EXHIBIT 4.5 AMENDMENT NO.2 TO AMENDED AND RESTATED CREDIT AGREEMENT AMENDMENT dated as of October 24, 1997 to the Amended and Restated Credit Agreement dated as of May 30, 1997, as amended as of June 24, 1997 (the "CREDIT AGREEMENT") among VENCOR, INC. ("VENCOR"), the BANKS, SWINGLINE BANK, LC ISSUING BANKS, MANAGING AGENTS and CO-AGENTS party thereto, MORGAN GUARANTY TRUST COMPANY OF NEW YORK, as Documentation Agent (the "DOCUMENTATION AGENT") and Collateral Agent, and NATIONSBANK, N.A., as Administrative Agent. W I T N E S S E T H : WHEREAS, the parties hereto desire to amend the Credit Agreement to increase by $50,000,000 the amount of Restricted Payments that Vencor is permitted to make; NOW, THEREFORE, the parties hereto agree as follows: Section 1. DEFINED TERMS; REFERENCES. Unless otherwise specifically defined herein, each term used herein which is defined in the Credit Agreement has the meaning assigned to such term in the Credit Agreement. Each reference to "hereof", "hereunder", "herein" and "hereby" and each other similar reference and each reference to "this Agreement" and each other similar reference contained in the Credit Agreement shall, after this Amendment becomes effective, refer to the Credit Agreement as amended hereby. Section 2. AMENDMENT OF RESTRICTED PAYMENTS COVENANT. Section 5.11 of the Credit Agreement is amended to read as follows: Section 5.11. RESTRICTED PAYMENTS. Unless Vencor has an Investment Grade Rating, Vencor will not, and will not permit any Subsidiary to, declare or make any Restricted Payment on or after the Initial Closing Date, except: (a) any distribution of shares of Ventech Systems, Inc. by Vencor to its own shareholders; (b) dividends on Equity Securities of Vencor declared and paid during the period from January 1, 1997 to March 31, 1998, inclusive, in an aggregate amount not exceeding $10,000,000; (c) Restricted Payments (other than dividends on Equity Securities of Vencor) made during the period from January 1, 1997 to March 31, 1998, inclusive, in an aggregate amount not exceeding $100,000,000; and (d) any other Restricted Payment declared and made after March 31, 1998 if, immediately after such Restricted Payment is declared or made, the aggregate amount of all Restricted Payments declared or made after March 31, 1998 does not exceed the sum of (i) the amount set forth below opposite the period in which the date of such declaration or payment occurs plus (ii) the amount by which $100,000,000 exceeds the aggregate amount of all Restricted Payments made pursuant to clause (c) above: PERIOD AMOUNT April 1, 1998 through March 31, 1999 $10,000,000 April 1, 1999 through March 31, 2000 $20,000,000 April 1, 2000 through March 31, 2001 $30,000,000 April 1, 2001 through March 31, 2002 $40,000,000 provided that in no event shall Vencor or any Subsidiary declare or make any Restricted Payment pursuant to this Section if, immediately before or after giving effect thereto, any Default shall have occurred and be continuing. SECTION 3. REPRESENTATIONS OF VENCOR. Vencor represents and warrants that (i) the representations and warranties of Vencor set forth in Article 4 of the Credit Agreement will be true on and as of the Amendment Effective Date and (ii) no Default will have occurred and be continuing on such date. SECTION 4. GOVERNING LAW. This Amendment shall be governed by and construed in accordance with the laws of the State of New York. SECTION 5. COUNTERPARTS. This Amendment may be signed in any number of counterparts, each of which shall be an original, with the same effect as if the signatures thereto and hereto were upon the same instrument. SECTION 6. EFFECTIVENESS. This Amendment shall become effective on the date (the "AMENDMENT EFFECTIVE DATE") when the Documentation Agent shall have received from each of Vencor and the Required Banks a counterpart hereof signed by such party or facsimile or other written confirmation (in form satisfactory to the Documentation Agent) that such party has signed a counterpart hereto. 2 IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed as of the date first above written. VENCOR, INC. By: /s/ Steven L. Monaghan ------------------------------------ Title: Vice President MORGAN GUARANTY TRUST COMPANY OF NEW YORK By: /s/ Diana H. Imhof ------------------------------------ Title: Vice President NATIONSBANK, N.A., By: /s/ Ashley M. Crabtree ------------------------------------ Title: Senior Vice President BANK OF AMERICA NT & SA, By: /s/ Edward S. Han ------------------------------------ Title: Vice President THE BANK OF NEW YORK By: /s/ Edward J. Dougherty, III ------------------------------------ Title: Vice President 3 THE CHASE MANHATTAN BANK By: /s/ Dawn Lee Lum ----------------------------- Title: Vice President PNC BANK, KENTUCKY, INC, By: /s/ Benjamin A. Willingham ----------------------------- Title: Vice President TORONTO DOMINION (TEXAS), INC. By: /s/ Darlene Riedel ------------------------------ Title: Vice President THE BANK OF NOVA SCOTIA By: /s/ W. J. Brown ------------------------------- Title: Vice President CREDIT LYONNAIS NEW YORK BRANCH By: /s/ Farboud Tavangar ------------------------------- Title: First Vice President 4 CREDIT SUISSE FIRST BOSTON By: /s/ Christian Bourqui -------------------------------- Title: Associate By: /s/ Thomas G. Muoio -------------------------------- Title: Vice President DEUTSCHE BANK AG NEW YORK AND/OR CAYMAN ISLAND BRANCHES By: /s/ Iain Stewart ------------------------------- Title: Vice President By: /s/ Susan L. Peterson ------------------------------- Title: Vice President FLEET NATIONAL BANK By: /s/ Ginger Stolzenthaler ------------------------------- Title: Senior Vice President THE INDUSTRIAL BANK OF JAPAN TRUST COMPANY By: /s/ Takuya Honjo ------------------------------- Title: Senior Vice President WACHOVIA BANK, N.A., By: /s/ John B. Tibe ------------------------------- Title: Assistant Vice President 5 ABN AMRO BANK N.V. By: /s/ Steven L. Hipsman ------------------------------------ Title: Vice President By: /s/ Linda K. Davis ------------------------------------ Title: Vice President BANK OF MONTREAL By: /s/ Peter W. Steelman ------------------------------------ Title: Director BANK ONE, KENTUCKY, NA By: /s/ Dennis P. Heishman ------------------------------------ Title: Senior Vice President COMERICA BANK By: /s/ Colleen M. Murphy ------------------------------------ Title: Assistant Vice President 6 CORESTATES BANK, N.A. By: /s/ Elizabeth D. Morris ----------------------------------- Title: Vice President THE FUJI BANK, LIMITED By: /s/ Tetsuo Kamatsu ----------------------------------- Title: Joint General Manager LTCB TRUST COMPANY By: /s/ Hiroshi Kitada ----------------------------------- Title: Senior Vice President NATIONAL CITY BANK OF KENTUCKY, By: /s/ Deroy Scott ----------------------------------- Title: Vice President NBD BANK, N.A. By: /s/ Christine M. Morrison ----------------------------------- Title: Vice President UNION BANK OF CALIFORNIA, N.A. By: /s/ Patricia A. Samson ----------------------------------- Title: Assistant Vice President 7 AMSOUTH BANK OF ALABAMA By: /s/ Keith S. Law ----------------------------------- Title: Vice President BANQUE PARIBAS By:___________________________________ Title: By:___________________________________ Title: FIRST UNION NATIONAL BANK OF NORTH CAROLINA By: /s/ Ann M. Dodd ----------------------------------- Title: Senior Vice President U.S. BANK OF WASHINGTON, N.A. By: /s/ Arnold J. Conrad ----------------------------------- Title: Vice President CIBC, INC. By: /s/ Judith A. Kirshner ----------------------------------- Title: Executive Director 8 KREDIETBANK, N.V. By: /s/ Robert Snauffer ------------------------------------ Title: Vice President By: /s/ Tod R. Angus ------------------------------------ Title: Vice President THE MITSUBISHI TRUST AND BANKING CORPORATION By: /s/ Nobuo Tominaga ------------------------------------ Title: Chief Manager THE SAKURA BANK LIMITED NEW YORK BRANCH By:____________________________________ Title: SOCIETE GENERALE, CHICAGO BRANCH By:____________________________________ Title: FIRST AMERICAN NATIONAL BANK By: /s/ Kent D. Wood ------------------------------------ Title: Assistant Vice President 9 BANK OF LOUISVILLE BY: /s/ Roy L. Johnson, Jr. ------------------------------------- Title: Senior Vice President THE DAI-ICHI KANGYO BANK, LTD. CHICAGO BRANCH By: /s/ Takeo Teramura ------------------------------------- Title: Vice President FIFTH THIRD BANK By: /s/ Judy R. Semaria ------------------------------------- Title: Assistant Vice President 10