Exhibit 10.21

                        AMENDMENT NO. 4 TO LOAN AGREEMENT

     AMENDMENT  NO. 4 TO LOAN  AGREEMENT  (this  "Amendment  No.  4"),  made and
executed as of this 1st day of April, 2002, by and among:

     OMEGA   HEALTHCARE   INVESTORS,   INC.  and  certain  of  its  subsidiaries
(individually, a "Borrower" and collectively, the "Borrowers"),

     The lenders that have executed the signature pages hereto (individually,  a
"Lender" and collectively, the "Lenders"); and

     THE PROVIDENT BANK, an Ohio banking  corporation,  as Agent for the Lenders
(in such capacity, together with its successors in such capacity, the "Agent").

                             PRELIMINARY STATEMENTS

     (A) The Borrowers have entered into a certain Loan  Agreement  dated August
11, 2000,  as amended by that certain  Amendment No. 1 to Loan  Agreement  dated
November 30, 2000, that certain Amendment No. 2 dated December 31, 2000 and that
certain Amendment No.3 dated as of December 21, 2001  (hereinafter  referred to,
as amended, as the "Loan Agreement") with the Agent and the Lenders; and

     (B) The  Borrowers  have  requested  that the Lenders and the Agent amend a
certain  provision  of the Loan  Agreement,  and the  Lenders  and the Agent are
willing to do so, all on the terms and conditions hereinafter set forth;

     NOW, THEREFORE, in consideration of the agreements and provisions contained
herein, the parties hereto hereby agree as follows:

     1.  Definitions.  Capitalized  terms used but not defined herein shall have
the meanings ascribed to such terms in the Loan Agreement.

     2. Amendment to the Loan Agreement.  Subject to the terms and conditions of
this Amendment No. 4, Section 8.11(b) of the Loan Agreement shall be amended and
restated to read in its entirety as follows:

     (b) The Fleet Obligations; provided, however, that notwithstanding anything
contained  in this  Agreement or any Schedule  thereto to the  contrary,  in the
event that the Fleet  Obligations  shall be amended or modified to (i)  increase
the  amount  of the  commitment  thereunder,  (ii)  increase  the  amount of the
amortization  thereunder,  (iii) increase the rate of interest thereunder,  (iv)
change the maturity of the obligations thereunder, (v) increase the fees payable
thereunder,  (vi)  increase the amount of  collateral  securing the  obligations
thereunder  (other than any increase in the collateral  value  occasioned by the
collateral  substitution  which closed on or about March 6, 2002, which resulted
in availability  under the Fleet  Documents of  approximately  $17,300,000),  or
(vii) impose on the Borrowers  financial  covenants more  restrictive than those
set forth in the Fleet  Obligations as of the date hereof (any such amendment or
modification, the "Fleet Amendment"), the Borrowers shall execute and deliver to
the Agent an amendment or modification  of this  Agreement,  the effect of which
shall be, to the extent reasonably determined necessary by Agent and Lenders, to
negate  any  materially  adverse  impact to the  interests  of the Agent and the
Lenders under this  Agreement  which would have otherwise been the effect of the
Fleet Amendment;

     3.  Representations and Warranties.  In order to induce the Lenders and the
Agent  to  enter  into  this  Amendment  No.  4,  each of the  Borrowers  hereby
represents and warrants to the Lenders and the Agent,  as to itself with respect
to the Loan Documents to which it is a party, as of the date hereof that:

     3.1 No Default.  After giving effect to this Amendment No. 4, no Default or
Event of Default shall have occurred or be continuing.

     3.2 Authority;  Enforceability. (i) The execution, delivery and performance
by each Borrower of this  Amendment No. 4 are within its  organizational  powers
and have been duly authorized by all necessary  action  (corporate or otherwise)
on the part of each Borrower,  (ii) this Amendment No. 4 is the legal, valid and
binding  obligation  of each  Borrower,  enforceable  against  each  Borrower in
accordance  with its terms,  and (iii) this  Amendment No. 4 and the  execution,
delivery and  performance  by each Borrower  hereof does not: (A) contravene the
terms of any Borrower's organization  documents,  (B) conflict with or result in
any breach or contravention  of, or the creation of any Lien under, any document
evidencing  any  contractual  obligation to which any Borrower is a party or any
order,  injunction,  writ or decree to which any  Borrower  or its  property  is
subject, or (C) violate any requirement of law.

     4.  Conditions to  Effectiveness  of Amendment.  The  effectiveness  of the
amendment in Section 2 of this Amendment No. 4 shall subject to the  fulfillment
of the following conditions to the satisfaction of Agent :

     4.1 As of the date of this  Amendment No. 4, Agent shall have received this
Amendment  No.4 duly executed by a duly  authorized  officer or officers of each
Borrower, Agent and each Lender.

     4.2 As of the date of this  Amendment  No. 4,  Agent  shall  have  received
opinions of counsel to the  Borrowers  in  substantially  the forms  attached as
Exhibits A-1 and A-2 hereto concerning this Amendment No. 4.

     4.3 On or before  April 15, 2002,  Agent shall have  received an opinion or
opinions of counsel to Borrowers in substantially  the forms attached as Exhibit
B-1  through  B-9  hereto to the  effect  that the  execution  and  delivery  of
Amendment No. 3 and Amendment No. 4 by Borrowers does not affect the validity or
enforceability  of any of the  Mortgages  delivered by Borrowers  under the Loan
Agreement in accordance with their respective terms.

     4.4 As of the date of this  Amendment  No. 4, Agent  shall have  received a
certificate  of the  Secretary of  Borrowers  in the form  attached as Exhibit C
hereto,  dated as of March 20,  2002,  with respect to the  representations  and
warranties of Borrowers as of such date.

     4.5 As of the date of this  Amendment  No. 4, Agent  shall have  received a
certificate  of the  Secretary  or  Assistant  Secretary  of each  Borrower  (i)
attaching a true and complete copy of the  resolutions of its Board of Directors
and of all  documents  evidencing  all necessary  corporate  action (in form and
substance  satisfactory to Agent) taken by it to authorize this Amendment No. 4,
and (ii) setting  forth the  incumbency  of its officer or officers who may sign
this  Amendment,  including  therein a  signature  specimen  of such  officer or
officers.

     5. Reference to and Effect Upon the Loan Agreement.

     5.1 Effect. Except as specifically set forth herein, the Loan Agreement and
the other Loan  Documents  shall  remain in full force and effect in  accordance
with their terms and are hereby ratified and confirmed.

     5.2 No Waiver;  References.  The execution,  delivery and  effectiveness of
this Amendment No. 4 shall not operate as a waiver of any right, power or remedy
of the Agent or any Lender under the Loan Agreement,  nor constitute a waiver of
any provision of the Loan Agreement,  except as  specifically  set forth herein.
Upon the effectiveness of this Amendment No. 4, each reference in:

          5.2.1 the Loan Agreement to "this Agreement",  "hereunder",  "hereof",
     "herein" or words of similar  import  shall mean and be a reference  to the
     Loan Agreement as amended hereby;

          5.2.2 the other Loan Documents to the "Loan  Agreement" shall mean and
     be a reference to the Loan Agreement as amended hereby; and

          5.2.3 the Loan  Documents to the "Loan  Documents"  shall be deemed to
     include this Amendment No. 4.

     6. Miscellaneous.

     6.1  Expenses.  The  Borrowers  agree to pay the Agent upon  demand for all
reasonable expenses,  including  reasonable  attorneys' fees and expenses of the
Agent, incurred by the Agent in connection with the preparation, negotiation and
execution of this Amendment No. 4.

     6.2 Law. THIS  AMENDMENT  NO. 4 SHALL BE CONSTRUED IN  ACCORDANCE  WITH AND
GOVERNED BY THE INTERNAL LAWS OF THE STATE OF OHIO.

     6.3  Successors.  This Amendment No. 4 shall be binding upon the Borrowers,
the Lenders and the Agent and their respective successors and assigns, and shall
inure to the  benefit  of the  Borrowers,  the  Lenders  and the  Agent  and the
successors and assigns of the Lenders and the Agent.

     6.4 Execution in Counterparts.  This Amendment No. 4 may be executed in any
number of counterparts and by different parties hereto in separate counterparts,
each of which when so executed and  delivered  shall be deemed to be an original
and all of which taken together shall constitute one and the same instrument.



     IN WITNESS WHEREOF,  the parties hereto have caused this Amendment No. 4 to
be executed and delivered by their respective officers thereunto duly authorized
as of the date first written above.

                                       LENDERS AND AGENT:

                                       THE PROVIDENT BANK, as Lender and Agent


                                       By: /s/  STEVEN J. BLOEMER
                                           --------------------------
                                       Its: Vice President
                                           --------------------------


                                       GREAT AMERICAN INSURANCE COMPANY


                                       By: /s/  RONALD C. HAYES
                                           --------------------------
                                       Its: Assistant Vice President
                                           --------------------------


                                       GREAT AMERICAN LIFE INSURANCE COMPANY


                                       By: /s/  MARK F. MUETHING
                                           --------------------------
                                       Its: Executive Vice President
                                           --------------------------





                                       BORROWERS:

                                       OMEGA HEALTHCARE INVESTORS, INC.

                                       STERLING ACQUISITION CORP.

                                       DELTA INVESTORS I, LLC

                                       OHI (CONNECTICUT) INC.


                                       By: /s/ DANIEL J. BOOTH
                                           --------------------------
                                       Its:  Chief Operating Officer
                                           --------------------------

     Daniel J.  Booth,  as an  executive  officer  of all of the  aforementioned
Borrowers,  has executed  this  Amendment  No. 4 and  intending  that all of the
Borrowers  above named are bound and are to be bound by the one  signature as if
(s)he had executed this  Amendment No. 4 separately  for each of the above named
Borrowers.




                        OMEGA HEALTHCARE INVESTORS, INC.

Exhibit Index              Description
- --------------------------------------------------------------------------------
Exhibit A-1                Munch Hardt Kopf & Harr, P.C. Opinion

Exhibit "A"                Subsidiaries

Exhibit "B"                Certificates of Existence and Good Standing

Exhibit "C"                Officers' Certificates

Schedule 1                 Orders, Judgments and Decrees

Exhibit A-2                Special Ohio Counsel Opinion

Exhibit B-1                Alabama Opinion of Counsel

Exhibit B-2                Arkansas Opinion of Counsel

Exhibit B-3                California Opinion of Counsel

Exhibit B-4                Connecticut Opinion of Counsel

Exhibit B-5                Florida Opinion of Counsel

Exhibit B-6                Kentucky Opinion of Counsel

Exhibit B-7                North Carolina Opinion of Counsel

Exhibit B-8                Ohio Opinion of Counsel

Exhibit B-9                West Virginia Opinion of Counsel

Exhibit C                  Secretary's Certificate

Exhibit A                  Borrowers

Exhibit B                  Articles of Incorporation or Articles of Organization

Exhibit C                  Bylaws or Operating Agreements