings per share growth rate for such year were assumed to be the
            actual growth rate for the year-to-date period prior to the
            Termination Date;

                 (ii) During the Continuation Period:

                       (A) the Company will arrange to provide Employee with
                  group medical, dental and vision benefits substantially
                  similar to those which Employee was receiving or entitled to
                  receive immediately prior to the Change in Control; and

                       (B) the Company (or successor) will provide Employee the
                  use of office space, furnishings and secretarial support
                  services comparable to those provided to Employee immediately
                  prior to the Change in Control;

                       If and to the extent that any benefit described in
                  Section 8(b)(ii)(A) is not or cannot be paid or provided
                  under any policy, plan program or arrangement of the Company,
                  then the Company will pay or provide for the payment to
                  Employee, his dependents and beneficiaries, of such Employee
                  Benefits in any manner selected by the Company.  Without
                  otherwise limiting the purposes or effect of Section 8,
                  Employee Benefits otherwise receivable by Employee pursuant
                  to Section 8(b)(ii)(A) will be reduced to the extent
                  comparable welfare benefits are actually received by Employee
                  from another employer during the Continuation Period, and any
                  such benefits received by Employee shall be reported by
                  Employee to the Company.



                                      7
<PAGE>   8

                 (iii) The Company shall take whatever action is necessary to
            fund completely any split-dollar life insurance arrangement
            maintained by the Company for the benefit of Employee, effective as
            of the Termination Date and based upon Employee's service through
            the end of the Continuation Period;

                 (iv) Effective as of the Termination Date, Employee will be
            credited with service with the Company for an additional 36 months
            for the purpose of determining service credits and benefits due and
            payable to Employee under the Company's retirement income,
            supplemental retirement and other benefit plans of the Company
            applicable to Employee, his dependents or his beneficiaries
            immediately prior to the Change in Control; and

                 (v) Employee shall be permitted to elect to defer receipt of
            amounts payable to him, if any, under the Company's Senior
            Management Savings Plan and Senior Management Savings Plan for
            Corporate Officers until any date not later than the expiration of
            the Continuation Period.

            (c) Without limiting the rights of Employee at law or in equity, if
      the Company fails to make any payment or provide any benefit required to
      be made or provided under this Section 8 on a timely basis, the Company
      will pay interest on the amount or value thereof at an annualized rate of
      interest equal to the so-called composite "prime rate" as quoted from
      time to time during the relevant period in the Midwest Edition of The
      Wall Street Journal.  Any change in such prime rate will be effective on
      and as of the date such change is so published.

            (d) Notwithstanding any other provision hereof, the parties'
      respective rights and obligations under this Section 8 and under Section
      11 will survive:

                 (i) any termination or expiration of this Agreement following
            a Change in Control prior to the expiration of the Protected Term;
            and

                 (ii) the termination of Employee's employment for any reason
            whatsoever following a Change in Control prior to the expiration of
            the Protected Term.

      9. NO SET-OFF; NO MITIGATION OBLIGATION.  The Company hereby acknowledges
that it will be difficult and may be impossible (a) for Employee to find
reasonably comparable employment following the Termination Date; and (b) to
measure the amount of damages which Employee may suffer as a result of
termination of employment hereunder.  In addition, the Company acknowledges
that its severance pay plans applicable to corporate officers do not provide
for mitigation, offset or reduction of any severance payment received
thereunder.  Accordingly, the payment of the severance compensation by the
Company to Employee in accordance with the terms of this Agreement is hereby
acknowledged by the Company to be reasonable and will be liquidated damages,
and Employee will not be required to mitigate the amount of any payment
provided for in this Agreement by seeking other employment or otherwise, nor
will any profits, income, earnings or other benefits from any source whatsoever
create any mitigation, offset, reduction or any other obligation on the part of
Employee hereunder or otherwise, except as expressly provided in Sections 7(d)
and (e) and the last sentence of Section 8 (b)(ii).


                                      8
<PAGE>   9

      10. CERTAIN ADDITIONAL PAYMENTS BY THE COMPANY.

           (a) Anything in this Agreement to the contrary notwithstanding, in
      the event that a Change in Control occurs prior to the expiration of the
      Protected Term and it shall be determined (as hereafter provided) that
      any payment or distribution by the Company or any of its affiliates to or
      for the benefit of Employee, whether paid or payable or distributed or
      distributable pursuant to the terms of this Agreement or otherwise
      pursuant to or by reason of any other agreement, policy, plan, program or
      arrangement, including without limitation any stock option, stock
      appreciation right or similar right, or the lapse or termination of any
      restriction on or the vesting or exercisability of any of the foregoing
      (collectively, a "Payment"), would be subject to the excise tax imposed
      by Section 4999 of the Internal Revenue Code (or any successor provision
      thereto) by reason of being considered "contingent on a change in
      ownership or control" of the Company, within the meaning of Section 280G
      of the Internal Revenue Code (or any successor provision thereto) or to
      any similar tax imposed by state or local law, or any interest or
      penalties with respect to such tax (such tax or taxes, together with any
      such interest and penalties, being hereafter collectively referred to as
      the "Excise Tax"), then Employee shall be entitled to receive an
      additional payment or payments (collectively, a "Gross-Up Payment");
      provided, however, that no Gross-up Payment shall be made with respect to
      the Excise Tax, if any, attributable to: (i) any incentive stock option,
      as defined by Section 422 of the Internal Revenue Code ("ISO"), granted
      prior to the execution of this Agreement; or (ii) any stock appreciation
      or similar right, whether or not limited, granted in tandem with any ISO
      described in clause (i).  The Gross-Up Payment shall be in an amount such
      that, after payment by Employee of all taxes, including any Excise Tax
      (and including any interest or penalties imposed with respect to such
      taxes), imposed upon the Gross-Up Payment, Employee retains an amount of
      the Gross-Up Payment equal to the Excise Tax imposed upon the Payment.

           (b) Subject to the provisions of Section 10(f) hereof, all
      determinations required to be made under this Section 10, including
      whether an Excise Tax is payable by Employee and the amount of such
      Excise Tax and whether a Gross-Up Payment is required to be paid by the
      Company to Employee and the amount of such Gross-Up Payment, if any,
      shall be made by a nationally recognized accounting firm (the "Accounting
      Firm") selected by the Company.  The Company shall direct the Accounting
      Firm to submit its determination and detailed supporting calculations to
      both the Company and Employee within thirty (30) calendar days after any
      Termination Date arising pursuant to Section 8(a).  If the Accounting
      Firm determines that any Excise Tax is payable by Employee, the Company
      shall pay the required Gross-Up Payment to Employee within five (5)
      business days after receipt of such determination.  If the Accounting
      Firm determines that no Excise Tax is payable by Employee, it shall, at
      the same time as it makes such determination, furnish the Company and
      Employee an opinion that Employee has substantial authority not to report
      any Excise Tax on his federal, state or local income or other tax return.
      As a result of the uncertainty in the application of Section 4999 of the
      Internal Revenue Code (or any successor provision thereto) and the
      possibility of similar uncertainty regarding applicable state or local
      tax law at the time of any determination by the Accounting Firm
      hereunder, it is possible that a Gross-Up Payment which will not have
      been made by the Company should have been made (an "Underpayment"),
      consistent with the calculations required to be made hereunder.  In the
      event that the Company exhausts or fails to pursue its remedies pursuant
      to Section 10(f) hereof and Employee thereafter is required to make a
      payment of any Excise Tax, Employee shall direct the Accounting Firm to
      determine the amount of the Underpayment that has occurred and to submit
      its determination and detailed supporting calculations to both the
      Company and Employee as promptly as possible.  Any such 


                                      9
<PAGE>   10

      Underpayment shall be promptly paid by the Company to, or for the         
      benefit of, Employee within five business days after receipt of such
      determination and calculations.

           (c) The Company and Employee shall each provide the Accounting Firm
      access to and copies of any books, records and documents in the
      possession of the Company or Employee, as the case may be, reasonably
      requested by the Accounting Firm, and otherwise cooperate with the
      Accounting Firm in connection with the preparation and issuance of the
      determination and calculations contemplated by Section 10(b) hereof.
      Except as contemplated by Sections 10(f) or 10(g), any final
      determination by the Accounting Firm as to the amount of the Gross-Up
      Payment shall be binding upon the Company and Employee.

           (d) The federal, state and local income or other tax returns filed
      by Employee shall be prepared and filed on a consistent basis with the
      determinations of the Accounting Firm with respect to the Excise Tax
      payable by Employee.  Employee shall make proper payment of the amount of
      any Excise Payment, and at the request of the Company, provide to the
      company true and correct copies (with any amendments ) of his federal
      income tax return as filed with the Internal Revenue Service and
      corresponding state and local tax returns, if relevant, as filed with the
      applicable taxing authority, and such other documents reasonably
      requested by the Company, evidencing such payment.  If prior to the
      filing of Employee's federal income tax return, or corresponding state or
      local tax return, if relevant, the Accounting Firm determines that the
      amount of the Gross-Up Payment should be reduced, Employee shall within
      five business days pay to the Company the amount of such reduction.

           (e) The fees and expenses of the Accounting Firm for its services in
      connection with the determinations and calculations contemplated by
      Section 10(b) hereof shall be borne by the Company.

           (f) Employee shall notify the Company in writing of any claim by the
      Internal Revenue Service or any other taxing authority that, if
      successful, would require the payment by the Company of a Gross-Up
      Payment.  Such notification shall be given as promptly as practicable but
      no later than 10 business days after Employee actually receives notice of
      such claim and Employee shall further apprise the Company of the nature
      of such claim and the date on which such claim is requested to be paid
      (in each case, to the extent known by Employee).  Employee shall not pay
      such claim prior to the earlier of: (i) the expiration of the ten (10)
      calendar day period following the date on which he gives such notice to
      the Company; and (ii) the date that any payment of such amount with
      respect to such claim is due.  If the Company notifies Employee in
      writing prior to the expiration of such period that it desires to contest
      such claim, Employee shall:

                       (A) provide the Company with any written records or
                  documents in his possession relating to such claim reasonably
                  requested by the Company;

                       (B) take such action in connection with contesting such
                  claim as the Company shall reasonably request in writing from
                  time to time, including  without limitation accepting legal
                  representation with respect to such claim by an attorney
                  competent in respect of the subject matter and reasonably
                  selected by the Company;



                                      10
<PAGE>   11

                       (C) cooperate with the Company in good faith in order
                  effectively to contest such claim; and

                       (D) permit the Company to participate in any proceedings
                  relating to such claim;

      provided, however, that the Company shall bear and pay directly all costs
      and expenses (including interest and penalties) incurred in connection
      with such contest and shall indemnify and hold harmless Employee, on an
      after-tax basis, for and against any Excise Tax or income tax, including
      interest and penalties with respect thereto, imposed as a result of such
      representation and payment of costs and expenses.  Without limiting the
      foregoing provisions of this Section 10(f), the Company shall control all
      proceedings taken in connection with the contest of any claim
      contemplated by this Section 10(f) and, at its sole option, may pursue or
      forego any and all administrative appeals, proceedings, hearings and
      conferences with the taxing authority in respect of such claim (provided,
      however, that Employee may participate therein at his own cost and
      expense) and may, at its option, either direct Employee to pay the tax
      claimed and sue for refund or contest the claim in any permissible
      manner, and Employee agrees to prosecute such contest to a determination
      before any administrative tribunal, in a court of initial jurisdiction
      and in one or more appellate courts, as the Company shall determine;
      provided, however, that if the Company directs Employee to pay the tax
      claimed and sue for a refund, the Company shall advance the amount of
      such payment to Employee on an interest-free basis and shall indemnify
      and hold Employee harmless, on an after tax basis, from any Excise Tax or
      income or other tax, including interest or penalties with respect
      thereto, imposed with respect to such advance; and provided, further,
      however, that any extension of the statute of limitations relating to
      payment of taxes for the taxable year of Employee with respect to which
      the contested amount is claimed to be due is limited solely to such
      contested amount.  Furthermore, the Company's control of any such
      contested claim shall be limited to issues with respect to which a
      Gross-Up Payment would be payable hereunder and Employee shall be
      entitled to settle or contest, as the case may be, any other issue raised
      by the Internal Revenue Service or any other taxing authority.

           (g) If, after the receipt by Employee of any amount advanced by the
      Company pursuant to Section 10(f) hereof, Employee receives any refund
      with respect to such claim, Employee shall (subject to the Company's
      complying with the requirements of Section 10(f) hereof) promptly pay to
      the Company the amount of such refund (together with any interest paid or
      credited thereon after any taxes applicable thereto).  If, after the
      receipt by Employee of any amount advanced by the Company pursuant to
      Section 10(f) hereof, a determination is made that Employee shall not be
      entitled to any refund with respect to such claim and the Company does
      not notify Employee in writing of its intent to contest such denial or
      refund prior to the expiration of 30 calendar days after such
      determination, then such advance shall be forgiven and shall not be
      required to be repaid and the amount of any such advance shall offset, to
      the extent thereof, the amount of Gross-Up Payment required to be paid by
      the Company to Employee pursuant to this Section 10.

      11. LEGAL FEES AND EXPENSES.  It is the intent of the Company that
Employee not be required to incur legal fees and the related expenses
associated with the interpretation, enforcement or defense of Employee's rights
under Section 8 of this Agreement by litigation or otherwise because the cost
and expense thereof would substantially detract from the benefits intended to
be extended to Employee hereunder.  Accordingly, if the Company fails to comply
with any of its obligations under this 


                                      11
<PAGE>   12

Agreement or in the event that the Company or any other person takes any action 
to declare this Agreement void or unenforceable, or institutes any litigation
or other action or proceeding designed to deny, or to recover from, Employee
the benefits provided or intended to be provided to Employee hereunder, the
Company irrevocably authorizes Employee from time to time to retain counsel of
Employee's choice, at the expense of the Company as hereafter provided, to
advise and represent Employee in connection with any such interpretation,
enforcement or defense, including, without limitation, the initiation or
defense of any litigation or other legal action, whether by or against the
Company or any Director, officer, stockholder or other person affiliated with
the Company, in any jurisdiction. Without respect to whether Employee prevails,
in whole or in part, in connection with any of the foregoing, the Company will
pay and be solely financially responsible for any and all reasonable attorneys'
and related fees and expenses by Employee in connection with any of the
foregoing.

     12. EMPLOYMENT RIGHTS: TERMINATION PRIOR TO CHANGE IN CONTROL.  Nothing
expressed or implied in this Agreement will create any right or duty on the
part of the Company or Employee to have Employee remain in the employment of
the Company prior to or following any Change in Control.  Any termination of
employment of Employee by the Company other than for Cause or by reason of his
death or disability pursuant to Sections 7(b), (d) or (e) during the period
beginning on the date that is sixty (60) days prior to the date of the first
public announcement by the Company of the potential occurrence of an event that
would constitute a Change in Control and ending on the date of consummation of
such Change in Control shall be deemed to be a termination of Employee after a
Change in Control for purposes of this Agreement.

      13. NON-COMPETITION/NON-SOLICITATION.

           (a) Covenant Not to Compete.  Employee covenants and agrees that
      during the period of Employee's employment hereunder and for a period of
      one (1) year following the termination of Employee's employment,
      including without limitation termination by the Company for cause or
      without cause, Employee shall not, in the United States of America,
      engage, directly or indirectly, whether as principal or as agent,
      officer, director, employee, consultant, shareholder or otherwise, alone
      or in association with any other person, corporation or other entity, in
      any Competing Business.

           (b) Non-Solicitation of Customers.  Employee agrees that during his
      employment with the Company he shall not, directly or indirectly, solicit
      the business of, or do business with, any customer or prospective
      customer of the Company for any business purpose other than for the
      benefit of the Company.  Employee further agrees that for one (1) year
      following termination of his employment with the Company, including
      without limitation termination by the Company for cause or without cause,
      Employee shall not, directly or indirectly, solicit the business of, or
      do business with, any customers or prospective customers of the Company.

           (c) Non-Solicitation of Employees.  Employee agrees that, during his
      employment with the Company and for one (1) year following termination of
      Employee's employment with the Company, including without limitation
      termination by the Company for cause or without cause, Employee shall
      not, directly or indirectly, solicit or induce, or attempt to solicit or
      induce, any employee of the Company to leave the employment of the
      Company for any reason whatsoever, or hire any employee of the Company
      except into the employment of the Company.

      14. VESTING OF OPTIONS AND RESTRICTED STOCK; EMPLOYEE BENEFITS.


                                      12
<PAGE>   13

           (a) Upon the consummation of a Change in Control prior to the
      expiration of the Protected Term,

                 (i) all options to purchase Company stock then held by
            Employee shall be fully vested and exercisable in full as of such
            date;

                 (ii) all shares of restricted Company stock issuable to
            Employee under outstanding restricted stock awards made to Employee
            prior to the date of such Change in Control shall be issued to
            Employee as of such date; and

                 (iii) the restrictions applicable to all shares of restricted
            stock then held by Employee (including shares issued pursuant to
            subsection (ii) above) shall lapse as of such date.

           (b) Except as otherwise expressly provided herein, no termination of
      Employee's employment with the Company will affect any rights which
      Employee may have pursuant to any agreement, policy, plan, program or
      arrangement of the Company providing Employee Benefits.

      15. WITHHOLDING OF TAXES.  The Company may withhold from any amounts
payable under this Agreement all federal, state, city or other taxes as the
Company is required to withhold pursuant to any law or governmental regulation
or ruling.

      16. SUCCESSORS AND BINDING AGREEMENT.

           (a) The Company will require all successors (whether direct or
      indirect, by purchase, merger, consolidation, reorganization or
      otherwise) to any substantial portion of the business or assets of the
      Company, by agreement in form and substance satisfactory to Employee,
      jointly and severally expressly to assume and agree to perform this
      Agreement in the same manner and to the same extent the Company would be
      required to perform if no such succession had taken place.  This
      Agreement will be binding upon and inure to the benefit of the Company
      and any successor to the Company, including without limitation any
      persons acquiring directly or indirectly all or substantially all of the
      business or assets of the Company whether by purchase, merger,
      consolidation, reorganization or otherwise (and such successor shall
      thereafter be deemed the "Company" for the purposes of this Agreement),
      but will not otherwise be assignable, transferable or delegable by the
      Company.

           (b) This Agreement will inure to the benefit of and be enforceable
      by Employee's personal or legal representatives, executors,
      administrators, successors, heirs, distributees and legatees.

           (c) This Agreement is personal in nature and neither of the parties
      hereto shall, without the consent of the other, assign, transfer or
      delegate this Agreement or any rights or obligations hereunder except as
      expressly provided in Sections 16(a) and 16(b) hereof.  Without limiting
      the generality or effect of the foregoing, Employee's right to receive
      payments hereunder will not be assignable, transferable or delegable,
      whether by pledge, creation of a security interest, or otherwise, other
      than by a transfer by Employee's will or by the laws of descent and
      distribution and, in the event of any attempted assignment or transfer
      contrary to this Section 16(c), the Company shall have no liability to
      pay any amount so attempted to be assigned, transferred or delegated.



                                      13
<PAGE>   14

     17. NOTICES.  For all purposes of this Agreement, all communications,
including without limitation notices, consents, requests or approvals, required
or permitted to be given hereunder will be in writing and will be deemed to
have been duly given when hand delivered or dispatched by electronic facsimile
transmission (with receipt thereof orally confirmed), or five business days
after having been mailed by United States registered or certified mail, return
receipt requested, postage prepaid, or three business days after having been
sent by a nationally recognized overnight courier service such as Federal
Express or UPS, addressed to the Company (to the attention of the Secretary of
the Company) at its principal executive office and to Employee at his principal
residence, or to such other address as any party may have furnished to the
other in writing and in accordance herewith, except that notices of changes of
address shall be effective only upon receipt.

     18. GOVERNING LAW.  The validity, interpretation, construction and
performance of this Agreement will be governed by and construed in accordance
with the substantive laws of the State of Delaware, without giving effect to
the principles of conflict of laws of such State.

     19. VALIDITY.  If any provision of this Agreement or the application of
any provision hereof to any person or circumstances is held invalid,
unenforceable or otherwise illegal, the remainder of this Agreement and the
application of such provision to any other person or circumstances will not be
affected, and the provision so held to be invalid, unenforceable or otherwise
illegal will be reformed to the extent (and only to the extent) necessary to
make it enforceable, valid or legal.

     20. MISCELLANEOUS.  No waiver by either party hereto at any time of any
breach by the other party hereto or compliance with any condition or provision
of this Agreement to be performed by such other party will be deemed a waiver
of similar or dissimilar provisions or conditions at the same or at any prior
or subsequent time.  No agreements or representations, oral or otherwise,
expressed or implied with respect to the subject matter hereof have been made
by either party which are not set forth expressly in this Agreement.
References to Sections are to references to Sections of this Agreement.

     21. COUNTERPARTS.  This Agreement may be executed in one or more
counterparts, each of which will be deemed to be an original but all of which
together will constitute one and the same agreement.

     22. TITLES.  Titles are provided herein for convenience only and are not
to serve as a basis for interpretation or construction of this Agreement.















                                      14
<PAGE>   15

     IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the date first above written.

                                   THE COMPANY:                              
                                                                             
                                   HEALTH CARE AND RETIREMENT                
                                   CORPORATION OF AMERICA                    
                                                                             
                                                                             
                                   By:  _______________________________      
                                                                             
                                   Its:   _____________________________    
                                                                             
                                                                             
                                   HEALTH CARE AND RETIREMENT                
                                   CORPORATION                               
                                                                             
                                                                             
                                   By:  _______________________________      
                                                                             
                                   Its:   _____________________________    
                                                                             
                                   EMPLOYEE:                                 
                                                                             
                                   ____________________________________       
                                   R. Jeffrey Bixler                         











                                      15
<PAGE>   16
                                   SCHEDULE I



Employee:           R. Jeffrey Bixler

Current Base Rate:  $172,000

Job Titles:         Vice President, General Counsel and Secretary



















<PAGE>   17
                                  SCHEDULE II


Annual Incentive Plan
Performance Award Plan
Stock Option Plan
Amended Restricted Stock Plan
Salary Retirement Plan (prior to January 1, 1993)
Stock Purchase and Savings Program (prior to January 1, 1993)
Senior Executive Retirement Plans
Supplemental Offset Plan
Excess and Supplemental Benefit Plans
Corporate Officer and Senior Executive Life Insurance Program
Senior Management Savings Plan
Senior Management Savings Plan For Corporate Officers
Such other benefit plans and arrangements as the Company provides, from time to
time, to salaried employees generally participation in which is approved by the
President.













<PAGE>   1

                                                                      EXHIBIT 21


<TABLE>
<CAPTION>
                                          STATE OF
                                          INC. OR
NAME OF SUBSIDIARY                        ORGANIZATION  DOING BUSINESS AS
- ------------------                        ------------  -----------------
<S>                                       <C>           <C>
HCRC Inc.                                 Delaware      Same
Ancillary Services Management, Inc.       Ohio          Same
HCR Acquisition Corp.                     Ohio          Same
MileStone Healthcare, Inc.                Delaware      Same
HCR Information Corporation               Ohio          Same
Heartland CarePartners, Inc.              Ohio          Same
RVA Management Services, Inc.             Ohio          Same
Vision Management Services, Inc.          Ohio          Same
 (majority owned)
HCR Home Health Care and Hospice, Inc.    Ohio          Same
Heartland Home Health Care Services, Inc. Ohio          Same
                                                        Heartland Home Health Care
                                                        Heartland Home Health Care and Hospice
Heartland Hospice Services, Inc.          Ohio          Same
                                                        Heartland Home Health Care
                                                        Heartland Home Health Care and Hospice
Heartland Services Corp.                  Ohio          Same
- -Heartland Healthcare Services            Ohio          Same
 (50% owned partnership)
HCR Rehabilitation Corp.                  Ohio          Same
Heartland Rehabilitation Services, Inc.   Ohio          Same
Heartland Home Care, Inc.                 Ohio          Same
                                                        Heartland Home Health Care
                                                        Heartland Home Health Care and Hospice
MileStone Health Systems, Inc.            Texas         Same
MileStone Rehabilitation Services, Inc.   Texas         Same
MileStone Therapy Services, Inc.          Texas         Same
Health Care and Retirement                Ohio          Same
Corporation of America
                                                        Heartland - Beavercreek
                                                        Heartland of Bellefontaine
                                                        Heartland of Browning
                                                        Heartland of Bucyrus
                                                        Heartland of Centerburg
                                                        Heartland of Chillicothe
                                                        Heartland of Eaton
                                                        Heartland - Fairfield
                                                        Heartland of Greenville
                                                        Heartland of Hillsboro
                                                        Heartland - Holly Glen
                                                        Heartland of Indian Lake N.C.
                                                        Heartland of Jackson
                                                        Heartland of Kettering
                                                        Heartland - Lansing
</TABLE>


<PAGE>   2



<TABLE>
<CAPTION>
                                   STATE OF
                                   INC. OR
NAME OF SUBSIDIARY                 ORGANIZATION  DOING BUSINESS AS
- ------------------                 ------------  -----------------
<S>                                <C>           <C>
                                                 Heartland of Marietta
                                                 Heartland of Marysville
                                                 Oak Pavilion Nursing Home
                                                 Heartland of Oak Ridge
                                                 Heartland of Perrysburg
                                                 Perrysburg Commons
                                                 Heartland of Piqua
                                                 Heartland of Portsmouth
                                                 Heartland of Riverview
                                                 Heartland of Springfield
                                                 Heartland of Urbana
                                                 Heartland - Victorian Village
                                                 Heartland of Wauseon
                                                 The Village at Westerville NC
                                                 The Village at Westerville RC
                                                 Christopher East Health Care Center
                                                 Heartland Health Care Center-Prestwick
                                                 Glenside Nursing Center
                                                 Hampton House
                                                 Heartland Health Care Center (Pittsburgh)
                                                 Shadyside Nursing & Rehab. Center
                                                 Sky Vue Terrace
                                                 Twinbrook Medical Center
                                                 Wallingford Nursing & Rehab. Center
                                                 Heartland of Beckley
                                                 Heartland of Charleston
                                                 Heartland of Clarksburg
                                                 Heartland of Keyser
                                                 Heartland of Preston County
                                                 Heartland of Rainelle
                                                 Heartland Health Care Center - Allen Park
                                                 Heartland Health Care Center - Crestview
                                                 Heartland Health Care Ctr-Dearborn Heights
                                                 Heartland Health Care Center - Dorvin
                                                 Heartland Health Care Center - Georgian East
                                                 Heartland Health Care Center - Grand Rapids
                                                 Heartland Health Care Ctr - Plymouth Court
                                                 Heartland Health Care Center - University
                                                 Marvin and Betty Danto Family, Health Care
                                                   Center, a Health Care and Retirement
                                                   Corporation facility
                                                 Dulaney-Towson Health Care Center
                                                 Heartland Health Care Center - Hyattsville
                                                 Heartland Health Care Center - Adelphi
                                                 Heartland Health Care Center - Charleston
                                                 Oakmont East
</TABLE>                                                        



<PAGE>   3



<TABLE>
<CAPTION>
                                   STATE OF
                                   INC. OR
NAME OF SUBSIDIARY                 ORGANIZATION  DOING BUSINESS AS
- ------------------                 ------------  -----------------
<S>                                <C>           <C>
                                                 Oakmont of Union
                                                 Oakmont West
                                                 Rosewood Manor Health Care Center
                                                 Heartland of Willow Lane
                                                 Medical Care Center
                                                 Oak Meadow Nursing Center
                                                 Heartland Health Care Center (Canton)
                                                 Heartland Health Care Center - Galesburg
                                                 Heartland Health Care Center (Henry)
                                                 Heartland Health Care Center (Homewood)
                                                 Heartland Health Care Center - Macomb
                                                 Heartland Health Care Center - Moline
                                                 Heartland Health Care Center (Paxton)
                                                 Heartland Health Care and Rehabilitation
                                                   Center of Boca Raton
                                                 Heartland Health Care Ctr-Boynton Beach
                                                 Heartland of Brooksville
                                                 Community Convalescent Center
                                                 Heartland Health Care Center-Ft. Myers
                                                 Jacaranda Manor
                                                 Heartland Health Care Ctr-Jacksonville
                                                 Heartland Health Care Center-Kendall
                                                 Heartland Health Care Ctr-Lauderhill
                                                 Heartland Health Care Ctr-Miami Lakes
                                                 Heartland Health Care Ctr-Orange Park
                                                 Pasadena Manor
                                                 Heartland Health Care Ctr-Prosperity Oaks
                                                 Regents Park of Jacksonville
                                                 Deerwood Place
                                                 Regents Park of Winter Park
                                                 The Westchester of Winter Park
                                                 Rosedale Manor
                                                 Heartland of St. Petersburg
                                                 Heartland Health Care and Rehabilitation
                                                   Center - Sunrise
                                                 The Westchester of Sunrise
                                                 Heartland of Tamarac
                                                 Heartland of Zephyrhills
Care Corporation                   Michigan      Inactive
Georgian Bloomfield, Inc.          Michigan      Heartland Health Care Center - Georgian
                                                  Bloomfield
Heartland of Indian Lake           Ohio          Heartland of Indian Lake
Rehab. Center, Inc.                              Rehab. Center
Heartland of Martinsburg, Inc.     Ohio          Heartland of Martinsburg
HGCC of Allentown, Inc.            Tennessee     Liberty Nursing & Rehab. Center
Lincoln Health Care, Inc.          Ohio          Heartland of Mentor
</TABLE>



<PAGE>   4

<TABLE>
<CAPTION>
                                  STATE OF
                                  INC. OR
NAME OF SUBSIDIARY                ORGANIZATION   DOING BUSINESS AS
- ------------------                ------------   -----------------
<S>                               <C>            <C>
Washtenaw Hills Manor, Inc.       Michigan       Same
                                                 Heartland Health Care Center - Ann Arbor
HCRA of Texas, Inc.               Texas          Same
                                                 Heartland Health Care Center (Austin)
                                                 Heartland Health Care Center (Bedford)
                                                 Heartland of Corpus Christi
                                                 Holiday Nursing Center
                                                 Heartland of San Antonio
                                                 Heartland Health Care Center (Temple)
                                                 Heartland Health Care Center at Willowbrook
                                                 Heartland Health Care Ctr (West Houston)
Care Corporation Holdings, Inc.    Michigan      Same
Care Real Estate, Inc.             Michigan      Same
Canterbury Village, Inc.           Michigan      Heartland Village Square
Care Manors, Inc.                  Michigan      Same
Birchwood Manor, Inc.              Michigan      Holland Health Care Center
Donahoe Manor, Inc.                Pennsylvania  Donahoe Manor
East Michigan Care Corporation     Michigan      Heartland Health Care Center - Briarwood
                                                 Heartland Health Care Center - Fostrian
                                                 Heartland Health Care Center - Hampton
                                                 Heartland Health Care Center - Marlin
Greenview Manor, Inc.              Michigan      Heartland Health Care Center - Greenview
Ionia Manor, Inc.                  Michigan      Heartland Health Care Center - Ionia
Knollview Manor, Inc.              Michigan      Heartland Health Care Center - Knollview
Marina View Manor, Inc.            Wisconsin     Marina View Manor
                                                 Heartland of Milwaukee
                                                 Parkview Terrace
                                                 Heartland of Shawano
                                                 Washington Manor
Ridgeview Manor, Inc.              Michigan      Heartland Health Care Center - Kalamazoo
Springhill Manor, Inc.             Michigan      Heartland Health Care Center - Battle Creek
Sun Valley Manor, Inc.             Michigan      Heartland Health Care Center - Saginaw
Three Rivers Manor, Inc.           Michigan      Heartland Health Care Center - Three Rivers
Whitehall Manor, Inc.              Michigan      Heartland Health Care Center - Whitehall
Care Manors of New England, Inc.   Delaware      Same
Crescent Hill Manor, Inc.          Mass.         Inactive
Kensington Manor, Inc.             Florida       Kensington Manor
                                                 Heartland Health Care and
                                                  Rehabilitation Center (Sarasota)
Mapleview Nursing Home, Inc.       Mass.         Inactive
Meadows Manor, Inc.                Conn.         Inactive
Spruce Manor Nursing Home, Inc.    Mass.         Inactive
Union Square Nursing Center, Inc.  Mass.         Inactive
Valley View Manor, Inc.            Mass.         Inactive
Waterbury Manor, Inc.              Conn.         Inactive
</TABLE>





<PAGE>   1

                                                                      EXHIBIT 23

                       CONSENT OF INDEPENDENT AUDITORS


We consent to the incorporation by reference in the Registration Statement
(Form S-8, No. 33-44257) pertaining to the Health Care and Retirement
Corporation of America Stock Purchase and Savings Program of Health Care and
Retirement Corporation (HCR), the Registration Statement (Form S-8, No.
33-48885) pertaining to the Health Care and Retirement Corporation Stock Option
Plan for Outside Directors and the Stock Option Plan for Key Employees of HCR,
the Registration Statement (Form S-8, No. 33-83324) pertaining to the Health
Care and Retirement Corporation Amended Stock Option Plan for Key Employees of
HCR, and the Registration Statement (Form S-8, No. 33-87640) pertaining to the
HCR Stock Purchase and Retirement Savings Plan (formerly known as Health Care
and Retirement Corporation of America Stock Purchase and Savings Program) of
HCR of our report dated January 27, 1998, with respect to the consolidated
financial statements and schedule of HCR included in the Annual Report (Form
10-K) for the year ended December 31, 1997.


                                                               ERNST & YOUNG LLP


Toledo, Ohio
February 17, 1998





<TABLE> <S> <C>

<ARTICLE> 5
<LEGEND>
THIS SCHEDULE CONTAINS SUMMARY FINANCIAL INFORMATION EXTRACTED FROM THE
CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEAR ENDED DECEMBER 31, 1997
AND IS QUALIFIED IN ITS ENTIRETY BY REFERENCE TO SUCH FORM 10-K FOR THE YEAR
ENDED DECEMBER 31, 1997.
</LEGEND>
<MULTIPLIER> 1,000
       
<S>                             <C>
<PERIOD-TYPE>                   YEAR
<FISCAL-YEAR-END>                          DEC-31-1997
<PERIOD-START>                             JAN-01-1997
<PERIOD-END>                               DEC-31-1997
<CASH>                                           7,455
<SECURITIES>                                         0
<RECEIVABLES>                                  157,233
<ALLOWANCES>                                    19,184
<INVENTORY>                                          0
<CURRENT-ASSETS>                               170,751
<PP&E>                                         690,457
<DEPRECIATION>                                 137,484
<TOTAL-ASSETS>                                 936,351
<CURRENT-LIABILITIES>                          121,324
<BONDS>                                        292,951
                                0
                                          0
<COMMON>                                           489
<OTHER-SE>                                     433,517
<TOTAL-LIABILITY-AND-EQUITY>                   936,351
<SALES>                                              0
<TOTAL-REVENUES>                               891,963
<CGS>                                                0
<TOTAL-COSTS>                                  705,867
<OTHER-EXPENSES>                                37,395
<LOSS-PROVISION>                                10,644
<INTEREST-EXPENSE>                              17,203
<INCOME-PRETAX>                                101,185
<INCOME-TAX>                                    31,064
<INCOME-CONTINUING>                             70,121
<DISCONTINUED>                                       0
<EXTRAORDINARY>                                      0
<CHANGES>                                            0
<NET-INCOME>                                    70,121
<EPS-PRIMARY>                                     1.57
<EPS-DILUTED>                                     1.51
        

</TABLE>


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