EXECUTION COPY


                     SECOND AMENDMENT dated as of July 16, 1996 (this "SECOND 
                 AMENDMENT"), to the Amended and Restated Credit Agreement 
                 dated as of September 26, 1995 (as amended to the date hereof,
                 the "AMENDED CREDIT AGREEMENT"), among Horizon/CMS Healthcare 
                 Corporation, a Delaware corporation ("HORIZON"), Continental 
                 Medical Systems, Inc., a Delaware corporation ("CONTINENTAL",
                 and together with Horizon, the "BORROWERS"), the lenders listed
                 on the signature pages thereto (the "LENDERS") and NationsBank
                 of Texas, N.A., as agent for the Lenders (in such capacity, the
                 "AGENT") and as issuing bank (in such capacity, the "ISSUING 
                 BANK").

     The parties hereto have agreed, subject to the terms and conditions 
hereof, to amend the Amended Credit Agreement as provided herein.

     Capitalized terms used and not otherwise defined herein shall have the 
meanings assigned to such terms in the Amended Credit Agreement (the Amended 
Credit Agreement, as amended and waived by, and together with, this Second 
Amendment, and as hereinafter amended, modified, extended or restated from 
time to time, being called the "AMENDED AGREEMENT").

     Accordingly, the parties hereto hereby agree as follows:

     SECTION 1.01.  AMENDMENT TO SECTION 2.10.  Section 2.10(b) of the 
Amended Agreement is hereby deleted in its entirety and the following is 
hereby substituted in lieu thereof:

          (b)  Horizon shall have the option to request the extension of the 
     Maturity Date by one year, on an annual basis in accordance with this 
     Section 2.10(b), so that a five-year Availability Period would be 
     maintained; PROVIDED that, in the case of any such request in 1997, Horizon
     may request an extension of the Maturity Date by two years so long as no 
     one-year extension was requested and granted in 1996 (a "1997 SPECIAL 
     EXTENSION").  In the event that Horizon desires to extend the maturity of 
     the Facility, Horizon shall give notice of such request to the Agent not 
     less than 30 days, and not more than 120 days, before the date (the 
     "PROPOSED EXTENSION DATE") which is four years (or three years in the case 
     of a 1997 Special Extension) prior to the existing Maturity Date. The Agent
     shall give the other Lenders prompt notice of the receipt of any such 
     request.  Such request shall be deemed granted if, and only if, the Agent 
     shall have received written notice of the approval of such proposed 
     extension, by September 30 immediately following the Proposed Extension 
     Date, from each Lender, except for any Lender which is replaced by Horizon
     as provided in this Section 2.10(b); otherwise, the existing Maturity Date
     shall not be extended.  Any such Lender which shall have failed to give 
     such notice of approval by such September 30 is referred to herein as a 
     "DISSENTING LENDER".  Horizon shall have the right to 







     replace any Dissenting Lender by causing such Lender to transfer and assign
     all its interests, rights and obligations under this Amended Agreement to 
     another financial institution pursuant to Section 2.19 (a "REPLACEMENT 
     LENDER") by October 15 immediately following such Proposed Extension Date;
     PROVIDED that the Consenting Lenders shall have given written notice to the
     Agent of the approval of the proposed extension by such September 30.  
     Horizon may request an extension of the Maturity Date pursuant to this 
     Section 2.10(b) in each year, commencing in 1996; PROVIDED that, except in
     the case of any such request in 1996 or pursuant to a 1997 Special 
     Extension, it shall have requested and received an extension of the 
     Maturity Date pursuant to this Section 2.10(b) in the previous year.  The
     Agent shall give Horizon and each Lender prompt written notice of whether
     any proposed extension has been granted or denied.  Any request for an 
     extension of the Maturity Date that has been granted in accordance with the
     procedure set forth in this Section 2.10(b) is referred to herein as an 
     "APPROVED EXTENSION" and the Proposed Extension Date relating to such 
     Approved Extension is referred to herein as an "EXTENSION DATE".

     SECTION 1.02.  AMENDMENT TO SECTION 3.09.  Section 3.09(b) of the 
Amended Agreement is hereby amended by adding the following language after 
the word "decree" and before the period at the end of the second sentence 
thereof:  

     ", except any such communication relating to matters that could not 
     reasonably be expected to result, individually or in the aggregate, in
     a Material Adverse Effect"

     SECTION 1.03.  AMENDMENT TO SECTION 6.05 AND RELATED SCHEDULE. (a) The 
following proviso is hereby added at the end of paragraph (C) of Section 
6.05(a):

     "PROVIDED that the dispositions described on Schedule 6.05(a) hereto shall
     not be subject to such $20,000,000 aggregate book value and $5,000,000 for
     any single asset book value limitations, so long as 100% of the Net 
     Proceeds thereof remaining after the repayment of existing debt (in an
     aggregate amount not to exceed $9,500,000) relating to the assets being 
     disposed of in such described dispositions shall be promptly applied to the
     prepayment of outstanding Loans, but shall not be applied to reduce the 
     Commitments;"

     (b)  Schedule 6.05(a) attached to this Second Amendment is hereby adopted 
as Schedule 6.05(a) for purposes of the Amended Agreement.

     SECTION 1.04.  AMENDMENT OF EBITDAR DEFINITION.  The following clause is 
hereby added at the end of the proviso to the definition of EBITDAR in Section 
1.01 of the Amended Agreement:

     ", (D) up to $11,000,000 of non-cash charges incurred during the fourth 
     quarter of fiscal year 1996 as a result of the implementation of Financial
     Accounting Standards Board Statement No. 121 and (E) up to $9,000,000 of 
     restructuring charges incurred during the fourth quarter of fiscal year 
     1996 as a result of the dispositions described on Schedule 6.05(a) hereto".

                                     -2- 


     SECTION 1.05.  WAIVER.  On and as of (but not before) the Second 
Amendment Effective Date (as defined in Section 1.07), any inaccuracies in 
the representations made after September 26, 1995 and prior to (but not 
after) the Second Amendment Effective Date pursuant to the second sentence of 
Section 3.09(b) of the Amended Agreement (but only to the extent such 
inaccuracies would have been averted if the amendment set forth in Section 
1.02 of this Second Amendment had been effective prior to the making of the 
such representations) shall be permanently waived.  The preceding sentence 
shall be limited precisely as written.

     SECTION 1.06.  REPRESENTATIONS AND WARRANTIES.  The Borrowers hereby 
represent and warrant to the Agent and the Lenders, as follows:

          (a)  The representations and warranties set forth in Article III of 
     the Amended Agreement, and in each other Loan Document, are true and 
     correct in all material respects on and as of the date hereof and on and as
     of the Second Amendment Effective Date with the same effect as if made on 
     and as of the date hereof or the Second Amendment Effective Date, as the 
     case may be, except to the extent such representations and warranties 
     expressly relate solely to an earlier date.

          (b)  Each of the Borrowers, the Subsidiary Pledgors and the Subsidiary
     Guarantors is in compliance in all material respects with all the terms and
     conditions of the Amended Agreement and the other Loan Documents on its 
     part to be observed or performed and no Default or Event of Default has 
     occurred or is continuing under the Amended Agreement.

          (c)  The execution, delivery and performance by each of the Borrowers
     of this Second Amendment have been duly authorized by such party.

          (d)  This Second Amendment constitutes the legal, valid and binding
     obligation of each of the Borrowers, enforceable against it in accordance
     with its terms.

          (e)  The execution, delivery and performance by each of the Borrowers
     of this Second Amendment (i) do not conflict with or violate (A) any 
     provision of law, statute, rule or regulation, or of the certificate of
     incorporation or by-laws of either of the Borrowers, (B) any order of any
     Governmental Authority or (C) any provision of any indenture, agreement or
     other instrument to which either of the Borrowers is a party or by which it
     or any of its property may be bound and (ii) do not require any consents 
     under, result in a breach of or constitute (with notice or lapse of time or
     both) a default under any such indenture, agreement or instrument.

     SECTION 1.07.  EFFECTIVENESS.  This Second Amendment shall become 
effective only upon satisfaction of the following conditions precedent (the 
first date upon which each such condition has been satisfied being herein 
called the "SECOND AMENDMENT EFFECTIVE DATE"):

                                     -3- 


          (a)  The Agent shall have received duly executed counterparts of this
     Second Amendment which, when taken together, bear the authorized signatures
     of the Borrowers and the Required Lenders.

          (b)  The Required Lenders shall be satisfied that the representations
     and warranties set forth in Section 1.06 are true and correct on and as of
     the Second Amendment Effective Date and that no Default or Event of Default
     has occurred or is continuing.

          (c)  There shall not be any action pending or any judgment, order or
     decree in effect which, in the judgment of the Required Lenders or their 
     counsel, is likely to restrain, prevent or impose materially adverse 
     conditions upon performance by any of the Borrowers, the Subsidiary 
     Pledgors or the Subsidiary Guarantors of its obligations under the Loan 
     Documents.

          (d)  The Required Lenders shall have received such other documents,
     legal opinions, instruments and certificates as they shall reasonably 
     request and such other documents, legal opinions, instruments and 
     certificates shall be satisfactory in form and substance to the Required 
     Lenders and their counsel.  All corporate and other proceedings taken or 
     to be taken in connection with this First Amendment and all documents 
     incidental thereto, whether or not referred to herein, shall be 
     satisfactory in form and substance to the Required Lenders and their 
     counsel.

          (e)  The Borrowers shall have paid in full all amounts due and payable
     as of the Second Amendment Effective Date under the Credit Agreement and 
     shall have paid a total amendment fee of $87,500 (of which $3,500 shall be
     distributed to each Lender).

     SECTION 1.08.  APPLICABLE LAW.  THIS SECOND AMENDMENT SHALL BE GOVERNED 
BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK, 
EXCEPT TO THE EXTENT THAT THE FEDERAL LAWS OF THE UNITED STATES OF AMERICA 
MAY APPLY.

     SECTION 1.09.  EXPENSES.  The Borrowers shall pay all reasonable 
out-of-pocket expenses incurred by the Agent and the Required Lenders in 
connection with the preparation, negotiation, execution, delivery and 
enforcement of this Second Amendment, including, but not limited to, the 
reasonable fees and disbursements of counsel.  The agreement set forth in 
this Section 1.09 shall survive the termination of this Second Amendment and 
the Amended Agreement.

     SECTION 1.10.  COUNTERPARTS.  This Second Amendment may be executed in 
any number of counterparts, each of which shall constitute an original but 
all of which when taken together shall constitute but one agreement.

     SECTION 1.11.  CREDIT AGREEMENT.  Except as expressly set forth herein, 
the amendments and waiver provided herein shall not by implication or 
otherwise limit, constitute 

                                     -4- 


a waiver of, or otherwise affect the rights and remedies of the Lenders, the 
Agent or the other Secured Parties under the Amended Agreement or any other 
Loan Document, nor shall they constitute a waiver of any Default or Event of 
Default, nor shall they alter, modify, amend or in any way affect any of the 
terms, conditions, obligations, covenants or agreements contained in the 
Amended Agreement or any other Loan Document.  Each of the amendments and 
waiver provided herein shall apply and be effective only with respect to the 
provisions of the Amended Agreement specifically referred to by such 
amendment or waiver, as the case may be.  Except as expressly amended herein, 
the Amended Agreement shall continue in full force and effect in accordance 
with the provisions thereof.  As used in the Amended Agreement, the terms 
"Agreement", "herein", "hereinafter", "hereunder", "hereto" and words of 
similar import shall mean, from and after the date hereof, the Amended 
Agreement.

                                     -5- 


     IN WITNESS WHEREOF, the parties hereto have caused this Second Amendment 
to be duly executed by their duly authorized officers, all as of the date 
first above written.

                         HORIZON/CMS HEALTHCARE CORPORATION,
                         as a Borrower


                         By /s/  ERNEST A. SCHOFIELD 
                            ------------------------------------------------- 
                         Name:  Ernest A. Schofield 
                         Title: Senior Vice President 

                         CONTINENTAL MEDICAL SYSTEMS, INC.,
                         as a Borrower


                         By /s/  ERNEST A. SCHOFIELD 
                            ------------------------------------------------- 
                         Name:  Ernest A. Schofield 
                         Title: Senior Vice President 

                         NATIONSBANK OF TEXAS, N.A., as Agent, as Issuing
                         Bank and as a Lender


                         By /s/  GUILLERMO BORDA 
                            ------------------------------------------------- 
                         Name:  Guillermo Borda 
                         Title: Vice President 

                         BANK OF AMERICA NT & SA, as Managing
                         Agent and as a Lender


                         By /s/  WYATT R. RITCHIE 
                            ------------------------------------------------- 
                         Name:  Wyatt R. Ritchie 
                         Title: Managing Director 

                         MORGAN GUARANTY TRUST COMPANY OF NEW
                         YORK, as a Lender


                         By /s/  ROBERT M. OSIESKI 
                            ------------------------------------------------- 
                         Name:  Robert M. Osieski 
                         Title: Vice President 

                         CREDIT LYONNAIS CAYMAN ISLAND BRANCH,
                         as Co-Agent and as a Lender


                         By /s/  FARBOUD TAVANGAR 
                            ------------------------------------------------- 
                         Name:  Farboud Tavangar 
                         Title: Authorized Signature 

                                     -6- 


                         LONG TERM CREDIT BANK OF JAPAN, LTD., LA
                         AGENCY, as Co-Agent and as a Lender


                         By /s/  T. MORGAN EDWARDS II
                            ------------------------------------------------- 
                         Name:  T. Morgan Edwards II 
                         Title: Deputy General Manager 


                         PNC BANK, NATIONAL ASSOCIATION, as Co-Agent
                         and as a Lender


                         By /s/  KAREN GEORGE 
                            ------------------------------------------------- 
                         Name:  Karen George 
                         Title: Assistant Vice President 


                         THE CHASE MANHATTAN BANK, as successor to 
                         CHEMICAL BANK, as a Lender


                         By /s/  DAWN LEE LUM 
                            ------------------------------------------------- 
                         Name:  Dawn Lee Lum 
                         Title: Vice President


                         WELLS FARGO BANK (TEXAS), NATIONAL ASSOCIATION, 
                         formerly FIRST INTERSTATE BANK OF TEXAS, N.A.,
                         as a Lender


                         By /s/  KIMBERLY K. WELCH 
                            ------------------------------------------------- 
                         Name:  Kimberly K. Welch 
                         Title: Assistant Vice President 


                         TORONTO DOMINION (TEXAS) INC., as a Lender


                         By /s/  NEVA NESBITT 
                            ------------------------------------------------- 
                         Name:  Neva Nesbitt 
                         Title: Vice President 


                         BANKERS TRUST COMPANY, as a Lender


                         By /s/  PATRICIA HOGAN 
                            ------------------------------------------------- 
                         Name:  Patricia Hogan 
                         Title: Vice President 

                                     -7- 


                         BANQUE PARIBAS, as a Lender


                         By /s/  PIERRE-JEAN DE FILIPPIS
                            ------------------------------------------------- 
                         Name:  Pierre-Jean de Filippis
                         Title: General Manager


                         By /s/  KENNETH E. MOORE, JR.
                            ------------------------------------------------- 
                         Name:  Kenneth E. Moore, Jr.
                         Title: Vice President


                         BANQUE NATIONALE de PARIS, as a Lender


                         By /s/  C. BETTLES
                            ------------------------------------------------- 
                         Name:  C. Bettles
                         Title: Senior Vice President and Manager


                         By /s/  MARGARET MUDD
                            ------------------------------------------------- 
                         Name:  Margaret Mudd
                         Title: VP


                         DEUTSCHE BANK AG, LOS ANGELES AND/OR
                         CAYMAN ISLANDS BRANCHES, as a Lender


                         By /s/  J. SCOTT JESSUP
                            ------------------------------------------------- 
                         Name:  J. Scott Jessup
                         Title: Vice President


                         By /s/  ROSS A. HOWARD
                            ------------------------------------------------- 
                         Name:  Ross A. Howard
                         Title: Director


                         MELLON BANK, N.A., as a Lender


                         By /s/  RICHARD A. LOPAIT
                            ------------------------------------------------- 
                         Name:  Richard A. Lopait
                         Title: Vice President


                         FIRST NATIONAL BANK, FORMERLY KNOWN AS
                         FLEET BANK OF MASSACHUSETTS, as a Lender


                         By /s/  GINGER STOLRENTHALER
                            ------------------------------------------------- 
                         Name:  Ginger Stolrenthaler
                         Title: Vice President

                                     -8- 


                         KEYBANK NATIONAL ASSOCIATION, as a Lender


                         By /s/  ANGELA G. MAGO
                            ------------------------------------------------- 
                         Name:  Angela G. Mago
                         Title: Vice President


                         SUNWEST BANK OF ALBUQUERQUE, N.A., as a
                         Lender and as Issuing Bank


                         By /s/  NANCY MADIGAN
                            ------------------------------------------------- 
                         Name:  Nancy Madigan
                         Title: Vice President


                         BANK OF TOKYO-MITSUBISHI TRUST COMPANY,
                         successor by merger to THE BANK OF TOKYO TRUST
                         COMPANY


                         By /s/  AUGUSTINE OKWU
                            ------------------------------------------------- 
                         Name:  Augustine Okwu
                         Title: Vice President


                         THE BOATMEN'S NATIONAL BANK OF ST. LOUIS,
                         as a Lender


                         By /s/  JUAN A. CAZORLA
                            ------------------------------------------------- 
                         Name:  Juan A. Cazorla
                         Title: Assistant Vice President


                         THE NIPPON CREDIT BANK, LTD., LOS ANGELES
                         AGENCY, as a Lender


                         By /s/  BERNARDO E. CORREA-HENSCHKE
                            ------------------------------------------------- 
                         Name:  Bernardo E. Correa-Henschke
                         Title: Vice President & Senior Manager


                         THE SUMITOMO BANK, LIMITED, as a Lender


                         By /s/  REIJI SATO
                            ------------------------------------------------- 
                         Name:  Reiji Sato
                         Title: Joint General Manager


                         THE SUMITOMO TRUST & BANKING CO., LTD., NEW
                         YORK BRANCH, as a Lender


                         By /s/  JOSEPH M. KELLEY
                            ------------------------------------------------- 
                         Name:  Joseph M. Kelley
                         Title: Senior Vice President

                                     -9- 


                         THE SUMITOMO BANK, LIMITED, CHICAGO
                         BRANCH, as a Lender


                         By /s/  JAMES T. WANG
                            ------------------------------------------------- 
                         Name:  James T. Wang
                         Title: Vice President & Manager


                         THE MITSUBISHI BANK, LTD., LOS ANGELES
                         BRANCH, as a Lender


                         By /s/  ALBERT W. KELLEY
                            ------------------------------------------------- 
                         Name:  Albert W. Kelley
                         Title: Vice President


                         THE INDUSTRIAL BANK OF JAPAN, LIMITED,
                         NEW YORK BRANCH, as a Lender


                         By /s/  AKIJIRO YOSHINO
                            ------------------------------------------------- 
                         Name:  Akijiro Yoshino
                         Title: Executive Vice President


                         NATIONSBANK, N.A., as a Lender


                         By /s/  CHRIS BARTON
                            ------------------------------------------------- 
                         Name:  Chris Barton
                         Title: VP




                                     -10-