Exhibit 10.5 July 16, 1996 Mellon Bank, N.A., as Agent AIM 199-5220 P.O. Box 7899 Philadelphia, PA 19101-7899 Attention: Linda Sigler, Loan Administration Dear Ms. Sigler: The undersigned, Borrowers under the Amended and Restated Credit Agreement dated as of September 29, 1995, as previously amended as of April 12, 1996 (the "Revolving Credit Agreement") and the Acquisition Credit Agreement dated as September 29, 1995, as amended as of April 12, 1996 (the "Acquisition Credit Agreement") have requested that the Revolving Credit Agreement, the Acquisition Credit Agreement and certain Loan Documents be amended and certain waivers thereto be granted, all as set forth in the form of Second Amendment and Waiver to Loan Documents (the "Amendment") forwarded to Lenders thereunder on or about June 29, 1996. In order to induce the Lenders and you, as ACA Agent and Lender, to execute the Amendment, the undersigned are agreeing as set forth herein with the intent to be legally bound hereby. Capitalized terms used but not defined in this letter have the meanings assigned to them in, or by reference in, the Revolving Credit Agreement, the Acquisition Credit Agreement or the Amendment, as the context requires. Each of the undersigned hereby agrees that, except as provided in the penultimate paragraph of this letter or unless and until otherwise consented to in writing by the Agent and all of the Lenders (the "Reborrowing Consent"), it shall not request any loan under the Acquisition Credit Agreement, as the same may be amended by the Amendment or otherwise. In furtherance of the foregoing agreement, each of the undersigned represents that there are no outstanding loan requests and agrees that, prior to the effectiveness of the Reborrowing Consent, no Lender shall have any obligation to make any Revolving Credit Loan under the Acquisition Credit Agreement and that any Standard Notice or other request for such Loan prior to the effectiveness of the Reborrowing Consent will be given no effect by the Lenders or by the ACA Agent. Each of the undersigned hereby waives any right which it may have that is inconsistent with this letter and waives any Mellon Bank, N.A. July 16, 1996 Page 2 claim of any nature whatsoever that it may otherwise have against any Lender or the ACA Agent for refusing to make such Revolving Credit Loans prior the effectiveness of a Reborrowing Consent. Each of the undersigned further agrees that the granting of a Reborrowing Consent shall be within the sole discretion of each Lender and the ACA Agent and represents that it has received no assurances that a Reborrowing Consent will be executed by the ACA Agent and all or any of the Lenders or that no conditions may be imposed under any such Reborrowing Consent. The undersigned agrees that, notwithstanding this letter, it shall continue to pay the commitment fee as provided under the Acquisition Credit Facility and that such fee shall accrue through the date of the commitment reduction referred to in the following paragraph. Pursuant to Section 2.02 of the Acquisition Credit Agreement, Genesis, on behalf of all Borrowers, hereby reduces to zero, effective upon closing under the Synthetic Lease referred to in the Amendment (the "Synthetic Lease"), the Revolving Credit Committed Amounts of the Lenders (and each thereof) under the Acquisition Credit Facility. Except as provided in the following paragraph, such reduction is irrevocable and permanent and shall occur automatically without the need for further action, although Genesis agrees to confirm the same in writing immediately following such closing. The undersigned acknowledge and confirm that, as provided in the Acquisition Credit Agreement, certain of their obligations thereunder shall survive the permanent termination of borrowing rights. This letter and the agreements respecting borrowing right and commitment reductions herein are made in anticipation of a closing under the Synthetic Lease. If the Borrowers shall confirm in writing to the ACA Agent that (a) the Synthetic Lease has not closed, (b) the Synthetic Lease transaction has been abandoned and (c) the Amendment shall be deemed void and ineffective and if the prospective Lessor under the Synthetic Lease shall confirm (a) and (b) above in writing to the ACA Agent, the reduction of the commitments and the restrictions on the right to borrow under the Acquisition Credit Agreement herein contained shall cease to be effective and shall be deemed withdrawn. Mellon Bank, N.A. July 16, 1996 Page 3 A copy of this letter may be forwarded by you to each of the Lenders. Sincerely, GENESIS HEALTH VENTURES, INC., a Pennsylvania corporation BREVARD MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Health, Inc., a Pennsylvania corporation, its sole general partners CATONSVILLE MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Health, Inc., a Pennsylvania corporation, one of its general partners EASTON MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Health, Inc., a Pennsylvania corporation, its sole general partner EDELLA STREET ASSOCIATES, a Pennsylvania limited partnership By: Genesis Health Ventures of Clarks Summit, Inc., its sole general partner GENESIS HEALTH VENTURES OF ARLINGTON, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF BLOOMFIELD, INC., a Pennsylvania corporation Mellon Bank, N.A. July 16, 1996 Page 4 GENESIS HEALTH VENTURES OF CLARKS SUMMIT, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF INDIANA, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF MASSACHUSETTS, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF NAUGATUCK, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF SALISBURY, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF WAYNE, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF WEST VIRGINIA, INC., a Pennsylvania corporation GENESIS HEALTH VENTURES OF WINDSOR, INC., a Pennsylvania corporation GENESIS IMMEDIATE MED CENTER, INC., a Pennsylvania corporation GENESIS MANAGEMENT RESOURCES, INC., a Pennsylvania corporation GENESIS ELDERCARE HOME CARE SERVICES, INC., a Pennsylvania corporation Mellon Bank, N.A. July 16, 1996 Page 5 GENESIS ELDERCARE PHYSICIANS SERVICES, INC., a Pennsylvania corporation GENESIS PROPERTIES LIMITED PARTNERSHIP, a Pennsylvania limited partnership By: Genesis Health Ventures of Arlington, Inc., its sole general partner GREENSPRING MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Healthcare, Inc., a Pennsylvania corporation, its sole general partner HALLMARK HEALTHCARE LIMITED PARTNERSHIP, a Maryland limited partnership By: Pharmacy Equities, Inc., a Pennsylvania corporation, its sole general partner HAMMONDS LANE MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Healthcare, Inc., a Pennsylvania corporation, one of its general partners HEALTHCARE RESOURCES CORP., a Pennsylvania corporation KNOLLWOOD MANOR, INC., a Pennsylvania corporation MERIDIAN/CONSTELLATION LIMITED PARTNERSHIP By: Meridian Healthcare, Inc., general partner Mellon Bank, N.A. July 16, 1996 Page 6 MERIDIAN EDGEWOOD LIMITED PARTNERSHIP By: Meridian Healthcare, Inc., a general partner MERIDIAN HEALTH, INC., a Pennsylvania corporation MERIDIAN HEALTHCARE, INC., a Pennsylvania corporation MERIDIAN PERRING LIMITED PARTNERSHIP By: Meridian Healthcare, Inc., a general partner MERIDIAN VALLEY LIMITED PARTNERSHIP By: Meridian Healthcare, Inc., a general partner MERIDIAN VALLEY VIEW LIMITED PARTNERSHIP By: Meridian Healthcare, Inc., a general partner MILLVILLE MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Healthcare, Inc., a Pennsylvania corporation, its sole general partner PHARMACY EQUITIES, INC., a Pennsylvania corporation PHILADELPHIA AVENUE ASSOCIATES, a Pennsylvania limited partnership By: Philadelphia Avenue Corp., its sole general partner PHILADELPHIA AVENUE CORPORATION, a Pennsylvania corporation Mellon Bank, N.A. July 16, 1996 Page 7 RIVER STREET ASSOCIATES, a Pennsylvania limited partnership By: Genesis Health Ventures of Wilkes-Barre, Inc., its sole general partner SEMINOLE MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Health, Inc., a Pennsylvania corporation, its sole general partner GENESIS ELDERCARE STAFFING SERVICES INC. a Pennsylvania corporation STATE STREET ASSOCIATES, L.P., a Pennsylvania limited partnership By: Genesis Health Ventures, Inc., its sole general partner STATE STREET ASSOCIATES, INC., a Pennsylvania corporation SUBURBAN MEDICAL SERVICES, INC. a Pennsylvania corporation GENESIS ELDERCARE REHABILITATION SERVICES, INC., a Pennsylvania corporation THERAPY CARE INC., a Pennsylvania corporation THERAPY CARE SYSTEMS, L.P. a Pennsylvania limited partnership By: Team Rehabilitation, Inc., its sole general partner THE TIDEWATER HEALTHCARE SHARED SERVICES GROUP, INC., a Pennsylvania corporation Mellon Bank, N.A. July 16, 1996 Page 8 VOLUSIA MERIDIAN LIMITED PARTNERSHIP, a Maryland limited partnership By: Meridian Health, Inc., a Pennsylvania corporation, its sole general partner WYNCOTE HEALTHCARE CORP., a Pennsylvania corporation ASCO HEALTHCARE, INC., a Maryland corporation BRINTON MANOR, INC., a Delaware corporation CONCORD HEALTHCARE CORPORATION, a Delaware corporation CRYSTAL CITY NURSING CENTER, INC., a Maryland corporation EASTERN MEDICAL SUPPLIES, INC., a Maryland corporation EASTERN REHAB SERVICES, INC., a Maryland corporation GENESIS HEALTH SERVICES CORPORATION, a Delaware corporation GENESIS HEALTHCARE CENTERS HOLDINGS, INC., a Delaware corporation GENESIS HOLDINGS, INC., a Delaware corporation GENESIS PROPERTIES OF DELAWARE CORPORATION, a Delaware corporation Mellon Bank, N.A. July 16, 1996 Page 9 GENESIS PROPERTIES OF DELAWARE LTD PARTNERSHIP, L.P., a Delaware limited partnership By: Genesis Properties of Delaware Corporation, a general partner GOVERNOR'S HOUSE NURSING HOME, INC., a Delaware corporation HEALTH CONCEPTS AND SERVICES, INC., a Maryland corporation HILLTOP HEALTH CARE CENTER, INC., a Delaware corporation KEYSTONE NURSING HOME, INC., a Delaware corporation LINCOLN NURSING HOME, INC., a Delaware corporation McKERLEY HEALTH CARE CENTERS, INC., a New Hampshire corporation McKERLEY HEALTH CARE CENTER- CONCORD, INC., a New Hampshire corporation McKERLEY HEALTH CARE CENTER-CONCORD LIMITED PARTNERSHIP, a New Hampshire limited partnership By: McKerley Health Care Center- Concord, Inc., a New Hampshire corporation, its general partner McKERLEY HEALTH FACILITIES, a New Hampshire general partnership By: Meridian Health, Inc., a Pennsylvania corporation, and Meridian Healthcare, Inc., a Pennsylvania corporation, its general partners Mellon Bank, N.A. July 16, 1996 Page 1 WAYSIDE NURSING HOME, INC., a Delaware corporation PROFESSIONAL PHARMACY SERVICES, INC., a Maryland Corporation MEDICAL SERVICES GROUP, INC., a Maryland Corporation CARECARD, INC., a Maryland Corporation TRANSPORT SERVICES, INC., a Maryland Corporation NEIGHBORCARE PHARMACIES, INC., a Maryland Corporation By: ----------------------------------- On behalf of each of the foregoing as Senior Vice President and Chief Financial Officer