EXHIBIT 2.2

                 FIRST AMENDMENT TO PURCHASE AND SALE AGREEMENT

         This FIRST AMENDMENT TO PURCHASE AND SALE AGREEMENT (this  "Amendment")
is made and  entered  into as of  October  25,  2002 by and among  Constellation
Health  Services,  Inc.,  a  Maryland  corporation  ("CHSI"),  and  the  persons
identified as Sellers on Schedule 7(k) of the Amended and Restated  Schedules to
the Purchase  Agreement (as hereinafter  defined and as amended hereby),  on the
one hand (CHSI and such persons,  collectively,  "Seller"),  and Senior  Housing
Properties Trust, a Maryland real estate investment trust ("SNH"), and Five Star
Quality Care, Inc., a Maryland  corporation  ("FVE"), on the other hand (SNH and
FVE, collectively, "Buyer").

                              W I T N E S S E T H:
                              --------------------

         WHEREAS, pursuant to that certain Purchase and Sale Agreement, dated as
of August 26,  2002,  by and among  Seller,  SNH and  Constellation  Real Estate
Group,  Inc. (the "Purchase  Agreement"),  Seller agreed to sell its interest in
certain  assets  constituting  senior living  properties  and facilities and SNH
agreed to purchase such assets and to assume certain liabilities thereto, all as
further described in the Purchase Agreement; and

         WHEREAS,  Seller and SNH have agreed to amend the Purchase Agreement so
as to make FVE a party thereto;

         NOW,  THEREFORE,  in  consideration of the foregoing and for other good
and  valuable  consideration,  the receipt and  sufficiency  of which are hereby
expressly acknowledged, and subject to the conditions hereinafter set forth, the
parties hereto hereby agree as follows:

         1. Capitalized Terms.  Capitalized terms used and not otherwise defined
herein shall have the meanings given such terms in the Purchase Agreement.

         2. FVE as Buyer.  FVE hereby joins in the Purchase  Agreement,  jointly
and  severally  with SNH, as Buyer  thereunder.  All  references in the Purchase
Agreement to Buyer shall refer to both SNH and FVE, jointly and severally.

         3.  Purchase  and Sale of the Senior  Living  Assets.  Section 1 of the
Purchase Agreement is hereby amended by deleting the third and fourth paragraphs
therefrom in their entirety and replacing them with the following:

                  "Seller  understands  that  SNH is a "real  estate  investment
         trust"  under the Code and that SNH intends to enter into an  agreement
         with a subsidiary of FVE ("Tenant") to lease and operate certain of the
         Facilities,   it  being   understood  that  none  of  the  negotiation,
         execution,  delivery or effectiveness of any agreement  between SNH and
         Tenant shall be a condition to Buyer's  obligation  to  consummate  the
         transactions  contemplated by this Agreement.  At SNH's expense, Seller
         shall  cooperate  in a  commercially  reasonable  manner  with  SNH  in
         connection with the negotiation of such agreement and the  consummation
         of the transactions contemplated by this Agreement.


                  Seller  further   understands  and  agrees  that  Buyer  shall
         designate each of the Facilities to be acquired  directly by either SNH
         or FVE (or any  wholly-owned  subsidiary  of  either of them)  and,  at
         Closing,  Seller shall sell, convey, transfer and deliver such Facility
         or Facilities,  Purchased  Assets and Assumed  Liabilities  directly to
         such  designee.  Notwithstanding  any  such  direct  sale  to any  such
         designee,  SNH and FVE shall at all times remain  jointly and severally
         liable in all respects under this Agreement."

         4. Purchase Price Adjustment. Section 5(c)(i) of the Purchase Agreement
is hereby  amended by  deleting  the  reference  to  "Seventy-Seven  Million Two
Hundred Fifty Thousand Dollars  ($77,250,000)" and replacing it with a reference
to "Seventy-Seven Million One Hundred Fifty Thousand Dollars ($77,150,000)." The
foregoing  adjustment in the Purchase Price reflects the reduction  attributable
to the Defect  Repair  Amount  pursuant  to  Section  5(a)(iv)  of the  Purchase
Agreement.

         5.  Buyer's  Representation  and  Warranties:   Organization  and  Good
Standing. Section 9(a) of the Purchase Agreement is hereby amended by adding the
following  sentence at the end thereof:  "FVE is a corporation  duly  organized,
validly existing and in good standing under the laws of the State of Maryland."

         6. HUD  Facility  Allocable  Amount.  Section  5(d)(ii) of the Purchase
Agreement is hereby amended by deleting the reference to  "Twenty-Five  Million,
Five Hundred Thousand Dollars  ($25,500,000)"  and replacing it with a reference
to "Nineteen Million Seven Hundred Fifty Thousand Dollars ($19,750,000)".

         7. Notices.  Any notices or other  communications  to be given to Buyer
pursuant  to  Section  21(a)  of the  Purchase  Agreement  shall be given to the
following address (in addition to the other addresses set forth therein):

                        Five Star Quality Care, Inc.
                        400 Centre Street
                        Newton, Massachusetts 02458
                        Attn:  Evrett W. Benton
                        Telecopy:  (617) 796-8385

         8.  Counterparts.  This  Amendment  may be  executed  in  one  or  more
counterparts  (including by means of telecopied  signature pages),  all of which
shall be considered one and the same agreement,  and shall become effective when
or more such  counterparts have been signed by each of the parties and delivered
to the other parties.

         9.  Ratification.  As amended hereby,  the Purchase Agreement is hereby
ratified and confirmed.


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         IN  WITNESS  WHEREOF,  the  parties  hereto  have  duly  executed  this
Amendment as of the day and year first above written.

                                     Seller:

                                     CONSTELLATION HEALTH SERVICES, INC.


                                     By: /s/ Steven D. Kesler
                                          Name:  Steven D. Kesler
                                          Title: President

                                     Each of the  other  Sellers
                                     pursuant   to  a  power  of
                                     attorney granted to CHSI:

                                     By:  CONSTELLATION HEALTH SERVICES, INC.


                                     By: /s/ Steven D. Kesler
                                          Name:  Steven D. Kesler
                                          Title: President

                                     Buyer:

                                     SENIOR HOUSING PROPERTIES TRUST


                                     By: /s/ John R. Hoadley
                                          Name:  John R. Hoadley
                                          Title: Treasurer

                                     FIVE STAR QUALITY CARE, INC.


                                     By:  /s/ Bruce J. Mackey
                                          Name:  Bruce J. Mackey
                                          Title: Treasurer and
                                                 Chief Financial Officer

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                                     For purposes of acknowledging the execution
                                     and delivery of this Amendment only

                                     CONSTELLATION REAL ESTATE GROUP, INC.


                                     By: /s/ Steven D. Kesler
                                          Name:  Steven D. Kesler
                                          Title: President

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