NATIONAL SURGERY CENTERS INC \DE\
10-K, 1998-03-31
OFFICES & CLINICS OF DOCTORS OF MEDICINE
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                                 UNITED STATES
                      SECURITIES AND EXCHANGE COMMISSION
                            WASHINGTON, D.C. 20549
                              -----------------                           
                                   FORM 10-K

[X]  ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE
     ACT OF 1934
 
     For the Fiscal Year Ended December 31, 1997
                                      OR
[ ] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES
    EXCHANGE ACT OF 1934

                        Commission File Number 0-27162
                           -----------------------  

                        NATIONAL SURGERY CENTERS, INC.
            (Exact name of Registrant as specified in its charter)

<S>                                      <C>                                 <C> 
              Delaware                                                          36-3549627
  (State or other jurisdiction of                                            (I.R.S. Employer
   incorporation or organization)                                          Identification Number)

                      30 SOUTH WACKER DRIVE, SUITE 2302, CHICAGO, ILLINOIS  60606
                              (Address of Principal Executive Offices)    (Zip Code)

                   Registrant's telephone number, including area code:  (312) 655-1400
                                        -----------------------
                    Securities registered pursuant to Section 12(b) of the Act:  None

                    Securities registered pursuant to Section 12(g) of the Act:
                                          Title of Each Class
                                          -------------------
                               Common Stock, par value $.01 per share
                          Non-Voting Common Stock, par value $.01 per share
                                        -----------------------
</TABLE> 

     Indicate by check mark whether the registrant: (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the
registrant was required to file such reports), and (2) has been subject to such
filing requirements for the past 90 days. Yes X  No
                                             ---   ---
     Indicate by check mark if disclosure of delinquent filers pursuant to Item
405 of Regulation S-K is not contained herein, and will not be contained, to the
best of registrant's knowledge, in definitive proxy or information statements
incorporated by reference in Part III of this Form 10-K or any amendment to this
Form 10-K.  [_]

     The aggregate market value of the voting stock of the registrant held by
stockholders who were not affiliates (as defined by regulations of the
Securities and Exchange Commission) of the registrant was approximately
$446,779,338 at March 20, 1998 (based on the closing sale price on the Nasdaq
National Market on March 20, 1998, as reported by The Wall Street Journal
(Midwest Edition)). At March 20, 1998, the registrant had issued and outstanding
an aggregate of 18,567,453 shares of common stock.

                      Documents Incorporated by Reference

     Those sections or portions of the registrant's Annual Report to
Shareholders for the fiscal year ended 1997, described in Part II hereof, are
incorporated by reference in this report.

     Those sections or portions of the registrant's proxy statement for the
Annual Meeting of Stockholders to be held on May 21, 1998, described in Part III
hereof, are incorporated by reference in this report.

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                                    PART I
ITEM 1.  BUSINESS

     The Company owns and operates freestanding ambulatory surgery centers that
provide the medical and administrative support necessary for physicians to
perform non-emergency surgical procedures. The Company also pursues
opportunities to develop new ambulatory surgery facilities with hospitals and
physician groups. As of December 31, 1997, the Company operated a network of 38
surgery centers in 14 states and anticipates expanding its network through
acquisition and development of surgery centers. The Company provides alternate-
site settings for high-quality surgical care that is more cost effective than
hospital-based surgical care and that is increasingly preferred by physicians,
payors and patients.

     The Company believes that many physicians prefer the efficiencies of
freestanding ambulatory surgery centers because they enhance physicians'
productivity by providing them with greater scheduling flexibility, more
consistent nurse staffing and faster turnaround time between cases, allowing
physicians to perform more surgeries in a defined period of time. In addition,
new technology and advances in anesthesia and the addition of overnight recovery
have significantly expanded the number and types of surgical procedures that are
being performed in ambulatory surgery centers.

     The Company's objective is to establish a nationwide organization of
freestanding ambulatory surgery centers in secondary and other selected markets
by acquiring established centers and developing new centers. The Company seeks
to provide a broad range of high-quality surgical services and to collaborate
with other participants in local health care delivery systems. The key
components of the Company's strategy are as follows:

 .    Acquire established ambulatory surgery centers that are seeking affiliation
     with an experienced operator having access to capital and other resources;

 .    Focus on secondary and other selected markets where the Company can
     establish a significant local presence or play an important role in the
     development of local integrated delivery systems;

 .    Develop new ambulatory surgery centers in markets where attractive
     acquisitions are not available or where the opportunity exists to increase
     the Company's presence in its existing markets;

 .    Develop joint ventures with hospitals and other providers to increase
     patient flow through joint marketing, access to managed care contracts and
     participation in a broader network of health care providers; and

 .    Expand the range of services offered to physicians and payors by offering
     state-of-the-art technology, administrative conveniences, flexible pricing
     alternatives and cost-effective care.

                                       2
<PAGE>
 
The Industry

     The Company believes that overall health care expenditures will continue to
increase with the aging of the population and the extension of health care
coverage to previously uninsured groups. In recent years, government programs,
private insurance companies, managed care organizations and self-insured
employers have implemented various cost-containment measures to limit the growth
of health care expenditures. See "Government Health Care Regulation - Medicare
Payment Rates". These cost-containment measures, together with technological
advances, have resulted in a significant shift in the delivery of health care
services away from traditional inpatient hospitals to more cost-effective
alternate sites, including ambulatory surgery centers.

     Industry sources estimate that in 1997 outpatient surgical procedures
represented approximately 69% of all surgical procedures performed in the United
States, compared with 44% in 1986, and that surgical procedures performed in
freestanding ambulatory surgery centers comprised 22% of total outpatient
surgery, compared with 11% in 1986. As of May 1997, there were approximately
2,425 surgery centers in the U.S., of which approximately 171 were owned by
hospitals and approximately 607 were owned by corporate chains. The remaining
approximately 1,647 centers were independently owned, primarily by physicians.

     Managed care organizations with significant numbers of covered lives are
seeking to direct large numbers of patients to high-quality, low-cost providers
and provider groups. In order to compete for the growing number of managed care
patients, hospitals, physicians and other providers, including alternate site
outpatient providers, are forming integrated delivery systems or provider joint
ventures. The Company believes that there will be opportunities for well-
positioned ambulatory surgery centers to participate in the development of these
delivery systems and joint ventures.

     The Company believes that the following factors contribute to the growth of
ambulatory surgery:

     Cost-Effective Alternative. Ambulatory surgery is generally less expensive
than hospital inpatient surgery. In addition, the Company believes that surgery
performed at a freestanding ambulatory surgery center is generally less
expensive than hospital-based ambulatory surgery for a number of reasons,
including lower facility development costs, more efficient staffing and space
utilization and a specialized operating environment focused on cost containment.

     Managed Care. The Company believes managed care enrollment will continue to
increase and that managed care organizations will seek high-quality, cost-
effective health care services for their enrollees. As a result, the Company
believes that interest in ambulatory surgery will grow as capitation and other
reimbursement arrangements shift the risk for health care costs from traditional
payors to providers such as hospitals and physician groups. "Capitation" is a
reimbursement arrangement in which a health care provider receives a fixed
payment per member per month for the provision of defined health care services
to members of a managed care plan.

                                       3
<PAGE>
 
     Physician and Patient Preference. The Company believes that many physicians
prefer freestanding ambulatory surgery centers. The Company believes that such
centers enhance physicians' productivity by providing them with greater
scheduling flexibility, more consistent nurse staffing and faster turnaround
time between cases, allowing physicians to perform more surgeries in a defined
period of time. In contrast, hospitals generally serve a broader group of
physicians, including those involved with emergency procedures that must be
given priority over scheduled non-emergency procedures, resulting in postponed
or delayed surgeries. Additionally, many physicians choose to perform surgery in
an ambulatory surgery center because their patients prefer the simplified
admissions and discharge procedures and the less institutional atmosphere.

     New Technology. New technology and advances in anesthesia, which have been
increasingly accepted by physicians, have significantly expanded the types of
surgical procedures that are being performed in ambulatory surgery centers.
Lasers, enhanced endoscopic techniques and fiber optics have reduced the trauma
and recovery time of many surgical procedures. Improved anesthesia has shortened
recovery time by minimizing post-operative side effects such as nausea and
drowsiness, thereby avoiding, in some cases, overnight hospitalization.

     Extended Recovery. In recent years, some states have permitted extended
recovery in ambulatory surgery centers. While states typically restrict the time
period a patient may remain in an ambulatory surgery center after surgery, a
number of states, including eight states in which the Company operates, allow
extended recovery stays of up to 24 hours. Longer recovery stays are being
considered in some states. Extended recovery significantly increases the types
of procedures that can be performed in ambulatory surgery centers.

Growth Strategy

     The Company's objective is to establish a nationwide network of ambulatory
surgery centers in secondary and other selected markets by acquiring established
centers and developing new centers. The Company seeks to provide a broad range
of high-quality surgical services and to collaborate with other participants in
the health care delivery system. The key components of the Company's strategy
are as follows:

     Focus on Secondary and Other Selected Markets. The Company plans to focus
on those markets where, either directly or through affiliation with physicians,
payors or hospitals, it can establish a significant local presence or play an
important role in the development of local integrated delivery systems. The
Company generally views secondary markets as those metropolitan areas with fewer
than 250,000 residents and one or two hospitals. The Company believes that in
secondary markets its centers can more easily achieve the scale that allows them
to become a significant local health care provider and a more attractive partner
in such delivery systems.

     Acquire Established Ambulatory Surgery Centers. The Company plans to
continue acquiring established ambulatory surgery centers. The ambulatory
surgery center industry is highly fragmented and is consolidating due to the
increasing complexity of the regulatory and business aspects of health care, the
growing influence of managed care, the rising cost of technology and the need
for capital.

                                       4
<PAGE>
 
In addition, physician operators of surgery centers are experiencing increasing
practice demands. The Company believes that a significant opportunity exists to
acquire ambulatory surgery centers that are seeking affiliation with experienced
operators having access to capital and other resources. The Company's goal is to
acquire six to eight additional ambulatory surgery centers by the end of 1998.
See "Acquisition and Development Programs."

     Develop New Ambulatory Surgery Centers. The Company plans to develop new
ambulatory surgery centers in selected markets. The Company pursues new center
development in markets where attractive acquisitions are not available or where
the opportunity exists to increase the Company's presence in its existing
markets. In the future, the Company's new center development efforts will
generally be undertaken in partnership with physicians, hospitals and other
local health care participants, including, where the opportunity presents
itself, acquisitions of centers that are currently under development. The
Company believes that such partnerships or acquisitions minimize the time
required to become an established provider. The Company's goal is to start
development of two to four additional ambulatory surgery centers by the end of
1998.

     Develop Joint Ventures with Hospitals, Physicians and Other Providers. The
Company has established joint ventures, limited or general partnerships or
limited liability companies in 34 of its network of 38 centers. The Company
believes that such affiliations increase patient flow through joint marketing,
access to managed care contracts and participation in a broader network of
health care providers. As part of its joint venture strategy, the Company
intends to manage the surgery centers in which it and other health care
providers have an equity interest. See "Acquisition and Development Programs."

     Expand Range of Services. The Company plans to continue to increase the
number and types of surgeries performed at its centers. The Company is committed
to adding programs and services for physicians and payors by providing state-of-
the-art technology, administrative conveniences, flexible pricing alternatives
and cost-effective care. The Company is also committed to offering extended
recovery services wherever possible, enabling its centers to accommodate a wider
range of higher-acuity procedures.

Acquisition and Development Programs

Acquisition Program

     The Company typically targets for acquisition ambulatory surgery centers
that meet certain criteria, including market demographics, size, profitability,
specialty mix, prominence within the local medical community, access to payors
and opportunities for growth. The Company principally targets physician-owned
ambulatory surgery centers. The Company believes that due to the increasing
complexity of the regulatory and business aspects of health care, physicians are
increasingly seeking affiliation with experienced ambulatory surgery center
operators having access to capital and other resources. Approximately 49% of the
approximately 1,647 physician-owned ambulatory surgery centers in the United
States are smaller centers performing fewer than 1,000 cases per year and are
often single specialty centers. The Company believes that, although some of
these smaller centers represent acquisition opportunities, the remaining
approximately 854 centers

                                       5
<PAGE>
 
represent the more likely universe of acquisition candidates and that in excess
of 200 of these centers meet the Company's acquisition criteria. In addition to
the acquisitions of multi-specialty centers, the Company may take advantage of
other opportunities that present themselves. Opportunities, such as the
acquisition of single specialty centers or ambulatory centers operated by multi-
market chains, may be pursued if those opportunities fit into the Company's
growth strategy and compliment its existing base of centers. During 1997, the
Company acquired six centers each in separate transactions. The Company's goal
is to effect six to eight acquisitions by the end of 1998 and the Company is
currently in various levels of discussion with additional centers regarding
possible acquisition. There can be no assurance that the Company will be able to
acquire additional surgery centers or, if acquired, that they can be operated
profitably.

     Acquisition pricing has varied widely in recent years. In the late 1980's
and early 1990's, large amounts of capital were being directed at many new
ventures in the ambulatory surgery center industry. The Company believed that
establishing scale and credibility were primary considerations to ensure its
future access to capital. As a result, from mid-1991 through 1992, the Company
acquired ten centers. However, during this period, the purchase prices for
surgery centers escalated due to the large amounts of capital available to
acquirers, the increased number of new acquirers in the market and the
relatively low cost of capital to the publicly traded acquirers. The Company
believes that during 1993, because of problems encountered by the non-surgery
center operations of certain of its larger competitors and the uncertainty
surrounding the changes in the health care industry, the capital available to
acquirers of surgery centers began to shrink. However, sellers' expectations
remained high. In light of this, the Company's management chose to (i) impose a
stricter pricing discipline upon its proposed acquisitions and (ii) review
carefully the position in existing markets of each center that the Company
proposed to acquire to evaluate the likelihood of each center's continued growth
and viability, taking into account the likely effects of the various federal and
state health care reform efforts. Although the Company continued to make
acquisition proposals during this period, the Company consummated only two
acquisitions in 1993 and 1994.

     The Company believes that more recently, the pricing environment for
acquisitions of ambulatory surgical centers has improved and it appears that
significant government reform of the U.S. health care delivery system is
unlikely. The Company believes that the current pricing environment for
acquisitions is attractive and that acquisitions prices have declined for
several reasons, including a reduction in potential sellers' expectations and a
reduction in the potential universe of buyers as many of the early acquirers of
surgery centers have either been unable to raise additional capital or have been
acquired themselves.

Development Program

     The Company develops new centers in markets where attractive acquisitions
are not available or where the Company seeks to increase its presence in markets
in which it already operates. In its development efforts, the Company targets
markets that have attractive size and demographic characteristics and a high
level of interest on the part of local physicians, hospitals or payors.
Historically, the Company's development strategy was based on a structure
involving majority Company ownership through joint venture arrangements with
local physicians. In the future, the Company's development strategy may also
included joint venture arrangements with local hospitals,

                                       6
<PAGE>
 
physicians and other providers. In some cases, this also includes instances of
minority ownership by the Company. In light of the Company's experience and the
slower than anticipated startup of the development centers opened by the Company
prior to 1995, the Company believes that this broadened development strategy has
provided greater access to patients and minimized the time required to become an
established provider.

Operation of Surgery Centers

     The Company operates a network of 38 surgery centers in fourteen states.
The Company's surgery center network has a total of 109 operating rooms and 52
treatment rooms. The Company's surgery centers are typically owned through
limited or general partnerships in which a wholly owned subsidiary of the
Company owns a general partnership interest and is the managing general partner
of the surgery center. Local physicians and the subsidiary generally own the
limited partnership interests and, in five instances, hospitals also own limited
partnership interests. Recently, the Company has also owned surgery centers
through limited liability companies ("LLC") in which a wholly owned subsidiary
of the Company owns a portion of the LLC and is its managing member.

     The Company's typical multi-specialty surgery center is a freestanding
facility with three to five fully equipped operating rooms, one or two treatment
rooms and ancillary areas for reception, pre-operative preparation, recovery and
administration. The Company's typical endoscopy center, which performs primarily
gastroenterological procedures, has two treatment rooms and ancillary areas for
reception, pre-operation preparation, recovery and administration and may also
have an operation room. The Company's surgery centers are generally located in
close proximity to physicians' offices. Each of the Company's surgery centers is
available for use only by licensed physicians who have been approved by the
center's medical credentialling committee.

                                       7
<PAGE>
 
     The following table sets forth information regarding each of the centers
operated by the Company as of December 31, 1997:

<TABLE>
<CAPTION>
 
                                Date                         Number of      Number of      Extended
                             operations      Percentage      operating      treatment      recovery
        Location            began by NSC     ownership(1)      rooms         rooms         service
- ---------------------      --------------   --------------   ---------     ----------      --------
<S>                       <C>              <C>              <C>           <C>             <C>
Bremerton, WA                October 1991           91.0         3             1              X
Brownsville, TX             November 1991           59.0         4             1
Fayetteville, NC            November 1991           50.2         9            --              X
Norman, OK                  November 1991           50.5         4             1              X
Greensboro, NC                  June 1992          100.0        11             3              X
Seattle, WA                     June 1992           52.5         7            --              X
Provo, UT                    October 1992          100.0         5            --              X   
Elizabethtown, KY           November 1992           78.5         3             1              X
Bakersfield, CA              January 1993           87.0         2             1
Somerset, KY                November 1993           88.0         2             1              X
Las Vegas, NV                 August 1994           69.2         4             3              X
Santa Monica, CA              August 1994           88.9         5             3              X
Las Vegas, NV               February 1995           10.0         2             1
Oxnard, CA                    August 1995           88.2         4             1              X
Greensboro, NC               October 1995           80.3         2            --
Chula Vista, CA             February 1996           51.0        --             2
Ft. Worth, TX               February 1996           51.0        --             2
Long Beach, CA              February 1996           50.0        --             3
Newport Beach, CA           February 1996           70.0        --             2
San Diego, CA               February 1996           51.3        --             3
Thousand Oaks, CA           February 1996           51.0        --             2
Kent, OH                       April 1996           83.5         2             1
Atlanta, GA                      May 1996           67.0         3            --
Billings, MT                 January 1996          100.0         4            --
Cincinnati, OH                   May 1996           58.0         1             1
Houston, TX                      May 1996           64.7         3             1              X 
Miami, FL                        May 1996           51.0         4             3
Sarasota, FL                     May 1996           55.5         1             2
Humble, TX                 September 1996           65.0         4             2              X
Auburn, CA                  November 1996           88.2         2             2
San Mateo, CA               December 1996           38.5        --             2
Port St. Lucie, FL           January 1997           80.0         2             1
Bakersfield, CA                 June 1997           80.0         2             -
South Oklahoma City, OK         June 1997           60.0         4             2              X
Edmond, OK                    August 1997           60.0         4             1              X  
Hartford, CT                  August 1997          100.0         2             1
Midwest City, OK           November, 1997           90.0         2             1
Manahawkin, NJ              December 1997           50.0         2             1
</TABLE>

(1)  Includes general partnership, limited partnership or limited liability
     company units

     The Company provides services to a wide range of specialties including:
ophthalmology, orthopedic surgery, otorhinolaryngology (ear, nose and throat),
gynecology, general surgery, gastroenterology, anesthesiology, neurosurgery,
oral surgery, plastic surgery, podiatry and urology. Medicare currently approves
over 2,400 types of surgical procedures that may be performed in

                                       8
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ambulatory surgery centers, up from 1,500 types in 1992. Common procedures
performed in the Company's surgery centers include knee and shoulder
arthroscopy, laparoscopy, hernia repair, tubal ligations and removal of
cataracts.

     Fifteen of the Company's multi-specialty surgery centers currently provide
for extended recovery stays. The Company intends to offer extended recovery
services at its multi-specialty facilities if permitted by state law. The
Company's ability to develop such recovery care facilities is dependent on state
regulatory environments. Extended recovery capability generally permits higher
acuity and higher revenue procedures to be performed, including the following:

         Specialty               Higher Acuity Procedures
         ---------               ------------------------
         Orthopedic surgery      Anterior cruciate ligament repair, shoulder
                                 surgery, total knee replacements, micro
                                 discectomies and laminectomies (back surgery)

         Gynecology              Laparascopically assisted vaginal
                                 hysterectomies
 
         General surgery         Laparascopically assisted hernia repair and
                                 laparascopic cholecystectomy

     After a physician determines that surgery is necessary and can be
appropriately performed in an ambulatory surgery center, the physician and
patient schedule the surgery and, if appropriate, request extended recovery
services. The surgery center's staff subsequently contacts the patient by
telephone to obtain payor and other patient information and to ensure that the
patient has arranged to be transported home following the recovery period.
Patients generally arrive at the center approximately one hour before scheduled
surgery to allow time for admission and a review of their medical history. A
local or general anesthetic is administered and the surgery is performed. After
surgery, patients generally spend three hours in the recovery area before being
discharged by the center's anesthesiologist or being transferred to the surgery
center's extended recovery area.

     The Company's multi-specialty surgery centers generally employ a staff of
between 15 and 30 and its endoscopy centers generally employ a staff of between
five and fifteen, depending on the size of the facility and the volume of cases.
The staff includes a center administrator, a business manager, a clinical
director, registered nurses, operating room technicians and clerical workers.
The center administrator is responsible for general oversight of the center's
operations, including liaison with physicians and coordination of marketing
efforts and reports to a regional manager or corporate vice president. The
business manager is responsible for the center's financial records and patient
billing and collections. The clinical director is responsible for providing
leadership and coordination for the professional and support staff and ensuring
efficient scheduling and staffing for the physicians.

     The Company provides each of its surgery centers with a full range of
financial, marketing and operating services as well as data processing support
both for internal operational control and for the orderly conduct of business
office functions. This includes a financial reporting and accounting package, a
billing and accounts receivable system, inventory and accounts payable

                                       9
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systems and a patient record-keeping system. Corporate management also supports
local marketing activities, including the analysis of market conditions and
patient utilization patterns and the development of prices and services which
are competitive with those offered by other local health care providers. The
Company, where appropriate, executes master agreements for purchasing equipment
and supplies enabling each center to realize the economies of scale available
through volume purchases. In addition, the Company provides support for Medicare
certification, local regulatory licensure and accreditation efforts.

Quality Assurance

     The Company's surgery centers implement quality assurance procedures to
ensure a high level of care provided at the surgery centers. Each center has a
medical advisory committee comprised of three to ten physicians that reviews the
professional credentials of physicians applying for medical staff privileges at
the center. In addition, each center has a medical director who supervises and
is responsible for the quality of medical care provided at the center. The
medical director, who is generally a practicing surgeon or anesthesiologist,
reports directly to the center's medical advisory committee. The center
administrator or clinical director, in conjunction with the medical director,
reviews and monitors surgical outcomes along with procedures performed and the
quality of the logistical, medical and technological support provided to the
physician. In addition, the patient is contacted by a center nurse on the day
following discharge to check on the patient's condition and to survey the
patient as to the quality of care provided. The Company believes that this
direct, systematic feedback from both physician and patient is an effective way
to monitor the level of care at each center. All of the Company's centers are
Medicare certified, which certification is required to obtain Medicare
reimbursement. Additionally, the Company's surgery centers seek approval by
either the Joint Commission for Accreditation of Health Care Organizations
("JCAHO") or the Accrediting Association of Ambulatory Health Care ("AAAHC"),
which are industry-based, self-regulatory organizations which grant
accreditation of surgery centers based on established criteria as an additional
indication of a center's quality. The Company is seeking accreditation in all of
its centers that have not been approved by either the JCAHO or the AAAHC.

Marketing

     Marketing activities directed at physicians and other health care providers
are coordinated locally by the individual center and are supplemented by
corporate management. These activities generally emphasize advantages offered by
the Company's surgery centers, such as the proximity of surgery centers to
physicians' offices, the ability to schedule consecutive cases without
preemption by inpatient or emergency procedures, the rapid turnaround time
between cases, the high technical capability and low turnover and consistency of
nurse staffing, state-of-the-art surgical equipment and the simplified
administrative procedures. A target list of physicians is developed at each
local surgery center. Although the center administrator is the primary point of
contact, physicians who utilize the Company's surgery centers are important
sources of recommendation to other physicians regarding the benefits of using
the Company's surgery centers. The Company periodically reviews each center's
physician marketing list and its progress in contacting and successfully
attracting local physicians.

                                      10
<PAGE>
 
          The Company also markets its surgery centers directly to payors,
including HMOs, PPOs, other managed care organizations, employers and other
payor-groups. Payor-group marketing activities conducted by the Company's
management and center administrators emphasize the high quality of care, cost
advantages and convenience of the Company's surgery centers and are focused on
making each center an approved provider under local managed care plans. In
addition, the Company is pursuing relationships with physician groups in its
markets in order to promote jointly its surgery centers and the physician groups
to payors. In some instances, this may involve invoicing the centers' charges,
on a case rate basis, with the surgeon, anesthesiologist, lab, x-ray and
pathology charges combined to provide the payor with one all-inclusive bill to
cover an episode of care.

Competition

          In each of its markets, the Company competes principally with
hospitals and other operators of freestanding surgery centers to attract
physicians and patients to its ambulatory surgery centers and for inclusion in
managed care programs. In developing new surgery centers and acquiring existing
surgery centers the Company competes with other surgery center companies and
local hospitals. In competing for physicians and patients, important competitive
factors are convenience, cost, quality of service, physician loyalty and
reputation. Hospitals have many competitive advantages in attracting physicians
and patients, including established standing in the community, historical
physician loyalty and convenience for physicians making rounds or performing
inpatient surgery in the hospital. However, the Company believes that many
physicians prefer to utilize and affiliate with freestanding ambulatory surgery
centers due to greater scheduling flexibility, more consistent nurse staffing
and faster turnaround time between cases, thereby allowing a physician to
perform more surgeries in a defined period of time.

Government Health Care Regulation

Health Care Reform

          In recent years, a variety of legislative proposals designed to change
access to and payment for health care services in the United States have been
introduced. Although no comprehensive health reform proposal has been passed by
Congress to date, other proposed health care reform legislation, including the
regulation of patient referral practices, reimbursement of health care
providers, formation and operation of physician joint ventures and tort reform,
has been and may be considered by Congress and the legislatures of many of the
states in which the Company operates. No predictions can be made as to whether
health care reform legislation or similar legislation will be enacted or, if
enacted, its effect on the Company. Any federal or state legislation
prohibiting, among other things, the referral to or treatment of patients at
surgery centers by health care providers with an investment interest in the
surgery centers may have a material adverse effect on the Company. In the event
that Federal or state regulations prohibit the ownership of surgery centers by
physicians, the Company would seek to purchase the interests held by its limited
partner physicians. Some of the Company's limited partnership agreements contain
a provision which allows the Company to purchase the interest of each limited
partner for an amount equal to a multiple of the partner's allocation of taxable
income in the most recent calendar year. The

                                       11
<PAGE>
 
Company may, at its option, issue cash, notes, or stock, including unregistered
stock, to purchase such limited partners' interests. The Company believes that
it would be able to buy out all of its limited partners if required.

Regulatory Environment

          The Company's surgery centers and the physicians utilizing its centers
are subject to numerous regulatory, accreditation and certification
requirements, including requirements related to licensure, certificate of need,
reimbursement from insurance companies and other private third-party payors,
Medicare and Medicaid participation and reimbursement, and utilization and
quality review organizations. The grant and renewal of these licenses,
certifications and accreditations are based upon governmental and private
regulatory agency inspections, surveys, audits, investigations or other reviews,
including self-reporting requirements. An adverse review or determination by any
regulatory authority could result in denial of a center's plan of development or
proposed expansion of facilities or services, the loss or restriction of
licensure by a center or one of its practitioners, or loss of center
certification or accreditation. A regulatory authority could also reduce, delay
or terminate reimbursement to a center or require repayment of reimbursement
received. The loss, denial or restriction of any such licensure, accreditation,
certification (including certificates of need or exemption therefrom) or
reimbursement through changes in the regulatory requirements, an enforcement
action, or otherwise, could have a material adverse effect on the Company.

          Medicare Payment Rates.  Medicare is a federally funded and
administered health insurance program that consists of Parts A and B. Part B
provides for payment of a facility fee for services furnished by Medicare
certified ambulatory surgical centers in connection with designated covered
surgical procedures. Each Medicare covered surgical procedure is assigned to a
payment group. Currently, there are eight payment groups. The Health Care
Financing Administration ("HCFA") assigns a base payment rate to each payment
group, which rate remains until revised by HCFA. The Company understands that
the number of payment groups and the base payment rates are currently under
discussion and the Company is unable to predict the outcome of these discussions
or its effect on the Company. Depending upon the nature and context of any
regulatory action, if any, which is taken, the Company could experience a
decrease in revenues from Medicare, which could have a material adverse change
on the Company's business, financial condition, cash flows or results of
operations.

          Federal Fraud and Abuse Statute.  Under the Medicare and Medicaid
programs, the federal government enforces a federal statute (the "Fraud and
Abuse Statute") that prohibits the offer, payment, solicitation or receipt of
any remuneration, directly or indirectly, overtly or covertly, in cash or in
kind to induce or in exchange for (i) the referral of patients covered by the
programs, or (ii) the leasing, purchasing, ordering, or arranging for or
recommending the lease, purchase, or order of any item, good, facility or
service covered by the programs. The federal courts have held that an
arrangement violates the Fraud and Abuse Statute if one purpose of a transaction
which results in the payment of remuneration (including the distribution of
profits) is to induce the referral of patients covered by the Medicare and
Medicaid programs, even if another purpose of the payment is to compensate an
individual for professional services. Violations of such statute can result in
criminal penalties, civil monetary penalties and exclusion from the Medicare and
Medicaid programs. In an attempt to clarify which arrangements are exempt from
program exclusion, civil sanctions or

                                       12
<PAGE>

criminal prosecution under the Fraud and Abuse Statute, the Department of Health
and Human Services published in 1991 a set of "safe harbor" regulations
outlining practices that are deemed not to violate the Fraud and Abuse Statute.
Although compliance with one of the safe harbors assures participants that an
arrangement does not violate the Fraud and Abuse Statute, failure of an
arrangement to fit within a safe harbor provision does not necessarily mean that
arrangement violates the Fraud and Abuse Statute. Although the Company has
determined that the current ownership structure of its surgery centers does not
fit within any of the safe harbors applicable to investments in health care
providers by physicians who are in a position to make or influence referrals, it
believes that its arrangements with physicians do not fall within the activities
prohibited by the Fraud and Abuse Statute. However, no assurances can be given
that regulatory authorities might not assert a contrary position or that new
laws, or the interpretation of existing laws, might not adversely affect
relationships established by the Company with physicians or other health care
providers or result in the imposition of penalties on the Company or its
facilities.

          "Stark Laws." The Company's surgery centers and their physicians,
dentists and podiatrists are also subject to the Ethics in Patient Referrals Act
of 1989 (the "Stark Law"). Unless excepted, a physician, dentist or podiatrist
may not make a referral of a Medicaid or Medicare patient to any clinical
laboratory services provider with whom he or she has a financial relationship
(either investment or compensation) for such restricted services and any
provider who accepts such a referral may not bill for the service provided
pursuant to the referral. Sanctions for violating the Stark Law can include
civil monetary penalties and exclusion from Medicare and Medicaid. Unlike the
Fraud and Abuse Statute in which an activity may fall outside a safe harbor and
still not violate the law, a referral under the Stark Law that does not fall
within an exception is strictly prohibited. In August 1993, Congress passed
legislation ("Stark II") that, effective January 1, 1995, expanded the self-
referral ban to include a number of health care services provided by entities
with which the physicians may have an ownership interest or a financial
relationship, although it does not specifically prohibit referrals by physicians
with an ownership interest in, or financial relationship with, an ambulatory
surgery center, provided that the surgery services are not provided as
"outpatient hospital services." Ambulatory surgery is not included in the list
of restricted services and the Company does not believe that ambulatory surgery
is subject to the Stark restrictions.

          AMA Restrictions. In June 1994, the American Medical Association
severely restricted the ability of physicians to refer to entities in which such
physicians have an ownership interest, except when the physician directly
provides care or services at a facility that is an extension of the physician's
practice and in very limited circumstances such as in rural areas where there is
lack of available capital from non-physician sources. If the American Medical
Association changes its ethical requirements to preclude all referrals by
physicians, physician referrals to the Company's ambulatory surgery centers
could be adversely affected. It is possible that a prohibition on physician
ownership could adversely affect the Company's future operations, although the
Company believes that the majority of physicians would continue to perform
surgery at the surgery centers even if they were no longer limited partners.

          State Anti-Referral Laws. In addition to the federal Fraud and Abuse
Statute and the Stark Laws, certain states in which the Company operates have
enacted similar patient referral legislation.

                                       13
<PAGE>
 

The Company believes its surgery centers' operations are consistent with
applicable statutes of the states in which they operate because either the state
statute (i) excludes from the definition of referral the recommendation by a
health care provider that a patient utilize the types of services provided at
the center, (ii) exempts health care provider investors who directly provide
services at the facility and are personally involved in the rendering of care to
the referred patient, or (iii) does not encompass the provider specialty or
services rendered at the center.

          Infectious Waste. As generators of infectious waste, the Company's
surgery centers are required to satisfy all federal, state and local waste
disposal requirements. If any regulatory agency finds a center to be in
violation of waste laws, penalties and fines may be imposed for each day of
violation, and the affected center could be forced to cease operations. The
Company believes its surgery centers dispose of such waste properly.

Insurance

          The Company maintains medical malpractice insurance under one
insurance policy in the amount of $1.0 million per occurrence and $3.0 million
in the aggregate, with retention limits of $100,000 per occurrence and $200,000
in the aggregate. In addition, the Company maintains excess medical malpractice
and general liability insurance in the amount of $25.0 million.

Employees

          As of December 31, 1997, the Company had 688 full-time, 32 of whom
were corporate personnel, and 752 part-time or per diem employees. Most of the
full-time employees are nurses and office personnel who work at the surgery
centers. None of the Company's employees is covered by a collective bargaining
agreement. The Company considers relations with its employees to be good.

Recent Developments

          Subsequent to December 31, 1997, the Company has acquired a specialty
endoscopy center in Norman, Oklahoma, the Company's fifth center in the Oklahoma
City market area, and a multi-specialty surgery center in Lancaster, California.

ITEM 2.  PROPERTIES

     The Company's multi-specialty surgery centers range from 4,900 to 26,000
square feet, with the typical surgery center occupying approximately 13,000
square feet, while the endoscopy centers range from 2,600 to 4,800 square feet.
The Company's surgery centers typically lease their facilities pursuant to long-
term lease agreements expiring from 1997 to 2015, most of which contain options
to extend the lease period for up to ten additional years. In certain instances,
the Company has financed the surgery center facility through long-term mortgages
or other financing arrangements in which the lender has a secured or
collateralized interest. The Company's principal executive officers are situated
in approximately 8,500 square feet located at 30 South Wacker Drive, Suite 2302,
Chicago, Illinois 60606. The Company leases this property and the current lease
expires in 2002. See "Operation of Surgery Centers" above for a list of the
Company's surgery centers.


                                       14
<PAGE>

<TABLE>
<CAPTION>

                                Expiration               Type of
Location                           Date                Encumbrance
- -----------------------       --------------          -------------
<S>                           <C>                     <C>
Billings, MT                  Month to Month              Lease
Greensboro, NC                   May 1999                 Lease
Auburn, CA                       June 1999                Lease
Bakersfield, CA                January 2000               Lease
Chula Vista, CA                January 2000               Lease
Humble, TX                      April 2000                Lease
Bremerton, WA                   August 2000               Lease
Atlanta, GA                    November 2000              Lease
San Mateo, CA                   March 2001                Lease
Houston, TX                      May 2002                 Lease
Norman, OK                       June 2002                Lease
Midwest City, OK               October 2002               Lease
Seattle, WA                    November 2002              Lease
San Diego, CA                  January 2003               Lease
Somerset, KY                     June 2003                Lease
Port St. Lucie, FL              August 2003               Lease
Greensboro, NC                 January 2004               Lease
Sarasota, FL                    March 2004                Lease
Newport Beach, CA               April 2004                Lease
Santa Monica, CA                April 2004                Lease
Kent, OH                         May 2004                 Lease
Long Beach, CA                   May 2004                 Lease
Fort Worth, TX                   June 2004                Lease
Cincinnati, OH                 October 2004               Lease
Miami, FL                      December 2004              Lease
Thousand Oaks, CA              January 2005               Lease
Manahawkin, NJ                September 2007              Lease
Bakersfield, CA                  May 2008                 Lease
Las Vegas, NV                    June 2008                Lease
Las Vegas, NV                    July 2009                Lease
Provo, UT                     September 2012              Lease
Fayetteville, NC                 July 2015                Lease
Brownsville, TX                November 2001          Collateralized
Elizabethtown, KY              February 2008             Mortgage
Edmond, OK                     October 2009              Mortgage
South Oklahoma City, OK          June 2010               Mortgage
Hartford, CT                        ---                   Owned
Oxnard, CA                          ---                   Owned
</TABLE>



                                       15
<PAGE>

 
ITEM 3.  LEGAL PROCEEDINGS

     The Company is party to certain claims and litigation in the ordinary
course of business. The Company is not involved in any legal proceeding that it
believes will result, individually or in the aggregate, in a material adverse
effect upon its financial condition or results of operations.


ITEM 4.  SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS

     No matters were submitted to the Company's security holders during the
fourth quarter of fiscal 1997.


                                    PART II

ITEM 5.  MARKET FOR REGISTRANT'S COMMON EQUITY AND RELATED STOCK HOLDER MATTERS

     The common stock of the Company ("Common Stock") has been included for
quotation in the National Market tier of The Nasdaq Stock Market ("Nasdaq")
under the symbol "NSCI" since the Company's initial public offering of Common
Stock on November 10, 1995. Prior to that time, there was no public market for
the Common Stock. On December 31, 1997, the last reported sale price of the
Common Stock on Nasdaq was $26.25. At December 31, 1997, there were
approximately 3,500 record holders of the Common Stock. The following table sets
the high and low closing prices for the Common Stock for the periods indicated
as reported by Nasdaq.

<TABLE>
<CAPTION>
                                               High         Low
                                              -------     --------
           <S>                                <C>         <C>
           Year Ended December 31, 1996
               First Quarter/(1)(2)/          $14-2/3     $ 9-6/10
               Second Quarter/(1)(2)/          21          12-4/10
               Third Quarter/(1)/              20-1/6      15
               Fourth Quarter/(1)/             25-1/3      16-1/2
 
           Year Ended December 31, 1997
               First Quarter/(1)/             $24         $18-1/3
               Second Quarter/(1)/             25-2/3      17-2/3
               Third Quarter                   23-1/3      18
               Fourth Quarter                  26-3/8      21-3/4
- --------------------
</TABLE>

/(1)/ Adjusted to reflect the 3-for-2 stock split of the Common Stock effected
      August 1997.

/(2)/ Adjusted to reflect the 3-for-2 stock split of the Common Stock effected
      in May 1996.

     The Company has never paid cash dividends on its common stock and the Board
of Directors intends to continue a policy of retaining any earnings for use in
the Company's operations and to fund the Company's and its area developers'
expansion program. The Company does not anticipate paying any cash dividends in
the foreseeable future. In addition, the Company's loan agreement contains a
prohibition on the payment of any cash dividends. See "Management's Discussion
and Analysis of Financial Condition and Results of Operations--Liquidity and
Capital Resources".


                                      16

<PAGE>

 
ITEM 6.  SELECTED CONSOLIDATED FINANCIAL DATA

     The information contained in the Company's Annual Report to
Shareholders for the fiscal year ended 1997 (the "Annual Report"), under the
caption "Selected Consolidated Financial Highlights," and only such information,
is incorporated herein by reference.


ITEM 7.  MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS
         OF OPERATIONS

     The information contained in the Company's Annual Report to Shareholders,
under the caption "Management's Discussion and Analysis of Financial Condition
and Results of Operations," and only such information, is incorporated herein by
reference.


ITEM 8.  FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

     The information contained in the Company's Annual Report to Shareholders,
under the captions "Consolidated Balance Sheets," "Consolidated Statements of
Income," "Consolidated Statements of Shareholders' Equity," "Consolidated
Statements of Cash Flows," "Notes to Consolidated Financial Statements" and 
"Report of Independent Auditors," and only such information, is incorporated
herein by reference.


ITEM 9.  CHANGES IN AND DISAGREEMENTS WITH THE ACCOUNTANTS ON ACCOUNTING AND
         FINANCIAL DISCLOSURE

     None


                                    PART III

ITEM 10. DIRECTORS AND EXECUTIVE OFFICERS OF THE REGISTRANT

Directors

     The information appearing under the captions "Election of Class III
Directors" and "Class I and Class II Directors" in the Company's proxy statement
for the Annual Meeting of the Stockholders scheduled for May 21, 1998 (the
"Proxy Statement") is incorporated herein by reference.


                                       17

<PAGE>
 
Executive Officers

     Set forth below are the names of the executive officers of the Company,
their ages as of December 31, 1997, the positions they held with the Company,
and summaries of their business experience. An officer is elected by the Board
of Directors and serve pursuant to annual employment agreements between such
officers and the Company.

<TABLE>
<CAPTION> 
                                                                           Officer
Name                 Age                Position(s)                         Since
- ------------------   ---   ---------------------------------------------   -------
<S>                  <C>   <C>                                             <C>
E. Timothy Geary      47   Chairman of the Board of Directors, Chief        1987
                           Executive Officer and President
Bryan S. Fisher       39   Senior Vice President of Finance, Chief          1993
                           Financial Officer, Secretary and Treasurer
Dennis D. Solheim     46   Senior Vice President of Business Development    1991
Dennis J. Zamojski    40   Senior Vice President of Operations              1992
Richard D. Pence      43   Vice President of Operations                     1991
</TABLE>

     Mr. Geary, has served as the Company's Chief Executive Officer, President
and Chairman of the Board since its founding in 1987. Mr. Geary served as a Vice
President of Operations and Development, respectively, with Medical Care
International, Inc. ("Medical Care"), a large owner and operator of freestanding
ambulatory surgery centers, from 1983 to 1987. Mr. Geary is a graduate of the
College at the University of Chicago and the University of Chicago Graduate
School of Business. Mr. Geary serves on the Board of Directors of Dianon
Systems, Inc., a provider of pathology testing services, and the Federated
Ambulatory Surgery Association ("FASA"), an industry association.

     Mr. Fisher joined the Company in 1991 as Controller, served as a Vice
President of the Company from 1993 to 1997, as the Company's Chief Financial
Officer since 1996, and as the Company's Senior Vice President of Finance,
Treasurer and Secretary since 1997. Mr. Fisher was an Accounting Manager and
Assistant Controller for Medical Care and, prior to that, an auditor for KPMG
Peat Marwick from 1984 to 1989. Mr. Fisher is a graduate of Brigham Young
University and is a certified public accountant.

     Mr. Solheim joined the Company as Project Manager in 1988 and served as a
Vice President of the Company from 1991 to 1997 and as Senior Vice President of
Business Development since 1997. Mr. Solheim was a Regional Director for Medical
Care from 1983 to 1988. Mr. Solheim is a graduate of Iowa State University.

     Mr. Zamojski joined the Company in 1992 and served as a Vice President of
the Company from 1992 to 1997, and as Senior Vice President of Operations since
1997. Mr. Zamojski was a Vice President with Medical Care from 1983 to 1992. Mr.
Zamojski is a graduate of the nursing program of Erie Community College, the
State University of New York and the Masters of Health Care Administration
program of the Medical College of Virginia/Virginia Commonwealth University.


                                       18

<PAGE>
 
     Mr. Pence joined the Company as a Vice President in 1991. Mr. Pence was a
Vice President and, previously Controller, for Medical Care from 1982 to 1991.
Mr. Pence is a graduate of the University of Alabama and the Masters of Business
Administration Program of Southern Methodist University.

ITEM 11.  EXECUTIVE COMPENSATION.

     The information appearing under the caption "Executive Compensation" in the
Proxy Statement is incorporated herein by reference.

ITEM 12.  SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT.

     The information appearing under the caption "Principal Stockholders and
Securities Ownership of Management" in the Proxy Statement is incorporated
herein by reference.

ITEM 13.  CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS.

     The information appearing under the captions "Director Compensation" and
"Compensation Committee Interlocks and Insider Participation" in the Proxy
Statement are incorporated herein by reference.

                                    PART IV

ITEM 14.  EXHIBITS, FINANCIAL STATEMENT SCHEDULE AND REPORTS ON FORM 8-K.

(a)(1) Financial Statements

     Reference is made to the information set forth in Part II, Item 8 of this
Report, which information is incorporated herein by reference.

(a)(2) Financial Statement Schedules

    (i)   Schedule II -- Valuation of Qualifying Accounts         S-1
    (ii)  Report of Independent Auditors on Schedules       See Exhibit 23.1

    All other schedules for which provision is made in the applicable accounting
regulations of the Securities and Exchange Commission have been omitted because
the required information is not significant or is included in the financial
statements or the notes thereto, or is not applicable.

 (a)(3) Exhibits

     The exhibits to this report are listed in the Exhibit Index included
elsewhere herein. Included in the exhibits listed therein are the following
exhibits which constitute management contracts or compensatory plans or
arrangements:

                                       19
<PAGE>

     10.1   Amended and Restated 1992 Stock Option Plan of the Company
     10.2   Employee Stock Purchase Plan of the Company
     10.9   Form of Employment Agreement between the Company and E. Timothy
            Geary
     10.10  Form of Employment Agreement between the Company and Bryan S. Fisher
     10.11  Form of Employment Agreement between the Company and Dennis D.
            Solheim
     10.12  Form of Employment Agreement between the Company and Richard D. 
            Pence
     10.13  Form of Employment Agreement between the Company and Dennis J.
            Zamojski
     10.14  Management Agreement dated November 22, 1991 among Physicians
            Ambulatory Management Corp., NSC Fayetteville, Inc. and Fayetteville
            Ambulatory Surgery Center Limited Partnership
     10.27  1997 Non-Employee Directors Stock Option Plan

(b)  Reports on Form 8-K

     The Company did not file any reports on Form 8-K during the fourth quarter
of 1997.

(c)  Exhibits
<TABLE>
<CAPTION>
     Exhibit
     Number        Description of Exhibit
     ------        ----------------------
     <S>           <C>
      3.1*         Certificate of Incorporation of the Company
      3.2**        Bylaws of the Company
      4.1*         Specimen certificate representing shares of Common Stock
      4.2***       Rights Agreement, dated as of December 22, 1997, between
                   the Company and Harris Trust and
                   Savings Bank as rights agent,
                   which includes Exhibit B thereto
                   the Form 8 Rights Certificate
     10.1**        Amended and Restated 1992 Stock Option Plan of the Company
     10.2****      Employee Stock Purchase Plan of the Company
     10.3*         Lease dated December 22, 1988 between Surgical Center
                   Investors, Ltd. ("SCI") and Surgical Center of Greensboro,
                   Inc. ("SCE")
     10.4*         Agreement dated June 23, 1992 among SCI, Surgical Care and
                   SCE
     10.5*         Second Amendment to Lease dated September 24, 1992 between
                   SCI and NSC Greensboro, Inc.
     10.6*****     Agreement dated April 22, 1997 between the Company and John
                   G. Rex-Waller
     10.7          Credit Agreement dated as of November 17, 1997 among National
                   Surgery Centers, Inc. and Bank of America National Trust and
                   Savings Association as Agent and other financial institutions
                   parties hereto
     10.9*         Form of Employment Agreement between the Company and E.
                   Timothy Geary
     10.10         Form of Employment Agreement between the Company and Bryan S.
                   Fisher
     10.11*        Form of Employment Agreement between the Company and Dennis
                   D. Solheim
     10.12*        Form of Employment Agreement between the Company and Richard
                   D. Pence
     10.13*        Form of Employment Agreement between the Company and Dennis
                   J. Zamojski
     10.14*        Management Agreement dated November 22, 1991 among
</TABLE>
                                       20
<PAGE>
<TABLE>
     <C>           <S>
                   Physicians Ambulatory Management Corp. ("PAM"), NSC
                   Fayetteville, Inc. and Fayetteville Ambulatory Surgery Center
                   Limited Partnership
     10.27**       1997 Non-Employee Directors Stock Option Plan
     11.1          Computation of Income Per Common Share
     13.1          Registrant's Annual Report to Shareholders for the fiscal
                   year ended 1997 (for the information of the Commission and
                   not deemed "filed" with the Commission, except for the
                   portions expressly incorporated by reference in this report).
     21.1          Subsidiaries of the Company
     23.1          Consent of Ernst & Young LLP
     27.1          Financial Data Schedule
</TABLE> 

        *   Incorporated by reference to the corresponding exhibit to the
            Company registration statement on Form S-1 Registration No. 33-
            96996.

       **   Incorporated by reference to the corresponding exhibit to the
            Company's Form 10-K for the fiscal year ended December 31, 1996.

      ***   Incorporated by reference to Exhibit 4 to the Company's Form 8-A
            dated December 24, 1997.

     ****   Incorporated by reference to the corresponding exhibit to the
            Company's registration statement on Form S-1 Registration No. 333-
            12927.

    *****   Incorporated by reference to Exhibit 10 to the Company's Form 10-Q
            for the quarter period ended March 31, 1997.

                                       21
<PAGE>
 
                                   SIGNATURES

                                        
     Pursuant to the requirements of Section 13 or 15(d) of the Securities Act
of 1934, the registrant has duly caused this to be signed on its behalf by the
undersigned, thereunto duly authorized.

                                  NATIONAL SURGERY CENTERS, INC.
                                  By: /s/ E. Timothy Geary
                                     ----------------------------------------
                                      E. Timothy Geary
                                      Chairman of the Board of Directors,
                                      Chief Executive Officer and President

                                  Date: March 27, 1998
                                        -------------------------------------
 

     Pursuant to the requirements of the Securities Act of 1934, this report has
been signed below by the following persons on behalf of the registrant in the
capacities and on the dates indicated.

            Signature                                   Title
            ---------                                   -----

  Principal Executive Officer:

     /s/ E. Timothy Geary                 Chairman of the Board of Directors,
- --------------------------------         Chief Executive Officer and President
        E. Timothy Geary                 


         March 27, 1998
- --------------------------------
              Date


 Principal Financial Officer and
  Principal Accounting Officer:

       /s/ Bryan S. Fisher                 Senior Vice President of Finance,
- ---------------------------------          Chief Financial Officer, Secretary
          Bryan S. Fisher                             and Treasurer
          

          March 27, 1998
- ---------------------------------
               Date

                                      22
<PAGE>
 
Directors:


       /s/ John K. Carlyle
- ---------------------------------          Director
         John K. Carlyle


         March 27, 1998
- ---------------------------------
              Date



      /s/ Russell L. Carson
- ---------------------------------          Director
        Russell L. Carson


         March 27, 1998
- ---------------------------------
              Date



  /s/ John T. Henley, Jr., M.D.
- ---------------------------------          Director
    John T. Henley, Jr., M.D.


         March 27, 1998
- ---------------------------------
              Date



   /s/ Donald E. Linder, M.D.
- ---------------------------------          Director
     Donald E. Linder, M.D.


         March 27, 1998
- ---------------------------------
              Date



      /s/ Rocco A. Ortenzio
- ---------------------------------          Director
        Rocco A. Ortenzio


         March 27, 1998
- ---------------------------------
              Date

                                       23
<PAGE>
 
Schedule II - Valuation of Qualifying Accounts
(in thousands)

<TABLE>
<CAPTION>
                                                   Charge to              Charged to
                                                   Beginning  Costs and      Other                    Ending
                                                    Balance    Expenses   Accounts/1/  Deductions/2/  Balance
                                                   ---------  ----------  -----------  -------------  -------
<S>                                                   <C>         <C>          <C>            <C>      <C>
Allowance for Uncollectible Accounts Receivable

Year ended December 31, 1995                        $1,098      $1,166       $   46       $1,143       $1,167

Year ended December 31, 1996                         1,167       2,674           94        2,212        1,723

Year ended December 31, 1997                         1,723       3,275        2,581        3,552        4,027
</TABLE>

- ----------------
/1/    Represents allowances for uncollectible accounts of acquired centers net
       of centers divested.

/2/    Represents charges off of accounts receivable net of recoveries.

                                       24

<PAGE>

                                                                    Exhibit 10.7
================================================================================



                               CREDIT AGREEMENT

                         Dated as of November 17, 1997

                                     among

                        NATIONAL SURGERY CENTERS, INC.,
                                 as Borrower,


                             CERTAIN SUBSIDIARIES,
                                as Guarantors,


                        BANK OF AMERICA NATIONAL TRUST
                           AND SAVINGS ASSOCIATION,
                                   as Agent,

                                      and

                THE OTHER FINANCIAL INSTITUTIONS PARTIES HERETO


                                  Arranged by

                        BANCAMERICA ROBERTSON STEPHENS



================================================================================
<PAGE>
 
<TABLE>
<CAPTION>
                               TABLE OF CONTENTS
 
Section                                                                  Page
<S>                                                                     <C>   

ARTICLE I  DEFINITIONS..................................................   1
     1.1  Certain Defined Terms.........................................   1
     1.2  Other Interpretive Provisions.................................  22
     1.3  Accounting Principles.........................................  23

ARTICLE II  THE CREDITS.................................................  23
     2.1  Amounts and Terms of Commitments..............................  23
     2.2  Loan Accounts.................................................  24
     2.3  Procedure for Borrowing.......................................  24
     2.4  Conversion and Continuation Elections.........................  25
     2.5  Voluntary Termination or Reduction of Commitments.............  26
     2.6  Optional Prepayments..........................................  27
     2.7  Mandatory Prepayments of Loans................................  27
     2.8  Repayment.....................................................  27
     2.9  Interest......................................................  27
     2.10  Fees.........................................................  28
           (a)  Fee Letter..............................................  28
           (b)  Commitment Fees.........................................  28
           (c)  Up-front Fees...........................................  29
     2.11  Computation of Fees and Interest.............................  29
     2.12  Payments by the Company......................................  29
     2.13  Payments by the Banks to the Agent...........................  30
     2.14  Sharing of Payments, Etc.....................................  30
     2.15  Increases to Commitments.....................................  31
     2.16  Extension of the Termination Date............................  34

</TABLE> 
<PAGE>
 
<TABLE> 
<CAPTION> 

<S>                                                                      <C>
ARTICLE III  TAXES, YIELD PROTECTION AND ILLEGALITY...................... 34
     3.1  Taxes.......................................................... 34
     3.2  Illegality..................................................... 35
     3.3  Increased Costs and Reduction of Return........................ 36
     3.4  Funding Losses................................................. 36
     3.5  Inability to Determine Rates................................... 37
     3.6  Reserves on Offshore Rate Loans................................ 37
     3.7  Certificates of Banks.......................................... 38
     3.8  Substitution of Banks.......................................... 38
     3.9  Survival....................................................... 38

ARTICLE IV  CONDITIONS PRECEDENT......................................... 38
     4.1  Conditions of Initial Loans.................................... 38
          (a) Credit Agreement and Notes................................. 38
          (b) Resolutions; Incumbency.................................... 39
          (c) Legal Opinions............................................. 39
          (d) Payment of Fees............................................ 39
          (e) Certificate................................................ 39
          (f) Other Documents............................................ 39
     4.2  Conditions to All Borrowings................................... 40
          (a) Notice of Borrowing or Conversion/Continuation............. 40
          (b) Continuation of Representations and Warranties............. 40
          (c) No Existing Default........................................ 40

ARTICLE V  REPRESENTATIONS AND WARRANTIES................................ 40
     5.1  Corporate Existence and Power.................................. 40
     5.2  Corporate Authorization; No Contravention...................... 41
     5.3  Governmental Authorization..................................... 41

</TABLE> 
<PAGE>

<TABLE> 
<CAPTION> 
 
<S>                                                                      <C>
     5.4   Binding Effect................................................ 41
     5.5   Litigation.................................................... 41
     5.6   No Default.................................................... 42
     5.7   ERISA Compliance.............................................. 42
     5.8   Use of Proceeds; Margin Regulations........................... 43
     5.9   Title to Properties........................................... 43
     5.10  Taxes......................................................... 43
     5.11  Financial Condition........................................... 43
     5.12  Environmental Matters......................................... 44
     5.13  Regulated Entities............................................ 44
     5.14  No Burdensome Restrictions.................................... 44
     5.15  Copyrights, Patents, Trademarks and Licenses, etc............. 44
     5.16  Subsidiaries.................................................. 44
     5.17  Insurance..................................................... 45
     5.18  Full Disclosure............................................... 45
     5.19  Health Care Regulatory Matters................................ 45

ARTICLE VI  AFFIRMATIVE COVENANTS........................................ 47
     6.1   Financial Statements.......................................... 47
     6.2   Certificates; Other Information............................... 48
     6.3   Notices....................................................... 48
     6.4   Preservation of Corporate Existence, Etc...................... 49
     6.5   Maintenance of Property....................................... 50
     6.6   Insurance..................................................... 50
     6.7   Payment of Obligations........................................ 50
     6.8   Compliance with Laws.......................................... 50
     6.9   Compliance with ERISA......................................... 51

</TABLE>
<PAGE>

<TABLE> 
<CAPTION> 
 
<S>                                                                      <C>
     6.10  Inspection of Property and Books and Records.................. 51
     6.11  Environmental Laws............................................ 51
     6.12  Use of Proceeds............................................... 51
     6.13  Financial Covenants........................................... 51
           (a) Minimum Interest Coverage Ratio........................... 51
           (b) Maximum Consolidated Funded Debt to Cash Flow Ratio....... 52
           (c) Minimum EBITDA............................................ 52
     6.14  Further Assurances............................................ 52

ARTICLE VII  NEGATIVE COVENANTS.......................................... 52
     7.1  Limitation on Liens............................................ 52
     7.2  Disposition of Assets.......................................... 54
     7.3  Consolidations and Mergers..................................... 55
     7.4  Loans and Investments.......................................... 55
     7.5  Limitation on Indebtedness..................................... 55
     7.6  Transactions with Affiliates................................... 56
     7.7  Use of Proceeds................................................ 56
     7.8  Contingent Obligations......................................... 57
     7.9  Joint Ventures................................................. 57
     7.10 Lease Obligations.............................................. 58
     7.11 Restricted Payments............................................ 58
     7.12 ERISA.......................................................... 59
     7.13 Accounting Changes............................................. 59
     7.14 Business Activities............................................ 59
     7.15 Take or Pay Contracts.......................................... 59
     7.16 Modification of Certain Agreements............................. 59

ARTICLE VIII  EVENTS OF DEFAULT.......................................... 59

</TABLE> 
<PAGE>

<TABLE> 
<CAPTION> 
 
<S>                                                                      <C>
     8.1  Event of Default..............................................  59
          (a) Non-payment...............................................  59
          (b) Representation or Warranty................................  60
          (c) Specific Defaults.........................................  60
          (d) Other Defaults............................................  60
          (e) Cross-default.............................................  60
          (f) Insolvency; Voluntary Proceedings.........................  60
          (g) Involuntary Proceedings...................................  60
          (h) ERISA.....................................................  61
          (i) Monetary Judgments........................................  61
          (j) Non-monetary Judgments....................................  61
          (k) Change of Control.........................................  61
          (l) Loss of Licenses..........................................  61
          (m) Adverse Change............................................  62
     8.2  Remedies......................................................  62
     8.3  Rights Not Exclusive..........................................  62
     8.4  Certain Financial Covenant Defaults...........................  63

ARTICLE IX  THE AGENT...................................................  63
     9.1  Appointment and Authorization.................................  63
     9.2  Delegation of Duties..........................................  63
     9.3  Liability of Agent............................................  63
     9.4  Reliance by Agent.............................................  64
     9.5  Notice of Default.............................................  64
     9.6  Credit Decision...............................................  65
     9.7  Indemnification...............................................  65
     9.8  Agent in Individual Capacity..................................  66

</TABLE>
<PAGE>

<TABLE> 
<CAPTION> 
 

<S>                                                                      <C>
     9.9  Successor Agent...............................................  66
     9.10  Withholding Tax..............................................  67

ARTICLE X  MISCELLANEOUS................................................  68
     10.1  Amendments and Waivers.......................................  68
     10.2  Notices......................................................  69
     10.3  No Waiver; Cumulative Remedies...............................  70
     10.4  Costs and Expenses...........................................  70
     10.5  Indemnity....................................................  70
     10.6  Payments Set Aside...........................................  71
     10.7  Successors and Assigns.......................................  71
     10.8  Assignments, Participations, etc.............................  71
     10.9  Confidentiality..............................................  73
     10.10 Setoff.......................................................  74
     10.11 Automatic Debits of Fees.....................................  74
     10.12 Notification of Addresses, Lending Offices, Etc..............  74
     10.13 Counterparts.................................................  74
     10.14 Severability.................................................  74
     10.15 No Third Parties Benefited...................................  75
     10.16 Governing Law and Jurisdiction...............................  75
     10.17 Waiver of Jury Trial.........................................  75
     10.18 Entire Agreement.............................................  75

ARTICLE XI  GUARANTY....................................................  76
     11.1  The Guaranty.................................................  76
     11.2  Guaranty Unconditional.......................................  76
     11.3  Discharge Only Upon Payment in Full; Reinstatement in Certain
             Circumstances..............................................  77
     11.4  Waiver.......................................................  77


</TABLE> 
<PAGE>

<TABLE> 
<CAPTION> 
 
<S>                                                                      <C>  
     11.5  Subrogation..................................................  77
     11.6  Stay of Acceleration.........................................  77
     11.7  Subordination of Indebtedness................................  77

</TABLE>

SCHEDULES

Schedule 2.1   Commitments
Schedule 5.5   Litigation
Schedule 5.7   ERISA
Schedule 5.11  Permitted Liabilities
Schedule 5.12  Environmental Matters
Schedule 5.16  Subsidiaries and Minority Interests
Schedule 5.17  Insurance Matters
Schedule 5.19  Health Care Regulatory Matters
Schedule 7.1   Permitted Liens
Schedule 7.5   Permitted Indebtedness
Schedule 7.8   Contingent Obligations
Schedule 10.2  Lending Offices; Addresses for Notices


EXHIBITS

Exhibit A    Form of Notice of Borrowing
Exhibit B    Form of Notice of Conversion/Continuation
Exhibit C    Form of Compliance Certificate
Exhibit D    Form of Legal Opinion of Counsel to the Company and the Guarantors
Exhibit E    Form of Assignment and Acceptance
Exhibit F    Form of Promissory Note
<PAGE>
 
                               CREDIT AGREEMENT
                               ----------------


This CREDIT AGREEMENT is entered into as of November 17, 1997, among National
Surgery Centers, Inc., a Delaware corporation (the "Company"), those
Subsidiaries of the Company that have executed a counterpart hereof as a
"Guarantor" (the "Guarantors"), the several financial institutions from time to
time party to this Agreement (collectively, the "Banks" and individually each, a
"Bank"), and Bank of America National Trust and Savings Association, as agent
for the Banks.

WHEREAS, the Banks have agreed to make available to the Company a revolving
credit facility upon the terms and conditions set forth in this Agreement;

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


                                   ARTICLE I

                                  DEFINITIONS
                                  -----------

I.1  Certain Defined Terms.  Unless otherwise specified, the following terms
have the following meanings:

"AAAHC" means the Accreditation Association for Ambulatory Health Care.

"Acquisition" means the acquisition by the Company or any of its Subsidiaries of
a Permitted Business (or any interest therein) that has commenced operations
prior to such acquisition, including any transaction, or series of related
transactions, by the Company or any of its Subsidiaries involving the sale,
transfer, lease, contribution or other conveyance of assets or capital stock,
limited liability company interests, partnership units or other equity or
ownership interests of any Person (including, where applicable, accounts
receivable or other intangible assets of such Person) to the Company or any of
its Subsidiaries.

"Affected Bank"  see Section 3.8.

"Affiliate" means, as to any Person, any other Person (other than a Subsidiary
or a Minority Owned Person) which, directly or indirectly, controls, is
controlled by, or is under common control with, such Person. A Person shall be
deemed to control another Person if the controlling Person possesses, directly
or indirectly, the power to direct or cause the direction of the management and
policies of the subject Person, whether through the ownership of voting
securities, by contract, or otherwise.

"Agent" means BofA in its capacity as agent for the Banks hereunder, and any
successor agent arising under Section 9.9.
<PAGE>
 
"Agent-Related Persons" means BofA and any successor agent arising under Section
9.9, together with their respective Affiliates (including, in the case of BofA,
the Arranger), and the officers, directors, employees, agents and attorneys-in-
fact of such Persons and Affiliates.

"Agent's Payment Office" means the address for payments set forth on Schedule
10.2 in relation to the Agent, or such other address as the Agent may from time
to time specify.

"Agreement" means this Credit Agreement.

"Applicable Margin" means, with respect to any Fiscal Quarter, the Applicable
Margin set forth below applicable to the Debt to EBITDA Ratio on the last day of
such Fiscal Quarter indicated as follows:


<TABLE> 
<CAPTION> 
                                         Applicable Margin
                                         -----------------

Debt to EBITDA                                        Offshore Rate
Ratio                                  Base Rate Loans    
- --------------------------------------------------------------------
<S>                                    <C>             <C> 
Greater than 2.50:1                         0.650%        1.650%

Greater than 2.00:1
and less than or
equal to 2.50:1                             0.350%        1.350%

Greater than 1.50:1
and less than or
equal to 2.00:1                             0.000%        1.000%

Greater than 1.00:1
and less than or
equal to 1.50:1                             0.000%        0.750%

Less than or
equal to 1.00:1                             0.000%        0.625%

</TABLE> 
provided, that the Applicable Margin shall be adjusted, to the extent
applicable, 60 days (or, in the case of the last Fiscal Quarter of any Fiscal
Year, 105 days) after the end of each Fiscal Quarter based on the Debt to EBITDA
Ratio determined as of the last day of such Fiscal Quarter; provided, further,
that if the Company fails to deliver the financial statements required by
Section 6.1 and the related certificate required by Section 6.2 by the 60th day
(or, if applicable, the 105th day) after the end of any Fiscal Quarter, the
Applicable Margin shall be deemed to be, until such financial statements are
delivered,  the Applicable Margin which applies when the Debt to EBITDA Ratio is
greater than 2.50:1.
<PAGE>
 
Solely for the purpose of determining the Applicable Margin and for no other
purpose, the Debt to EBITDA Ratio shall be calculated as of the last day of each
Fiscal Quarter on a pro forma basis as if any Acquisitions had occurred, or any
resulting Indebtedness been incurred, as of the first day of the four-Fiscal
Quarter period then ended, using for the pro forma calculation, where
applicable, the actual historical financial results of the acquired Person or
assets in respect of the preceding four-Fiscal Quarter period; provided that the
pro forma EBITDA of any Person acquired pursuant to any such Acquisition may be
adjusted to take into account salaries and other expenses which will be
eliminated upon the completion of such Acquisition.

"Arranger" means BancAmerica ROBERTSON STEPHENS, a Delaware corporation.

"Assignee" see subsection 10.8(a).

"Attorney Costs" means and includes all reasonable fees and disbursements of any
law firm or other external counsel, the reasonable allocated cost of internal
legal services and all reasonable disbursements of internal counsel.

"Bank" see the preamble.

"Bankruptcy Code" means the Federal Bankruptcy Reform Act of 1978 (11 U.S.C.
(S)101, et seq.).

"Base Rate" means, for any day, the higher of: (a) 0.50% per annum above the
latest Federal Funds Rate for such date; and (b) the rate of interest in effect
for such day as publicly announced from time to time by BofA in San Francisco,
California, as its "reference rate." (The "reference rate" is a rate set by BofA
based upon various factors including BofA's costs and desired return, general
economic conditions and other factors, and is used as a reference point for
pricing some loans, which may be priced at, above, or below such announced
rate.) Any change in the reference rate announced by BofA shall take effect at
the opening of business on the day specified in the public announcement of such
change.

"Base Rate Loan" means a Loan that bears interest at a rate based on the Base
Rate.

"BofA" means Bank of America National Trust and Savings Association, a national
banking association.

"Borrowing" means a borrowing hereunder consisting of Loans of the same Type
made to the Company on the same day by the Banks under Article II, and, other
than in the case of Base Rate Loans, having the same Interest Period.

"Borrowing Date" means any date on which a Borrowing occurs under Section 2.3.
 
<PAGE>
 
"Business Day" means any day other than a Saturday, Sunday or other day on which
commercial banks in Chicago, New York City or San Francisco are authorized or
required by law to close and, if the applicable Business Day relates to any
Offshore Rate Loan, means such a day on which dealings are carried on in the
applicable offshore dollar interbank market.

"Capital Adequacy Regulation" means any guideline, request or directive of any
central bank or other Governmental Authority, or any other law, rule or
regulation, whether or not having the force of law, in each case, regarding
capital adequacy of any bank or of any corporation controlling a bank.

"Capitalized Lease Liabilities" means the portion of all monetary obligations of
the Company or any of its Subsidiaries under any leasing or similar arrangement
which, in accordance with GAAP, is required to be shown on the Company's
consolidated balance sheet in respect of any lease or similar arrangement
classified as a capital lease, and, for purposes of this Agreement and each
other Loan Document, the amount of such obligations shall be the capitalized
amount thereof, determined in accordance with GAAP, and the stated maturity
thereof shall be the date of the last payment of rent or any other amount due
under such lease prior to the first date upon which such lease may be terminated
by the lessee without payment of a penalty.

"Change of Control" means (i) any "person" (as such term is used in Sections
13(d) and 14(d) of the Exchange Act) is or becomes the beneficial owner (within
the meaning of Rules 13d-3 and 13d5 under the Exchange Act) of 30% or more of
the outstanding shares of voting stock of the Company or (ii) during any period
of two consecutive years, individuals who at the beginning of such period
constituted the board of directors of the Company (together with any new
directors whose election or appointment by such board of directors or whose
nomination for election by the stockholders of the Company was approved by a
majority of the directors of the Company then still in office who were either
directors at the beginning of such period or whose election or nomination for
election was previously so approved) cease for any reason to constitute a
majority of the board of directors of the Company then in office.

"Closing Date" means the date on which all conditions precedent set forth in
Section 4.1 are satisfied or waived by all Banks (or, in the case of subsection
4.1(e), waived by the Person entitled to receive such payment).

"Code" means the Internal Revenue Code of 1986.

"Commitment", as to each Bank, has the meaning specified in Section 2.1.

"Commitment Date"  see subsection 2.15(b).

"Commitment Increase"  see subsection 2.15(a).

"Company"  see the preamble.


<PAGE>
 
"Compliance Certificate" means a certificate substantially in the form of
Exhibit C.

"CON" means a certificate of need or other license or permit issued by a state
health facilities planning board or similar agency or body required for the
construction, expansion, or investment in a health facility or a Permitted
Business.

"Consolidated Interest Expense" means, for any period, the aggregate interest
expense of the Company and its Subsidiaries, in each case for such period, as
determined on a consolidated basis in accordance with GAAP and in any event
including, without duplication, all commissions, discounts and other fees and
charges owed with respect to letters of credit and banker's acceptances, net
costs under interest rate protection agreements and the portion of any
Capitalized Lease Liabilities allocable to consolidated interest expense.

"Consolidated Net Income" means, for any period, all amounts which, in
conformity with GAAP, would be included under net income on a consolidated
income statement of the Company and its Subsidiaries, in each case for such
period; provided that (i) the net income (but not loss) of any Subsidiary, or of
any other Person accounted for by the equity method of accounting, shall be
excluded to the extent and for the period of time that the declaration or
payment of dividends or similar distributions by such Subsidiary or other Person
of such net income is not permitted without prior governmental approval (that
has not been obtained) or, directly or indirectly, by operation of the terms of
its charter or any agreement, instrument, judgment, decree, order, statute, rule
or governmental regulation applicable to such Subsidiary or Person or the
stockholders of such Subsidiary or Person, provided, further, that,
notwithstanding any of the foregoing, such net income shall be included to the
extent and for the period of time that such dividends or similar distributions
are paid in cash; (ii) the net income of any Person acquired in a pooling of
interests transaction for any period prior to the date of such acquisition shall
be excluded; and (iii) the cumulative effect of a change in accounting
principles shall be excluded.

"Consolidated Total Assets" means, as of any date of determination thereof, the
total amount of all of the consolidated assets of the Company and its
Subsidiaries determined in accordance with GAAP.

"Contingent Obligation" means, as to any Person, any direct or indirect
liability for the payment of money of that Person, with or without recourse, (a)
with respect to any Indebtedness, lease, dividend, letter of credit or other
obligation for the payment of money (the "primary obligations") of another
Person (the "primary obligor"), including any obligation of that Person (i) to
purchase, repurchase or otherwise acquire such primary obligations or any
security therefor, (ii) to advance or provide funds for the payment or discharge
of any such primary obligation, or to maintain working capital or equity capital
of the primary obligor or otherwise to maintain the net worth or solvency or any
balance sheet item, level of income or financial condition of the primary
obligor, (iii) to purchase property, securities or services primarily for the
purpose of assuring the owner of any such primary obligation of the ability of
the primary obligor to make payment of such primary obligation, or (iv)
otherwise to assure or hold harmless the holder of

<PAGE>
 
any such primary obligation against loss in respect thereof (each, a "Guaranty
Obligation"); (b) with respect to any Surety Instrument issued for the account
of that Person or as to which that Person is otherwise liable, for reimbursement
of drawings or other payments made hereunder; (c) to purchase any materials,
supplies or other property from, or to obtain the services of, another Person if
the relevant contract or other related document or obligation requires that
payment for such materials, supplies or other property, or for such services,
shall be made regardless of whether delivery of such materials, supplies or
other property is ever made or tendered, or such services are ever performed or
tendered, or (d) in respect of any Swap Contract. The amount of any Contingent
Obligation shall, in the case of Guaranty Obligations, be deemed equal to the
stated or determinable amount of the primary obligation in respect of which such
Guaranty Obligation is made or, if not stated or if indeterminable, the maximum
reasonably anticipated liability in respect thereof, and in the case of other
Contingent Obligations, shall be equal to the maximum reasonably anticipated
liability in respect thereof.

"Contractual Obligation" means, as to any Person, any provision of any security
issued by such Person or of any agreement, undertaking, contract, indenture,
mortgage, deed of trust or other instrument, document or agreement to which such
Person is a party or by which it or any of its property is bound.

"Conversion/Continuation Date" means any date on which, under Section 2.4, the
Company (a) converts Loans of one Type to another Type, or (b) continues as
Loans of the same Type, but with a new Interest Period, Offshore Rate Loans
having Interest Periods expiring on such date.

"Debt" means the outstanding principal amount of all Indebtedness of the Company
and its Subsidiaries of the nature referred to in clauses (a), (b), (c), (d),
(e), (f) and (h) of the definition of "Indebtedness", and all amounts then due
under Swap Contracts.

"Debt to EBITDA Ratio" means, as of the last day of any Fiscal Quarter, the
ratio of

(a)  the amount of Debt of the Company and its Subsidiaries outstanding on such
date

to

(b)  the aggregate EBITDA of the Company and its Subsidiaries for the four
consecutive Fiscal Quarters then ended.

"Default" means any event or circumstance which, with the giving of notice, the
lapse of time, or both, would (if not cured or otherwise remedied during such
time) constitute an Event of Default.

"Development" means the acquisition, construction, equipping, installation or
development by the Company or any of its Subsidiaries of a Permitted Business
(or an interest therein) that has not commenced operations prior to such
acquisition, construction, equipping, installation or development, including any
transaction, or series of related transactions, by the Company or any


<PAGE>
 
of its Subsidiaries involving the sale, transfer, lease, contribution or other
conveyance of assets or capital stock, limited liability company interests,
partnership units or other equity or ownership interests of any Person
(including, where applicable, accounts receivable or other intangible assets of
such Person) to the Company or any of its Subsidiaries.

"Dollars", "dollars" and "$" each mean lawful money of the United States.

"Earnout" means, with respect to any Person, any obligation with respect to such
Person, whether contingent or otherwise, to pay a deferred purchase price for
property or services based on contractually-agreed performance criteria.

"EBITDA" means, for any period, the sum of

(a)  Consolidated Net Income before extraordinary items (as defined by GAAP) for
such period,

plus

(b)  Consolidated Interest Expense for such period, in each case deducted in
determining Consolidated Net Income for such period, if any,

plus

(c)  all United States Federal, state, local and foreign income taxes of the
Company and its Subsidiaries, in each case deducted in determining Consolidated
Net Income for such period, if any,

plus

(d)  all amortization of assets (including goodwill and other intangible assets
(including noncompetition agreements)) of the Company and its Subsidiaries, in
each case deducted in determining Consolidated Net Income for such period,

plus

(e)  all depreciation of assets of the Company and its Subsidiaries, in each
case deducted in determining Consolidated Net Income for such period.

provided that, if the Majority Banks consent in their sole discretion, EBITDA
shall be determined on a pro forma basis giving effect to the Acquisition of an
acquired company or assets as if such Acquisition had occurred on the first day
of such period. The Company shall provide to the Majority Banks a computation
(in form and substance reasonably satisfactory to the Majority Banks) of its
proposed pro forma EBITDA together with reasonable details showing the
supporting information therefor.


<PAGE>
 
"EBT" means, for any period, the sum of Consolidated Net Income for such period
(before extraordinary items, as defined by GAAP, for such period) and all United
States Federal, state, local and foreign income taxes of the Company and its
Subsidiaries, in each case deducted in determining Consolidated Net Income for
such period.

"Eligible Assignee" means (i) a commercial bank organized under the laws of the
United States, or any state thereof, and having a combined capital and surplus
of at least $100,000,000; (ii) a commercial bank organized under the laws of any
other country which is a member of the Organization for Economic Cooperation and
Development (the "OECD"), or a political subdivision of any such country, and
having a combined capital and surplus of at least $100,000,000, provided that
such bank is acting through a branch or agency located in the country in which
it is organized or another country which is also a member of the OECD; and (iii)
a Person organized under the laws of the United States or a state thereof that
is primarily engaged in the business of commercial banking and that is (A) a
Subsidiary of a Bank, (B) a Subsidiary of a Person of which a Bank is a
Subsidiary, or (C) a Person of which a Bank is a Subsidiary.

"Environmental Claims" means all written claims, however asserted, by any
Governmental Authority or other Person alleging potential liability or
responsibility for violation of any Environmental Law, or for release or injury
to the environment.

"Environmental Laws" means all federal, state or local laws, statutes, common
law duties, rules, regulations, ordinances and codes, together with all
administrative orders, licenses, authorizations and permits of, and agreements
with, any Governmental Authorities, in each case relating to environmental,
health and safety matters.

"ERISA" means the Employee Retirement Income Security Act of 1974.

"ERISA Affiliate" means any trade or business (whether or not incorporated)
under common control with the Company within the meaning of Section 414(b) or
(c) of the Code (and Sections 414(m) and (o) of the Code for purposes of
provisions relating to Section 412 of the Code).

"ERISA Event" means (a) a Reportable Event with respect to a Pension Plan; (b) a
withdrawal by the Company or any ERISA Affiliate from a Pension Plan subject to
Section 4063 of ERISA during a plan year in which it was a substantial employer
(as defined in Section 4001(a)(2) of ERISA) or a cessation of operations which
is treated as such a withdrawal under Section 4062(e) of ERISA; (c) a complete
or partial withdrawal by the Company or any ERISA Affiliate from a Multiemployer
Plan or notification that a Multiemployer Plan is in reorganization; (d) the
filing of a notice of intent to terminate, the treatment of a Plan amendment as
a termination under Section 4041 or 4041A of ERISA, or the commencement of
proceedings by the PBGC to terminate a Pension Plan or Multiemployer Plan; (e)
an event or condition which might reasonably be expected to constitute grounds
under Section 4042 of ERISA for the termination 


<PAGE>
 
of, or the appointment of a trustee to administer, any Pension Plan or
Multiemployer Plan; or (f) the imposition of any liability under Title IV of
ERISA, other than PBGC premiums due but not delinquent under Section 4007 of
ERISA, upon the Company or any ERISA Affiliate.

"Eurodollar Reserve Percentage" has the meaning specified in the definition of
"Offshore Rate".

"Event of Default" means any of the events or circumstances specified in Section
8.1.

"Exchange Act" means the Securities and Exchange Act of 1934.

"Federal Funds Rate" means, for any day, the rate set forth in the weekly
statistical release designated as H.15(519), or any successor publication,
published by the Federal Reserve Bank of New York (including any such successor,
"H.15(519)") on the preceding Business Day opposite the caption "Federal Funds
(Effective)"; or, if for any relevant day such rate is not so published on any
such preceding Business Day, the rate for such day will be the arithmetic mean
as determined by the Agent of the rates for the last transaction in overnight
Federal funds arranged prior to 9:00 a.m. (New York City time) on that day by
each of three leading brokers of Federal funds transactions in New York City
selected by the Agent.

"Fee Letter"  see subsection 2.10(a).

"Fiscal Quarter" means any quarter of a Fiscal Year.

"Fiscal Year" means any period of twelve consecutive calendar months ending on
December 31; references to a Fiscal Year with a number corresponding to any
calendar year (e.g., the "1988 Fiscal Year") refer to the Fiscal Year ending on
the December 31 occurring during such calendar year.

"FRB" means the Board of Governors of the Federal Reserve System, and any
Governmental Authority succeeding to any of its principal functions.

"Funded Debt" means, as of any date of determination, (i) the Loans and (ii) all
other Indebtedness of the Company and its Subsidiaries (on a consolidated basis,
eliminating intercompany items) that matures more than one year from the date of
determination, or matures within one year of such date but is renewable or
extendable, at the option of the debtor to a date more than one year from such
date (in each case including amounts of Funded Debt required to be paid or
prepaid within one year from the date of determination).

"GAAP" means generally accepted accounting principles set forth from time to
time in the opinions and pronouncements of the Accounting Principles Board and
the American Institute of Certified Public Accountants and statements and
pronouncements of the Financial Accounting Standards Board (or agencies with
similar functions of comparable stature and authority within 


<PAGE>
 
the U.S. accounting profession), which are applicable to the circumstances as of
the date of determination. 

"Governmental Authority" means any nation or government, any state or other
political subdivision thereof, any central bank (or similar monetary or
regulatory authority) thereof, any entity exercising executive, legislative,
judicial, regulatory or administrative functions of or pertaining to government,
and any corporation or other entity owned or controlled, through stock or
capital ownership or otherwise, by any of the foregoing.

"Guaranteed Obligations" means all Obligations whether or not (a) for the
payment of money or the performance or nonperformance of any act, (b) arising or
accruing before or after the filing by or against the Company of a petition
under the Bankruptcy Code or (c) allowable under Section 502(b)(2) of the
Bankruptcy Code.

"Guarantor"  see the preamble.

"Guaranty Obligation" has the meaning specified in the definition of "Contingent
Obligation."

"HCFA" means the Health Care Financing Administration of HHS and any Person
succeeding to the functions thereof.

"Health Facility License" means a license or permit to provide surgical or other
health-related services or otherwise operate a Subsidiary, including any permit,
where applicable, under Medicare Regulations, Medicaid Regulations or applicable
state laws.

"HHS" means the Department of Health and Human Services and any Person
succeeding to the functions thereof.

"Increase Date"  see subsection 2.15(a).

"Increasing Bank"  see subsection 2.15(c).

"Indebtedness" of any Person means, without duplication, (a) all indebtedness
for borrowed money; (b) all obligations issued, undertaken or assumed as the
deferred purchase price of property or services (other than trade payables
entered into in the ordinary course of business on ordinary terms); (c) all
noncontingent reimbursement or payment obligations with respect to Surety
Instruments; (d) all obligations evidenced by notes, bonds, debentures or
similar instruments, including obligations so evidenced incurred in connection
with the acquisition of property, assets or businesses; (e) all indebtedness
created or arising under any conditional sale or other title retention
agreement, or incurred as financing, in either case with respect to property
acquired by the Person (even though the rights and remedies of the seller or
bank under such agreement in the event of default are limited to repossession or
sale of such property); (f) all Capitalized Lease Liabilities; (g) all net
obligations with respect to Swap Contracts; (h) all 


<PAGE>
 
indebtedness referred to in clauses (a) through (g) above secured by (or for
which the holder of such Indebtedness has an existing right, contingent or
otherwise, to be secured by) any Lien upon or in property (including accounts
and contract rights) owned by such Person, even though such Person has not
assumed or become liable for the payment of such Indebtedness; and (i) all
Guaranty Obligations in respect of indebtedness or obligations of others of the
kinds referred to in clauses (a) through (g) above.

"Indemnified Liabilities"  see Section 10.5.

"Indemnified Person"  see Section 10.5.

"Independent Auditor"  see subsection 6.1(a).

"Ineligible Securities"  see subsection 7.7(c).

"Insolvency Proceeding" means (a) any case, action or proceeding before any
court or other Governmental Authority relating to bankruptcy, reorganization,
insolvency, liquidation, receivership, dissolution, winding-up or relief of
debtors, or (b) any general assignment for the benefit of creditors,
composition, marshaling of assets for creditors, or other similar arrangement in
respect of its creditors generally or any substantial portion of its creditors;
undertaken under U.S. Federal, state or foreign law, including the Bankruptcy
Code.

"Interest Payment Date" means, as to any Offshore Rate Loan, the last day of
each Interest Period applicable to such Loan and, as to any Base Rate Loan, the
last Business Day of each calendar quarter and each date such Loan is converted
into another Type of Loan, provided, however, that if any Interest Period for an
Offshore Rate Loan exceeds three months, the date that falls on each three-month
anniversary of the beginning of such Interest Period shall also be an Interest
Payment Date.

"Interest Period" means, as to any Offshore Rate Loan, the period commencing on
the Borrowing Date of such Loan or on the Conversion/Continuation Date on which
the Loan is converted into or continued as an Offshore Rate Loan, and ending
either on the date one, two, three or six months thereafter as selected by the
Company in its Notice of Borrowing or Notice of Conversion/Continuation;
provided that:

(i)  if any Interest Period would otherwise end on a day that is not a Business
Day, that Interest Period shall be extended to the following Business Day unless
the result of such extension would be to carry such Interest Period into another
calendar month, in which event such Interest Period shall end on the preceding
Business Day;

(ii)  any Interest Period pertaining to an Offshore Rate Loan that begins on the
last Business Day of a calendar month (or on a day for which there is no
numerically corresponding day in the 


<PAGE>
 
calendar month at the end of such Interest Period) shall end on the last
Business Day of the calendar month at the end of such Interest Period; and

(iii)  no Interest Period shall extend beyond the Termination Date.

"IRS" means the Internal Revenue Service, and any Governmental Authority
succeeding to any of its principal functions under the Code.

"JCAHO" means the Joint Commission on Accreditation of Health Organizations.

"Joint Venture" means a single-purpose corporation, partnership, joint venture
or other similar legal arrangement (whether created by contract or conducted
through a separate legal entity) now or hereafter formed by the Company or any
of its Subsidiaries with another Person in order to conduct a common venture or
enterprise with such Person.

"Lending Office" means, as to any Bank, the office or offices of such Bank
specified as its "Lending Office" or "Domestic Lending Office" or "Offshore
Lending Office", as the case may be, on Schedule 10.2, or such other office or
offices as such Bank may from time to time notify the Company and the Agent.

"Lien" means any security interest, mortgage, deed of trust, pledge,
hypothecation, assignment, charge or deposit arrangement, encumbrance, lien
(statutory or other) or preferential arrangement of any kind or nature
whatsoever in respect of any property (including those created by, arising under
or evidenced by any conditional sale or other title retention agreement, the
interest of a lessor under a capital lease, any financing lease having
substantially the same economic effect as any of the foregoing, or the filing of
any financing statement naming the owner of the asset to which such lien relates
as debtor, under the Uniform Commercial Code or any comparable law) and any
contingent or other agreement to provide any of the foregoing, but not including
the interest of a lessor under an operating lease.

"Loan" means an extension of credit by a Bank to the Company under Article II,
and may be a Base Rate Loan, or an Offshore Rate Loan (each, a "Type" of Loan),
and includes any Revolving Loan.

"Loan Documents" means this Agreement, any Notes, the Fee Letter and all other
documents delivered to the Agent or any Bank in connection herewith.

"Majority Banks" means at any time at least two Banks then holding, in the
aggregate, in excess of 50% of the Commitments, or, if the Commitments have been
terminated, Banks then having in excess of 50% of the then aggregate unpaid
principal amount of the Loans.

"Majority Ownership Interest" means the ownership, either directly or
indirectly, of more than 50% of the capital stock, limited liability company
interests, partnership units or other equity or ownership interests of a Person.

<PAGE>

"Margin Stock" means "margin stock" as such term is defined in Regulation G, T,
U or X of the FRB.
 
"Material Adverse Effect" means (a) a material adverse change in, or a material
adverse effect upon, the operations, business, properties, condition (financial
or otherwise) or prospects of the Company and its Subsidiaries taken as a whole;
(b) a material impairment of the ability of the Company or any Material
Subsidiary to perform its respective obligations under any Loan Document; or (c)
a material adverse effect upon the legality, validity, binding effect or
enforceability against the Company or any Material Subsidiary of any Loan
Document.

"Material Subsidiary" means and includes any Subsidiary where either:

(i)  the portion of the Company's EBT which such Subsidiary contributed during
the preceding four Fiscal Quarters exceeded 5%; or

(ii)  the portion of Consolidated Total Assets which were attributable to such
Subsidiary as at the end of the preceding Fiscal Quarter exceeded 5%.

"Medicaid" means the medical assistance program established by Title XIX of the
Social Security Act (42 U.S.C. (S)(S) 1396, et seq.) and any successor thereto.

"Medicaid Certification" means certification by a state agency that the health
facility fully complies in all material respects with all the requirements for
participation in the Medicaid Regulations.

"Medicaid Provider Agreement" means an agreement entered into between a state
agency or other such entity administering the Medicaid program and a health
facility under which the agency agrees to pay for services provided by the
health facility to qualified Medicaid beneficiaries in accordance with the terms
of the agreement and Medicaid Regulations.

"Medicaid Regulations" means, collectively, (i) all Federal statutes (whether
set forth in Title XIX of the Social Security Act or elsewhere) affecting the
medical assistance program established by Title XIX of the Social Security Act
(42 U.S.C. (S)(S) 1396, et seq.), (ii) all applicable provisions of all federal
rules, regulations, manuals, orders and administrative, reimbursement and other
guidelines of all Governmental Authorities (whether or not having the force of
law) promulgated pursuant to or in connection with the statutes described in
clause (i), (iii) all state statutes and plans for medical assistance enacted in
connection with the statutes and provisions described in clauses (i) and (ii),
and (iv) all applicable provisions of all rules, regulations, manuals, orders
and administrative, reimbursement and other guidelines of all Governmental
Authorities (whether or not having the force of law) promulgated pursuant to or
in connection with any of the foregoing.


<PAGE>
 
"Medicare" means the health insurance program established by Title XVIII of the
Social Security Act (42 U.S.C. (S)(S) 1395, et seq.) and any successor thereto.

"Medicare Certification" means certification by HCFA or a state agency or entity
under contract with HCFA that the health facility complies with all the
requirements for participation set forth in the Medicare Regulations.

"Medicare Provider Agreement" means an agreement entered into between HCFA or a
state agency under contract with HCFA and a health facility under which HCFA
agrees to pay for services provided by the health facility to qualified Medicare
beneficiaries in accordance with the terms of the agreement and Medicare
Regulations.

"Medicare Regulations" means, collectively, all Federal statutes (whether set
forth in Title XVIII of the Social Security Act or elsewhere) affecting the
health insurance program for the aged and disabled established by Title XVIII of
the Social Security Act (42 U.S.C. (S)(S) 1395, et seq.), together with all
applicable provisions of all rules, regulations, manuals, orders and
administrative, reimbursement and other guidelines of all Governmental
Authorities including HHS, HCFA, the Office of the Inspector General of HHS, or
any Person succeeding to the functions of any of the foregoing (whether or not
having the force of law).

"Minority Owned Person" means, with respect to the Company or any Subsidiary of
the Company, any Person of which less than 50% of the voting stock, limited
liability company interests, partnership units or other equity or ownership
interests is owned or controlled directly or indirectly by the Company, or one
or more Subsidiaries of the Company, or a combination thereof.

"Multiemployer Plan" means a "multiemployer plan", within the meaning of Section
4001(a)(3) of ERISA, to which the Company or any ERISA Affiliate makes, is
making, or is obligated to make contributions or, during the preceding three
calendar years, has made, or been obligated to make, contributions.

"New Bank"  see subsection 2.15(e).

"Note" means a promissory note executed by the Company in favor of a Bank
pursuant to subsection 2.2(b), in substantially the form of Exhibit F.

"Notice of Borrowing" means a notice in substantially the form of Exhibit A.

"Notice of Conversion/Continuation" means a notice in substantially the form of
Exhibit B.

"Obligations" means all advances, debts, liabilities, obligations, covenants and
duties arising under any Loan Document owing by the Company to any Bank, the
Agent, or any Indemnified 


<PAGE>
 
Person, whether direct or indirect (including those acquired by assignment),
absolute or contingent, due or to become due, now existing or hereafter arising.

"Offshore Rate" means, for any Interest Period, with respect to Offshore Rate
Loans comprising part of the same Borrowing, the rate of interest per annum
(rounded upward, if necessary, to the next 1/16th of 1%) determined by the Agent
as follows:

                               LIBOR
Offshore Rate = ------------------------------------
                1.00 - Eurodollar Reserve Percentage

where:

"Eurodollar Reserve Percentage" means for any day for any Interest Period the
maximum reserve percentage (expressed as a decimal, rounded upward, if
necessary, to the next 1/100th of 1%) in effect on such day (whether or not
applicable to any Bank) under regulations issued from time to time by the FRB
for determining the maximum reserve requirement (including any emergency,
supplemental or other marginal reserve requirement) with respect to Eurocurrency
funding (currently referred to as "Eurocurrency liabilities"); and

"LIBOR" means the rate of interest per annum determined by the Agent (rounded
upward, if necessary, to the next 1/16th of 1%) as the rate of interest at which
dollar deposits in the approximate amount of BofA's Offshore Rate Loan for such
Interest Period would be offered by BofA to major banks in the London interbank
market at their request at approximately 11:00 a.m. (London time) two Business
Days prior to the commencement of such Interest Period.

The Offshore Rate shall be adjusted automatically as to all Offshore Rate Loans
then outstanding as of the effective date of any change in the Eurodollar
Reserve Percentage.

"Offshore Rate Loan" means a Loan that bears interest based on the Offshore
Rate.

"Organization Documents" means, with respect to any Person other than an
individual, where applicable, the certificate or articles of incorporation,
organization or formation, the bylaws or limited liability company agreement,
any certificate of designation or instrument relating to the rights of preferred
shareholders of the corporation, any shareholder rights agreement, all
applicable resolutions of the board of directors (or any committee thereof) of
such Person, the partnership agreement establishing the partnership, the joint
venture agreement establishing the Joint Venture, the instrument establishing
the trust, or any other constitutive documents.

"Originating Bank" see section 10.8(d).

"Other Taxes" means any present or future stamp or documentary taxes or any
other excise or property taxes, charges or similar levies which arise from any
payment made hereunder or from


<PAGE>
 
the execution, delivery or registration of, or otherwise with respect to, this
Agreement or any other Loan Documents.

"Participant" see subsection 10.8(d).

"PBGC" means the Pension Benefit Guaranty Corporation, or any Governmental
Authority succeeding to any of its principal functions under ERISA.

"Pension Plan" means a pension plan (as defined in Section 3(2) of ERISA)
subject to Title IV of ERISA which the Company sponsors, maintains, or to which
it makes, is making, or is obligated to make contributions, or in the case of a
multiple employer plan (as described in Section 4064(a) of ERISA) has made
contributions at any time during the immediately preceding five (5) plan years.

"Permitted Acquisition" means, with respect to the Company or any Subsidiary of
the Company, an Acquisition by the Company or such Subsidiary of the Company, as
the case may be, and as to which;

(a)  the Person whose equity or ownership interests are to be acquired or the
Person whose assets are the subject of the Acquisition is not an Affiliate of
the Company or of any Subsidiary of the Company;

(b)  if required by law or the Organization Documents of the Person whose equity
or ownership interests or property is the subject of such Acquisition, the
Acquisition has been approved by the board of directors (or similar governing
body) of the Person in whom equity or ownership interests are to be acquired or
of the Person whose assets were the subject of the Acquisition, or by any
committee thereof or authorized officers as provided by such board of directors,
and such board or persons have not commenced any litigation to oppose such
Acquisition;

(c)  the Company has received all necessary approvals relating to such
Acquisition as are customary and usual for similar transactions, including,
where applicable, the approval of the Company's board of directors;

(d)  unless otherwise established by the consent of the Banks prior to such
Acquisition, the Company or any of its Subsidiaries, after giving effect to such
Acquisition, will have a Majority Ownership Interest in the Person owning the
Permitted Business subject to such Acquisition;

(e)  at the time of such Acquisition, the Company is in compliance with all
financial covenants required under the Loan Documents, including those specified
in Section 6.13 (provided, that none of the cashflow generated prior to the date
of such Acquisition by any Person that was not a Subsidiary, or a Minority Owned
Person of the Company or of any


<PAGE>
 
Subsidiary of the Company, prior to the date of the Acquisition may be taken
into account in determining compliance with such financial covenants);

(f)  if the written consent of the Majority Banks is required under clauses (g)
or (h) hereof, the Banks have received written notice of such Acquisition at
least 30 days' prior to the consummation of such Acquisition, such notice to
indicate (i) the location of the property or the Person whose equity or
ownership interests are to be acquired, (ii) the price which the Company or any
of its Subsidiaries has agreed to pay for such property or equity or ownership
interests and (iii) a brief description of such property or Person;

(g)  the Majority Banks, in their sole and absolute discretion, have delivered
to the Company their written consent to any Acquisition, whether or not financed
hereunder, for which total consideration to be paid exceeds $10,000,000,
including Earnout provisions, if any;

(h)  the Majority Banks, in their sole and absolute discretion, have delivered
to the Company their written consent to any Acquisition, whether or not financed
hereunder, for which total consideration paid exceeds $5,000,000 and the
purchase multiple exceeds pretax income multiplied by eight; and

(i)  where the Company owns 100% of the Person whose equity or ownership
interests are acquired upon the consummation of the Acquisition, such Person has
become a party to this Agreement as a Guarantor, provided that the obligations
of such Person as a Guarantor under Article XI of this Agreement shall terminate
if such Person thereafter ceases, in accordance with the terms of this
Agreement, to be a Wholly-Owned Subsidiary of the Company.

"Permitted Business" means either (a) any business which provides surgical
services but not long-term care, or (b) any activity, business or service
ancillary, complementary or related to surgical services other than long-term
care.

"Permitted Development" means, with respect to the Company or any Subsidiary of
the Company, a Development as to which:

(a)  the Company has received all necessary approvals relating to such
Development as are customary and usual for similar transactions, including,
where applicable, the approval of the Company's board of directors;

(b)  unless otherwise established by the consent of the Banks prior to such
Development, the Company or any of its Subsidiaries, after giving effect to such
Development, will have a Majority Ownership Interest in the Person owning the
Permitted Business subject to such Development;

(c)  at all times during the Development, the Company is in compliance with all
financial covenants required under the Loan Documents, including those specified
in Section 6.13;


<PAGE>
 
(d)  if the written consent of the Majority Banks is required under clauses (e)
or (f) hereof, the Banks have received written notice of such Development at
least 30 days' prior to the consummation of such Development, such notice to
indicate (i) the location of the property or the Person to be developed, (ii)
the price which the Company or any of its Subsidiaries has agreed to pay for
such property or the equity or ownership interests of such Person and (iii) a
brief description of such property or Person;

(e)  the Majority Banks, in their sole and absolute discretion, have delivered
to the Company their written consent to any Development which will be financed
hereunder, and for which total consideration to be paid exceeds $5,000,000; and

(f)  the Majority Banks, in their sole and absolute discretion, have delivered
to the Company their written consent to any Development, which will not be
financed hereunder, and for which total consideration to be paid exceeds
$10,000,000.

"Permitted Investment" means, with respect to the Company or any Subsidiary of
the Company, any Acquisition or Development which, (i) in the case of an
Acquisition, meets all the requirements of the definition of "Permitted
Acquisition" in Section 1.1 except for clause (d) thereof or, (ii) in the case
of a Development, meets all the requirements of the definition of "Permitted
Development" in Section 1.1 except for clause (b) thereof.

"Permitted Liens" see Section 7.1.

"Permitted Transaction" means, as the context may require, a Permitted
Acquisition or a Permitted Development.

"Person" means an individual, partnership, corporation, business trust, joint
stock company, trust, unincorporated association, joint venture, limited
liability company, or Governmental Authority.

"Plan" means an employee benefit plan (as defined in Section 3(3) of ERISA)
which the Company sponsors or maintains or to which the Company makes, is
making, or is obligated to make contributions and includes any Pension Plan.

"Pro Rata Share" means, as to any Bank at any time, the percentage equivalent
(expressed as a decimal, rounded to the ninth decimal place) at such time of
such Bank's Commitment divided by the combined Commitments of all Banks.

"Replacement Bank" see Section 3.8.

"Reportable Event" means, any of the events set forth in Section 4043(b) of
ERISA, other than any such event for which the 30-day notice requirement under
ERISA has been waived in regulations issued by the PBGC.


<PAGE>
 
"Requirement of Law" means, as to any Person, any law (statutory or common),
treaty, rule or regulation or determination of an arbitrator or of a
Governmental Authority, in each case applicable to or binding upon the Person or
any of its property or to which the Person or any of its property is subject.

"Responsible Officer" means the chief executive officer or the president of the
Company, or any other officer having substantially the same authority and
responsibility; or, with respect to compliance with financial covenants, the
chief financial officer or the treasurer of the Company, or any other officer
having substantially the same authority and responsibility.

"Revolving Loan" see Section 2.1.

"SEC" means the Securities and Exchange Commission, or any Governmental
Authority succeeding to any of its principal functions.

"Subordinated Debt" means all unsecured Indebtedness of the Company or its
Subsidiaries for borrowed money which is subordinated, upon terms reasonably
satisfactory to the Banks, in right of payment to the payment in full in cash of
all Obligations, including certain Indebtedness set forth in Schedule 7.5.

"Subsidiary" of a Person means any corporation, limited liability company,
association, partnership, joint venture or other business entity of which more
than 50% of the voting stock, limited liability company interests, partnership
units or other equity or ownership interests (in the case of Persons other than
corporations), is owned or controlled directly or indirectly by the Person, or
one or more of the Subsidiaries of the Person, or a combination thereof. Unless
the context otherwise clearly requires, references herein to a "Subsidiary"
refer to a Subsidiary of the Company.

"Surety Instruments" means all letters of credit (including standby and
commercial), banker's acceptances, bank guaranties, shipside bonds, surety bonds
and similar instruments.

"Swap Contract" means any agreement (including any master agreement and any
agreement, whether or not in writing, relating to any single transaction) that
is an interest rate swap agreement, basis swap, forward rate agreement,
commodity swap, commodity option, equity or equity index swap or option, bond
option, interest rate option, forward foreign exchange agreement, rate cap,
collar or floor agreement, currency swap agreement, cross-currency rate swap
agreement, swaption, currency option or any other, similar agreement (including
any option to enter into any of the foregoing).

"Taxes" means any and all present or future taxes, levies, imposts, deductions,
charges or withholdings, and all liabilities with respect thereto, excluding, in
the case of each Bank and the Agent, such taxes (including income taxes or
franchise taxes) as are imposed on or measured by


<PAGE>
 
each Bank's net income by the jurisdiction (or any political subdivision
thereof) under the laws of which such Bank or the Agent, as the case may be, is
organized or maintains a lending office.

"Termination Date" means the earlier to occur of:

(a)  November 17, 2000 (as such date may be extended pursuant to Section 2.16);
     and

(b)  the date on which the Commitments terminate in accordance with the
provisions of this Agreement.

"Type" has the meaning specified in the definition of "Loan."

"Unfunded Pension Liability" means the excess of a Plan's benefit liabilities
under Section 4001(a)(16) of ERISA, over the current value of that Plan's
assets, determined in accordance with the assumptions used for funding the
Pension Plan pursuant to Section 412 of the Code for the applicable plan year.

"United States" and "U.S." each means the United States of America.

"Wholly-Owned Subsidiary" means any corporation in which (other than directors'
qualifying shares required by law) 100% of the capital stock of each class
having ordinary voting power, and 100% of the capital stock of every other
class, in each case, at the time as of which any determination is being made, is
owned, beneficially and of record, by the Company, or by one or more of the
other Wholly-Owned Subsidiaries, or both.

I.2  Other Interpretive Provisions.  Unless the context otherwise clearly
requires:

(a)  The meanings of defined terms are equally applicable to the singular and
plural forms of the defined terms.

(b)  The words "hereof", "herein", "hereunder" and similar words refer to this
Agreement as a whole and not to any particular provision of this Agreement; and
subsection, Section, Schedule and Exhibit references are to this Agreement
unless otherwise specified.

(c)  (i)  The term "documents" includes any and all instruments, documents,
agreements, certificates, indentures, notices and other writings, however
evidenced.

(ii)   The term "including" is not limiting and means "including without
limitation."

(iii)  In the computation of periods of time from a specified date to a later
specified date, the word "from" means "from and including"; the words "to" and
"until" each mean "to but excluding", and the word "through" means "to and
including."

<PAGE>
 
(d)  Unless otherwise expressly provided herein, (i) references to agreements
(including this Agreement) and other contractual instruments shall be deemed to
include all subsequent amendments and other modifications thereto, but only to
the extent such amendments and other modifications are not prohibited by the
terms of any Loan Document, and (ii) references to any statute or regulation are
to be construed as including all statutory and regulatory provisions
consolidating, amending, replacing, supplementing or interpreting the statute or
regulation.

(e)  The table of contents, captions and headings of this Agreement are for
convenience of reference only and shall not affect the interpretation of this
Agreement.

(f)  This Agreement and other Loan Documents may use several different
limitations, tests or measurements to regulate the same or similar matters.  All
such limitations, tests and measurements are cumulative and shall each be
performed in accordance with their terms.

(g)  This Agreement and the other Loan Documents are the result of negotiations
among and have been reviewed by counsel to the Agent, the Company and the other
parties, and are the products of all parties. Accordingly, they shall not be
construed against the Banks or the Agent merely because of the Agent's or Banks'
involvement in their preparation.

I.3  Accounting Principles.  Unless the context otherwise clearly requires, all
accounting terms not expressly defined herein shall be construed, and all
financial computations required under this Agreement shall be made, in
accordance with GAAP, consistently applied.

                                  ARTICLE II

                                  THE CREDITS
                                  -----------

II.1  Amounts and Terms of Commitments.  Each Bank severally agrees, on the
terms and conditions set forth herein, to make loans to the Company (each such
loan, a "Revolving Loan") from time to time on any Business Day during the
period from the Closing Date to the Termination Date, in an aggregate amount not
to exceed at any time outstanding amount set forth on Schedule 2.1 (such amount,
as the same may be reduced under Section 2.5 or as a result of one or more
assignments under Section 10.8, or increased under Section 2.15, the Bank's
"Commitment"); provided that, after giving effect to any Borrowing of Revolving
Loans, the aggregate principal amount of all outstanding Revolving Loans shall
not at any time exceed the combined Commitments.  Within the limits of each
Bank's Commitment, and subject to the other terms and conditions hereof, the
Company may borrow under this Section 2.1, prepay under Section 2.6 and reborrow
under this Section 2.1.

II.2  Loan Accounts.  (a)  The Loans made by each Bank shall be evidenced by one
or more loan accounts or records maintained by such Bank in the ordinary course
of business.  The loan accounts or records maintained by the Agent and each Bank
shall be conclusive absent manifest 
<PAGE>
 
error of the amount of the Loans made by the Banks to the Company and the
interest and payments thereon. Any failure so to record or any error in doing so
shall not, however, limit or otherwise affect the obligation of the Company
hereunder to pay when due any amount owing with respect to the Loans.

(b)  Upon the request of any Bank made through the Agent, the Loans made by such
Bank may be evidenced by one or more Notes, in addition to loan accounts. Each
such Bank may endorse on the schedules annexed to its Note(s) the date, amount,
type, interest rate and maturity of each Loan made by such Bank to the Company
and the amount of each payment of principal made by the Company with respect
thereto. Each such Bank is irrevocably authorized by the Company to endorse its
Note(s) and each Bank's record shall be conclusive absent manifest error;
provided, however, that the failure of a Bank to make, or an error in making, a
notation thereon with respect to any Loan shall not limit or otherwise affect
the obligations of the Company hereunder or under any such Note to such Bank.

II.3  Procedure for Borrowing.  (a)  Each Borrowing shall be made upon the
Company's irrevocable written notice delivered to the Agent in the form of a
Notice of Borrowing, which notice must be received by the Agent (i) in the case
of Base Rate Loans, prior to 10:00 a.m. (Chicago time) on the requested
Borrowing Date and (ii) in the case of Offshore Rate Loans, prior to 12:00 noon
on the third Business Day prior to the requested Borrowing Date, specifying:

(A)  the amount of the Borrowing, which shall be in an aggregate minimum amount
of $1,000,000 or any multiple of $500,000 in excess thereof;

(B)  the requested Borrowing Date, which shall be a Business Day;

(C)  the Type of Loans comprising the Borrowing; and

(D)  in the case of Offshore Rate Loans, the duration of the Interest Period
applicable to such Loans included in such notice. If the Notice of Borrowing
fails to specify the duration of the Interest Period for any Borrowing comprised
of Offshore Rate Loans, such Interest Period shall be one month.

provided, however, that with respect to the Borrowing, if any, to be made on the
Closing Date, the Notice of Borrowing shall be delivered to the Agent not later
than 12:00 noon (Chicago time) one Business Day before the Closing Date and such
Borrowing will consist of Base Rate Loans only.

(b)  The Agent will promptly notify each Bank of the Agent's receipt of any
Notice of Borrowing and of the amount of such Bank's Pro Rata Share of that
Borrowing.

(c)  Each Bank will make the amount of its Pro Rata Share of each Borrowing
available to the Agent for the account of the Company at the Agent's Payment
Office by 12:00 noon (Chicago

<PAGE>
 
time) on the Borrowing Date requested by the Company in funds immediately
available to the Agent. The proceeds of all such Loans will then be made
available to the Company by the Agent at such office by crediting the account of
the Company on the books of BofA with the aggregate of the amounts made
available to the Agent by the Banks and in like funds as received by the Agent.

(d)  After giving effect to any Borrowing, there may not be more than seven
different Interest Periods in effect.

II.4  Conversion and Continuation Elections.  (a)  The Company may, upon
irrevocable written notice to the Agent in accordance with subsection 2.4(b):

(i)  elect, as of any Business Day, in the case of Base Rate Loans, or as of the
last day of the applicable Interest Period, in the case of Offshore Rate Loans,
to convert any such Loans (or any part thereof in an amount not less than
$1,000,000, or that is in an integral multiple of $500,000 in excess thereof)
into Loans of the other Type; or

(ii)  elect, as of the last day of the applicable Interest Period, to continue
any Offshore Rate Loans having Interest Periods expiring on such day (or any
part thereof in an amount not less than $1,000,000, or that is in an integral
multiple of $500,000 in excess thereof) as Offshore Rate Loans;

provided, that if at any time the aggregate amount of Offshore Rate Loans in
respect of any Borrowing is reduced, by payment, prepayment, or conversion of
part thereof to be less than $1,000,000, such Offshore Rate Loans shall
automatically convert into Base Rate Loans, and on and after such date the right
of the Company to continue such Loans as, and convert such Loans into,  Offshore
Rate Loans shall terminate.

(b)  The Company shall deliver a Notice of Conversion/ Continuation to be
received by the Agent not later than 12:00 noon (Chicago time) at least (i)
three Business Days in advance of the Conversion/Continuation Date, if the Loans
(or parts thereof) are to be converted into or continued as Offshore Rate Loans;
and (ii) one Business Day in advance of the Conversion/Continuation Date, if the
Loans (or parts thereof) are to be converted into Base Rate Loans, specifying:

(A)  the proposed Conversion/Continuation Date;

(B)  the aggregate amount of Loans (or parts thereof) to be converted or
     continued;

(C)  the Types of Loans resulting from the proposed conversion or continuation;
     and

(D)  other than in the case of conversions into Base Rate Loans, the duration of
the requested Interest Period.
<PAGE>
 
(c)  If upon the expiration of any Interest Period applicable to Offshore Rate
Loans, the Company has failed to select timely a new Interest Period to be
applicable to such Offshore Rate Loans, or if any Default or Event of Default
then exists, the Company shall be deemed to have elected to convert such
Offshore Rate Loans into Base Rate Loans effective as of the expiration date of
such Interest Period.

(d)  The Agent will promptly notify each Bank of the Agent's receipt of a Notice
of Conversion/Continuation, or, if no timely notice is provided by the Company,
the Agent will promptly notify each Bank of the details of any automatic
conversion. All conversions and continuations shall be made ratably according to
the respective outstanding principal amounts of the Loans with respect to which
the notice was given held by each Bank.

(e)  Unless the Majority Banks otherwise agree, during the existence of a
Default or Event of Default, the Company may not elect to have a Loan converted
into or continued as an Offshore Rate Loan.

(f)  After giving effect to any conversion or continuation of Loans, there may
not be more than seven different Interest Periods in effect.

II.5  Voluntary Termination or Reduction of Commitments.  The Company may, upon
not less than three Business Days' prior notice to the Agent, terminate the
Commitments, or permanently reduce the Commitments by an aggregate minimum
amount of $1,000,000 or any multiple of $1,000,000 in excess thereof; unless,
after giving effect thereto and to any prepayments of Loans made on the
effective date thereof, the then-outstanding principal amount of the Loans would
exceed the amount of the combined Commitments then in effect.  Once reduced in
accordance with this Section, the Commitments may not be increased (including
increases under Section 2.15). Any reduction of the Commitments shall be applied
to each Bank according to its Pro Rata Share. All accrued commitment fees to,
but not including the effective date of any reduction or termination of
Commitments, shall be paid on the effective date of such reduction or
termination.

II.6  Optional Prepayments. Subject to Section 3.4, the Company may, at any time
or from time to time, prior to 10:00 a.m. (Chicago time) on any Business Day,
ratably prepay Loans, without premium or penalty (other than as contemplated by
Section 3.4(d)), in whole or in part, in minimum amounts of $500,000 or any
multiple of $500,000 in excess thereof.  Such notice of prepayment shall specify
the date and amount of such prepayment and the Type(s) of Loans to be prepaid.
The Agent will promptly notify each Bank of the Agent's receipt of any such
notice, and of such Bank's Pro Rata Share of such prepayment.  If any such
notice is given by the Company, the Company shall make such prepayment and the
payment amount specified in such notice shall be due and payable on the date
specified therein, together with accrued interest to each such date on the
amount prepaid and any amounts required pursuant to Section 3.4.
<PAGE>
 
II.7  Mandatory Prepayments of Loans.  Subject to Section 3.4, on each date when
any reduction in any Bank's Commitment pursuant to Section 2.5 shall become
effective, the Company shall make a mandatory prepayment of the principal amount
of all applicable Loans equal to the excess, if any, of the aggregate principal
amount of such Loans over such Commitment as so reduced.  Pursuant to such
mandatory prepayment, Base Rate Loans shall be prepaid first, followed by
Offshore Rate Loans in the manner elected by the Company or, if no such election
is made, in the inverse order of maturity.


II.8  Repayment.   The Company shall repay to the Banks on the Termination Date
the aggregate principal amount of Revolving Loans outstanding on such date.

II.9  Interest.  (a)  Each Loan shall bear interest on the outstanding principal
amount thereof from the applicable Borrowing Date at a rate per annum equal to
the Offshore Rate or the Base Rate, as the case may be (and subject to the
Company's right to convert to the other Type of Loans under Section 2.4), plus
the Applicable Margin.

(b)  Interest on each Loan shall be paid in arrears on each Interest Payment
Date therefor. Interest shall also be paid on the date of any prepayment of
Loans under Section 2.6 or 2.7 for the portion of the Loans so prepaid and upon
payment (including prepayment) in full thereof and, during the continuance of
any Event of Default, interest shall be paid on demand of the Agent at the
request or with the written consent of the Majority Banks.

(c)  Notwithstanding subsection (a) of this Section, while any Event of Default
is continuing or after acceleration, the Company shall pay interest (after as
well as before entry of judgment thereon to the extent permitted by law) on the
principal amount of all outstanding Loans, at a rate per annum which is
determined by adding 2% per annum to the sum of the Offshore Rate or the Base
Rate, as the case may be, and the Applicable Margin then in effect for such
Loans and, in the case of Obligations not subject to an Applicable Margin, at a
rate per annum equal to the Base Rate plus 2% per annum; provided, however,
that, on and after the expiration of any Interest Period applicable to any
Offshore Rate Loan outstanding on the date of occurrence of such Event of
Default or acceleration, the principal amount of such Loan shall, during the
continuation of such Event of Default or after acceleration, bear interest at a
rate per annum equal to the sum of the Applicable Margin, the Base Rate and 2%
per annum.

(d)  Anything herein to the contrary notwithstanding, the obligations of the
Company to any Bank hereunder shall be subject to the limitation that payments
of interest shall not be required for any period for which interest is computed
hereunder, to the extent (but only to the extent) that contracting for or
receiving such payment by such Bank would be contrary to the provisions of any
law applicable to such Bank limiting the highest rate of interest that may be
lawfully contracted for, charged or received by such Bank, and in such event the
Company shall pay such Bank interest at the highest rate permitted by applicable
law.
<PAGE>
   
II.10 Fees. (a) Fee Letter. The Company shall pay the fees as required by the
letter agreement ("Fee Letter") among the Company and the Arranger and Agent
dated September 11, 1997.

(b) Commitment Fees. The Company shall pay to the Agent for the account of each
Bank a commitment fee on the average daily unused portion of such Bank's
Revolving Commitment, computed on a quarterly basis in arrears on the last
Business Day of each calendar quarter at the applicable rate per annum set forth
in the table below. Such commitment fee shall accrue from the Closing Date to
the Termination Date and shall be due and payable quarterly in arrears on the
last Business Day of each calendar quarter commencing on December 31, 1997
through the Termination Date, with the final payment to be made on the
Termination Date; provided that, in connection with any reduction or termination
of Commitments under Section 2.5, the accrued commitment fee calculated with
respect to such portion of the Commitments as is reduced or terminated for the
period ending on such date shall also be paid on the date of such reduction or
termination, with the following quarterly payment being calculated on the basis
of the period from such reduction or termination date to such quarterly payment
date. The commitment fees provided in this subsection shall accrue at all times
after the Closing Date, including at any time during which one or more
conditions in Article IV are not met.

Debt to EBITDA Ratio            Commitment Fee
- ---------------------           ---------------
Greater than 2.50:1             0.400%

Greater than 2.00:1 and
less than or equal to
2.50:1                          0.350%

Greater than 1.50:1 and
less than or equal to
2.00:1                          0.300%

Greater than 1.00:1 and
less than or equal to
1.50:1                          0.250%

Less than or equal to 1.00:1    0.200%

provided, that the Commitment Fee shall be adjusted, to the extent applicable,
60 days (or, in the case of the last Fiscal Quarter of any Fiscal Year, 105
days) after the end of each Fiscal Quarter based on the Debt to EBITDA Ratio
determined as of the last day of such Fiscal Quarter; provided, further, that if
the Company fails to deliver the financial statements required by Section 6.1
and the related certificate required by Section 6.2 by the 60th day (or, if
applicable, the 105th day) after the end of any Fiscal quarter, the Commitment
Fee shall be deemed to be, until such financial statements are delivered, the
Commitment Fee which applies when the Debt to EBITDA Ratio is greater than
2.50:1.
<PAGE>
 
(c) Up-front Fees. The Company agrees to pay to each Bank at the Closing Date an
up-front fee of 0.15% of that Bank's Commitment.

II.11 Computation of Fees and Interest. (a) All computations of interest for
Base Rate Loans when the Base Rate is determined by BofA's "reference rate"
shall be made on the basis of a year of 365 or 366 days, as the case may be, and
actual days elapsed. All other computations of fees and interest shall be made
on the basis of a 360-day year and actual days elapsed (which results in more
interest being paid than if computed on the basis of a 365-day year). Interest
and fees shall accrue during each period during which interest or such fees are
computed from the first day thereof to the last day thereof.

(b) Each determination of an interest rate by the Agent shall be conclusive and
binding on the Company and the Banks absent manifest error. The Agent will, at
the request of the Company or any Bank, deliver to the Company or the Bank, as
the case may be, a statement showing the quotations used by the Agent in
determining any interest rate and the resulting interest rate.

II.12 Payments by the Company. (a) All payments to be made by the Company shall
be made without set-off, recoupment or counterclaim. Except as otherwise
expressly provided herein, all payments by the Company shall be made to the
Agent for the account of the Banks at the Agent's Payment Office, and shall be
made in dollars and in immediately available funds, no later than 2:00 p.m.
(Chicago time) on the date specified herein. The Agent will promptly distribute
to each Bank its Pro Rata Share (or other applicable share as expressly provided
herein) of such payment in like funds as received. Any payment received by the
Agent later than 3:00 p.m. (Chicago time) shall be deemed to have been received
on the following Business Day and any applicable interest or fee shall continue
to accrue.

(b) Subject to the provisions set forth in the definition of "Interest Period"
herein, whenever any payment is due on a day other than a Business Day, such
payment shall be made on the following Business Day, and such extension of time
shall in such case be included in the computation of interest or fees, as the
case may be.

(c) Unless the Agent receives notice from the Company prior to the date on which
any payment is due to the Banks that the Company will not make such payment in
full as and when required, the Agent may assume that the Company has made such
payment in full to the Agent on such date in immediately available funds and the
Agent may (but shall not be so required), in reliance upon such assumption,
distribute to each Bank on such due date an amount equal to the amount then due
such Bank. If and to the extent the Company has not made such payment in full to
the Agent, each Bank shall repay to the Agent on demand such amount distributed
to such Bank, together with interest thereon at the Federal Funds Rate for each
day from the date such amount is distributed to such Bank until the date repaid.
<PAGE>
 
II.13 Payments by the Banks to the Agent. (a) Unless the Agent receives notice
from a Bank on or prior to the Closing Date or, with respect to any Borrowing
after the Closing Date, at least one Business Day prior to the date of such
Borrowing, that such Bank will not make available as and when required hereunder
to the Agent for the account of the Company the amount of that Bank's Pro Rata
Share of the Borrowing, the Agent may assume that each Bank has made such amount
available to the Agent in immediately available funds on the Borrowing Date and
the Agent may (but shall not be so required), in reliance upon such assumption,
make available to the Company on such date a corresponding amount. If and to the
extent any Bank shall not have made its full amount available to the Agent in
immediately available funds and the Agent in such circumstances has made
available to the Company such amount, that Bank shall on the Business Day
following such Borrowing Date make such amount available to the Agent, together
with interest at the Federal Funds Rate for each day during such period. A
notice of the Agent submitted to any Bank with respect to amounts owing under
this subsection (a) shall be conclusive, absent manifest error. If such amount
is so made available, such payment to the Agent shall constitute such Bank's
Loan on the date of Borrowing for all purposes of this Agreement. If such amount
is not made available to the Agent on the Business Day following the Borrowing
Date, the Agent will notify the Company of such failure to fund and, upon demand
by the Agent, the Company shall pay such amount to the Agent for the Agent's
account, together with interest thereon for each day elapsed since the date of
such Borrowing, at a rate per annum equal to the interest rate applicable at the
time to the Loans comprising such Borrowing.

(b) The failure of any Bank to make any Loan on any Borrowing Date shall not
relieve any other Bank of any obligation hereunder to make a Loan on such
Borrowing Date, but no Bank shall be responsible for the failure of any other
Bank to make the Loan to be made by such other Bank on any Borrowing Date.

II.14 Sharing of Payments, Etc. If, other than as expressly provided elsewhere
herein, any Bank shall obtain on account of the Loans made by it any payment
(whether voluntary, involuntary, through the exercise of any right of set-off,
or otherwise) in excess of its Pro Rata Share, such Bank shall immediately (a)
notify the Agent of such fact, and (b) purchase from the other Banks such
participations in the Loans made by them as shall be necessary to cause such
purchasing Bank to share the excess payment pro rata with each of them;
provided, however, that if all or any portion of such excess payment is
thereafter recovered from the purchasing Bank, such purchase shall to that
extent be rescinded and each other Bank shall repay to the purchasing Bank the
purchase price paid therefor, together with an amount equal to such paying
Bank's ratable share (according to the proportion of (i) the amount of such
paying Bank's required repayment to (ii) the total amount so recovered from the
purchasing Bank) of any interest or other amount paid or payable by the
purchasing Bank in respect of the total amount so recovered. The Company agrees
that any Bank so purchasing a participation from another Bank may, to the
fullest extent permitted by law, exercise all its rights of payment (including
the right of set-off, but subject to Section 10.10) with respect to such
participation as fully as if such Bank were the direct creditor of the Company
in the amount of such participation. The Agent will keep records (which shall
<PAGE>
 
be conclusive and binding in the absence of manifest error) of participations
purchased under this Section and will in each case notify the Banks following
any such purchases or repayments.

II.15 Increases to Commitments. (a) The Company may, at any time, by notice to
the Agent, request that the aggregate amount of the Commitments be increased by
an amount not to exceed $20,000,000 in excess of the aggregate amount of the
Commitments as of the date of this Agreement (the "Commitment Increase") to be
effective as of a date (the "Increase Date") specified in the related notice to
the Agent that is (i) prior to the scheduled Termination Date and (ii) at least
15 Business Days after the date of such notice; provided, however, that (1) in
no event shall the aggregate amount of the Commitments at any time exceed
$80,000,000 without the consent of all Banks and (2) no Event of Default or
Default shall have occurred and be continuing as of the date of such request or
as of the applicable Increase Date, or shall occur as a result of the Commitment
Increase.

(b) The Agent shall promptly notify the Banks of the request by the Company for
the Commitment Increase, which notice shall include (A) the proposed amount of
the requested Commitment Increase, (B) the proposed Increase Date, (C) the date
by which Banks wishing to participate in the Commitment Increase must commit to
an increase in the amount of their respective Commitments (the "Commitment
Date"), which date shall be no later than five Business Days prior to the
Increase Date and (D) the fees, if any, to be paid by the Company to the Banks
and other financial institutions participating in the proposed Commitment
Increase.

(c) Each Bank that is willing to participate in such requested Commitment
Increase (each, an "Increasing Bank") shall give written notice to the Agent no
later than 10:00 a.m. (Chicago time) on the Commitment Date of the amount by
which it is willing to increase its Commitment, which amount shall not exceed
the amount of the requested Commitment Increase. It shall be in each Bank's sole
discretion whether to offer to increase its Commitment in connection with the
proposed Commitment Increase. If the Banks notify the Agent that they are
willing to increase the amount of their respective Commitments by an aggregate
amount that exceeds the amount of the requested Commitment Increase, the
Commitment Increase shall be allocated among the Banks willing to participate
therein in the manner specified by the Company and the Agent.

(d) Promptly following the Commitment Date, the Agent shall notify the Company
as to the amount, if any, by which the Banks are willing to participate in the
requested Commitment Increase. If the aggregate amount by which the Banks are
willing to participate in the requested Commitment Increase on the Commitment
Date is less than the requested Commitment Increase, then the Company may extend
offers to one or more financial institutions acceptable to the Agent and willing
to participate in any portion of the requested Commitment Increase that has not
been committed to by the Banks on the Commitment Date; provided, however, that
the Commitment of each such financial institution shall be in a minimum
aggregate amount of the lesser of (x) $5,000,000 or (y) the remaining
uncommitted amount of the requested Commitment Increase.
<PAGE>
 
(e) On the Increase Date, each financial institution that accepts an offer to
participate in the requested Commitment Increase as a Bank in accordance with
subsection 2.15(d) shall become a Bank party to this Agreement as of the
Increase Date (each a "New Bank") and the Commitment of each Increasing Bank for
the requested Commitment Increase shall be increased as of the Increase Date by
the amount set forth in its notice delivered to the Agent in accordance with
subsection 2.15(c) (or by the amount allocated to such Bank pursuant to the last
sentence of subsection 2.15(c)); provided, however, that the Agent shall have
received on or before noon (Chicago time) on the Increase Date the following,
each dated such date, and in sufficient copies for each Bank:

(i) (A) a certificate of a duly authorized officer of the Company stating that
no Default or Event of Default has occurred and is continuing, or would result
from the Commitment Increase, (B) certified copies of resolutions of the board
of directors of the Company or committee thereof or authorized officers as
provided by the board of directors approving the Commitment Increase and the
corresponding modifications to this Agreement and the Notes, (C) opinions of
counsel to the Company, in form and substance reasonably satisfactory to the
Agent and, as to legal matters, its counsel and (D) such other approvals,
certificates or documents as any Bank through the Agent may reasonably request
in connection with the Commitment Increase;

(ii) a counterpart of this Agreement duly executed by each New Bank; and

(iii) confirmation from each Increasing Bank of the increase in the amount of
its Commitment, in a writing satisfactory to the Company and the Agent.

(f) On the Increase Date, upon fulfillment of the conditions set forth in
subsection 2.15(e) the Agent shall notify the Banks and the Company, on or
before 1:00 p.m. (Chicago time), by facsimile of the occurrence of the
Commitment Increase to be effected on the Increase Date and the Company and the
Agent shall amend Schedule 2.1 to reflect the increased Commitments on such
date. Each Increasing Bank and each New Bank shall, before 2:00 p.m. (Chicago
time) on the Increase Date, make available to the Agent in immediately available
funds, (A) in the case of any New Bank, an amount equal to such New Bank's
ratable portion of the Loans then outstanding (calculated based on its Pro Rata
Share after giving effect to the Commitment Increase) and (B) in the case of any
Increasing Bank, an amount equal to the excess of (1) such Increasing Bank's
ratable portion of the Loans then outstanding (calculated based on its Pro Rata
Share after giving effect to the relevant Commitment Increase) over (2) such
Increasing Bank's ratable portion of the Loans then outstanding (calculated
based on its Pro Rata Share without giving effect to the relevant Commitment
Increase). After the Agent's receipt of such funds from each such Increasing
Bank and each such New Bank, the Agent will promptly thereafter cause to be
distributed like funds to the other Banks in an amount to each other Bank such
that the aggregate amount owing to each Bank after giving effect to such
distribution equals such Bank's Pro Rata Share of the Loans then outstanding
(calculated after giving effect to the Commitment Increase). If the Increase
Date shall occur on a date that is not the last day of the Interest Period for
all Borrowings of Offshore Rate Loans then outstanding, (x) the Company shall
pay any amounts owing pursuant to Section 3.4 as a result of the distributions
to Banks under this
<PAGE>
 
subsection 2.15(f) and (y) for each outstanding Borrowing of Offshore Rate
Loans, the respective Loans made by the Increasing Banks and the New Banks
pursuant to this subsection 2.15(f) shall be deemed to be funded at the
applicable Offshore Rate for such Loan.

2.16  Extension of the Termination Date.  Unless the Commitments shall have been
terminated in their entirety or an Event of Default or Default has occurred and
is continuing, not earlier than the 90th day prior to the date which is one year
prior to the then-scheduled Termination Date, the Company may request the Agent
and the Banks to extend the Termination Date for an additional one-year period.
The Termination Date may be so extended on not more than two occasions. The
Agent and the Banks have no obligation to extend the Termination Date and any
decision to extend the Termination Date must be agreed to by the Agent and all
Banks. Any decision to extend the Termination Date shall be in the sole and
absolute discretion of the Agent and the Banks and shall be evidenced by a
writing executed by each of them. The failure of any Person to respond to a
request for such an extension within 30 days of such request shall be deemed a
decision not to so extend.


                                  ARTICLE III

                    TAXES, YIELD PROTECTION AND ILLEGALITY

III.1  Taxes.  (a)  Any and all payments by the Company to each Bank or the
Agent under this Agreement and any other Loan Document shall be made free and
clear of, and without deduction or withholding for any Taxes. In addition, the
Company shall pay all Other Taxes.

(b)  The Company agrees to indemnify and hold harmless each Bank and the Agent
for the full amount of Taxes or Other Taxes (including any Taxes or Other Taxes
imposed by any jurisdiction on amounts payable under this Section) paid by such
Bank or the Agent and any liability (including penalties, interest, additions to
tax and expenses) arising therefrom or with respect thereto, whether or not such
Taxes or Other Taxes were correctly or legally asserted. Payment under this
indemnification shall be made within 30 days after the date such Bank or the
Agent makes written demand therefor.

(c)  If the Company shall be required by law to deduct or withhold any Taxes or
Other Taxes from or in respect of any sum payable hereunder to any Bank or the
Agent, then:

(i)  the sum payable shall be increased as necessary so that after making all
required deductions and withholdings (including deductions and withholdings
applicable to additional sums payable under this Section) such Bank or the
Agent, as the case may be, receives an amount equal to the sum it would have
received had no such deductions or withholdings been made;

(ii)  the Company shall make such deductions and withholdings;


<PAGE>
 
(iii)  the Company shall pay the full amount deducted or withheld to the
relevant taxing authority or other authority in accordance with applicable law;
and

(iv)  the Company shall also pay to each Bank or the Agent for the account of
such Bank, at the time interest is paid, all additional amounts which the
respective Bank specifies as necessary to preserve the after-tax yield such Bank
would have received if such Taxes or Other Taxes had not been imposed.

(d)  Within 30 days after the date of any payment by the Company of Taxes or
Other Taxes, the Company shall furnish the Agent the original or a certified
copy of a receipt evidencing payment thereof, or other evidence of payment
satisfactory to the Agent.

(e)  If the Company is required to pay additional amounts to any Bank or the
Agent pursuant to subsection (c) of this Section, then such Bank shall use
reasonable efforts (consistent with legal and regulatory restrictions) to change
the jurisdiction of its Lending Office so as to eliminate any such additional
payment by the Company which may thereafter accrue, if such change in the
judgment of such Bank is not otherwise disadvantageous to such Bank.

III.2  Illegality.  (a)  If any Bank determines that the introduction of any
Requirement of Law, or any change in any Requirement of Law, or in the
interpretation or administration of any Requirement of Law, has made it
unlawful, or that any central bank or other Governmental Authority has asserted
that it is unlawful, for any Bank or its applicable Lending Office to make
Offshore Rate Loans, then, on notice thereof by the Bank to the Company through
the Agent, any obligation of that Bank to make Offshore Rate Loans shall be
suspended until the Bank notifies the Agent and the Company that the
circumstances giving rise to such determination no longer exist.

(b)  If a Bank determines that it is unlawful to maintain any Offshore Rate
Loan, the Company shall, upon its receipt of notice of such fact and demand from
such Bank (with a copy to the Agent), prepay in full such Offshore Rate Loans of
that Bank then outstanding, together with interest accrued thereon and amounts
required under Section 3.4, either on the last day of the Interest Period
thereof, if the Bank may lawfully continue to maintain such Offshore Rate Loans
to such day, or immediately, if the Bank may not lawfully continue to maintain
such Offshore Rate Loan. If the Company is required to so prepay any Offshore
Rate Loan, then concurrently with such prepayment, the Company may borrow from
the affected Bank, in the amount of such repayment, a Base Rate Loan.

(c)  If the obligation of any Bank to make or maintain Offshore Rate Loans has
been so terminated or suspended, the Company may elect, by giving notice to the
Bank through the Agent, that all Loans which would otherwise be made by the Bank
as Offshore Rate Loans shall be instead Base Rate Loans.


<PAGE>
 
(d)  Before giving any notice to the Agent under this Section, the affected Bank
shall designate a different Lending Office with respect to its Offshore Rate
Loans if such designation will avoid the need for giving such notice or making
such demand and will not, in the judgment of the Bank, be illegal or otherwise
disadvantageous to the Bank.

III.3  Increased Costs and Reduction of Return.  (a)  If any Bank determines
that, due to either (i) the introduction of or any change (other than any change
by way of imposition of or increase in reserve requirements included in the
calculation of the Offshore Rate) in or in the interpretation of any law or
regulation or (ii) the compliance by that Bank with any guideline or request
from any central bank or other Governmental Authority (whether or not having the
force of law), there shall be any increase in the cost to such Bank of agreeing
to make or making, funding or maintaining any Offshore Rate Loans, then the
Company shall be liable for, and shall from time to time, upon demand (with a
copy of such demand to be sent to the Agent), pay to the Agent for the account
of such Bank, additional amounts as are sufficient to compensate such Bank for
such increased costs.

(b)  If any Bank shall have determined that (i) the introduction of any Capital
Adequacy Regulation, (ii) any change in any Capital Adequacy Regulation, (iii)
any change in the interpretation or administration of any Capital Adequacy
Regulation by any central bank or other Governmental Authority charged with the
interpretation or administration thereof, or (iv) compliance by the Bank (or its
Lending Office) or any corporation controlling the Bank with any Capital
Adequacy Regulation, affects or would affect the amount of capital required or
expected to be maintained by the Bank or any corporation controlling the Bank
and (taking into consideration such Bank's or such corporation's policies with
respect to capital adequacy and such Bank's desired return on capital)
determines that the amount of such capital is increased as a consequence of its
Commitment, loans, credits or obligations under this Agreement, then, upon
demand of such Bank to the Company through the Agent, the Company shall pay to
the Bank, from time to time as specified by the Bank, additional amounts
sufficient to compensate the Bank for such increase.

III.4  Funding Losses.  The Company shall reimburse each Bank and hold each Bank
harmless from any loss or expense which the Bank may sustain or incur as a
consequence of:

(a)  the failure of the Company to make on a timely basis any payment of
principal of any Offshore Rate Loan;

(b)  the failure of the Company to borrow, continue or convert a Loan after the
Company has given (or is deemed to have given) a Notice of Borrowing or a Notice
of Conversion/ Continuation;

(c)  the failure of the Company to make any prepayment in accordance with any
notice delivered under Section 2.6;


<PAGE>
 
(d)  the prepayment (including pursuant to Section 2.7) or other payment
(including after acceleration thereof) of an Offshore Rate Loan on a day that is
not the last day of the relevant Interest Period, provided that this Section 3.4
shall not apply in respect of any Bank which, under Section 2.13(a), does not
make an amount available to the Agent on the Business Day following any
Borrowing Date; or

(e)  the automatic conversion under Section 2.4 of any Offshore Rate Loan to a
Base Rate Loan on a day that is not the last day of the relevant Interest
Period;

including any such loss or expense arising from the liquidation or reemployment
of funds obtained by it to maintain its Offshore Rate Loans or from fees payable
to terminate the deposits from which such funds were obtained. For purposes of
calculating amounts payable by the Company to the Banks under this Section and
under subsection 3.3(a), each Offshore Rate Loan made by a Bank (and each
related reserve, special deposit or similar requirement) shall be conclusively
deemed to have been funded at the LIBOR used in determining the Offshore Rate
for such Offshore Rate Loan by a matching deposit or other borrowing in the
interbank eurodollar market for a comparable amount and for a comparable period,
whether or not such Offshore Rate Loan is in fact so funded.

III.5  Inability to Determine Rates.  If the Agent determines that for any
reason adequate and reasonable means do not exist for determining the Offshore
Rate for any requested Interest Period with respect to a proposed Offshore Rate
Loan, or that the Offshore Rate applicable pursuant to subsection 2.9(a) for any
requested Interest Period with respect to a proposed Offshore Rate Loan does not
adequately and fairly reflect the cost to the Banks of funding such Loan, the
Agent will promptly so notify the Company and each Bank. Thereafter, the
obligation of the Banks to make or maintain Offshore Rate Loans, as the case may
be, hereunder shall be suspended until the Agent upon the instruction of the
Majority Banks revokes such notice in writing. Upon receipt of such notice, the
Company may revoke any Notice of Borrowing or Notice of Conversion/Continuation
then submitted by it. If the Company does not revoke such Notice, the Banks
shall make, convert or continue the Loans, as proposed by the Company, in the
amount specified in the applicable notice submitted by the Company, but such
Loans shall be made, converted or continued as Base Rate Loans instead of
Offshore Rate Loans.

III.6  Reserves on Offshore Rate Loans.  The Company shall pay to each Bank, as
long as such Bank shall be required under regulations of the FRB to maintain
reserves with respect to liabilities or assets consisting of or including
Eurocurrency funds or deposits (currently known as "Eurocurrency liabilities"),
additional costs on the unpaid principal amount of each Offshore Rate Loan equal
to the actual costs of such reserves allocated to such Loan by the Bank (as
determined by the Bank in good faith, which determination shall be conclusive
absent manifest error), payable on each date on which interest is payable on
such Loan, provided the Company shall have received at least 15 Business Days'
prior written notice (with a copy to the Agent) of such additional interest from
the Bank. If a Bank fails to give notice 15 Business Days prior to


<PAGE>
 
the relevant Interest Payment Date, such additional interest shall be payable 15
Business Days from receipt of such notice.

III.7 Certificates of Banks. Any Bank claiming reimbursement or compensation
under this Article III shall deliver to the Company (with a copy to the Agent) a
certificate setting forth in reasonable detail the amount payable to the Bank
hereunder and such certificate shall be conclusive and binding on the Company
absent manifest error.

III.8 Substitution of Banks. Upon the receipt by the Company from any Bank (an
"Affected Bank") of a claim for compensation under Section 3.3, the Company may:
(i) request the Affected Bank to use its best efforts to obtain a replacement
bank or financial institution satisfactory to the Company to acquire and assume
all or a ratable part of all of such Affected Bank's Loans and Commitment (a
"Replacement Bank"); (ii) request one more of the other Banks to acquire and
assume all or part of such Affected Bank's Loans and Commitment; or (iii)
designate a Replacement Bank. Any such designation of a Replacement Bank under
clause (i) or (iii) above shall be subject to the prior written consent of the
Agent (which consent shall not be unreasonably withheld).

III.9 Survival. The agreements and obligations of the Company in this Article
III shall survive the payment of all other Obligations.

                                  ARTICLE IV

                             CONDITIONS PRECEDENT
                             --------------------

IV.1 Conditions of Initial Loans. The obligation of each Bank to make its
initial Loan hereunder is subject to the condition that the Agent has received
on or before the Closing Date all of the following, in form and substance
reasonably satisfactory to the Agent and each Bank, and in sufficient copies for
each Bank:

(a) Credit Agreement and Notes. This Agreement and the Notes executed by each
party thereto;

(b)  Resolutions; Incumbency.

(i) Copies of the resolutions of the boards of directors of the Company and each
Subsidiary party hereto as a Guarantor authorizing the transactions contemplated
hereby, certified as of the Closing Date by the Secretary or an Assistant
Secretary of such Person; and
<PAGE>
 
(ii) A certificate of the Secretary or Assistant Secretary of each of the
Company and each Subsidiary party hereto as a Guarantor certifying the names and
true signatures of the officers of the Company or such Subsidiary, as
applicable, authorized to execute, deliver and perform, as applicable, this
Agreement and all other Loan Documents to be delivered by it hereunder;

(c)  Legal Opinions.

(i) an opinion of Bell, Boyd & Lloyd, counsel to the Company and the Guarantors
and addressed to the Agent and the Banks, substantially in the form of Exhibit
D; and

(ii) a favorable opinion of Mayer, Brown & Platt, special counsel to the Agent.

(d) Payment of Fees. Evidence of payment by the Company of all accrued and
unpaid reasonable fees, costs and expenses to the extent then due and payable on
the Closing Date, together with reasonable Attorney Costs of BofA to the extent
invoiced at least two Business Days prior to or on the Closing Date, plus such
additional amounts of Attorney Costs as shall constitute BofA's reasonable
estimate of Attorney Costs incurred or to be incurred by it through the closing
proceedings (provided that such estimate shall not thereafter preclude final
settling of accounts between the Company and BofA); including any such costs,
fees and expenses arising under or referenced in Sections 2.10 and 10.4(a);

(e) Certificate. A certificate signed by a Responsible Officer, dated as of the
Closing Date, stating that:

(i) the representations and warranties contained in Article V are true and
correct on and as of such date, as though made on and as of such date;

(ii) no Default or Event of Default exists; and

(iii) there has occurred since December 31, 1996, no event or circumstance that
has resulted or could reasonably be expected to result in a Material Adverse
Effect; and

(f) Other Documents. Such other approvals, opinions, documents or materials as
the Agent or any Bank may reasonably request.

IV.2 Conditions to All Borrowings. The obligation of each Bank to make any Loan
to be made by it (including its initial Loan) or to continue or convert any Loan
under Section 2.4 is subject to the satisfaction of the following conditions
precedent on the relevant Borrowing Date or Conversion/Continuation Date:

(a) Notice of Borrowing or Conversion/Continuation. The Agent shall have
received a Notice of Borrowing or a Notice of Conversion/Continuation, as
applicable;
<PAGE>
 
(b) Continuation of Representations and Warranties. The representations and
warranties in Article V shall be true and correct on and as of such Borrowing
Date with the same effect as if made on and as of such Borrowing Date (except to
the extent such representations and warranties expressly refer to an earlier
date, in which case they shall be true and correct as of such earlier date); and

(c) No Existing Default. No Default or Event of Default shall exist or shall
result from such Borrowing or such continuation or conversion.

Each Notice of Borrowing submitted by the Company hereunder shall constitute a
representation and warranty by the Company hereunder, as of the date of each
such notice and as of each Borrowing Date that the conditions in this Section
4.2 are satisfied.

                                   ARTICLE V

                        REPRESENTATIONS AND WARRANTIES
                        ------------------------------

The Company represents and warrants to the Agent and each Bank that:

V.1 Corporate Existence and Power. The Company and each of its Subsidiaries:

(a) is a corporation duly organized, validly existing and in good standing under
the laws of the jurisdiction of its organization;

(b) has the power and authority and all governmental licenses, authorizations,
consents and approvals to own its assets, carry on its business and to execute,
deliver and perform its obligations under the Loan Documents;

(c) is duly qualified as a foreign corporation and is licensed and in good
standing under the laws of each jurisdiction where its ownership, lease or
operation of property or the conduct of its business requires such qualification
or license and where failure to do so would have a Material Adverse Effect; and

(d) is in compliance with all Requirements of Law in respect of the conduct of
its business and the ownership of its properties; except to the extent that the
failure to do so would not reasonably be expected to have a Material Adverse
Effect.

V.2 Corporate Authorization; No Contravention. The execution, delivery and
performance by the Company and its Subsidiaries of this Agreement and each other
Loan Document to which such Person is a party have been duly authorized by all
necessary corporate action, and do not and will not:
<PAGE>
 
(a) contravene the terms of any of that Person'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
such Person is a party or any order, injunction, writ or decree of any
Governmental Authority to which such Person or its property is subject; or

(c) violate any Requirement of Law.

V.3 Governmental Authorization. No approval, consent, exemption, authorization,
or other action by, or notice to, or filing with, any Governmental Authority is
necessary or required in connection with the execution, delivery or performance
by, or enforcement against, the Company or any of its Subsidiaries of the
Agreement or any other Loan Document.

V.4 Binding Effect. This Agreement and each other Loan Document to which the
Company or any of its Subsidiaries is a party constitute the legal, valid and
binding obligations of the Company and any of its Subsidiaries to the extent it
is a party thereto, enforceable against such Person in accordance with their
respective terms, except as enforceability may be limited by applicable
bankruptcy, insolvency, fraudulent conveyance or similar laws affecting the
enforcement of creditors' rights generally or by equitable principles relating
to enforceability (regardless of whether the application of such principles is
considered in a proceeding in equity or at law).

V.5 Litigation. Except as specifically disclosed in Schedule 5.5, there are no
actions, suits, proceedings, claims or disputes pending, or to the best
knowledge of the Company, threatened or contemplated, at law, in equity, in
arbitration or before any Governmental Authority, against the Company, or its
Subsidiaries or any of their respective properties which: (a) purport to affect
or pertain to this Agreement or any other Loan Document, or any of the
transactions contemplated hereby or thereby; or (b) if determined adversely to
the Company or its Subsidiaries, would reasonably be expected to have a Material
Adverse Effect. No injunction, writ, temporary restraining order or any order of
any nature has been issued by any court or other Governmental Authority
purporting to enjoin or restrain the execution, delivery or performance of this
Agreement or any other Loan Document, or directing that the transactions
provided for herein or therein not be consummated as herein or therein provided.

V.6 No Default. No Default or Event of Default exists or would result from the
incurring of any Obligations by the Company. As of the Closing Date, neither the
Company nor any Subsidiary is in default under or with respect to any material
Contractual Obligation in any respect which, individually or together with all
such defaults, would reasonably be expected to have a Material Adverse Effect,
or that would, if such default had occurred after the Closing Date, create an
Event of Default under subsection 8.1(e).

V.7 ERISA Compliance. Except as specifically disclosed in Schedule 5.7:

<PAGE>
 
(a) Each Plan is in compliance in all material respects with the applicable
provisions of ERISA, the Code and other federal or state law. Each Plan which is
intended to qualify under Section 401(a) of the Code has received or applied for
a favorable determination letter from the IRS, if required, and to the best
knowledge of the Company, nothing has occurred which would cause the loss of
such qualification so received or cause such application to be denied. The
Company and each ERISA Affiliate has made all required contributions to any Plan
subject to Section 412 of the Code, and no application for a funding waiver or
an extension of any amortization period pursuant to Section 412 of the Code has
been made with respect to any Plan.

(b) There are no pending or, to the best knowledge of Company, threatened
claims, actions or lawsuits, or action by any Governmental Authority, with
respect to any Plan which has resulted or would reasonably be expected to result
in a Material Adverse Effect. There has been no prohibited transaction or
violation of the fiduciary responsibility rules with respect to any Plan which
has resulted or could reasonably be expected to result in a Material Adverse
Effect.

(c) (i) No ERISA Event has occurred or is reasonably expected to occur; (ii) no
Pension Plan has any Unfunded Pension Liability; (iii) neither the Company nor
any ERISA Affiliate has incurred, or reasonably expects to incur, any liability
exceeding $5,000,000 under Title IV of ERISA with respect to any Pension Plan
(other than premiums due and not delinquent under Section 4007 of ERISA); (iv)
neither the Company nor any ERISA Affiliate has incurred, or reasonably expects
to incur, any liability exceeding $5,000,000 (and no event has occurred which,
with the giving of notice under Section 4219 of ERISA, would result in such
liability) under Section 4201 or 4243 of ERISA with respect to a Multiemployer
Plan; and (v) neither the Company nor any ERISA Affiliate has engaged in a
transaction that could be subject to Section 4069 or 4212(c) of ERISA.

V.8 Use of Proceeds; Margin Regulations. The proceeds of the Loans are to be
used solely for the purposes set forth in and permitted by Section 6.12 and
Section 7.7. Neither the Company nor any Subsidiary is generally engaged in the
business of purchasing or selling Margin Stock or extending credit for the
purpose of purchasing or carrying Margin Stock.

V.9 Title to Properties. The Company and each Subsidiary have good record and
marketable title in fee simple to, or valid leasehold interests in, all real
property necessary or used in the ordinary conduct of their respective
businesses, except for such defects in title as could not, individually or in
the aggregate, have a Material Adverse Effect. As of the Closing Date, the
property of the Company and its Subsidiaries is subject to no Liens, other than
Permitted Liens.

V.10 Taxes. The Company and its Subsidiaries have filed all Federal and other
material tax returns and reports required to be filed, and have paid all Federal
and other material taxes, assessments, fees and other governmental charges
levied or imposed upon them or their properties, income or assets otherwise due
and payable, except those which are being contested in good faith by appropriate
proceedings and for which adequate reserves have been provided in
<PAGE>
    
accordance with GAAP. There is no proposed tax assessment against the Company or
any Subsidiary that would, if made, have a Material Adverse Effect.

V.11 Financial Condition. (a) The audited consolidated financial statements of
the Company and its Subsidiaries dated December 31, 1996, and the related
consolidated statements of income or operations, shareholders' equity and cash
flows for the Fiscal Year ended on that date, and the unaudited consolidated
financial statements of the Company and its Subsidiaries dated September 30,
1997, and the related unaudited consolidated statements of income and cash flows
for the nine-month fiscal period ended on that date:

(i) were prepared in accordance with GAAP consistently applied throughout the
period covered thereby, except as otherwise expressly noted therein, subject to
ordinary, good faith year-end audit adjustments;

(ii) fairly present the financial condition of the Company and its Subsidiaries
as of the date thereof and results of operations for the period covered thereby;
and

(iii) except as specifically disclosed in Schedule 5.11, show all material
indebtedness and other liabilities, direct or contingent, of the Company and its
consolidated Subsidiaries as of the date thereof, including liabilities for
taxes, material commitments and Contingent Obligations.

(b) Since September 30, 1997, there has been no Material Adverse Effect. 
V.12 Environmental Matters. To the best of the Company's knowledge, its
business, operations and properties are in compliance with existing
Environmental Laws. There are no pending or, to the best of the Company's
knowledge, threatened Environmental Claims against the Company or any property
owned by the Company, except as specifically disclosed in Schedule 5.12.
Notwithstanding anything to the contrary in this Section 5.12, the
representations made in this Section 5.12 shall be untrue only if the aggregate
effect of any noncompliance with such representations would reasonably be
expected to have a Material Adverse Effect.

V.13 Regulated Entities. None of the Company, any Person controlling the
Company, or any Subsidiary, is an "Investment Company" within the meaning of the
Investment Company Act of 1940. The Company is not subject to regulation under
the Public Utility Holding Company Act of 1935, the Federal Power Act, the
Interstate Commerce Act, any state public utilities code, or any other Federal
or state statute or regulation limiting its ability to incur Indebtedness.

V.14 No Burdensome Restrictions. Neither the Company nor any Subsidiary is a
party to or bound by any Contractual Obligation, or subject to any restriction
in any Organization Document, or any Requirement of Law, which could reasonably
be expected to have a Material Adverse Effect.

V.15 Copyrights, Patents, Trademarks and Licenses, etc. The Company or its
Subsidiaries own or are licensed or otherwise have the right to use all of the
patents, trademarks, service marks,
<PAGE>
 
trade names, copyrights, contractual franchises, authorizations and other rights
that are reasonably necessary for the operation of their respective businesses,
without conflict with the rights of any other Person, except as such use
otherwise would not reasonably be expected to have a Material Adverse Effect. To
the best knowledge of the Company, no slogan or other advertising device,
product, process, method, substance, part or other material now employed, or now
contemplated to be employed, by the Company or any Subsidiary infringes upon any
rights held by any other Person, except as such infringement would not
reasonably be expected to have a Material Adverse Effect. Except as specifically
disclosed in Schedule 5.5, no claim or litigation regarding any of the foregoing
is pending or, to the knowledge of the Company, threatened, and no patent,
invention, device, application, principle or any statute, law, rule, regulation,
standard or code is pending or, to the knowledge of the Company, proposed,
which, in either case, could reasonably be expected to have a Material Adverse
Effect.

V.16 Subsidiaries. As of the Closing Date, the Company has no Subsidiaries other
than those specifically disclosed in part (a) of Schedule 5.16 hereto and has no
equity investments in any other corporation or entity other than those
specifically disclosed in part (b) of Schedule 5.16.

V.17 Insurance. Except as specifically disclosed in Schedule 5.17, the
properties of the Company and its Subsidiaries are insured with financially
sound and reputable insurance companies not Affiliates of the Company, in such
amounts, with such deductibles and covering such risks as are customarily
carried by companies engaged in similar businesses and owning similar properties
in localities where the Company or such Subsidiary operates.

V.18 Full Disclosure. None of the representations or warranties made by the
Company or any Subsidiary in the Loan Documents as of the date such
representations and warranties are made or deemed made, and none of the
statements contained in any exhibit, report, statement or certificate furnished
by or on behalf of the Company or any Subsidiary in connection with the Loan
Documents (including the offering and disclosure materials delivered by or on
behalf of the Company to the Banks prior to the Closing Date), contains any
untrue statement of a material fact or omits any material fact required to be
stated therein or necessary to make the statements made therein, in light of the
circumstances under which they are made, not misleading as of the time when made
or delivered.

V.19 Health Care Regulatory Matters.

(a) Except as disclosed on Schedule 5.19 and except where noncompliance does not
and would not reasonably be expected to have a Material Adverse Effect on the
condition (financial or otherwise), operations, assets, business, properties or
prospects of the Company and its Subsidiaries on a consolidated basis, each
Subsidiary, including any Person who becomes a Subsidiary pursuant to any
Permitted Acquisition or Permitted Development, has:

     (i) where required by applicable law, obtained all required CONs for the
operation of any Permitted Business created by such Subsidiary or investment in
such Subsidiary;
<PAGE>
 
     (ii) obtained and maintains in good standing all Health Facility Licenses
necessary to operate such Subsidiary as a Permitted Business;

     (iii) obtained and maintains, where appropriate, Medicaid Certification and
Medicare Certification with respect to such Subsidiary to the extent required
for reimbursement under the Medicaid Regulations or the Medicare Regulations, as
the case may be; and

     (iv) entered into and maintains in good standing, where appropriate, its
Medicaid Provider Agreement and its Medicare Provider Agreement with respect to
such Subsidiary to the extent required for reimbursement under the Medicaid
Regulations or the Medicare Regulations, as the case may be.

(b) The Company and its Subsidiaries, including any Person who becomes a
Subsidiary, will use their best efforts to maintain any certifications received
from the JCAHO or the AAAHC or any such other applicable accrediting body to the
extent required, and to obtain such certifications from the JCAHO or the AAAHC
or any such other applicable accrediting body not obtained as at the Effective
Date, if failure to maintain or obtain such certifications would reasonably be
expected to constitute a Material Adverse Effect.

(c) Except as disclosed on Schedule 5.19, all necessary steps have been or are
being taken to secure the renewal of any Health Facility License, Medicaid
Provider Agreement or Medicare Provider Agreement issued with respect to any
Subsidiary that is to expire within 60 days after the date of execution and
delivery of this Agreement by the Banks, and there is no reasonable basis known
to the Company or its Subsidiaries that any such renewal will not be obtained.

(d) Except as disclosed on Schedule 5.19, there are no proceedings pending, or,
to the best knowledge of the Company or any Subsidiary after due inquiry,
threatened by any Governmental Authority seeking to modify, revoke or suspend
any Health Facility License, or, to the extent required for reimbursement,
Medicaid Provider Agreement, Medicare Provider Agreement, Medicare Certification
or Medicaid Certification with respect to any Subsidiary, nor is there pending
any governmental investigation or inquiry which might result in fines or
penalties which could materially adversely affect any Subsidiary. Since the date
of the most recent Medicare Certification and Medicaid Certification with
respect to each Subsidiary (where applicable), to the best knowledge of the
Company or any of its Subsidiaries after due inquiry, neither the Company nor
any Subsidiary has taken any action that would materially adversely affect the
Certification or the Medicare Provider Agreement or Medicaid Provider Agreement
with respect to such Subsidiary.

(e) Neither the Company, any Subsidiary, any Affiliate nor any officer or
director of the foregoing has engaged in any of the following: (i) knowingly and
wilfully making or causing to be made a false statement or representation of a
material fact in any application for any benefit or payment under Medicare or
Medicaid; (ii) knowingly and wilfully making or causing to be made
<PAGE>
 
any false statement or representation of a material fact for use in determining
rights to any benefit or payment under Medicare or Medicaid; (iii) failing to
disclose knowledge by a claimant of the occurrence of any event affecting the
initial or continued right to any benefit or payment under Medicare or Medicaid
on its own behalf or on behalf of another, with intent to secure such benefit or
payment fraudulently; (iv) knowingly and wilfully soliciting or receiving any
remuneration (including any kickback, bribe or rebate), directly or indirectly,
overtly or covertly, in cash or in kind or offering to pay such remuneration (1)
in return for referring an individual to a Person for the furnishing or
arranging for the furnishing of any item or service for which payment may be
made in whole or in part by Medicare or Medicaid or (2) in return for
purchasing, leasing or ordering or arranging for or recommending the purchasing,
leasing or ordering of any good, facility, service or item for which payment may
be made in whole or in part by Medicare or Medicaid. With respect to this
subsection 5.19(e), knowledge by a Responsible Officer of the Company or of a
Subsidiary of any events described in this subsection 5.19(e) shall not be
imputed to the Company or such Subsidiary unless such knowledge was obtained or
learned by such Responsible Officer in his or her official capacity as a
Responsible Officer of the Company or such Subsidiary. No activity of the
Company, any Subsidiary, any Affiliate or any director or officer of the
foregoing shall be considered to be a breach of this subsection 5.19(e) unless
the Company, a Subsidiary or an Affiliate of the foregoing has received
notification, written or oral, by a Governmental Authority of competent
jurisdiction as to any such violation.

                                  ARTICLE VI

                             AFFIRMATIVE COVENANTS
                             ---------------------

So long as any Bank shall have any Commitment hereunder, or any Loan or other
Obligation shall remain unpaid or unsatisfied, unless the Majority Banks waive
compliance in writing:

VI.1 Financial Statements. The Company shall deliver to the Agent, in form and
detail satisfactory to the Agent and the Majority Banks, with sufficient copies
for each Bank:

(a) as soon as available, but not later than 105 days after the end of each
Fiscal Year, a copy of the audited consolidated balance sheet of the Company and
its Subsidiaries as at the end of such year and the related consolidated
statements of income, stockholders' equity and cash flows for such year, setting
forth in each case in comparative form the figures for the previous Fiscal Year,
and accompanied by the opinion of Ernst & Young LLP or another nationally-
recognized independent public accounting firm (the "Independent Auditor") which
report shall state that such consolidated financial statements present fairly
the financial position for the periods indicated in conformity with GAAP applied
on a basis consistent with prior years (such opinion shall not be qualified or
limited because of a restricted or limited examination by the Independent
Auditor of any material portion of the Company's or any Subsidiary's records),
it being
<PAGE>
 
understood that the delivery by the Company of its Form 10K as filed with the
SEC shall satisfy the requirements of this Section 6.1(a); and

(b) as soon as available, but not later than 60 days after the end of each
Fiscal Quarter of each Fiscal Year, a copy of the consolidated balance sheet of
the Company and its Subsidiaries as of the end of such quarter and the related
consolidated statements of income and cash flows for the period commencing on
the first day and ending on the last day of such Fiscal Quarter, and certified
by a Responsible Officer as fairly presenting, in accordance with GAAP (subject
to ordinary, good faith year-end audit adjustments), the financial position and
the results of operations of the Company and the Subsidiaries for the periods
indicated, it being understood that the delivery by the Company of its Form 10Q
as filed with the SEC shall satisfy the requirements of this Section 6.1(b).

VI.2 Certificates; Other Information. The Company shall furnish to the Agent,
with sufficient copies for each Bank:

(a) concurrently with the delivery of the financial statements referred to in
subsection 6.1(a), a certificate of the Independent Auditor stating that in
making the examination necessary therefor no knowledge was obtained of any
Default or Event of Default, except as specified in such certificate;

(b) concurrently with the delivery of the financial statements referred to in
subsections 6.1(a) and (b), a Compliance Certificate executed by a Responsible
Officer;

(c) promptly, copies of all financial statements and reports that the Company
sends to its stockholders generally, and copies of all financial statements and
regular, periodical or special reports (including Forms 10K, 10Q and 8K) that
the Company or any Subsidiary may make to, or file with, the SEC; and

(d) promptly, such additional information regarding the business, financial or
corporate affairs of the Company or any Subsidiary as the Agent, at the
reasonable request of any Bank, may from time to time reasonably request.

VI.3 Notices. The Company shall promptly notify the Agent and each Bank:

(a) of the occurrence of any Default or Event of Default;

(b) of any matter that has resulted or may result in a Material Adverse Effect,
including (i) breach or non-performance of, or any default under, a Contractual
Obligation of the Company or any Subsidiary, (ii) any dispute, litigation,
investigation, proceeding or suspension between the Company or any Subsidiary
and any Governmental Authority or (iii) the commencement of, or any material
development in, any litigation or proceeding affecting the Company or any
Subsidiary, including pursuant to any applicable Environmental Laws;
<PAGE>
 
(c) of the occurrence of any of the following events affecting the Company or
any ERISA Affiliate (but in no event more than 10 days after such event), and
deliver to the Agent and each Bank a copy of any notice with respect to such
event that is filed with a Governmental Authority and any notice delivered by a
Governmental Authority to the Company or any ERISA Affiliate with respect to
such event:

(i) an ERISA Event;

(ii) a material increase in the Unfunded Pension Liability of any Pension Plan;

(iii) the adoption of, or the commencement of contributions to, any Plan subject
to Title IV of ERISA by the Company or any ERISA Affiliate; or

(iv) the adoption of any amendment to a Plan subject to Title IV of ERISA, if
such amendment results in a material increase in contributions or Unfunded
Pension Liability.

(d) of any material change in accounting policies or financial reporting
practices by the Company or any of its consolidated Subsidiaries.

Each notice under this Section shall be accompanied by a written statement by a
Responsible Officer setting forth details of the occurrence referred to therein,
and stating what action the Company or any affected Subsidiary proposes to take
with respect thereto and at what time. Each notice under subsection 6.3(a) shall
describe with particularity any and all clauses or provisions of this Agreement
or other Loan Document that have been breached or violated.

VI.4 Preservation of Corporate Existence, Etc. The Company shall, and shall
cause each Material Subsidiary to:

(a) subject to Section 7.3, preserve and maintain in full force and effect its
corporate existence and good standing under the laws of its state or
jurisdiction of incorporation;

(b) preserve and maintain in full force and effect all governmental rights,
privileges, qualifications, permits, licenses and franchises, the
nonpreservation or maintenance of which would reasonably be expected to have a
Material Adverse Effect except in connection with transactions permitted by
Section 7.3 and sales of assets permitted by Section 7.2;

(c) subject to Sections 7.2 and 7.3, use reasonable efforts, in the ordinary
course of business, to preserve its business organization and goodwill; and

(d) preserve or renew all of its registered patents, trademarks, trade names and
service marks, the non-preservation of which would reasonably be expected to
have a Material Adverse Effect.
<PAGE>
 
VI.5 Maintenance of Property. The Company shall maintain, and shall cause each
Subsidiary to maintain, and preserve all its property which is used or useful in
its business in good working order and condition, ordinary wear and tear
excepted and make all necessary repairs thereto and renewals and replacements
thereof except where the failure to do so would not reasonably be expected to
have a Material Adverse Effect, except as permitted by Section 7.2. The Company
and each Subsidiary shall use the standard of care typical in the industry in
the operation and maintenance of its facilities.

VI.6 Insurance. The Company shall maintain, and shall cause each Subsidiary to
maintain, with financially sound and reputable independent insurers, insurance
with respect to its properties and business against loss or damage of the kinds
customarily insured against by Persons engaged in the same or similar business,
of such types and in such amounts as are customarily carried under similar
circumstances by such other Persons.

VI.7 Payment of Obligations. The Company shall, and shall cause each Subsidiary
to, pay and discharge as the same shall become due and payable, all their
respective obligations and liabilities, including:

(a) all tax liabilities, assessments and governmental charges or levies upon it
or its properties or assets, unless the same are being contested in good faith
by appropriate proceedings and adequate reserves in accordance with GAAP are
being maintained by the Company or such Subsidiary;

(b) all lawful claims which, if unpaid, would by law become a Lien upon its
property, where such Lien is not otherwise permitted by Section 7.1; and

(c) all indebtedness, as and when due and payable, but subject to any
subordination provisions contained in any instrument or agreement evidencing
such Indebtedness.

VI.8 Compliance with Laws. The Company shall comply, and shall cause each
Subsidiary to comply, in all material respects with all Requirements of Law of
any Governmental Authority having jurisdiction over it or its business
(including the Federal Fair Labor Standards Act), noncompliance with which would
reasonably be expected to have a Material Adverse Effect, except such as may be
contested in good faith or as to which a bona fide dispute may exist.

VI.9 Compliance with ERISA. The Company shall, and shall cause each of its ERISA
Affiliates to: (a) maintain each Plan in compliance in all material respects
with the applicable provisions of ERISA, the Code and other federal or state
law; (b) cause each Plan which is qualified under Section 401(a) of the Code to
maintain such qualification; and (c) make all required contributions to any Plan
subject to Section 412 of the Code.

VI.10 Inspection of Property and Books and Records. The Company shall maintain
and shall cause each Subsidiary to maintain proper books of record and account,
in which full, true and
<PAGE>
 
correct entries in conformity with GAAP consistently applied shall be made of
all financial transactions and matters involving the assets and business of the
Company and such Subsidiary. The Company shall permit, and shall cause each
Subsidiary to permit, representatives and independent contractors of the Agent,
once each Fiscal Year, to visit and inspect any of their respective properties,
to examine their respective corporate, financial and operating records, and make
copies thereof or abstracts therefrom, and to discuss their respective affairs,
finances and accounts with their respective directors, officers, and independent
public accountants, all at the expense of the Banks and at such reasonable times
during normal business hours as may be reasonably desired, upon reasonable
advance notice to the Company; provided, however, when an Event of Default
exists, the Agent or any Bank may do any of the foregoing at the expense of the
Company as often as may reasonably be desired by the Agent or any Bank, at any
time during normal business hours and without advance notice.

VI.11 Environmental Laws. The Company shall, and shall cause each Subsidiary to,
conduct its operations and keep and maintain its property in compliance with all
Environmental Laws, noncompliance with which would reasonably be expected to
have a Material Adverse Effect.

VI.12 Use of Proceeds. The Company shall use the proceeds of the Loans only for
(i) the financing of the general corporate needs of the Company or any
Subsidiary and (ii) the financing of Permitted Transactions and Permitted
Investments.

VI.13 Financial Covenants. The Company shall maintain the following covenants
(all calculations to be made on a consolidated basis, in accordance with GAAP,
and by reference to the most recently audited financial statements):

(a) Minimum Interest Coverage Ratio. The Company shall not permit, as at the
end of any Fiscal Quarter, its ratio of EBITDA to Consolidated Interest Expense
to be less than 3.0:1, calculated by reference to the four Fiscal Quarter period
then ending.

(b) Maximum Consolidated Funded Debt to Cash Flow Ratio. The Company shall not
permit, as at the end of any Fiscal Quarter, its ratio of Funded Debt
outstanding as at the end of such Fiscal Quarter to EBITDA for the period of
four Fiscal Quarters ending on such date to exceed 3.0:1.

(c) Minimum EBITDA. The Company shall not permit, at the end of any Fiscal
Quarter, EBITDA for the period of four Fiscal Quarters then ending to be less
than $20,000,000.

6.14 Further Assurances. The Company will, and will cause each Wholly-Owned
Subsidiary to, take such actions as are reasonably necessary or as the Agent
(acting at the request of any Bank) may reasonably request from time to time to
ensure that the Obligations are guaranteed by all Wholly-Owned Subsidiaries of
the Company pursuant to Article XI.
<PAGE>
 
                                  ARTICLE VII

                              NEGATIVE COVENANTS
                              ------------------

So long as any Bank shall have any Commitment hereunder, or any Loan or other
Obligation shall remain unpaid or unsatisfied, unless the Majority Banks waive
compliance in writing:

VII.1 Limitation on Liens. The Company shall not, and shall not suffer or permit
any Subsidiary to, directly or indirectly, make, create, incur, assume or suffer
to exist any Lien upon or with respect to any part of its property, whether now
owned or hereafter acquired, other than the following ("Permitted Liens"):

(a) any Lien existing on property of the Company or any Subsidiary on the
Closing Date and set forth in Schedule 7.1 securing Indebtedness outstanding on
such date;

(b) any Lien created under any Loan Document;

(c) Liens for taxes, fees, assessments or other governmental charges or levies
which are not delinquent, are being contested in good faith or remain payable
without penalty, or to the extent that non-payment thereof is permitted by
Section 6.7, provided that no notice of lien has been filed or recorded under
the Code;

(d) carriers', warehousemen's, mechanics', landlords', materialmen's,
repairmen's or other similar Liens arising in the ordinary course of business
which are not delinquent, are being contested in good faith or remain payable
without penalty;

(e) Liens incidental to the conduct of business or the ownership of properties
and assets (other than any Lien imposed by ERISA) incurred in the ordinary
course of business and not in connection with the borrowing of money (including
Liens in connection with workers' compensation, unemployment insurance and other
social security legislation);

(f) Liens on the property of the Company or any of its Subsidiaries securing (i)
the nondelinquent performance of bids, trade contracts (other than for borrowed
money), leases, statutory obligations, (ii) contingent obligations on surety
bonds (excluding appeal bonds and other bonds posted in connection with court
proceedings or judgments) and (iii) other nondelinquent obligations of a like
nature; in each case, incurred in the ordinary course of business, provided all
such Liens in the aggregate would not (even if enforced) cause a Material
Adverse Effect;

(g) Liens consisting of judgment, award or judicial attachment Liens and Liens
securing contingent obligations on appeal bonds and other bonds posted in
connection with court proceedings or judgments, provided that the time for the
appeal or petition for rehearing of which shall not have expired, or the
enforcement of such Liens is effectively stayed and all such Liens
<PAGE>
 
in the aggregate at any time outstanding for the Company and its Subsidiaries do
not exceed $1,000,000;

(h) easements, rights-of-way, restrictions, utilities and other similar
purposes, or zoning or other restrictions as to the use of real properties and
other similar encumbrances which are necessary for the conduct of the activities
of the Company and its Subsidiaries or which customarily exist on properties of
entities engaged in similar activities and similarly situated, in the aggregate,
are not substantial in amount, and which do not in any case materially detract
from the value of the property subject thereto or interfere with the ordinary
conduct of the businesses of the Company and its Subsidiaries;

(i) Liens on assets of corporations which become Subsidiaries after the date of
this Agreement, provided, however, that such Liens existed at the time the
respective corporations became Subsidiaries and were not created in anticipation
thereof;

(j) purchase money security interests on any property acquired or held by the
Company or its Subsidiaries in the ordinary course of business or in connection
with a Permitted Transaction or a Permitted Investment, securing Indebtedness
incurred or assumed for the purpose of financing all or any part of the cost of
acquiring such property, provided that (i) any such Lien attaches to such
property concurrently with or within 60 days after the acquisition thereof, (ii)
such Lien attaches solely to the property so acquired in such transaction and
(iii) the principal amount of the debt secured thereby does not exceed 100% of
the cost of such property;

(k) Liens securing obligations in respect of capital leases on assets subject to
such leases, provided that such capital leases are otherwise permitted
hereunder;

(l) Liens arising solely by virtue of any statutory or common law provision
relating to banker's liens, rights of setoff or similar rights and remedies as
to deposit accounts or other funds maintained with a creditor depository
institution; provided that (i) such deposit account is not a dedicated cash
collateral account and is not subject to restrictions against access by the
Company in excess of those set forth by regulations promulgated by the FRB and
(ii) such deposit account is not intended by the Company or any Subsidiary to
provide collateral to the depository institution; and

(m) Liens securing Indebtedness of a Subsidiary to the Company or to another
Subsidiary.

VII.2 Disposition of Assets. The Company shall not, and shall not suffer or
permit any Subsidiary to, directly or indirectly, sell, assign, lease, convey,
transfer or otherwise dispose of (whether in one or a series of transactions)
any property (including accounts and notes receivable, with or without recourse)
or enter into any agreement to do any of the foregoing, except:
<PAGE>
 
(a) dispositions of inventory, or used, worn-out or surplus equipment, all in
the ordinary course of business;

(b) the sale of assets to the extent that such assets are exchanged for credit
against the purchase price of similar replacement assets, or the net proceeds of
such sale are reasonably promptly applied to the purchase price of such
replacement assets;

(c) dispositions of inventory/equipment by the Company or any Subsidiary to the
Company or any Subsidiary pursuant to reasonable business requirements;

(d) dispositions of Subsidiaries or any interest therein, provided that no such
disposition may occur without the prior written consent of the Majority Banks
where, (i) in the case of the disposition of all or any portion of the ownership
interest in a Material Subsidiary, the Company would own 50% or less of such
Material Subsidiary after giving effect to such disposition, or (ii) the Company
intends to dispose of a portion of its ownership interest in a Subsidiary and
such portion accounted for more than 5% of EBT for the preceding four-Fiscal
Quarter period; and

(e) dispositions not otherwise permitted hereunder which are made for fair
market value; provided that, (i) at the time of any disposition, no Event of
Default shall exist or shall result from such disposition, (ii) at least 85% of
the aggregate sales price from such disposition shall be paid in cash or
equivalents, and (iii) unless the Company receives the prior written consent of
the Majority Banks, the assets subject to such disposition shall not account for
more than 5% of the Company's Consolidated Total Assets as at the end of the
preceding Fiscal Quarter.

VII.3 Consolidations and Mergers. The Company shall not, and shall not suffer or
permit any Subsidiary to, merge, consolidate with or into, any Person, except
that any Subsidiary may merge or consolidate with or into the Company, provided
that the Company shall be the continuing or surviving corporation, or with any
one or more Subsidiaries; provided further that, if any transaction shall be
between a Subsidiary and a Wholly-Owned Subsidiary, the Wholly-Owned Subsidiary
shall be the continuing or surviving corporation.

VII.4 Loans and Investments. The Company shall not, and shall not permit any
Subsidiary to, purchase or acquire, or make any commitment therefor, any capital
stock, equity interest or any obligations or other securities of, or any
interest in, any Person, or make or commit to make any Acquisitions, or make or
commit to make any advance, loan, extension of credit or capital contribution to
or any other investment in, any Person including any Affiliate of the Company,
except for:

(a) investments in cash and cash equivalents in the ordinary course of business;

(b) extensions of credit in the nature of accounts receivable or notes
receivable arising from the sale or lease of goods or services in the ordinary
course of business;
<PAGE>
 
(c) extensions of credit by the Company to any of its Subsidiaries or by any of
its Subsidiaries to another of its Subsidiaries;

(d) without duplication, Permitted Transactions;

(e) investments in a Person who becomes a Subsidiary pursuant to a Permitted
Acquisition or Permitted Development which are not made in connection with or
otherwise in contemplation of such Permitted Acquisition or Permitted
Development; and

(f) Permitted Investments not otherwise permitted hereunder, provided that the
aggregate net book value of such investments does not exceed 15% of Consolidated
Total Assets as at the end of the immediately preceding Fiscal Quarter.

VII.5 Limitation on Indebtedness. The Company shall not, and shall not suffer or
permit any Subsidiary to, create, incur, assume, suffer to exist, or otherwise
become or remain directly or indirectly liable with respect to, any
Indebtedness, except:

(a) Indebtedness incurred pursuant to this Agreement;

(b) Indebtedness consisting of Contingent Obligations permitted pursuant to
Section 7.8;

(c) Indebtedness existing on the Closing Date and set forth in Schedule 7.5;

(d) Indebtedness secured by Liens permitted by Section 7.1(i), provided that the
aggregate amount of assets subject to such Liens does not exceed 10% of
Consolidated Total Assets as at the end of the immediately preceding Fiscal
Quarter;

(e)  Indebtedness incurred in connection with leases permitted pursuant to
Section 7.10;

(f) any other unsecured Indebtedness of the Company not otherwise permitted
hereunder and incurred after the Closing Date, provided that, as at the time of
creation, assumption, or incurrence thereof and after giving effect thereto and
to the application of the proceeds thereof, Indebtedness of the Company does not
exceed 5% of Consolidated Total Assets at the end of the immediately preceding
Fiscal Quarter;

(g) Indebtedness (i) issued in exchange for, or the proceeds from the issuance
and sale of which are used substantially concurrently to repay, redeem, defease,
refinance, discharge or otherwise retire for value, in whole or in part, or (ii)
constituting an amendment, modification or supplement to, or a deferral or
renewal of, any Indebtedness described in subsections 7.1(a) through (g);
provided that the incurring of Indebtedness under this subsection (g) shall not
(1) accelerate the date of any required repayment, repurchase or redemption of
any Indebtedness described in subsections 7.1(a) through (g), (2) include the
repayment, repurchase or redemption of subordinated Indebtedness by or with any
Indebtedness other than subordinated Indebtedness
<PAGE>
 
or (3) involve the repayment, repurchase or redemption of Indebtedness of the
Company by or with Indebtedness of any Subsidiary of the Company; and

(h) Indebtedness secured by Liens permitted by Section 7.1(j) and (m).

VII.6 Transactions with Affiliates. The Company shall not, and shall not suffer
or permit any Subsidiary to, enter into any transaction with any Affiliate of
the Company, except upon fair and reasonable terms no less favorable to the
Company or such Subsidiary than would obtain in a comparable arms'-length
transaction with a Person not an Affiliate of the Company or such Subsidiary.

VII.7 Use of Proceeds. (a) The Company shall not use any portion of the
Revolving Loan proceeds, directly or indirectly, other than in connection with
(i) the financing of the general corporate needs of the Company or any
Subsidiary and (ii) the financing of Permitted Transactions or Permitted
Investments.

(b) The Company shall not, and shall not suffer or permit any Subsidiary to, use
any portion of the Loan proceeds, directly or indirectly, (i) to purchase or
carry Margin Stock, (ii) to repay or otherwise refinance indebtedness of the
Company or others incurred to purchase or carry Margin Stock, (iii) to extend
credit for the purpose of purchasing or carrying any Margin Stock or (iv) to
acquire any security in any transaction that is subject to Section 13 or 14 of
the Exchange Act.

(c) The Company shall not, directly or indirectly, use any portion of the Loan
proceeds (i) knowingly to purchase Ineligible Securities from the Arranger
during any period in which the Arranger makes a market in such Ineligible
Securities, (ii) knowingly to purchase during the underwriting or placement
period Ineligible Securities being underwritten or privately placed by the
Arranger or (iii) to make payments of principal or interest on Ineligible
Securities underwritten or privately placed by the Arranger and issued by or for
the benefit of the Company or any Affiliate of the Company. The Arranger is a
registered broker-dealer and permitted to underwrite and deal in certain
Ineligible Securities; and "Ineligible Securities" means securities which may
not be underwritten or dealt in by member banks of the Federal Reserve System
under Section 16 of the Banking Act of 1933 (12 U.S.C. (S) 24, Seventh).

VII.8 Contingent Obligations. The Company shall not, and shall not suffer or
permit any Subsidiary to, create, incur, assume or suffer to exist any
Contingent Obligations except:

(a) endorsements for collection or deposit in the ordinary course of business;

(b) Swap Contracts entered into in the ordinary course of business as bona fide
hedging transactions;

(c) guaranties of the Company given in respect of leases entered into by its
Subsidiaries;
<PAGE>
 
(d)  guaranties of the Company given in respect of the Indebtedness of
Subsidiaries of the Company to the extent permitted under Section 7.5;

(e)  Contingent Obligations of the Company and its Subsidiaries existing as of
the Closing Date and listed in Schedule 7.8;

(f) any Earnout incurred in connection with a Permitted Transaction or a
Permitted Investment; and

(g) guaranties of the Company given in respect of the Indebtedness of any
Minority Owned Person of the Company, provided that the net book value of such
guaranties does not exceed 7% of Consolidated Total Assets as at the end of the
immediately preceding Fiscal Quarter.

VII.9  Joint Ventures.  The Company shall not, and shall not suffer or permit
any Subsidiary to enter into any Joint Venture, other than (a) in the ordinary
course of business and (b) in connection with a Permitted Transaction or a
Permitted Investment.

VII.10  Lease Obligations.  The Company shall not, and shall not suffer or
permit any Subsidiary to, create or suffer to exist any obligations for the
payment of rent for any property under lease or agreement to lease, except for:

(a)  leases of the Company and of Subsidiaries in existence on the Closing Date
and any renewal, extension or refinancing thereof;

(b)  operating leases entered into by the Company or any Subsidiary after the
Closing Date in the ordinary course of business;

(c)  leases entered into by the Company or any Subsidiary after the Closing Date
pursuant to sale-leaseback transactions permitted under subsection 7.2(d); and

(d)  capital leases other than those permitted under clauses (a) and (c) of this
Section, entered into by the Company or any Subsidiary after the Closing Date to
finance the acquisition of equipment; provided that the aggregate assets subject
to such capital leases shall not exceed 7% of Consolidated Total Assets as at
the end of the immediately preceding Fiscal Quarter.

VII.11  Restricted Payments.  The Company shall not, and shall not suffer or
permit any Subsidiary to, declare or make any dividend payment or other
distribution of assets, properties, cash, rights, obligations or securities on
account of any shares of any class of its capital stock or other ownership
interests, or purchase, redeem or otherwise acquire for value any shares of its
capital stock or other ownership interests, or any warrants, rights or options
to acquire such shares or other ownership interests, now or hereafter
outstanding; except that the Company and any Subsidiary may:
<PAGE>
 
(a)  declare and make dividend payments or other distributions payable solely in
its common stock;

(b)  purchase, redeem or otherwise acquire shares of its common stock or
warrants or options to acquire any such shares with the proceeds received from
the substantially concurrent issue of new shares of its common stock;

(c)  any Subsidiary may declare or make any such dividend payment or other
distribution, provided that any such dividend payment or other distribution
shall be proportionate to the ownership interests of the Persons in whose favor
such dividend payment or other distribution is declared or made (but need not be
proportionate as between different classes of equity or ownership interests);
and

(d) any Subsidiary may purchase or acquire its own capital stock or other equity
or ownership interests from a Person other than the Company or another
Subsidiary of the Company.

VII.12  ERISA.  The Company shall not, and shall not suffer or permit any of its
ERISA Affiliates to:  (a) engage in a prohibited transaction or violation of the
fiduciary responsibility rules with respect to any Plan which has resulted or
could reasonably expected to result in liability of the Company in an aggregate
amount in excess of $5,000,000; or (b) engage in a transaction that could be
subject to Section 4069 or 4212(c) of ERISA.

VII.13  Accounting Changes.  The Company shall not, and shall not suffer or
permit any Subsidiary to, make any significant change in accounting treatment or
reporting practices, except as required by GAAP, or change the fiscal year of
the Company or of any Subsidiary.

VII.14  Business Activities.  The Company will not, and will not permit any of
its Subsidiaries to, engage in any business activity except Permitted
Businesses.

VII.15  Take or Pay Contracts.  The Company will not, and will not permit any of
its Subsidiaries to, enter into or be a party to any arrangement for the
purchase of materials, supplies, other property or services if such arrangement
by its express terms requires that payment be made by the Company or such
Subsidiary regardless of whether such materials, supplies, other property or
services are delivered or furnished to it.

VII.16  Modification of Certain Agreements.  The Company will not consent to any
amendment, supplement or other modification of any of the terms or provisions
(including with respect to any instruments evidencing any Subordinated Debt, any
provision in respect of acceleration, covenant, default, subordination, sinking
fund, repayment, required repurchase, interest rate or redemption thereof or
relating thereto) contained in any document or instrument evidencing or
applicable to any Subordinated Debt, other than any amendment, supplement or
other modification which extends the date or reduces the amount of any required
repayment or redemption, if such amendment, supplement or other modification
does not otherwise have an adverse effect on the rights of the Banks.
<PAGE>
 
                                 ARTICLE VIII

                               EVENTS OF DEFAULT
                               -----------------

VIII.1  Event of Default.  Any of the following shall constitute an "Event of
Default":

(a)  Non-Payment.  The Company fails to pay, (i) when and as required to be
paid herein, any amount of principal of any Loan, or (ii) within 5 days after
the same becomes due, any interest, fee or any other amount payable hereunder or
under any other Loan Document; or

(b)  Representation or Warranty.  Any representation or warranty by the
Company or any Subsidiary made or deemed made herein, in any other Loan
Document, or which is contained in any certificate, document or financial or
other statement by the Company, any Subsidiary, or any Responsible Officer,
furnished at any time under this Agreement, or in or under any other Loan
Document, is incorrect in any material respect on or as of the date made or
deemed made; or

(c)  Specific Defaults.  The Company fails to perform or observe any term,
covenant or agreement contained in any of Section 6.1, 6.2, 6.3, 6.9, or 6.13 or
in Article VII; or

(d)  Other Defaults.  The Company or any Subsidiary party thereto fails to
perform or observe any other term or covenant contained in this Agreement or any
other Loan Document, and such default shall continue unremedied for a period of
20 days after the date upon which written notice thereof is given to the Company
by the Agent or any Bank; or

(e)  Cross-Default.  The Company or any Material Subsidiary (i) fails to make
any payment in respect of any Indebtedness or Contingent Obligation having an
aggregate principal amount (including undrawn committed or available amounts and
including amounts owing to all creditors under any combined or syndicated credit
arrangement) of more than $1,000,000 when due (whether by scheduled maturity,
required prepayment, acceleration, demand, or otherwise) and such failure
continues after the applicable grace or notice period, if any, specified in the
relevant document on the date of such failure; or (ii) fails to perform or
observe any other condition or covenant, or any other event shall occur or
condition exist, under any agreement or instrument relating to any such
Indebtedness or Contingent Obligation, and such failure continues after the
applicable grace or notice period, if any, specified in the relevant document on
the date of such failure if the effect of such failure, event or condition is to
cause, or to permit the holder or holders of such Indebtedness or beneficiary or
beneficiaries of such Indebtedness (or a trustee or agent on behalf of such
holder or holders or beneficiary or beneficiaries) to cause such Indebtedness to
be declared to be due and payable prior to its stated maturity, or such
Contingent Obligation to become payable or cash collateral in respect thereof to
be demanded;

(f)  Insolvency; Voluntary Proceedings.  The Company or any Material
Subsidiary (i) ceases or fails to be solvent, or generally fails to pay, or
admits in writing its inability to pay, its debts as 
<PAGE>
 
they become due, subject to applicable grace periods, if any, whether at stated
maturity or otherwise; (ii) voluntarily ceases to conduct its business in the
ordinary course; (iii) commences any Insolvency Proceeding with respect to
itself; or (iv) takes any action to effectuate or authorize any of the
foregoing; or

(g)  Involuntary Proceedings.  (i) Any involuntary Insolvency Proceeding is
commenced or filed against the Company or any Material Subsidiary, or any writ,
judgment, warrant of attachment, execution or similar process, is issued or
levied against a substantial part of the Company's or any Material Subsidiary's
properties, and any such proceeding or petition shall not be dismissed, or such
writ, judgment, warrant of attachment, execution or similar process shall not be
released, vacated or fully bonded within 60 days after commencement, filing or
levy; (ii) the Company or any Material Subsidiary admits the material
allegations of a petition against it in any Insolvency Proceeding, or an order
for relief (or similar order under non-U.S. law) is ordered in any Insolvency
Proceeding; or (iii) the Company or any Material Subsidiary acquiesces in the
appointment of a receiver, trustee, custodian, conservator, liquidator,
mortgagee in possession (or agent therefor), or other similar Person for itself
or a substantial portion of its property or business; or

(h)  ERISA.  (i) An ERISA Event shall occur with respect to a Pension Plan or
Multiemployer Plan which has resulted or could reasonably be expected to result
in liability of the Company under Title IV of ERISA to the Pension Plan,
Multiemployer Plan or the PBGC in an aggregate amount in excess of $5,000,000;
(ii) the aggregate amount of Unfunded Pension Liability among all Pension Plans
at any time exceeds $5,000,000; or (iii) the Company or any ERISA Affiliate
shall fail to pay when due, after the expiration of any applicable grace period,
any installment payment with respect to its withdrawal liability under Section
4201 of ERISA under a Multiemployer Plan in an aggregate amount in excess of
$5,000,000; or

(i)  Monetary Judgments.  One or more non-interlocutory judgments, non-
interlocutory orders, decrees or arbitration awards is entered against the
Company or any Material Subsidiary involving in the aggregate a liability (to
the extent not covered by independent third-party insurance as to which the
insurer does not dispute coverage) as to any single or related series of
transactions, incidents or conditions, of $500,000 or more, and the same shall
remain unsatisfied, unvacated and unstayed pending appeal for a period of 10
days after the entry thereof; or

(j)  Non-Monetary Judgments.  Any non-monetary judgment, order or decree is
entered against the Company or any Subsidiary which does or would reasonably be
expected to have a Material Adverse Effect, and there shall be any period of 10
consecutive days during which a stay of enforcement of such judgment or order,
by reason of a pending appeal or otherwise, shall not be in effect; or

(k)  Change of Control.  There occurs any Change of Control; or

<PAGE>
 
(l)  Loss of Licenses.  Any Governmental Authority revokes or fails to renew
any material license, permit or franchise of the Company or any Material
Subsidiary, or the Company or any Material Subsidiary for any reason loses any
material license, permit or franchise, or the Company or any Material Subsidiary
suffers the imposition of any restraining order, escrow, suspension or impound
of funds in connection with any proceeding (judicial or administrative) with
respect to any material license, permit or franchise, and such revocations,
failure to renew, loss or imposition has or would reasonably be expected to have
a Material Adverse Effect; or

(m)  Adverse Change.  There occurs a Material Adverse Effect; or

(n)  Guarantor Defaults.  Any Guarantor fails in any material respect to perform
or observe any term, covenant or agreement in Article XI; or, except as
specifically provided in Article XI, Article XI is for any reason partially
(including with respect to future advances) or wholly revoked or invalidated, or
otherwise ceases to be in full force and effect, or any Guarantor or any other
Person contests in any manner the validity or enforceability thereof or denies
that it has any further liability or obligation thereunder, and such failure,
revocation, invalidation, cessation, contest or denial has or would reasonably
be expected to have a Material Adverse Effect.

VIII.2  Remedies.  If any Event of Default occurs, the Agent shall, at the
request of, or may, with the consent of, the Majority Banks,

(a)  declare the commitment of each Bank to make Loans to be terminated,
whereupon such commitments shall be terminated;

(b)  declare the unpaid principal amount of all outstanding Loans, all interest
accrued and unpaid thereon, and all other amounts owing or payable hereunder or
under any other Loan Document to be immediately due and payable, without
presentment, demand, protest or other notice of any kind, all of which are
hereby expressly waived by the Company; and

(c)  exercise on behalf of itself and the Banks all rights and remedies
available to it and the Banks under the Loan Documents or applicable law;
provided, however, that upon the occurrence of any event specified in subsection
(f) or (g) of Section 8.1 (in the case of clause (i) of subsection (g) upon the
expiration of the 60-day period mentioned therein), the obligation of each Bank
to make Loans shall automatically terminate and the unpaid principal amount of
all outstanding Loans and all interest and other amounts as aforesaid shall
automatically become due and payable without further act of the Agent or any
Bank.

VIII.3  Rights Not Exclusive.  The rights provided for in this Agreement and the
other Loan Documents are cumulative and are not exclusive of any other rights,
powers, privileges or remedies provided by law or in equity, or under any other
instrument, document or agreement now existing or hereafter arising.
<PAGE>
 
VIII.4 Certain Financial Covenant Defaults.  In the event that, after taking
into account any extraordinary charge to earnings taken or to be taken as of the
end of any fiscal period of the Company (a "Charge"), and if solely by virtue of
such Charge, there would exist an Event of Default due to the breach of Section
6.13 as of such fiscal period end date, such Event of Default shall be deemed to
arise upon the earlier of (a) the date after such fiscal period end date on
which the Company announces publicly it will take, is taking or has taken such
Charge (including an announcement in the form of a statement in a report filed
with the SEC) or, if such announcement is made prior to such fiscal period end
date, the date that is such fiscal period end date, and (b) the date the Company
delivers to the Agent its audited annual or unaudited quarterly financial
statements in respect of such fiscal period reflecting such Charge as taken.

                                  ARTICLE IX

                                   THE AGENT
                                   ---------

IX.1  Appointment and Authorization.  Each Bank hereby irrevocably (subject to
Section 9.9) appoints, designates and authorizes the Agent to take such action
on its behalf under the provisions of this Agreement and each other Loan
Document and any other instruments and agreements referred to herein or therein
and to exercise such powers and perform such duties hereunder and thereunder as
are expressly delegated to or required of it by the terms hereof and thereof,
together with such powers as are reasonably incidental thereto.  Notwithstanding
any provision to the contrary contained elsewhere in this Agreement or in any
other Loan Document, the Agent shall not have any duties or responsibilities,
except those expressly set forth herein, nor shall the Agent have or be deemed
to have any fiduciary relationship with any Bank, and no implied covenants,
functions, responsibilities, duties, obligations or liabilities shall be read
into this Agreement or any other Loan Document or otherwise exist against the
Agent.

IX.2  Delegation of Duties.  The Agent may execute any of its duties under this
Agreement or any other Loan Document by or through its agents, employees or
attorneys-in-fact and shall be entitled to advice of counsel concerning all
matters pertaining to such duties.  The Agent shall not be responsible for the
negligence or misconduct of any agent or attorney-in-fact that it selects with
reasonable care.

IX.3  Liability of Agent.  None of the Agent-Related Persons shall (i) be liable
for any action taken or omitted to be taken by any of them under or in
connection with this Agreement or any other Loan Document or the transactions
contemplated hereby (except for its own gross negligence or willful misconduct),
or (ii) be responsible in any manner to any of the Banks for any recital,
statement, representation or warranty made by the Company or any Subsidiary or
Affiliate of the Company, or any officer thereof, contained in this Agreement or
in any other Loan 
<PAGE>
 
Document, or in any certificate, report, statement or other document referred to
or provided for in, or received by the Agent under or in connection with, this
Agreement or any other Loan Document, or the validity, effectiveness,
genuineness, enforceability or sufficiency of this Agreement or any other Loan
Document, or for any failure of the Company or any other party to any Loan
Document to perform its obligations hereunder or thereunder. No Agent-Related
Person shall be under any obligation to any Bank to ascertain or to inquire as
to the observance or performance of any of the agreements contained in, or
conditions of, this Agreement or any other Loan Document, or to inspect the
properties, books or records of the Company or any of the Company's Subsidiaries
or Affiliates.

IX.4  Reliance by Agent.  (a)  The Agent shall be entitled to rely, and shall be
fully protected in relying, upon any writing, resolution, notice, consent,
certificate, affidavit, letter, telegram, facsimile, telex or telephone message,
statement or other document or conversation believed by it to be genuine and
correct and to have been signed, sent or made by the proper Person or Persons,
and upon advice and statements of legal counsel (including counsel to the
Company), independent accountants and other experts selected by the Agent. The
Agent shall be fully justified in failing or refusing to take any action under
this Agreement or any other Loan Document unless it shall first receive such
advice or concurrence of the Majority Banks as it deems appropriate and, if it
so requests, it shall first be indemnified to its satisfaction by the Banks
against any and all liability and expense which may be incurred by it by reason
of taking or continuing to take any such action.  The Agent shall in all cases
be fully protected in acting, or in refraining from acting, under this Agreement
or any other Loan Document in accordance with a request or consent of the
Majority Banks and such request and any action taken or failure to act pursuant
thereto shall be binding upon all of the Banks.

(b)  For purposes of determining compliance with the conditions specified in
Section 4.1, each Bank that has executed this Agreement shall be deemed to have
consented to, approved or accepted or to be satisfied with, each document or
other matter either sent by the Agent to such Bank for consent, approval,
acceptance or satisfaction, or required thereunder to be consented to or
approved by or acceptable or satisfactory to the Bank.

IX.5  Notice of Default.  The Agent shall not be deemed to have knowledge or
notice of the occurrence of any Default or Event of Default, except with respect
to defaults in the payment of principal, interest and fees required to be paid
to the Agent for the account of the Banks, unless the Agent shall have received
written notice from a Bank or the Company referring to this Agreement,
describing such Default or Event of Default and stating that such notice is a
"notice of default".  The Agent will notify the Banks of its receipt of any such
notice.  The Agent shall take such action with respect to such Default or Event
of Default as may be requested by the Majority Banks in accordance with Article
VIII; provided, however, that unless and until the Agent has received any such
request, the Agent may (but shall not be obligated to) take such action, or
refrain from taking such action, with respect to such Default or Event of
Default as it shall deem advisable or in the best interest of the Banks.

IX.6  Credit Decision.  Each Bank acknowledges that none of the Agent-Related
Persons has made any representation or warranty to it, and that no act by the
Agent hereinafter taken, 
<PAGE>
 
including any review of the affairs of the Company and its Subsidiaries, shall
be deemed to constitute any representation or warranty by any Agent-Related
Person to any Bank. Each Bank represents to the Agent that it has, independently
and without reliance upon any Agent-Related Person and based on such documents
and information as it has deemed appropriate, made its own appraisal of and
investigation into the business, prospects, operations, property, financial and
other condition and creditworthiness of the Company and its Subsidiaries, and
all applicable bank regulatory laws relating to the transactions contemplated
hereby, and made its own decision to enter into this Agreement and to extend
credit to the Company and its Subsidiaries hereunder. Each Bank also represents
that it will, independently and without reliance upon any Agent-Related Person
and based on such documents and information as it shall deem appropriate at the
time, continue to make its own credit analysis, appraisals and decisions in
taking or not taking action under this Agreement and the other Loan Documents,
and to make such investigations as it deems necessary to inform itself as to the
business, prospects, operations, property, financial and other condition and
creditworthiness of the Company. Except for notices, reports and other documents
expressly herein required to be furnished to the Banks by the Agent, the Agent
shall not have any duty or responsibility to provide any Bank with any credit or
other information concerning the business, prospects, operations, property,
financial and other condition or creditworthiness of the Company which may come
into the possession of any of the Agent-Related Persons.

IX.7  Indemnification.  Whether or not the transactions contemplated hereby are
consummated, the Banks shall indemnify upon demand the Agent-Related Persons (to
the extent not reimbursed by or on behalf of the Company and without limiting
the obligation of the Company to do so), pro rata, from and against any and all
Indemnified Liabilities; provided, however, that no Bank shall be liable for the
payment to the Agent-Related Persons of any portion of such Indemnified
Liabilities resulting solely from such Agent-Related Person's gross negligence
or willful misconduct. Without limitation of the foregoing, each Bank shall
reimburse the Agent upon demand for its ratable share of any costs or out-of-
pocket expenses (including Attorney Costs) incurred by the Agent in connection
with the preparation, execution, delivery, administration, modification,
amendment or enforcement (whether through negotiations, legal proceedings or
otherwise) of, or legal advice in respect of rights or responsibilities under,
this Agreement, any other Loan Document, or any document contemplated by or
referred to herein, to the extent that the Agent is not reimbursed for such
expenses by or on behalf of the Company. The undertaking in this Section shall
survive the payment of all Obligations hereunder and the resignation or
replacement of the Agent.

IX.8  Agent in Individual Capacity.  BofA and its Affiliates may make loans to,
issue letters of credit for the account of, accept deposits from, acquire equity
interests in and generally engage in any kind of banking, trust, financial
advisory, underwriting or other business with the Company and its Subsidiaries
and Affiliates as though BofA were not the Agent hereunder and without notice to
or consent of the Banks.  The Banks acknowledge that, pursuant to such
activities, BofA or its Affiliates may receive information regarding the Company
or its Affiliates (including information that may be subject to confidentiality
obligations in favor of the Company or such 
<PAGE>
 
Subsidiary) and acknowledge that the Agent shall be under no obligation to
provide such information to them. With respect to its Loans, BofA shall have the
same rights and powers under this Agreement as any other Bank and may exercise
the same as though it were not the Agent, and the terms "Bank" and "Banks"
include BofA in its individual capacity.

IX.9  Successor Agent.  The Agent may, and at the request of the Majority Banks
shall, resign as Agent upon 30 days' notice to the Banks and the Company.  If
the Agent resigns under this Agreement, the Majority Banks shall appoint from
among the Banks a successor agent for the Banks.  If no successor agent is
appointed prior to the effective date of the resignation of the Agent, the Agent
may appoint, after consulting with the Banks and obtaining the Company's
consent, a successor agent from among the Banks.  Upon the acceptance of its
appointment as successor agent hereunder, such successor agent shall succeed to
all the rights, powers and duties of the retiring Agent and the term "Agent"
shall mean such successor agent and the retiring Agent's appointment, powers and
duties as Agent shall be terminated. After any retiring Agent's resignation
hereunder as Agent, the provisions of this Article IX and Sections 10.4 and 10.5
shall inure to its benefit as to any actions taken or omitted to be taken by it
while it was Agent under this Agreement.  If no successor agent has accepted
appointment as Agent by the date which is 30 days following a retiring Agent's
notice of resignation, the retiring Agent's resignation shall nevertheless
thereupon become effective and the Banks shall perform all of the duties of the
Agent hereunder until such time, if any, as the Majority Banks appoint a
successor agent as provided for above.

IX.10  Withholding Tax.  (a)  If any Bank is a "foreign corporation, partnership
or trust" within the meaning of the Code and such Bank claims exemption from, or
a reduction of, U.S. withholding tax under Sections 1441 or 1442 of the Code,
such Bank agrees with and in favor of the Agent, to deliver to the Agent:

(i) if such Bank claims an exemption from, or a reduction of, withholding tax
under a United States tax treaty, properly completed IRS Forms 1001 and W-8
before the payment of any interest in the first calendar year and before the
payment of any interest in each third succeeding calendar year during which
interest may be paid under this Agreement;

(ii) if such Bank claims that interest paid under this Agreement is exempt from
United States withholding tax because it is effectively connected with a United
States trade or business of such Bank, two properly completed and executed
copies of IRS Form 4224 before the payment of any interest is due in the first
taxable year of such Bank and in each succeeding taxable year of such Bank
during which interest may be paid under this Agreement, and IRS Form W-9; and

(iii) such other form or forms as may be required under the Code or other laws
of the United States as a condition to exemption from, or reduction of, United
States withholding tax.

Such Bank agrees to promptly notify the Agent of any change in circumstances
which would modify or render invalid any claimed exemption or reduction.
<PAGE>
 
(b)  If any Bank claims exemption from, or reduction of, withholding tax under a
United States tax treaty by providing IRS Form 1001 and such Bank sells,
assigns, grants a participation in, or otherwise transfers all or part of the
Obligations of the Company to such Bank, such Bank agrees to notify the Agent of
the percentage amount in which it is no longer the beneficial owner of
Obligations of the Company to such Bank.  To the extent of such percentage
amount, the Agent will treat such Bank's IRS Form 1001 as no longer valid.

(c)  If any Bank claiming exemption from United States withholding tax by filing
IRS Form 4224 with the Agent sells, assigns, grants a participation in, or
otherwise transfers all or part of the Obligations of the Company to another
Bank, such other Bank agrees to undertake sole responsibility for complying with
the withholding tax requirements imposed by Sections 1441 and 1442 of the Code.

(d)  If any Bank is entitled to a reduction in the applicable withholding tax,
the Agent may withhold from any interest payment to such Bank an amount
equivalent to the applicable withholding tax after taking into account such
reduction. If the forms or other documentation required by subsection (a) of
this Section are not delivered to the Agent, then the Agent may withhold from
any interest payment to such Bank not providing such forms or other
documentation an amount equivalent to the applicable withholding tax.

(e)  If the IRS or any other Governmental Authority of the United States or
other jurisdiction asserts a claim that the Agent did not properly withhold tax
from amounts paid to or for the account of any Bank (because the appropriate
form was not delivered, was not properly executed, or because such Bank failed
to notify the Agent of a change in circumstances which rendered the exemption
from, or reduction of, withholding tax ineffective, or for any other reason)
such Bank shall indemnify the Agent fully for all amounts paid, directly or
indirectly, by the Agent as tax or otherwise, including penalties and interest,
and including any taxes imposed by any jurisdiction on the amounts payable to
the Agent under this Section, together with all costs and expenses (including
Attorney Costs). The obligation of the Banks under this subsection shall survive
the payment of all Obligations and the resignation or replacement of the Agent.

                                   ARTICLE X

                                 MISCELLANEOUS
                                 -------------

X.1  Amendments and Waivers.  No amendment or waiver of any provision of this
Agreement or any other Loan Document, and no consent with respect to any
departure by the Company or any applicable Subsidiary therefrom, shall be
effective unless the same shall be in writing and signed by the Majority Banks
(or by the Agent at the written request of the Majority Banks) and the Company
and acknowledged by the Agent, and then any such waiver or consent shall be
effective only in the specific instance and for the specific purpose for which
given; provided, 
<PAGE>
 
however, that no such waiver, amendment, or consent shall, unless in writing and
signed by all the Banks and the Company and acknowledged by the Agent, do any of
the following:

(a)  except as otherwise expressly permitted under this Agreement, increase or
extend the Commitment of any Bank (or reinstate any Commitment terminated
pursuant to Section 8.2);

(b)  postpone or delay any date fixed by this Agreement or any other Loan
Document for any payment of principal, interest, fees or other amounts due to
the Banks (or any of them) hereunder or under any other Loan Document;

(c)  reduce the principal of, or the rate of interest specified herein on any
Loan, or (subject to clause (ii) below) any fees or other amounts payable
hereunder or under any other Loan Document;

(d)  except as otherwise expressly permitted under this Agreement, change the
percentage of the Commitments or of the aggregate unpaid principal amount of the
Loans which is required for the Banks or any of them to take any action
hereunder;

(e)  amend this Section, or Section 2.14, or any provision herein providing for
                            ------------                                       
consent or other action by all Banks; or

(f)  release any Subsidiary from its respective obligations under Article XI or
amend or waive Article XI as it applies to any Subsidiary; and, provided
further, that (i) no amendment, waiver or consent shall, unless in writing and
signed by the Agent in addition to the Majority Banks or all the Banks, as the
case may be, affect the rights or duties of the Agent under this Agreement or
any other Loan Document, and (ii) the Fee Letter may be amended, or rights or
privileges thereunder waived, in a writing executed by the parties thereto.

X.2  Notices.  (a)  All notices, requests and other communications shall be in
writing (including, unless the context expressly otherwise provides, by
facsimile transmission, provided that any matter transmitted by the Company by
facsimile (i) shall be promptly confirmed by a telephone call to the recipient
at the number specified on Schedule 10.2, and (ii) shall be followed promptly by
delivery of a hard copy original thereof) and mailed, faxed or delivered, to the
address or facsimile number specified for notices on Schedule 10.2; or, as
directed to the Company or the Agent, to such other address as shall be
designated by such party in a written notice to the other parties, and as
directed to any other party, at such other address as shall be designated by
such party in a written notice to the Company and the Agent.

(b)  All such notices, requests and communications shall, when transmitted by
overnight delivery, or faxed, be effective when delivered for overnight (next
day) delivery, or transmitted in legible form by facsimile machine,
respectively, or if mailed, upon the third Business Day
<PAGE>
 
after the date deposited into the U.S. mail, or if delivered, upon delivery;
except that notices pursuant to Article II or IX shall not be effective until
actually received by the Agent.

(c)  Any agreement of the Agent and the Banks herein to receive certain notices
by telephone or facsimile is solely for the convenience and at the request of
the Company. The Agent and the Banks shall be entitled to rely on the authority
of any Person purporting to be a Person authorized by the Company to give such
notice and the Agent and the Banks shall not have any liability to the Company
or other Person on account of any action taken or not taken by the Agent or the
Banks in reliance upon such telephonic or facsimile notice. The obligation of
the Company to repay the Loans shall not be affected in any way or to any extent
by any failure by the Agent and the Banks to receive written confirmation of any
telephonic or facsimile notice or the receipt by the Agent and the Banks of a
confirmation which is at variance with the terms understood by the Agent and the
Banks to be contained in the telephonic or facsimile notice.

X.3 No Waiver; Cumulative Remedies. No failure to exercise and no delay in
exercising, on the part of the Agent or any Bank, any right, remedy, power or
privilege hereunder, shall operate as a waiver thereof; nor shall any single or
partial exercise of any right, remedy, power or privilege hereunder preclude any
other or further exercise thereof or the exercise of any other right, remedy,
power or privilege.

X.4  Costs and Expenses.  The Company shall:
     ------------------                     

(a)  whether or not the transactions contemplated hereby are consummated, pay or
reimburse BofA (including in its capacity as Agent) within five Business Days
after demand (subject to subsection 4.1(e)) for reasonable costs and expenses
incurred by BofA (including in its capacity as Agent) in connection with the
development, preparation, delivery, administration and execution of, and any
amendment, supplement, waiver or modification to (in each case, whether or not
consummated), this Agreement, any Loan Document and any other documents prepared
in connection herewith or therewith, and the consummation of the transactions
contemplated hereby and thereby, including reasonable Attorney Costs incurred by
BofA (including in its capacity as Agent) with respect thereto; and

(b)  pay or reimburse the Agent, the Arranger and each Bank within five Business
Days after demand (subject to subsection 4.1(e)) for reasonable costs and
expenses (including reasonable Attorney Costs) incurred by them in connection
with the enforcement, attempted enforcement, or preservation of any rights or
remedies under this Agreement or any other Loan Document during the existence of
an Event of Default or after acceleration of the Loans (including in connection
with any "workout" or restructuring regarding the Loans, and including in any
Insolvency Proceeding or appellate proceeding).

X.5  Indemnity.  Whether or not the transactions contemplated hereby are
consummated, the Company shall indemnify and hold the Agent-Related Persons, and
each Bank and each of its respective officers, directors, employees, counsel,
agents and attorneys-in-fact (each, an
<PAGE>
 
"Indemnified Person") harmless from and against any and all liabilities,
obligations, losses, damages, penalties, actions, judgments, suits, costs,
charges, expenses and disbursements (including reasonable Attorney Costs) of any
kind or nature whatsoever which may at any time (including at any time following
repayment of the Loans and the termination, resignation or replacement of the
Agent or replacement of any Bank) be imposed on, incurred by or asserted against
any such Indemnified Person in any way relating to or arising out of this
Agreement or any document contemplated by or referred to herein, or the
transactions contemplated hereby, or any action taken or omitted by any such
Indemnified Person under or in connection with any of the foregoing, including
with respect to any investigation, litigation or proceeding (including any
Insolvency Proceeding or appellate proceeding) related to or arising out of this
Agreement or the Loans or the use of the proceeds thereof, whether or not any
Indemnified Person is a party thereto (all the foregoing, collectively, the
"Indemnified Liabilities"); provided, that the Company shall have no obligation
hereunder to any Indemnified Person with respect to Indemnified Liabilities
resulting solely from the gross negligence or willful misconduct of such
Indemnified Person. The agreements in this Section shall survive payment of all
other Obligations.

X.6  Payments Set Aside.  To the extent that the Company makes a payment to the
Agent or the Banks, or the Agent or the Banks exercise their right of setoff,
and such payment or the proceeds of such setoff or any part thereof are
subsequently invalidated, declared to be fraudulent or preferential, set aside
or required (including pursuant to any settlement entered into by the Agent or
such Bank in its discretion) to be repaid to a trustee, receiver or any other
party, in connection with any Insolvency Proceeding or otherwise, then (a) to
the extent of such recovery the obligation or part thereof originally intended
to be satisfied shall be revived and continued in full force and effect as if
such payment had not been made or such setoff had not occurred, and (b) each
Bank severally agrees to pay to the Agent upon demand its pro rata share of any
amount so recovered from or repaid by the Agent.

X.7  Successors and Assigns.  The provisions of this Agreement shall be binding
upon and inure to the benefit of the parties hereto and their respective
successors and assigns, except that the Company may not assign or transfer any
of its rights or obligations under this Agreement without the prior written
consent of the Agent and each Bank.

X.8  Assignments, Participations, etc.  (a)  Any Bank may, with the written
consent of the Company at all times other than during the existence of an Event
of Default and the Agent, which consents shall not be unreasonably withheld, at
any time assign and delegate to one or more Eligible Assignees (provided that no
written consent of the Company or the Agent shall be required in connection with
any assignment and delegation by a Bank to an Eligible Assignee that is an
Affiliate of such Bank) (each an "Assignee") all, or any ratable part of all, of
the Loans, the Commitments and the other rights and obligations of such Bank
hereunder, in a minimum amount of $5,000,000; provided, however, that the
Company and the Agent may continue to deal solely and directly with such Bank in
connection with the interest so assigned to an Assignee until (i) written notice
of such assignment, together with payment instructions,
<PAGE>
 
addresses and related information with respect to the Assignee, shall have been
given to the Company and the Agent by such Bank and the Assignee; (ii) such Bank
and its Assignee shall have delivered to the Company and the Agent an Assignment
and Acceptance in the form of Exhibit E ("Assignment and Acceptance") together
with any Note or Notes subject to such assignment and (iii) the assignor Bank or
Assignee has paid to the Agent a processing fee in the amount of $3,500.

(b)  From and after the date that the Agent notifies the assignor Bank that it
has received (and provided its consent with respect to) an executed Assignment
and Acceptance and payment of the above-referenced processing fee, (i) the
Assignee thereunder shall become a party hereto and, to the extent that rights
and obligations hereunder have been assigned to it pursuant to such Assignment
and Acceptance, shall have the rights and obligations of a Bank under the Loan
Documents, and (ii) the assignor Bank shall, to the extent that rights and
obligations hereunder and under the other Loan Documents have been assigned by
it pursuant to such Assignment and Acceptance, relinquish its rights and be
released from its obligations under the Loan Documents.

(c)  Within five Business Days after its receipt of notice by the Agent that it
has received an executed Assignment and Acceptance and payment of the processing
fee, (and provided that it consents to such assignment in accordance with
subsection 10.8(a)), the Company shall execute and deliver to the Agent, new
Notes evidencing such Assignee's assigned Loans and Commitment and, if the
assignor Bank has retained a portion of its Loans and its Commitment,
replacement Notes in the principal amount of the Revolving Loans retained by the
assignor Bank (such Notes to be in exchange for, but not in payment of, the
Notes held by such Bank). Immediately upon each Assignee's making its processing
fee payment under the Assignment and Acceptance, this Agreement shall be deemed
to be amended to the extent, but only to the extent, necessary to reflect the
addition of the Assignee and the resulting adjustment of the Commitments arising
therefrom. The Commitment allocated to each Assignee shall reduce the Commitment
of the assigning Bank pro tanto.

(d)  Any Bank may at any time sell to one or more commercial banks or other
Persons not Affiliates of the Company (a "Participant") participating interests
in any Loans, the Commitment of that Bank and the other interests of that Bank
(the "Originating Bank") hereunder and under the other Loan Documents; provided,
however, that (i) the Originating Bank's obligations under this Agreement shall
remain unchanged, (ii) the Originating Bank shall remain solely responsible for
the performance of such obligations, (iii) the Company and the Agent shall
continue to deal solely and directly with the Originating Bank in connection
with the originating Bank's rights and obligations under this Agreement and the
other Loan Documents, and (iv) no Bank shall transfer or grant any participating
interest under which the Participant has rights to approve any amendment to, or
any consent or waiver with respect to, this Agreement or any other Loan
Document, except to the extent such amendment, consent or waiver would require
unanimous consent of the Banks as described in the first proviso to Section
10.1. In the case of any such participation, the Participant shall be entitled
to the benefit of Sections 3.1, 3.3 and 10.5 as though it were also a Bank
hereunder, and if amounts outstanding under this Agreement are due
<PAGE>
 
and unpaid, or shall have been declared or shall have become due and payable
upon the occurrence of an Event of Default, each Participant shall be deemed to
have the right of set-off in respect of its participating interest in amounts
owing under this Agreement to the same extent as if the amount of its
participating interest were owing directly to it as a Bank under this Agreement.

(e)  Notwithstanding any other provision in this Agreement, any Bank may at any
time create a security interest in, or pledge, all or any portion of its rights
under and interest in this Agreement and the Note held by it in favor of any
Federal Reserve Bank in accordance with Regulation A of the FRB or U.S. Treasury
Regulation 31 CFR (S)203.14, and such Federal Reserve Bank may enforce such
pledge or security interest in any manner permitted under applicable law.

X.9  Confidentiality.  Each Bank agrees to take and to cause its Affiliates to
take normal and reasonable precautions and exercise due care to maintain the
confidentiality of all information identified as "confidential" or "secret" by
the Company and provided to it by the Company or any Subsidiary, or by the Agent
on such Company's or Subsidiary's behalf, under this Agreement or any other Loan
Document, and neither it nor any of its Affiliates shall use any such
information other than in connection with or in enforcement of this Agreement
and the other Loan Documents or in connection with other business now or
hereafter existing or contemplated with the Company or any Subsidiary; except to
the extent such information (i) was or becomes generally available to the public
other than as a result of disclosure by the Bank, or (ii) was or becomes
available on a nonconfidential basis from a source other than the Company,
provided that such source is not bound by a confidentiality agreement with the
Company known to the Bank; provided, however, that any Bank may disclose such
information (A) at the request or pursuant to any requirement of any
Governmental Authority to which the Bank is subject or in connection with an
examination of such Bank by any such authority; (B) pursuant to subpoena or
other court process; (C) when required to do so in accordance with the
provisions of any applicable Requirement of Law; (D) to the extent reasonably
required in connection with any litigation or proceeding to which the Agent, any
Bank or their respective Affiliates may be party; (E) to the extent reasonably
required in connection with the exercise of any remedy hereunder or under any
other Loan Document; (F) to such Bank's independent auditors and other
professional advisors; (G) to any Participant or Assignee, actual or potential,
provided that such Person agrees in writing to keep such information
confidential to the same extent required of the Banks hereunder; (H) as to any
Bank or its Affiliate, as expressly permitted under the terms of any other
document or agreement regarding confidentiality to which the Company or any
Subsidiary is party or is deemed party with such Bank or such Affiliate; and (I)
to its Affiliates.

X.10  Set-off.  In addition to any rights and remedies of the Banks provided by
law, if an Event of Default exists or the Loans have been accelerated, each Bank
is authorized at any time and from time to time, without prior notice to the
Company, any such notice being waived by the Company to the fullest extent
permitted by law, to set off and apply any and all deposits (general or special,
time or demand, provisional or final) at any time held by, and other
indebtedness at any time owing by, such Bank to or for the credit or the account
of the Company against any and
<PAGE>
 
all Obligations owing to such Bank, now or hereafter existing, irrespective of
whether or not the Agent or such Bank shall have made demand under this
Agreement or any Loan Document and although such Obligations may be contingent
or unmatured. Each Bank agrees promptly to notify the Company and the Agent
after any such set-off and application made by such Bank; provided, however,
that the failure to give such notice shall not affect the validity of such set-
off and application.

X.11  Automatic Debits of Fees. With respect to any commitment fee, arrangement
fee, or other fee, or any other cost or expense (including reasonable Attorney
Costs) due and payable to the Agent, BofA or the Arranger under the Loan
Documents, the Company hereby irrevocably authorizes BofA to debit any deposit
account of the Company with BofA in an amount such that the aggregate amount
debited from all such deposit accounts does not exceed such fee or other cost or
expense. If there are insufficient funds in such deposit accounts to cover the
amount of the fee or other cost or expense then due, such debits will be
reversed (in whole or in part, in BofA's sole discretion) and such amount not
debited shall be deemed to be unpaid. No such debit under this Section shall be
deemed a setoff.

X.12  Notification of Addresses, Lending Offices, Etc.  Each Bank shall notify
the Agent in writing of any changes in the address to which notices to the Bank
should be directed, of addresses of any Lending Office, of payment instructions
in respect of all payments to be made to it hereunder and of such other
administrative information as the Agent shall reasonably request.

X.13  Counterparts.  This Agreement may be executed in any number of separate
counterparts, each of which, when so executed, shall be deemed an original, and
all of said counterparts taken together shall be deemed to constitute but one
and the same instrument.

X.14  Severability.  The illegality or unenforceability of any provision of this
Agreement or any instrument or agreement required hereunder shall not in any way
affect or impair the legality or enforceability of the remaining provisions of
this Agreement or any instrument or agreement required hereunder.

X.15  No Third Parties Benefited.  This Agreement is made and entered into for
the sole protection and legal benefit of the Company, the Banks, the Agent and
the Agent-Related Persons, and their permitted successors and assigns, and no
other Person shall be a direct or indirect legal beneficiary of, or have any
direct or indirect cause of action or claim in connection with, this Agreement
or any of the other Loan Documents.

X.16  Governing Law and Jurisdiction.  (a) THIS AGREEMENT AND THE NOTES SHALL BE
GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE INTERNAL LAW OF THE STATE OF
ILLINOIS; PROVIDED THAT THE AGENT AND THE BANKS SHALL RETAIN ALL RIGHTS ARISING
UNDER FEDERAL LAW.
<PAGE>
 
(b)  ANY LEGAL ACTION OR PROCEEDING WITH RESPECT TO THIS AGREEMENT OR ANY OTHER
LOAN DOCUMENT MAY BE BROUGHT IN THE COURTS OF THE STATE OF ILLINOIS OR OF THE
UNITED STATES FOR THE NORTHERN DISTRICT OF ILLINOIS, AND BY EXECUTION AND
DELIVERY OF THIS AGREEMENT, EACH OF THE COMPANY, THE AGENT AND THE BANKS
CONSENTS, FOR ITSELF AND IN RESPECT OF ITS PROPERTY, TO THE NONEXCLUSIVE
JURISDICTION OF THOSE COURTS. EACH OF THE COMPANY, THE AGENT AND THE BANKS
IRREVOCABLY WAIVES ANY OBJECTION, INCLUDING ANY OBJECTION TO THE LAYING OF VENUE
OR BASED ON THE GROUNDS OF FORUM NON CONVENIENS, WHICH IT MAY NOW OR HEREAFTER
HAVE TO THE BRINGING OF ANY ACTION OR PROCEEDING IN SUCH JURISDICTION IN RESPECT
OF THIS AGREEMENT OR ANY DOCUMENT RELATED HERETO. THE COMPANY, THE AGENT AND THE
BANKS EACH WAIVE PERSONAL SERVICE OF ANY SUMMONS, COMPLAINT OR OTHER PROCESS,
WHICH MAY BE MADE BY ANY OTHER MEANS PERMITTED BY ILLINOIS LAW.

X.17  Waiver of Jury Trial.  THE COMPANY, THE BANKS AND THE AGENT EACH WAIVE
THEIR RESPECTIVE RIGHTS TO A TRIAL BY JURY OF ANY CLAIM OR CAUSE OF ACTION BASED
UPON OR ARISING OUT OF OR RELATED TO THIS AGREEMENT, THE OTHER LOAN DOCUMENTS,
OR THE TRANSACTIONS CONTEMPLATED HEREBY OR THEREBY, IN ANY ACTION, PROCEEDING OR
OTHER LITIGATION OF ANY TYPE BROUGHT BY ANY OF THE PARTIES AGAINST ANY OTHER
PARTY OR ANY AGENT-RELATED PERSON, PARTICIPANT OR ASSIGNEE, WHETHER WITH RESPECT
TO CONTRACT CLAIMS, TORT CLAIMS, OR OTHERWISE.  THE COMPANY, THE BANKS AND THE
AGENT EACH AGREE THAT ANY SUCH CLAIM OR CAUSE OF ACTION SHALL BE TRIED BY A
COURT TRIAL WITHOUT A JURY.  WITHOUT LIMITING THE FOREGOING, THE PARTIES FURTHER
AGREE THAT THEIR RESPECTIVE RIGHT TO A TRIAL BY JURY IS WAIVED BY OPERATION OF
THIS SECTION 10.17 AS TO ANY ACTION, COUNTERCLAIM OR OTHER PROCEEDING WHICH
SEEKS, IN WHOLE OR IN PART, TO CHALLENGE THE VALIDITY OR ENFORCEABILITY OF THIS
AGREEMENT OR THE OTHER LOAN DOCUMENTS OR ANY PROVISION HEREOF OR THEREOF.  THIS
WAIVER SHALL APPLY TO ANY SUBSEQUENT AMENDMENTS, RENEWALS, SUPPLEMENTS OR
MODIFICATIONS TO THIS AGREEMENT AND THE OTHER LOAN DOCUMENTS.

X.18  Entire Agreement.  This Agreement, together with the other Loan Documents,
embodies the entire agreement and understanding among the Company, the Banks and
the Agent, and supersedes all prior or contemporaneous agreements and
understandings of such Persons, verbal or written, relating to the subject
matter hereof and thereof.

<PAGE>
 
                                  ARTICLE XI

                                   GUARANTY
                                   --------

XI.1  The Guaranty.   Subject to Section 11.3, the Guarantors hereby, jointly
and severally, unconditionally and irrevocably guarantee to the Banks and the
Agent, and to each of them, the due and punctual payment, observance and
performance of all of the Guaranteed Obligations when and as due, whether at
maturity, by acceleration, mandatory prepayment or otherwise, according to the
terms hereof and thereof, and the Guarantors hereby, jointly and severally,
unconditionally and irrevocably agree to cause payment or performance of the
Guaranteed Obligations to be made punctually as and when the same shall become
due upon demand.  This Guaranty shall be of payment and performance and not of
collection merely.

XI.2  Guaranty Unconditional.  Subject to Section 11.3, the obligations of the
Guarantors under this Article XI shall be continuing, unconditional and absolute
and, without limiting the generality of the foregoing, shall not be released,
discharged or otherwise affected by:

(i)   any extension, renewal, settlement, compromise, waiver or release in
respect of any Guaranteed Obligation, by operation of law or otherwise;

(ii)  any modification or amendment of or supplement to any Loan Document;

(iii) any modification, amendment, waiver, release, non-perfection or
invalidity of any direct or indirect security, or of any Guaranty Obligation or
other liability of any third party, for any Guaranteed Obligation;

(iv)  any change in the corporate existence, structure or ownership of the
Company or any other Guarantor (unless such Guarantor ceases to be a Wholly-
Owned Subsidiary after giving effect to such change as described in Section
11.3), or any insolvency, bankruptcy, reorganization or other similar proceeding
affecting the Company or any other Guarantor or its assets or any resulting
release or discharge of any Guaranteed Obligation;

(v)   the existence of any claim, setoff or other right which such Guarantor may
have at any time against the Company, the Agent, any Bank or any other
Person, whether or not arising in connection with the Loan Documents;

(vi)  any invalidity or unenforceability relating to or against the Company or
any other Guarantor for any reason of the whole or any provision of any Loan
Document, or any provision of applicable law purporting to prohibit the payment
or performance by the Company of the Guaranteed Obligations; or

(vii) any other act or omission to act or delay of any kind by the Company, any
other Guarantor, the Agent, any Bank or any other Person or any other
circumstance whatsoever that might, but for the provisions of this Section 11.2,
constitute a legal or equitable discharge of the obligations of such Guarantor
under this Article XI.
<PAGE>
 
XI.3  Discharge Only Upon Payment in Full; Reinstatement in Certain
Circumstances.  The obligations of each Guarantor under this Article XI shall
remain in full force and effect until either (a) all of the Commitments shall
have been terminated, and all of the Guaranteed Obligations shall have been paid
in full in cash or (b) such Guarantor ceases, in accordance with the terms of
this Agreement, to be a Wholly-Owned Subsidiary of the Company, whichever occurs
first.  If at any time all or any part of any payment previously applied to any
Guaranteed Obligation is rescinded or must be otherwise restored or returned
upon the insolvency, bankruptcy or reorganization of the Company or otherwise,
the obligations of the Guarantors under this Article XI with respect to such
payment shall be reinstated at such time as though such payment had become due
but not been made at such time.

XI.4  Waiver.  Each Guarantor irrevocably waives acceptance hereof, presentment,
demand, protest and any notice not provided for herein, as well as any
requirement that at any time any action be taken by any Person against the
Company or any other Person or any collateral.

XI.5  Subrogation.  Each Guarantor irrevocably waives any claim or right which
such Guarantor may now or hereafter acquire against the Company or any other
Person that arises from the existence, payment or performance of such
Guarantor's obligations under this Article XI, including (without limitation)
any right of subrogation, contribution, reimbursement or indemnification.

XI.6  Stay of Acceleration.  If acceleration of the time for payment of any
amount payable by the Company under any Loan Document is stayed upon the
insolvency, bankruptcy or reorganization of the Company, all such amounts
otherwise subject to acceleration under the terms of the Loan Documents shall
nonetheless be payable by the Guarantors hereunder forthwith on demand by the
Agent made at the request of the Majority Banks.

XI.7  Subordination of Indebtedness.  Any indebtedness of the Company for
borrowed money now or hereafter owed to any Guarantor is hereby subordinated in
right of payment to the payment of the Guaranteed Obligations, and if a default
in the payment of any amount owing under the Loan Documents shall have occurred
and be continuing, any such indebtedness of the Company owed to any Guarantor,
if collected or received by such Guarantor, shall be held in trust by such
Guarantor for the Banks and be paid over to the Agent for application in
accordance with this Agreement.
<PAGE>
 
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly
executed and delivered in Chicago by their proper and duly authorized officers
as of the day and year first above written.

NATIONAL SURGERY CENTERS, INC.
                            

By: ______________________
Title: ___________________


BANK OF AMERICA NATIONAL TRUST
AND SAVINGS ASSOCIATION,
as Agent


By: _________________________
Title: ______________________


BANK OF AMERICA NATIONAL TRUST
AND SAVINGS ASSOCIATION,
as a Bank


By: _________________________
Title: ______________________


CORESTATES BANK, N.A.,


By: _________________________
Title: ______________________


FIRSTAR BANK MILWAUKEE, N.A.,


By: _________________________
Title: ______________________
<PAGE>
 
HARRIS TRUST & SAVINGS BANK,


By: _________________________
Title: ______________________


SUNTRUST BANK, NASHVILLE, N.A.,


By: _________________________
Title: ______________________
The undersigned are executing a counterpart to the Credit Agreement, dated as of
November __, 1997, among National Surgery Centers, Inc., certain guarantors,
certain banks, and Bank of America National Trust and Savings Association, as
agent, as amended from time to time, for purposes of becoming a "Guarantor"
thereunder:


KPSC, INC., NSC AUBURN, INC., NSC PORT ST. LUCIE, INC., NSC BROWNSVILLE, INC.,
NORTHERN ROCKIES SURGICENTER, INC., NSC KENT, INC., NSC HOUSTON, INC., NSC
CHANNEL ISLANDS, INC., NSC FAYETTEVILLE, INC., NSC NORMAN, INC., NSC GREENSBORO
WEST, INC., NSC GREENSBORO, INC., NSC EDMOND, INC., NSC SEATTLE, INC., NSC
CONNECTICUT, INC., NSC PROVO, INC., NSC MANAHAWKIN, INC., NSC ELIZABETHTOWN,
INC., NATIONAL SURGERY CENTERS - BAKERSFIELD, INC., NSC LAS VEGAS, INC., NSC -
LAS VEGAS EAST, INC., WALK-IN AND OUT SURGERY CENTER, INC., NATIONAL SURGERY
CENTERS - SANTA MONICA, INC., NSC PHOENIX, INC., NSC DALLAS, INC., ENDOSCOPY
CENTER AFFILIATES, INC., NSC MIAMI, INC., NSC - SARASOTA, INC., NSC ATLANTA,
INC., NSC OKLAHOMA CITY, INC., NSC MIDWEST CITY, INC., CONNECTICUT SURGICAL
CENTER, INC., and EYE MICROSURGERY CENTER, INC.,


By: _________________________

Title: ______________________
<PAGE>
 
     SCHEDULE 2.1
     ------------



COMMITMENTS
- -----------
AND PRO RATA SHARES
- -------------------



                                                   Pro Rata
          Bank                  Commitment           Share
          ----                  ----------           -----

Bank of America National
Trust and Savings
Association                     $25,000,000         41.7%

CoreStates Bank, N.A.            $8,750,000         12.075%

Firstar Bank Milwaukee, N.A.     $8,750,000         12.075%

Harris Trust and Savings Bank    $8,750,000         12.075%

SunTrust Bank, Nashville, N.A.   $8,750,000         12.075%


TOTAL                           $60,000,000         100%
<PAGE>
 
SCHEDULE 10.2
- -------------



OFFSHORE AND DOMESTIC LENDING OFFICES,
- --------------------------------------
ADDRESSES FOR NOTICES
- ---------------------


NATIONAL SURGERY CENTERS, INC.
- ------------------------------
30 South Wacker Drive
Suite 2302
Chicago, Illinois 60601

Attention:    Bryan S. Fisher
              Chief Financial Officer

Telephone:    (312) 655-1571
Facsimile:    (312) 655-0239


BANK OF AMERICA NATIONAL TRUST
- ------------------------------
AND SAVINGS ASSOCIATION,
- ----------------------- 

Bank of America National Trust
and Savings Association
Agency Management Services #33499
231 South La Salle Street, 8th Floor
Chicago, IL 60697
Attention:  Jay McKeown
Assistant Vice President
Telephone: (312) 828-7299
Facsimile: (415) 974-9102
<PAGE>
 
     EXHIBIT A

     NOTICE OF BORROWING
     -------------------


Date:  ________________, ____


To: Bank of America National Trust and Savings Association as Agent for the
Banks parties to the Credit Agreement dated as of October __, 1997 (as extended,
renewed, amended or restated from time to time, the "Credit Agreement") among
National Surgery Centers, Inc., certain Banks which are signatories thereto and
Bank of America National Trust and Savings Association, as Agent


Ladies and Gentlemen:

The undersigned, National Surgery Centers, Inc. (the "Company"), refers to the
Credit Agreement, the terms defined therein being used herein as therein
defined, and hereby gives you notice irrevocably, pursuant to Section 2.3 of the
Credit Agreement, of the Borrowing specified below:

1.  The Business Day of the proposed Borrowing is
________________________, _____.

2.  The aggregate amount of the proposed Borrowing is
$_____________________.

3. The Borrowing is to be comprised of $___________ of [Base Rate] [Offshore
Rate] Loans.

[4. The duration of the Interest Period for the Offshore Rate Loans included in
the Borrowing shall be _____ months].

The undersigned hereby certifies that the following statements are true on the
date hereof, and will be true on the date of the proposed Borrowing, before and
after giving effect thereto and to the application of the proceeds therefrom:

(a)  the representations and warranties of the Company contained in Article V of
the Credit Agreement are true and correct as though made on and as of such date
(except to the extent such representations and warranties relate to an earlier
date, in which case they are true and correct as of such date);
<PAGE>
 
(b) no Default or Event of Default has occurred and is continuing, or would
result from such proposed Borrowing; and

(c) The proposed Borrowing will not cause the aggregate principal amount of all
outstanding Revolving Loans to exceed the combined Commitments of the Banks.


NATIONAL SURGERY CENTERS, INC.



By: _________________________

Title: ______________________
<PAGE>
 
     EXHIBIT B

     NOTICE OF CONVERSION/CONTINUATION



Date:  ________________, ______

To: Bank of America National Trust and Savings Association, as Agent for the
Banks parties to the Credit Agreement dated as of October __, 1997 (as extended,
renewed, amended or restated from time to time, the "Credit Agreement") among
National Surgery Centers, Inc., certain Banks which are signatories thereto and
Bank of America National Trust and Savings Association, as Agent

Ladies and Gentlemen:

The undersigned, National Surgery Centers, Inc. (the "Company"), refers to the
Credit Agreement, the terms defined therein being used herein as therein
defined, and hereby gives you notice irrevocably, pursuant to Section 2.4 of the
Credit Agreement, of the [conversion] [continuation] of the Loans specified
herein, that:

1. The Conversion/Continuation Date is ____________, ____.

2. The aggregate amount of the Loans to be [converted] [continued] is
$______________.

3. The Loans are to be [converted into] [continued as] [Offshore Rate] [Base
Rate] Loans.

4. [If applicable:] The duration of the Interest Period for the Loans included
in the [conversion] [continuation] shall be [____ days] [____ months].

The undersigned hereby certifies that the following statements are true on the
date hereof, and will be true on the proposed Conversion/Continuation Date,
before and after giving effect thereto and to the application of the proceeds
therefrom:

(a) the representations and warranties of the Company contained in Article V of
the Credit Agreement are true and correct as though made on and as of such date
(except to the extent such representations and warranties relate to an earlier
date, in which case they are true and correct as of such date); provided,
however, that this condition shall not apply to the conversion of an outstanding
Offshore Rate Loan to a Base Rate Loan unless such Offshore Rate Loan shall have
become due and payable, whether according to scheduled maturity or earlier as
provided in the Credit Agreement or elsewhere;
<PAGE>
 
(b) no Default or Event of Default has occurred and is continuing, or would
result from such proposed [conversion] [continuation]; and

(c) the proposed [conversion][continuation] will not cause the aggregate
principal amount of all outstanding Revolving Loans to exceed the combined
Commitments of the Banks.



NATIONAL SURGERY CENTERS, INC.



By: ________________________

Title: _____________________

                                      -2-
<PAGE>
 
     EXHIBIT C


     NATIONAL SURGERY CENTERS, INCORPORATED
     COMPLIANCE CERTIFICATE



  Financial
  Statement Date:  ____________, ___


Reference is made to that certain Credit Agreement dated as of October ___, 1997
(as extended, renewed, amended or restated from time to time, the "Credit
Agreement") among National Surgery Centers, Inc., a Delaware corporation (the
"Company"), the several financial institutions from time to time parties to this
Credit Agreement (the "Banks") and Bank of America National Trust and Savings
Association, as agent for the Banks (in such capacity, the "Agent"). Unless
otherwise defined herein, capitalized terms used herein have the respective
meanings assigned to them in the Credit Agreement.

The undersigned Responsible Officer of the Company hereby certifies as of the
date hereof that he/she is the __________________ of the Company, and that, as
such, he/she is authorized to execute and deliver this Certificate to the Banks
and the Agent on the behalf of the Company and its consolidated Subsidiaries,
and that:

[Use the following paragraph if this Certificate is delivered in connection with
the financial statements required by subsection [6.1(a)] of the Credit
Agreement.]

1. Attached as Schedule 1 hereto are (a) a true and correct copy of the audited
consolidated balance sheet of the Company and its consolidated Subsidiaries as
at the end of the fiscal year ended _______________, ___ and (b) the related
consolidated statements of income or operations, [retained earnings,]
shareholders' equity and cash flows for such fiscal year, setting forth in each
case in comparative form the figures for the previous fiscal year, [reported on
without a "going concern" or like qualification or exception, or qualification
arising out of the scope of the audit] and accompanied by the opinion of
_________________ or another nationally-recognized certified independent public
accounting firm (the "Independent Auditor") which report shall state that such
consolidated financial statements are complete and correct and have been
prepared in accordance with GAAP, and fairly present, in all material respects,
the financial position of the Company and its consolidated Subsidiaries for the
periods indicated and on a basis consistent with prior periods.

     or
<PAGE>
 
[Use the following paragraph if this Certificate is delivered in connection with
the financial statements required by subsection [6.1(b)] of the Credit
Agreement.]

1. Attached as Schedule 1 hereto are (a) a true and correct copy of the
unaudited consolidated balance sheet of the Company and its consolidated
Subsidiaries as of the end of the fiscal quarter ended __________, ___, and (b)
the related unaudited consolidated statements of income and cash flows for the
period commencing on the first day and ending on the last day of such quarter,
[setting forth in each case in comparative form the figures for the previous
year,] and certified by a Responsible Officer that such financial statements
were prepared in accordance with GAAP (subject only to ordinary, good faith
year-end audit adjustments and the absence of footnotes) and fairly present, in
all material respects, the financial position and the results of operations of
the Company and its consolidated Subsidiaries.

2. The undersigned has reviewed and is familiar with the terms of the Credit
Agreement and has made, or has caused to be made under his/her supervision, a
detailed review of the transactions and conditions (financial or otherwise) of
the Company during the accounting period covered by the attached financial
statements.

3. To the best of the undersigned's knowledge, the Company, during such period,
has observed, performed or satisfied all of its covenants and other agreements,
and satisfied every condition in the Credit Agreement to be observed, performed
or satisfied by the Company, and the undersigned has no knowledge of any Default
or Event of Default.

4. The following financial covenant analyses and information set forth on
Schedule 2 attached hereto are true and accurate on and as of the date of this
Certificate.
<PAGE>
 
IN WITNESS WHEREOF, the undersigned has executed this Certificate as of
___________________, ____.


NATIONAL SURGERY CENTERS, INC.



By: ______________________________

Title: ___________________________
<PAGE>
 
     [attach calculation worksheet]
<PAGE>
 
     EXHIBIT D

     FORM OF OPINION OF COUNSEL TO THE COMPANY AND THE GUARANTORS
<PAGE>
 
     EXHIBIT E

     FORM OF ASSIGNMENT AND ACCEPTANCE AGREEMENT


This ASSIGNMENT AND ACCEPTANCE AGREEMENT (this "Assignment and Acceptance")
dated as of __________, _____ is made between ______________________________
(the "Assignor") and __________________________ (the "Assignee").


     RECITALS

WHEREAS, the Assignor is party to that certain
Credit Agreement dated as of October __, 1997 (as amended, amended and restated,
modified, supplemented or renewed, the "Credit Agreement") among National
Surgery Centers, Inc., a Delaware corporation (the "Company"), certain
guarantors, the several financial institutions from time to time party thereto
(including the Assignor, the "Banks"), and Bank of America National Trust and
Savings Association, as agent for the Banks (the "Agent").  Any terms defined in
the Credit Agreement and not defined in this Assignment and Acceptance are used
herein as defined in the Credit Agreement;

WHEREAS, as provided under the Credit Agreement, the Assignor has committed to
making Loans (the "Loans") to the Company in an aggregate amount not to exceed
$__________ (the "Commitment");

WHEREAS, [the Assignor has made Loans in the aggregate principal amount of
$__________ to the Company] [no Loans are outstanding under the Credit
Agreement];

WHEREAS, the Assignor wishes to assign to the Assignee [part of the] [all]
rights and obligations of the Assignor under the Credit Agreement in respect of
its Commitment, [together with a corresponding portion of each of its
outstanding Loans] in an amount equal to $__________ (the "Assigned Amount") on
the terms and subject to the conditions set forth herein and the Assignee wishes
to accept assignment of such rights and to assume such obligations from the
Assignor on such terms and subject to such conditions;

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


1.  Assignment and Acceptance.


<PAGE>
 
(a)  Subject to the terms and conditions of this Assignment and Acceptance, (i)
the Assignor hereby sells, transfers and assigns to the Assignee, and (ii) the
Assignee hereby purchases, assumes and undertakes from the Assignor, without
recourse and without representation or warranty (except as provided in this
Assignment and Acceptance) __% (the "Assignee's Percentage Share") of (A) the
Commitment [and the Loans] of the Assignor and (B) all related rights, benefits,
obligations, liabilities and indemnities of the Assignor under and in connection
with the Credit Agreement and the Loan Documents.

[If appropriate, add paragraph specifying payment to Assignor by Assignee of
outstanding principal of, accrued interest on, and fees with respect to, Loans
assigned.]

(b)  With effect on and after the Effective Date (as defined in Section 5
hereof), the Assignee shall be a party to the Credit Agreement and succeed to
all of the rights and be obligated to perform all of the obligations of a Bank
under the Credit Agreement, including the requirements concerning
confidentiality and the payment of indemnification, with a Commitment in an
amount equal to the Assigned Amount. The Assignee agrees that it will perform in
accordance with their terms all of the obligations which by the terms of the
Credit Agreement are required to be performed by it as a Bank. It is the intent
of the parties hereto that the Commitment of the Assignor shall, as of the
Effective Date, be reduced by an amount equal to the Assigned Amount and the
Assignor shall relinquish its rights and be released from its obligations under
the Credit Agreement to the extent such obligations have been assumed by the
Assignee; provided, however, the Assignor shall not relinquish its rights under
Article III or Sections 10.4 and 10.5 of the Credit Agreement to the extent such
rights relate to the time prior to the Effective Date.

(c)  After giving effect to the assignment and assumption set forth herein, on
the Effective Date the Assignee's Commitment will be $__________ and the
Assignee's outstanding Loans (assuming no repayments or new fundings after
______) will be $_______.

(d)  After giving effect to the assignment and assumption set forth herein, on
the Effective Date the Assignor's Commitment will be $__________ and the
Assignor's outstanding Loans (assuming no repayments or new fundings after
________) will be $__________.

2.  Payments.

(a)  As consideration for the sale, assignment and transfer contemplated in
Section 1 hereof, the Assignee shall pay to the Assignor on the Effective Date
in immediately available funds an amount equal to $__________, representing the
Assignee's Pro Rata Share of the principal amount of all Loans.

<PAGE>
 
(b)  The [Assignor] [Assignee] further agrees to pay to the Agent a processing
fee in the amount specified in Section 10.8(a) of the Credit Agreement.


3.  Reallocation of Payments.

Any interest, fees and other payments accrued to the Effective Date with respect
to the Commitment[,] [and] Loans shall be for the account of the Assignor.  Any
interest, fees and other payments accrued on and after the Effective Date with
respect to the Assigned Amount shall be for the account of the Assignee.  Each
of the Assignor and the Assignee agrees that it will hold in trust for the other
party any interest, fees and other amounts which it may receive to which the
other party is entitled pursuant to the preceding sentence and pay to the other
party any such amounts which it may receive promptly upon receipt.


4.  Independent Credit Decision.

The Assignee (a) acknowledges that it has received a copy of the Credit
Agreement and the Schedules and Exhibits thereto, together with copies of the
most recent financial statements referred to in Section 6.1 of the Credit
Agreement, and such other documents and information as it has deemed appropriate
to make its own credit and legal analysis and decision to enter into this
Assignment and Acceptance; and (b) agrees that it will, independently and
without reliance upon the Assignor, the Agent or any other Bank and based on
such documents and information as it shall deem appropriate at the time,
continue to make its own credit and legal decisions in taking or not taking
action under the Credit Agreement.


5.  Effective Date; Notices.

(a)  As between the Assignor and the Assignee, the effective date for this
Assignment and Acceptance shall be

________, ____ (the "Effective Date"); provided that the following conditions
precedent have been satisfied on or before the Effective Date:

     (i) this Assignment and Acceptance shall be executed and delivered by the
Assignor and the Assignee;

     (ii) the consent of the Company and the Agent required for an effective
assignment of the Assigned Amount by the Assignor to the Assignee under Section
10.8(a) of the Credit Agreement shall have been duly obtained and shall be in
full force and effect as of the Effective Date;

<PAGE>
 
     (iii)  the Assignee shall pay to the Assignor all amounts due to the
Assignor under this Assignment and Acceptance;

     [(iv)  the Assignee shall have complied with Section 9.10(a) of the Credit
Agreement (if applicable);

     (v)    the processing fee referred to in Section 2(b) hereof shall have
been paid to the Agent; and

     (vi)   the Assignor shall have assigned and the Assignee shall have assumed
a percentage equal to the Assignee's Percentage Share of the rights and
obligations of the Assignor under the Credit Agreement.

(b)  Promptly following the execution of this Assignment and Acceptance, the
Assignor shall deliver to the Company and the Agent for acknowledgment by the
Agent, a Notice of Assignment substantially in the form attached hereto as
Schedule 1.

[6.  Agent.  [INCLUDE ONLY IF ASSIGNOR IS AGENT]

(a)  The Assignee hereby appoints and authorizes the Assignor to take such
action as agent on its behalf and to exercise such powers under the Credit
Agreement as are delegated to the Agent by the Banks pursuant to the terms of
the Credit Agreement.

(b)  The Assignee shall assume no duties or obligations held by the Assignor in
its capacity as Agent under the Credit Agreement.]

7.  Withholding Tax.

The Assignee (a) represents and warrants to the Bank, the Agent and the Company
that under applicable law and treaties no tax will be required to be withheld by
the Bank with respect to any payments to be made to the Assignee hereunder, (b)
agrees to furnish (if it is organized under the laws of any jurisdiction other
than the United States or any State thereof) to the Agent and the Company prior
to the time that the Agent or Company is required to make any payment of
principal, interest or fees hereunder, duplicate executed originals of either
U.S. Internal Revenue Service Form 4224 or U.S. Internal Revenue Service Form
1001 (wherein the Assignee claims entitlement to the benefits of a tax treaty
that provides for a complete exemption from U.S. federal income withholding tax
on all payments hereunder) and agrees to provide new Forms 4224 or 1001 upon the
expiration of any previously delivered form or comparable statements in
accordance with applicable U.S. law and regulations and amendments thereto, duly
executed and completed by the Assignee, and (c) agrees to comply with all
applicable U.S. laws and regulations with regard to such withholding tax
exemption.

<PAGE>
 
8.  Representations and Warranties.

(a)  The Assignor represents and warrants that (i) it is the legal and
beneficial owner of the interest being assigned by it hereunder and that such
interest is free and clear of any Lien or other adverse claim; (ii) it is duly
organized and existing and it has the full power and authority to take, and has
taken, all action necessary to execute and deliver this Assignment and
Acceptance and any other documents required or permitted to be executed or
delivered by it in connection with this Assignment and Acceptance and to fulfill
its obligations hereunder; (iii) no notices to, or consents, authorizations or
approvals of, any Person are required (other than any already given or obtained)
for its due execution, delivery and performance of this Assignment and
Acceptance, and apart from any agreements or undertakings or filings required by
the Credit Agreement, no further action by, or notice to, or filing with, any
Person is required of it for such execution, delivery or performance; and (iv)
this Assignment and Acceptance has been duly executed and delivered by it and
constitutes the legal, valid and binding obligation of the Assignor, enforceable
against the Assignor in accordance with the terms hereof, subject, as to
enforcement, to bankruptcy, insolvency, moratorium, reorganization and other
laws of general application relating to or affecting creditors' rights and to
general equitable principles.

(b)  The Assignor makes no representation or warranty and assumes no
responsibility with respect to any statements, warranties or representations
made in or in connection with the Credit Agreement or the execution, legality,
validity, enforceability, genuineness, sufficiency or value of the Credit
Agreement or any other instrument or document furnished pursuant thereto. The
Assignor makes no representation or warranty in connection with, and assumes no
responsibility with respect to, the solvency, financial condition or statements
of the Company, or the performance or observance by the Company, of any of its
respective obligations under the Credit Agreement or any other instrument or
document furnished in connection therewith.

(c)  The Assignee represents and warrants that (i) it is duly organized and
existing and it has full power and authority to take, and has taken, all action
necessary to execute and deliver this Assignment and Acceptance and any other
documents required or permitted to be executed or delivered by it in connection
with this Assignment and Acceptance, and to fulfill its obligations hereunder;
(ii) no notices to, or consents, authorizations or approvals of, any Person are
required (other than any already given or obtained) for its due execution,
delivery and performance of this Assignment and Acceptance; and apart from any
agreements or undertakings or filings required by the Credit Agreement, no
further action by, or notice to, or filing with, any Person is required of it
for such execution, delivery or performance; (iii) this Assignment and
Acceptance has been duly executed and delivered by it and constitutes the legal,
valid and binding obligation of the Assignee, enforceable against the Assignee
in accordance with the terms hereof, subject, as to enforcement, to bankruptcy,
insolvency, moratorium, reorganization and other laws

<PAGE>
 
of general application relating to or affecting creditors' rights and to general
equitable principles; and (iv) it is an Eligible Assignee.


9.  Further Assurances.

The Assignor and the Assignee each hereby agree to execute and deliver such
other instruments, and take such other action, as either party may reasonably
request in connection with the transactions contemplated by this Assignment and
Acceptance, including the delivery of any notices or other documents or
instruments to the Company or the Agent, which may be required in connection
with the assignment and assumption contemplated hereby.


10.  Miscellaneous.

(a)  Any amendment or waiver of any provision of this Assignment and Acceptance
shall be in writing and signed by the parties hereto. No failure or delay by
either party hereto in exercising any right, power or privilege hereunder shall
operate as a waiver thereof and any waiver of any breach of the provisions of
this Assignment and Acceptance shall be without prejudice to any rights with
respect to any other or further breach thereof.

(b)  All payments made hereunder shall be made without any setoff or
counterclaim.

(c)  The Assignor and the Assignee shall each pay its own costs and expenses
incurred in connection with the negotiation, preparation, execution and
performance of this Assignment and Acceptance.

(d)  This Assignment and Acceptance may be executed in any number of
counterparts and all of such counterparts taken together shall be deemed to
constitute one and the same instrument.

(e)  THIS ASSIGNMENT AND ACCEPTANCE SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE INTERNAL LAW OF THE STATE OF ILLINOIS. The Assignor and the
Assignee each irrevocably submits to the nonexclusive jurisdiction of any State
or Federal court sitting in Illinois over any suit, action or proceeding arising
out of or relating to this Assignment and Acceptance and irrevocably agrees that
all claims in respect of such action or proceeding may be heard and determined
in such Illinois State or Federal court. Each party to this Assignment and
Acceptance hereby irrevocably waives, to the fullest extent it may effectively
do so, the defense of an inconvenient forum to the maintenance of such action or
proceeding.

(f)  THE ASSIGNOR AND THE ASSIGNEE EACH HEREBY KNOWINGLY, VOLUNTARILY AND
INTENTIONALLY WAIVE ANY RIGHTS THEY MAY 

<PAGE>
 
HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LITIGATION BASED HEREON, OR ARISING
OUT OF, UNDER, OR IN CONNECTION WITH THIS ASSIGNMENT AND ACCEPTANCE, THE CREDIT
AGREEMENT, ANY RELATED DOCUMENTS AND AGREEMENTS OR ANY COURSE OF CONDUCT, COURSE
OF DEALING, OR STATEMENTS (WHETHER ORAL OR WRITTEN).

[Other provisions to be added as may be negotiated between the Assignor and the
Assignee, provided that such provisions are not inconsistent with the Credit
Agreement.]

IN WITNESS WHEREOF, the Assignor and the Assignee have caused this Assignment
and Acceptance to be executed and delivered by their duly authorized officers as
of the date first above written.

     [ASSIGNOR]


By:
   --------

Title:
      -----

By:
   --------

Title:
      -----

Address:


     [ASSIGNEE]


By:
   --------

Title:
      -----

By:
   --------

Title:
      -----

Address:

<PAGE>
 
                                  SCHEDULE 1

                      NOTICE OF ASSIGNMENT AND ACCEPTANCE
                      -----------------------------------


     _______________, 19__



Bank of America National Trust
 and Savings Association, as Agent
1455 Market Street, 12th Floor
San Francisco, CA  94103
Attn.:  Global Agency #5596

National Surgery Centers, Inc.
[address]

Ladies and Gentlemen:

We refer to the Credit Agreement dated as of October __, 1997 (as amended,
amended and restated, modified, supplemented or renewed from time to time the
"Credit Agreement") among National Surgery Centers, Inc. (the "Company"),
certain guarantors, the Banks referred to therein and Bank of America National
Trust and Savings Association as agent for the Banks (the "Agent").  Terms
defined in the Credit Agreement are used herein as therein defined.

1.  We hereby give you notice of, and request your consent to, the assignment by
__________________ (the "Assignor") to _______________ (the "Assignee") of
_____% of the right, title and interest of the Assignor in and to the Credit
Agreement (including, without limitation, the right, title and interest of the
Assignor in and to the Commitments of the Assignor[,] [and] all outstanding
Loans made by the Assignor) pursuant to the Assignment and Acceptance Agreement
attached hereto (the "Assignment and Acceptance").  Before giving effect to such
assignment the Assignor's Commitment is $ ___________[,] [and] the aggregate
amount of its outstanding Loans is $_____________.

2.  The Assignee agrees that, upon receiving the consent of the Agent and, if
applicable, National Surgery Centers, Incorporated to such assignment, the
Assignee will be bound by the terms of the Credit Agreement as fully and to the
same extent as if the Assignee were the Bank originally holding such interest in
the Credit Agreement.

3.  The following administrative details apply to the Assignee:


<PAGE>
 
(A)  Notice Address:

Assignee name: __________________________
Address:  _______________________________
_______________________________
_______________________________
Attention:  _____________________________
Telephone:  (___) _______________________
Telecopier:  (___) ______________________
Telex (Answer-back):  ____________________

(B)  Payment Instructions:

Account No.:  ___________________________
At:      ___________________________
    ___________________________
         ___________________________
Reference:    ___________________________
Attention:    ___________________________

4.  You are entitled to rely upon the representations, warranties and covenants
of each of the Assignor and Assignee contained in the Assignment and Acceptance.

IN WITNESS WHEREOF, the Assignor and the Assignee have caused this Notice of
Assignment and Acceptance to be executed by their respective duly authorized
officials, officers or agents as of the date first above mentioned.


Very truly yours,

[NAME OF ASSIGNOR]


By:
   --------

Title:
      ________________________


By:
   --------

Title:
      ________________________

<PAGE>
 
[NAME OF ASSIGNEE]


By:
   --------

Title:
      ________________________


By:
   --------

Title:
      ________________________



ACKNOWLEDGED AND ASSIGNMENT
CONSENTED TO:


NATIONAL SURGERY CENTERS, INC.


By: 
   --------

Title: 
      __________________________



BANK OF AMERICA NATIONAL TRUST AND
 SAVINGS ASSOCIATION, as Agent


By: __________________________

Its: _________________________

<PAGE>
 
                                   EXHIBIT F
                                   ---------


                            FORM OF PROMISSORY NOTE
                            -----------------------


$___________      _________, 199__


FOR VALUE RECEIVED, the undersigned, National Surgery Centers, Inc., a Delaware
corporation (the "Company"), hereby promises to pay to the order of
___________________ (the "Bank") the principal sum of ____________ Dollars
($___________) or, if less, the aggregate unpaid principal amount of all Loans
made by the Bank to the Company pursuant to the Credit Agreement, dated as of
October __, 1997 (such Credit Agreement, as it may be amended, restated,
supplemented or otherwise modified from time to time, being hereinafter called
the "Credit Agreement"), among the Company, certain guarantors, the Bank, the
other banks parties thereto, and Bank of America National Trust and Savings
Association, as Agent for the Banks, on the dates, at the place and in the
amounts provided in the Credit Agreement. The Company further promises to pay
interest on the unpaid principal amount of the Loans evidenced hereby from time
to time at the rates, on the dates, at the place and otherwise as provided in
the Credit Agreement.

The Bank is authorized to endorse the amount of and the date on which each Loan
is made, the maturity date therefor and each payment of principal and interest
with respect thereto on the schedules annexed hereto and made a part hereof, or
on continuations thereof which shall be attached hereto and made a part hereof;
provided, that any failure to endorse such information on such schedule or
continuation thereof shall not in any manner affect any obligation of the
Company under the Credit Agreement and this Promissory Note (the "Note").

This Note is one of the Notes referred to in, and is entitled to the benefits
of, the Credit Agreement, which Credit Agreement, among other things, contains
provisions for acceleration of the maturity hereof upon the happening of certain
stated events and also for voluntary and mandatory prepayments on account of
principal hereof prior to the maturity hereof upon the terms and conditions
therein specified.


<PAGE>
 

Terms defined in the Credit Agreement are used herein with their defined
meanings therein unless otherwise defined herein. This Note shall be governed
by, and construed and interpreted in accordance with, the internal laws of the
State of Illinois.



NATIONAL SURGERY CENTERS, INC.



By:
   ___________________________

Title: 
      ________________________

<PAGE>

     Schedule A to Note



     BASE RATE LOANS AND REPAYMENT OF BASE RATE LOANS
     ------------------------------------------------

<TABLE>
<S>        <C>         <C>         <C>         <C>
           (2)         (3)         (4)
           Amount      Maturity    Amount of
           of          Date of     Base        (5)
  (1)      Base        Base        Rate Loan   Notation
  Date     Rate Loan   Rate Loan   Repaid      Made By
- --------   ---------   ---------   ---------   --------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   ---------   ---------

- --------   ---------   --------    ---------

- --------   ---------   --------    ---------

- --------   ---------   --------    ---------

- --------   ---------   --------    ---------
</TABLE>

<PAGE>
 
- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

<PAGE>

     Schedule B to Note


     OFFSHORE RATE LOANS AND REPAYMENT OF OFFSHORE RATE LOANS
     --------------------------------------------------------


<TABLE>

        (2)        (3)        (4)
        Amount     Maturity   Amount of
        of         Date of    Offshore     (5)
(1)     Offshore   Offshore   Rate         Notation
Date    Rate Loan  Rate Loan  Loan Repaid  Made By
- ------- ---------  ---------  -----------  -------
<S>     <C>        <C>        <C>          <C>

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

- ------- ---------  ---------  -----------

</TABLE>



<PAGE>
 

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----

- --------  ---------  ----------  -----




<PAGE>
 
                                 EXHIBIT 10.10

                             EMPLOYMENT AGREEMENT

This Agreement, dated as of ____________, 199_ between National Surgery Centers,
Inc., a Delaware corporation (hereafter referred to as the "Company"), and Bryan
S. Fisher (hereinafter referred to as the "Employee").

                                   Recitals

The Employee has been employed by the Company, for a substantial period of time
and currently serves as the Chief Financial Officer, Vice President, Secretary,
and Treasurer of the Company. Because of the Employee's extensive experience
with the Company, the Company wishes to have the Employee available to perform
duties for the Company substantially similar to those currently being performed
by him for the Company, and to contribute to the Company's growth and success as
he has for the Company in the past.  The Employee is willing to commit to
perform his services for the Company upon the terms and conditions set forth
herein.

                                   Covenants

NOW, THEREFORE, in consideration of the mutual promises herein contained and
other good and valuable consideration, the receipt and sufficiency of which are
hereby acknowledged, the parties hereto agree as follows:

1.   Employment.  The Company hereby agrees to employ Employee as Chief
     Financial Officer, Vice President, Secretary, and Treasurer of the Company
     to perform the duties described herein, and Employee hereby accepts such
     employment on the terms and conditions stated herein.

2.   Term of Employment.  Subject to provisions for termination set forth
     herein, the term of Employee's employment hereunder shall commence on the
     date hereof and shall expire on the first anniversary of such date (the
     "Employment Term"); provided, however, that commencing on the date one year
     after the date hereof, and on each annual anniversary of such date (the
     date one year after the date hereof and each annual anniversary of such
     date, is hereinafter referred to as a "Renewal Date"), the Employment Term
     shall be automatically extended, unless at least 60 days prior to the
     Renewal Date the Company shall give notice that the Employment Term shall
     not be so extended.

3.   Duties of Employee.  Employee shall be Chief Financial Officer, Vice
     President, Secretary, and Treasurer of the Company and shall perform such
     duties and responsibilities for the Company as may be assigned to him by
     the board of directors of the Company and which are not unreasonably
     inconsistent with the duties of Chief Financial Officer, Vice President,
     Secretary, and Treasurer, including such duties as are currently being
     performed by the Employee for the Company.  During the term of his
     employment, Employee shall devote substantially all of his business time,
     attention and energy, and his reasonable best efforts, to the interests and
     business of the Company and to the performance of his duties and
     responsibilities on behalf of the Company.                
<PAGE>
 
4.   Compensation.  Throughout the term of Employee's employment hereunder, the
     Company shall pay Employee, for services to be rendered by him hereunder, a
     guaranteed minimum salary at an annual rate equal to that being paid by the
     Company on the date the term of employment hereunder commences, which
     salary shall not be less than $______________, less all applicable federal
     and state income tax withholding, FICA taxes and other payroll taxes. The
     guaranteed minimum salary shall be reviewed by the Company on a yearly
     basis to ascertain if any upward adjustment in the annual rate is in order,
     and if any increase is made, the new annual rate shall become the
     guaranteed minimum salary under this Section 4.

     Employee also shall be entitled to receive, during such employment
     hereunder, compensation in addition to such annual salary in the form of an
     annual bonus, grants of stock options under the Company's Amended and
     Restated 1992 Stock Option Plan ("Plan"), each such form of additional
     compensation to be paid or awarded consistent with the performance by
     Employee of his duties prescribed hereunder and to be determined by the
     board of directors of the Company. Any stock options granted under the Plan
     to Employee prior to or during the term of this Agreement pursuant to this
     Section 4 shall become immediately exercisable in the event of termination
     of Employee's employment hereunder by the Company for any reason other than
     cause as outlined in Section 8(c) hereof.

5.   Working Facilities and Fringe Benefits.  The Employee shall be furnished
     with office space, secretarial assistance and such other facilities and
     services as are appropriate to his position and adequate for the
     performance of his duties.  The Company also shall provide to Employee
     during the term of employment fringe benefits and perquisites at least
     equal to those provided to Employee immediately prior to the date hereof,
     and the Company shall not discriminate against Employee with respect to any
     vacation or holiday plan, medical, hospital, life and disability insurance
     programs, retirement and 401(k) programs and other similar welfare benefit
     and remuneration programs from time to time made available to the officers
     and key employees of the Company.

6.   Expenses.  The Company shall pay or reimburse Employee for all reasonable
     expenses actually incurred or paid by him in the performance of services
     rendered by him pursuant to this Agreement.  Such expenses shall be
     supported by the documentary evidence required to substantiate them as
     income tax deductions.

7.   Nondisclosure of Confidential Information.  Employee acknowledges that in
     his employment, he is or will be making use of, acquiring or adding to,
     confidential information of the Company, and is or will be familiar with
     the Company's business, activities, employees, customers and suppliers.
     Therefore, in order to protect such confidential information and to protect
     other employees who depend upon the Company for regular employment,
     Employee agrees that, except in connection with his employment by the
     Company, he will not during or after the term of his employment hereunder
     in any way utilize any of said confidential information and he will not
     copy, reproduce, or take with him the original or any copies of said
     confidential information and will not disclose any of said confidential
     information to anyone.

     In the event of a breach of the covenants contained in this Section 7, the
     Company shall be entitled to an injunction restraining such breach in
     addition to any other remedies provided by law.
              
                                       2
<PAGE>
 
     If any provision of this Section 7 is adjudged by a court to be invalid or
     unenforceable, the same will in no way affect any other provision of this
     Section 7 or any other part of this Agreement, the application of such
     provision in any other circumstances or the validity or enforceability of
     this Agreement. If any such provision, or any part thereof, is held to be
     unenforceable because of the duration of such provision or the area covered
     thereby, the parties agree that the court making such determination will
     have the power to reduce the duration and/or area of such provision, and/or
     to delete specific words or phrases, and in its reduced form such provision
     will then be enforceable and will be enforced.

8.   Termination by Company

     (a)  Disability.  The Company may terminate the active employment of
          the Employee if, in the reasonable judgment of the board of directors
          of the Company, he becomes unable to satisfactorily perform his duties
          and responsibilities hereunder during the term of his employment
          because of mental or physical disability. Upon such termination, the
          Employee shall be relieved of all further obligations hereunder except
          obligations pursuant to Section 7. In the event of such termination,
          the Company shall continue to pay to the Employee, until the end of
          the term of his employment hereunder, a salary at a rate equal to the
          annual rate in effect on the date of such termination (as set forth in
          Section 4). Notwithstanding the foregoing, the amounts so payable
          shall be reduced by any amounts payable to the Employee during the
          term of his employment hereunder pursuant to any disability benefit or
          wage continuation plan of the Company in effect.

     (b)  Death.  In the event of the death of the Employee during the term,
          the Company shall make, until the end of the term of employment
          hereunder, payments at a rate equal to the annual rate in effect on
          the date of death. The payments to be made under this Section 8(b)
          shall not be reduced by reason of any insurance proceeds payable
          directly to the Employee's beneficiaries or estate pursuant to
          insurance carried or provided by the Company, and shall be made to
          such beneficiary as the Employee may designate for that purpose in
          written notice given to the Secretary of the Company prior to his
          death, or if the Employee has not so designated, then to the personal
          representative of the Estate.

     (c)  Termination for Cause.  The Company may terminate the Employee's
          employment for "Cause". "Cause" shall mean (1) any act or acts of
          dishonesty by the Employee constituting a felony and resulting or
          intended to result, directly or indirectly, in an improper gain to or
          personal enrichment of the Employee at the Company's expense, or (2)
          the willful and continued failure by the Employee to substantially
          perform his duties hereunder (other than any such failure resulting
          from the Employee's disability), after written demand for substantial
          performance is delivered by the Company to the Employee specifically
          identifying the manner in which the Company believes the Employee to
          be not substantially performing his duties. For purposes of this
          paragraph, no act, or failure to act, on the Employee's part, shall be
          considered "willful" unless done, or not done, as the case may be, by
          him in bad faith and without reasonable belief that his action or
          omission was in the best interest of the Company. In the event the
          Company terminates this Agreement for cause upon giving written notice
          to the Employee and thereafter, neither the Employee, his surviving
          spouse or his estate shall be entitled to any further salary or
          compensation from the Company pursuant to this Agreement, but the
          Employee's obligations under
                                  
                                       3
<PAGE>
 
          Section 7 shall remain in effect. The parties agree that the
          provisions of this Section 8(c) shall not be utilized in any manner by
          the Company to avoid, negate or frustrate application of the
          provisions of Section 9 of this Agreement.

     (d)  Termination Without Cause.  In the event the Company terminates
          employment of the Employee other than by reason of termination under
          Section 8(c) hereof, the Employee shall, in consideration of the lump
          sum payment described in Section 9(d) hereof, agree that the Employee
          shall neither directly nor indirectly, for a period of one year
          following such termination engage anywhere in a fifteen mile radius of
          any ambulatory surgery center operated, managed, or being developed by
          the Company on such termination date, in the development, management,
          or direct or indirect ownership of other ambulatory surgery centers or
          in any other business which would be competitive with the business
          being conducted by the Company on such termination date, or acquire or
          retain any direct or indirect financial interest in any business which
          is so engaged, provided, however, that nothing contained in the
          foregoing shall prohibit the Employee from acquiring or retaining
          ownership of up to 1% of the outstanding shares of a publicly-held
          corporation.

9.   Termination by Employee.

     (a)  If Location of Office Changes.  In the event that, at any time during
          the term of employment, the Company, without Employee's consent,
          changes the location of the offices at which Employee works at the
          time of such change to a city more than 50 miles from its location in
          Chicago, Illinois, the Employee may terminate his employment hereunder
          by giving to the Secretary of the Company notice in writing within
          three months after this right to termination arises.

     (b)  If Responsibilities Change.  It is the intention of the parties that
          the Employee will be the Chief Financial Officer, Vice President,
          Secretary, and Treasurer of the Company during the entire term of
          employment hereunder. In the event that, at any time during the term
          hereunder, Employee, without his consent, does not have the duties and
          responsibilities similar to those at the date of commencement hereof
          (except by reason of termination under Section 8), Employee may
          terminate his employment hereunder by giving to the Secretary of the
          Company written notice of such termination within three months after
          this right to terminate arises.

     (c)  Following Change in Control.  Employee may terminate his employment
          under this Agreement in the event of a Change in Control of the
          Company, as defined herein, by giving written notice of such
          termination to the Secretary of the Company not less than six months
          nor more than twelve months following such Change in Control. For
          purposes of this Section 9(c), a "Change in Control" shall mean a
          change in control of a nature that would be required to be reported in
          response to Item 6(e) of Schedule 14A of Regulation 14A promulgated
          under the Securities Exchange Act of 1934; provided that, without
          limitation, such a Change in Control shall be deemed to have occurred
          if during any period of two consecutive years subsequent to
          ______________, 199_, individuals who at the beginning of such period
          constitute members of the board of directors cease for any reason to
          constitute at least a majority thereof, unless the nomination or
          election of each director who was not a director at the beginning of
          the period was approved by a vote of a majority
              
                                       4
<PAGE>
 
          of the directors still in office at the time of such nomination or
          election who were directors at the beginning of the period.

     (d)  Lump Sum Payment.  In the event of termination pursuant to subsections
          (a), (b) or (c) of this Section 9, or in the event the Company
          terminates employment of the Employee other than by reason of
          termination under Section 8(c) hereof, the Company shall pay to the
          Employee, in a lump sum and within 30 days of such termination, an
          amount equal to the sum of (i) the Employee's annual base salary and
          (ii) the annual bonus paid for the last full fiscal year during the
          Employment Term, or the initial annual bonus which would have been
          payable for the fiscal year in which the Employment Term commenced, as
          the case may be, by the Company.

     (e)  Reimbursement.  If a tax is imposed pursuant to Section 4999 of the
          Internal Revenue Code, or successor provision of like import, upon
          payments due under this Agreement or upon other payments to the
          Employee by the Company, the Employee shall be paid an additional
          amount calculated so as to provide the Employee, after he has paid the
          tax imposed by Section 4999 of the Code, with the same compensation he
          would have received had no tax been imposed by Section 4999. For
          purposes of this subsection (e), the term "Company" shall include any
          subsidiary, affiliate, assignee, or successor in interest of the
          Company or of such assignee or successor in interest.

10.  Assignment.  This Agreement is binding upon and shall be for the benefit of
     the successors and assigns of the Company, including any corporation or any
     other form of business organization with which the Company may merge or
     consolidate, or to which it may transfer substantially all of its assets.
     Employee shall not assign his interest in this Agreement or any part
     thereof.

11.  Consent of the Company.  Any act, request, approval, consent or opinion of
     the Company under this Agreement must be in writing and may be authorized,
     given or expressed only by resolution of the board of directors of the
     Company, or by such other person as the board of directors of the Company
     may designate.

12.  Notices.  Any notice required hereunder to be given shall be in writing and
     if:

     (a)  by the Company to Employee shall be directed to him at his address set
          forth below, or to such other address as he shall have furnished in
          writing to the Company; or

     (b)  by Employee to the Company shall be directed to National Surgery
          Centers, Inc., 30 South Wacker Drive, Suite 2302, Chicago, IL 60606,
          Attn: Secretary, or to such designee or other address as the board of
          directors shall name and have furnished in writing to Employee.

13.  Governing Law.  This Agreement shall be governed by and construed in
     accordance with the laws of the State of Illinois applicable to contracts
     made and to be performed therein.

14.  Enforcement Expenses and Arbitration.  The Company agrees to reimburse the
     Employee for all costs and expenses incurred by him (including the
     reasonable fees of his counsel) in successfully enforcing any of his rights
     under this Agreement or any claim arising out of the
                  
                                       5
<PAGE>
 
          breach thereof. In addition, the parties acknowledge the relative
          economic power of the Company versus the Employee, and the ability of
          the Company to resist the conclusion of litigation should the Employee
          institute legal proceedings to enforce this Agreement or to recover
          damages for the breach thereof. In recognition of this, any
          controversy or claim arising out of or relating to this Agreement,
          including any dispute over or interpretation of the occurrence of a
          "Change in Control", as previously defined, shall be settled by
          arbitration in accordance with the Commercial Arbitration Rules of the
          American Arbitration Association, at the sole election of the
          Employee; provided, however, that an action by the Company to enforce
          its rights under Section 7 hereof shall be excluded from the
          arbitration provisions of this Section 14. Any such election by
          Employee shall be made in written notice given to the Company any time
          after such controversy or claim arises, and in the event Employee is
          served with process relating to any court proceeding concerning any
          such claim or controversy commenced by the Company, such election, to
          be effective, shall be made in written notice within 15 days of the
          time Employee is served with such process. Commencement of court
          proceedings by Employee shall be deemed an election not to arbitrate.
          In the event the Company commences court proceedings (other than an
          action by the Company solely to enforce its rights under Section 7
          hereof) and is given notice of the election to arbitrate by the
          Employee within the time period set forth above, the Company agrees to
          promptly dismiss such court proceedings and submit to arbitration. In
          the event of such arbitration, judgment upon the award rendered by the
          arbitrators may be entered in any court having jurisdiction thereof.

      IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
      the date first above written.


                                          NATIONAL SURGERY CENTERS, INC.
                                         By:
                                      Title:
                                    Address:
        
                                       6

<PAGE>
 
                                  EXHIBIT 11.1
                     Computation of Income Per Common Share
                    (in thousands, except per share amounts)
<TABLE>
<CAPTION>
                                                             Years Ended December 31,
                                                           ----------------------------
                                                             1997       1996     1995
                                                           ---------  --------  -------
<S>                                                        <C>        <C>       <C>
BASIC INCOME PER COMMON SHARE
Average shares outstanding                                    18,133    13,886    8,082
                                                             =======   =======   ======
Income:
  Before extraordinary item                                  $12,589   $ 7,377   $3,099
  Extraordinary item                                            (138)     (463)    (253)
                                                             -------   -------   ------
  Net income                                                 $12,451   $ 6,914   $2,846
                                                             =======   =======   ======
Per common share:       
  Before extraordinary item                                  $  0.70   $  0.53   $ 0.38
  Extraordinary item                                           (0.01)    (0.03)   (0.03)
                                                             -------   -------   ------
  Net income                                                 $  0.69   $  0.50   $ 0.35
                                                             =======   =======   ======
DILUTED INCOME PER COMMON SHARE
Average shares outstanding                                    18,133    13,886    8,082
Net effect of dilutive stock options and warrants - based 
  on the treasury stock method using average market price        690       840      104
Shares assumed issued upon conversion of dilutive         
 convertible debt                                                 11       478        -
                                                             -------   -------   ------
                                                              18,834    15,204    8,186
                                                             =======   =======   ======
Income:
  Before extraordinary item                                  $12,589   $ 7,377   $3,099
  Interest expense on dilutive convertible debt                    4       182        -
                                                             -------   -------   ------
  Adjusted income before extraordinary item                   12,593     7,559    3,099
  Extraordinary item                                            (138)     (463)    (253)
                                                             -------   -------   ------
  Net income                                                 $12,455   $ 7,096   $2,846
                                                             =======   =======   ======
Per common share:       
  Before extraordinary item                                  $  0.67   $  0.50   $ 0.38
  Extraordinary item                                           (0.01)    (0.03)   (0.03)
                                                             -------   -------   ------
  Net income                                                 $  0.66   $  0.47   $ 0.35
                                                             =======   =======   ======
</TABLE>
NOTE:  Number of shares and per share amounts have been adjusted, when
       applicable, to reflect the three-for-two stock dividend effected August
       29, 1997 and May 31, 1996.

<PAGE>
                                 EXHIBIT 13.1 

                  Selected Consolidated Financial Highlights

<TABLE>
<CAPTION>
 
                                                                 Years ended December 31,
- --------------------------------------------------------------------------------------------------------
                                                     1997       1996       1995       1994       1993
- --------------------------------------------------------------------------------------------------------
                                                     (In thousands, except per share and center data)
<S>                                                <C>        <C>         <C>        <C>       <C>
Statements of Operations Data/1/:
  Net revenue                                      $102,632   $ 77,359    $53,165    $41,707   $ 35,230
  Writedown of goodwill/2/                               --         --         --         --    (50,871)
  Operating income (loss)/2/                         26,920     17,205     10,237      7,566    (44,385)
  Interest expense                                    1,025      2,616      4,139      4,186      4,016
  Income (loss) before income taxes and
    extraordinary item/2/                            20,104     11,993      5,080      2,511    (49,463)
  Income (loss) before extraordinary item/2/         12,589      7,377      3,099      1,493    (43,236)
  Net income (loss)/2/                               12,451      6,914      2,846      1,120    (43,236)
 
  Diluted income (loss) per common share:
    Income (loss) before extraordinary item/2/     $   0.67   $   0.50    $  0.38    $  0.23   $  (7.57)
    Extraordinary item                                (0.01)     (0.03)     (0.03)     (0.06)        --
- --------------------------------------------------------------------------------------------------------
    Net income (loss)/2/                           $   0.66   $   0.47    $  0.35    $  0.17   $  (7.57)
======================================================================================================== 
  Diluted weighted average number of common
    and common equivalent shares outstanding         18,834     15,204      8,186      6,404      5,715
 
General Data:
  Centers at end of year                                 38         32         16         14         12
  Cases/3/                                          107,911     84,970     53,460     43,419     38,113
  Net revenue per case/3/                          $    951   $    910    $   994    $   961   $    924
  Operating margin/4/                                  26.2%      22.2%      19.3%      18.1%      18.4%
 
Same Center Data/5/:
  Net revenue growth                                    8.9%      16.0%      12.6%      11.7%      22.8%
  Case growth                                           8.3       13.1        9.1        6.6       12.3
  Net revenue per case growth                           0.6        2.6        3.2        4.8        9.4
 
Balance Sheet Data/1/:
  Working capital                                  $ 46,166   $ 59,968    $22,145    $ 6,300   $  2,789
  Total assets                                      169,951    142,252     82,287     56,954     49,393
  Long-term debt, less current installments          10,466      6,990     17,005     38,200     41,882
  Shareholders' equity (deficit)                    136,795    117,669     48,192      6,724     (3,134)

</TABLE>

1  The Company's financial statements for the periods presented are not strictly
   comparable due to the significant effect that acquisitions have on such
   statements. See "Management's Discussion and Analysis of Financial Condition
   and Results of Operations."
2  Operating results for the year ended December 31, 1993, include a non-
   recurring charge of approximately $50.9 million ($43.8 million after tax
   benefit), principally incurred in connection with the writedown of goodwill.
3  Excludes data from centers in which the Company has a minority ownership
   position.
4  Excludes effects of goodwill writedown for the year ended December 31, 1993.
5  Same center data is calculated based on centers that the Company operated for
   all of both the current and prior year periods.

                                       1
<PAGE>
 
         Management's Discussion and Analysis of Financial Condition 
                           and Results of Operations


Certain statements set forth in this Annual Report, including trends in or
expectations regarding the Company's operations, constitute "forward-looking
statements" within the meaning of the Private Securities Litigation Reform Act
of 1995.  Such statements are based on currently available operating, financial
and competitive information, and are subject to risks and uncertainties. Actual
future results and trends may differ materially depending on a variety of
factors, including, but not limited to successful execution of internal
performance and expansion plans, the impact of competition, the availability of
financing, the volatility of interest rates and other risks detailed herein and
in the Company's Securities and Exchange Commission filings, including the
Company's Annual Report on Form 10-K for the fiscal year ended December 31,
1997.

General - The Company's consistent growth can be directly attributed to strong
internal growth combined with the benefits from the acquisition and development
of surgery centers.  As of December 31, 1997, the Company operated a network of
38 surgery centers, including four centers in which the Company has a minority
ownership position.

     During 1997, the Company continued to execute its strategy for growth in
addition to other financial or operating activities which have enhanced the
Company's financial condition.  Some of the key activities during the year
included:

 .    Acquired six multi-specialty surgery centers and increased the Company's
     ownership from a minority to a majority position in one multi-specialty
     surgery center.
 .    Converted $1.3 million of convertible notes into 110,229 shares of common
     stock and redeemed $24,000 of such notes.
 .    Prepaid $1.2 million in debt.
 .    Declared a 3-for-2 stock split for all holders of record of common stock on
     August 15, 1997, which was effected as a stock dividend on August 29, 1997.

     During 1996, some of the key activities included:
 .    Acquired six multi-specialty surgery centers (including a minority interest
     in one surgery center) and two companies which operated specialty endoscopy
     centers.
 .    Developed a specialty endoscopy center.
 .    Converted $6.7 million of convertible notes into 768,059 shares of common
     stock and redeemed $71,000 of such notes.
 .    Completed a public offering of 3.6 million shares of common stock at $16.17
     per share. In conjunction with this offering, the Company prepaid $9.2
     million in debt.
 .    Declared a 3-for-2 stock split for all holders of record of common stock on
     May 15, 1996, which was effected as a stock dividend on May 31, 1996.
 .    Divested its interest in two centers, including one multi-specialty and one
     specialty endoscopy center.

     Because of the financial impact of the Company's recent acquisition and
development of surgery centers and other financial related activities, it is
difficult to make meaningful comparisons between the Company's financial
statements for the fiscal years presented.  In addition, due to the limited
number of operating surgery centers, each additional center acquired or
developed can affect the overall operating margin of the Company.  Upon the
acquisition of a surgery center, the Company has typically implemented certain
steps to improve operating margins.  The impact of such actions and of other
activities to improve operating margins may not occur immediately.
Consequently, the financial performance of an acquired surgery center may
adversely affect overall operating margins in the near-term.  As the Company
makes additional surgery center acquisitions, the Company expects that this
effect will be mitigated by the expanded financial base of existing surgery
centers.

     The Company's principal source of revenue is a facility fee charged for
surgical procedures performed in its surgery centers. This fee varies depending
on the procedure performed, but usually includes all charges for operating room
usage, special equipment usage, supplies, recovery room usage, nursing staff and
medications. Facility fees do not include the charges of the patient's surgeon,
anesthesiologist or other attending physicians, which are billed directly by
such physicians. For those surgery centers providing extended recovery care, an
additional fee is typically charged for an overnight stay. This fee generally
includes a flat fee for post-operative care and may include itemized amounts for
medications and other supplies.

     The Company receives payments for services rendered to patients from
private insurers, HMOs, PPOs, the patients directly and governmental payors,
including Medicare and Medicaid. In many instances, the Company has agreed with
certain payors to provide services at discounted prices. The Company charges for
services rendered on a fee-for-service basis and may in the future enter into
capitation agreements with payors whereby the Company may share some of the
financial risk of delivering health care services. The sources and amounts of
the Company's revenues derived from its surgery centers are determined by a
number of factors, including the number of patient procedures performed, the mix
of patient procedures and the rates of reimbursement among payor categories.
Generally, private insurance reimbursement is greater than HMO/PPO and Blue
Cross/Blue Shield reimbursement which, in turn, is greater than Medicare and
Medicaid reimbursement. Changes in the Company's payor mix can significantly
affect its profitability. The following table provides certain information
concerning the Company's payor mix during the periods indicated:

                                       2
<PAGE>
 
<TABLE>
<CAPTION>
 
                                                                  Years ended December 31,
- -------------------------------------------------------------------------------------------
                                                                1997        1996      1995
- -------------------------------------------------------------------------------------------
                                                              (percentage of gross revenue)
<S>                                                            <C>         <C>       <C>
Medicare/Medicaid                                               38.3%       38.2%     38.4%
HMO/PPO                                                         27.2        28.7      27.2
Blue Cross/Blue Shield                                          10.0        11.3      10.7
Private insurance, discounted fee for service and other         24.5        21.8      23.7
- -------------------------------------------------------------------------------------------
                                                               100.0%      100.0%    100.0%
===========================================================================================
</TABLE>

     Medicare part B provides for payment of a facility fee for services
furnished by Medicare certified ambulatory surgical centers in connection with
designated covered surgical procedures. Each Medicare covered surgical procedure
is assigned to a payment group. Currently, there are eight payment groups. The
Health Care Financing Administration ("HCFA") assigns a base payment rate to
each payment group, which rate remains until revised by HCFA. The Company
understands that the number of payment groups and the base payment rates are
currently under discussion and the Company is unable to predict the outcome of
these discussions or its effect on the Company. Depending upon the nature and
context of any regulatory action, if any, which is taken, the Company could
experience a decrease in revenues from Medicare, which could have a material
adverse change on the Company's business, financial condition, cash flows or
results of operations.

Results of Operations

The following table sets forth certain consolidated financial data as a
percentage of net revenue for the periods indicated:

<TABLE>
<CAPTION>
                                                                  Years ended December 31,
- -------------------------------------------------------------------------------------------
                                                                1997        1996      1995
- -------------------------------------------------------------------------------------------
                                                                (percentage of net revenue)
<S>                                                            <C>         <C>       <C>
Net revenue                                                    100.0%      100.0%    100.0%
Costs and expenses:                                       
  Operating expenses                                            62.2        65.6      69.6
  General and administrative expenses                            4.7         4.7       4.4
  Depreciation and amortization expense                          6.9         7.5       6.7
- -------------------------------------------------------------------------------------------
    Total costs and expenses                                    73.8        77.8      80.7
- -------------------------------------------------------------------------------------------
      Operating income                                          26.2        22.2      19.3
- -------------------------------------------------------------------------------------------
Other (income) expense:                                   
  Interest expense                                               1.0         3.3       7.8
  Interest income                                               (1.5)       (0.9)     (0.5)
  Minority interests                                             7.4         4.7       2.6
  Other, net                                                    (0.2)       (0.4)     (0.1)
- -------------------------------------------------------------------------------------------
    Total other expenses                                         6.7         6.7       9.8
- -------------------------------------------------------------------------------------------
Income before income taxes and extraordinary item               19.5        15.5       9.5
Provision for income taxes                                       7.3         6.0       3.7
- -------------------------------------------------------------------------------------------
Income before extraordinary item                                12.2         9.5       5.8
Early extinguishment of debt, net of applicable taxes           (0.1)       (0.6)     (0.5)
- -------------------------------------------------------------------------------------------
Net income                                                      12.1%        8.9%      5.3%
===========================================================================================
</TABLE>

Years Ended December 31, 1997 and 1996

Net Revenue.  Net revenue is net of provisions for contractual adjustments and
doubtful accounts.  Net revenue increased 32.7% to $102.6 million in 1997 from
$77.4 million in 1996.  Same center net revenue increased 8.9% due to a 8.3%
increase in cases combined with a 0.6% increase in net revenue per case to
$1,016 from $1,010.  Overall net revenue per case increased 4.5% to $951 in 1997
from $910 in 1996.

Operating Expenses.  Operating expenses include salaries and benefits, drugs and
medical supplies, utilities, marketing and maintenance costs and rent expense of
the centers.  Operating expenses increased 25.8% to $63.8 million in 1997 from
$50.7 million in 1996.  As a percentage of net revenue, operating expenses
decreased to 62.2% in 1997 from 65.6% in 1996 as a result of continued
efficiencies resulting from same-center growth and the effects of acquired
centers, where margins have continued to improve since the date of acquisition.

General and Administrative Expenses.  General and administrative expenses
include only corporate-level expenses and do not include any center-level
administrative expenses.  General and administrative expenses increased 32.1% to
$4.8 million in 1997 from $3.6 million in 


                                       3
<PAGE>
 
1996. As a percentage of net revenue, however, general and administrative
expenses remained constant at 4.7%. The increase in total general and
administration expenses is primarily attributable to the hiring of personnel to
handle the acquisition and management of centers as the Company continues to
expand its network of surgery centers. The Company believes that as same center
cases and overall net revenue increases, and if, as the Company anticipates,
additional acquisitions are made or centers are developed, further leverage of
existing management will occur and general and administrative expense may
decline slightly as a percentage of net revenue.

Depreciation and Amortization Expense.  Depreciation and amortization expense
increased 22.1% to $7.1 million in 1997 from $5.8 million in 1996.  The increase
in depreciation and amortization expense resulted primarily from the addition of
centers since the beginning of 1996.

Interest Expense.  Interest expense decreased 60.8% to $1.0 million in 1997 from
$2.6 million in 1996.  The decrease in interest expense was primarily the result
of the repayment of the $10.4 million in debt with proceeds from the October
1996 public offering, the conversion of $1.3 million in convertible notes during
1997 and the effects of $6.7 million converted in the last half of 1996.  This
decrease in interest was partially offset by assumptions of $6.9 million in debt
for centers acquired in 1997.

Interest Income.  Interest income more than doubled to $1.6 million in 1997 from
$715,000 in 1996.  The increase in interest income reflects interest earned on
cash, cash equivalents, and short-term investments, resulting from investment of
funds remaining from the Company's public offering in October 1996.

Minority Interests.  Minority interests include the minority partners' ownership
share in the earnings (losses) of the operating center.  Minority interests
increased 109.0% to $7.6 million in 1997 from $3.6 million in 1996.  This
increase in minority interests resulted from improved operating performance at
existing surgery centers and the effects of centers acquired since the beginning
of 1997 which are operated in partnership with physicians.

Provision for Income Taxes.  Provision for income taxes increased to $7.5
million in 1997 from $4.6 million in 1996.  The effective tax rate decreased to
37.4% in 1997 from 38.5% in 1996 due primarily to the effects of tax-exempt
interest earned during 1997 from cash, cash equivalents and short-term
investments and lower state income taxes.

Years Ended December 31, 1996 and 1995

Net Revenue.  Net revenue increased 45.5% to $77.4 million in 1996 from $53.2
million in 1995.  Same center net revenue increased 16.0% due to a 13.1%
increase in cases combined with a 2.6% increase in net revenue per case to
$1,017 from $991.  Of the remaining increase in net revenue, $12.5 million
resulted from centers acquired in 1996.  Additionally, during 1996, the Company
divested two centers which had revenues of $2.1 million.

Operating Expenses.  Operating expenses increased 37.1% to $50.7 million in 1996
from $37.0 million in 1995.  As a percentage of net revenues, operating expenses
decreased to 65.6% in 1996 from 69.6% in 1995 as a result of continued expense
efficiencies resulting from strong same-center growth and the effect of acquired
centers, particularly the specialty endoscopy centers, which have operating
expenses slightly below the Company's overall average.

General and Administrative Expenses.  General and administrative expenses
increased 52.2% to $3.6 million in 1996 from $2.4 million in 1995.  The increase
in total general and administrative expenses is primarily attributable to
additional personnel to handle the management of the centers acquired or
developed during 1996 as the total network of centers doubled from sixteen to
thirty-two.  As a percentage of net revenue, however, general and administrative
expenses increased to 4.7% in 1996 from 4.4% in 1995.

Depreciation and Amortization Expense.  Depreciation and amortization expense
increased  62.9% to $5.8 million in 1996 from $3.6 million in 1995.  The
increase in depreciation and amortization expense resulted primarily from
centers acquired in 1996 and includes amortization of deferred development costs
associated with the specialty endoscopy centers which are being amortized over a
two year period.

Interest Expense.  Interest expense decreased 36.8% to $2.6 million in 1996 from
$4.1 million in 1995.  The decrease in interest expense was primarily the result
of the repayment of the $20.0 million subordinated debt in November 1995 with
proceeds from the initial public offering and the conversion of $6.7 million of
convertible notes during the second half of 1996.  As a percentage of net
revenue, interest expense decreased to 3.3% in 1996 from 7.8% in 1995.

Interest Income.  Interest income increased 157.2% to $715,000 in 1996 from
$278,000 in 1995.  The increase in interest income is primarily attributable to
investment of excess proceeds from the November 1995 initial public offering and
the October 1996 public offering which were invested in tax-exempt or other
short-term investments.

                                       4
<PAGE>
 
Minority Interests.  Minority interests increased 163.0% to $3.6 million in 1996
from $1.4 million in 1995.  The increase in minority interests resulted
primarily from improved operating performance at existing surgery centers and
the acquisition or development of 16 centers in 1996 which are operating as
limited or general partnerships.

Provision for Income Taxes.  Provision for income taxes increased 133.0% to $4.6
million in 1996 from $2.0 million in 1995.  The effective tax rate decreased to
38.5% in 1996 from 39.0% in 1995 due to the effects of non-deductible goodwill
amortization.

Seasonality

The Company's business experiences some degree of seasonality because patients
have some degree of discretion in scheduling elective surgery.  Accordingly,
surgical procedures at the Company's centers are lower in the first and third
quarters.  The first quarter tends to be lower due to beginning of the year
deductibles while the third quarter reflects the effects of vacations taken by
both patients and physicians.  Although the Company's growth and development of
centers may obscure the effects of seasonality in the Company's financial
results, the Company's first and third quarters generally reflect lower net
revenue on a same center basis when compared to the Company's second and fourth
quarters.  For example, for the centers owned and operated during the entire
twelve months of 1997, net revenue for the first, second, third and fourth
quarters was 24.3%, 25.7%, 24.4% and 25.6% as a percentage of net revenue for
the year.

Year 2000 Compliance

The "Year 2000 Issue" is the result of computer programs being written using two
digits rather than four to define the applicable year.  Accordingly, such
programs may recognize a date using "00" as the year 1900 rather than the year
2000.  This could result in a system failure or miscalculations causing
disruptions of operations, including, among other things, a temporary inability
to process transactions, send invoices, transfer funds electronically, or engage
in similar business activities.  The Company has not developed any proprietary
computer programs or systems which it uses which will require modification to
avoid the Year 2000 Issue.  However, the Company utilizes third party computer
programs and software.  Based on its recent assessment, management of the
Company does not anticipate that any significant modification or replacement of
the Company's computer programs or systems will be necessary for its computer
systems to properly utilize dates beyond December 31, 1999 or that the Company
will incur significant operating expenses to make any such computer system
improvements.  In addition, the Company continues to monitor the progress of the
licensors of its computer programs and systems to ensure that such programs and
systems will operate properly on and after January 1, 2000.  The Company
believes that most of the costs necessary to make its computer programs and
systems Year 2000 compliant will be incurred in 1998 and will not have a
material impact on the Company's operations or financial condition.  The Company
is not able to determine, however, whether any of its suppliers, lenders, or
service providers will need to make any such computer program or system
modifications or replacements or whether the failure to make such corrections
will have an adverse effect on the Company's operations or financial conditions.

Liquidity and Capital Resources

The Company's cash flow from operations increased to $31.1 million in 1997 from
$12.2 million in 1996.  The Company's cash flow from operations combined with
proceeds of $40.3 million from the sale of short-term investments were used
primarily to finance acquisitions and developments of $39.3 million, capital
expenditures of $4.3 million, purchases of short-term investments of $16.4
million, distributions to minority interests of $6.3 million and repayment of
long-term debt of $2.8 million, including $1.2 million of which was early
retirement of debt.

     The Company expects that its principal use of funds in the near future will
be in connection with acquisition and development of centers, working capital
requirements, debt repayments and purchases of property and equipment. The
Company expects that cash generated from operations and available credit
borrowings will be adequate to provide for the Company's cash requirements for
at least the next twelve months, unless the rate of acquisitions significantly
increases beyond current expectations. No assurances can be given that such
proceeds, cash and borrowings will be sufficient to provide for the Company's
cash requirements beyond the next twelve months. At December 31, 1997, the
Company had working capital of $46.2 million including cash, cash equivalents
and short-term investments of $32.6 million, as compared to working capital of
$60.0 million including cash, cash equivalents and short-term investments of
$51.3 million at December 31, 1996.

     The Company has a bank loan agreement which provides for revolving loans of
up to $60.0 million, to be used by the Company for funding acquisition or
development of surgical services and related businesses. As of December 31,
1997, $60.0 million was available under the terms of the loan agreement.
Borrowings under the loan agreement mature on November 17, 2000. The loan
agreement provides for payment of interest only until maturity, at which time a
balloon payment of outstanding principal is due. Borrowings under the loan
agreement are denominated at the Company's option as either Eurodollar Tranches
(loans bearing interest at a rate 0.625% above the Eurodollar Rate) or Base Rate
Tranches (loans bearing interest at the lender prime rate or Federal Funds Rate
plus 0.5%, whichever is greater), subject to adjustment in certain
circumstances. Additionally, the loan agreement prohibits the payment of
dividends or other distributions on the Company's common stock.

                                       5
<PAGE>
 
                       Consolidated Statements of Income
                   (in thousands, except per share amounts)

<TABLE>
<CAPTION>
 
                                                                                                  Years ended December 31,
- ------------------------------------------------------------------------------------------------------------------------------------
                                                                                                  1997       1996      1995      
- ------------------------------------------------------------------------------------------------------------------------------------
<S>                                                                                             <C>        <C>       <C>         
Net revenue                                                                                     $102,632   $77,359   $53,165     
                                                                                                                                 
Costs and expenses:                                                                                                              
  Operating expenses                                                                              63,831    50,720    36,982     
  General and administrative expenses                                                              4,755     3,599     2,365     
  Depreciation and amortization expense                                                            7,126     5,835     3,581     
- ------------------------------------------------------------------------------------------------------------------------------------
     Total costs and expenses                                                                     75,712    60,154    42,928     
- ------------------------------------------------------------------------------------------------------------------------------------
        Operating income                                                                          26,920    17,205    10,237     
Other (income) expenses:                                                                                                         
  Interest expense                                                                                 1,025     2,616     4,139     
  Interest income                                                                                 (1,590)     (715)     (278)    
  Minority interests                                                                               7,596     3,634     1,382     
  Other, net                                                                                        (215)     (323)      (86)    
- ------------------------------------------------------------------------------------------------------------------------------------
     Total other expenses                                                                          6,816     5,212     5,157     
- ------------------------------------------------------------------------------------------------------------------------------------
Income before income taxes and extraordinary item                                                 20,104    11,993     5,080     
Provision for income taxes                                                                         7,515     4,616     1,981     
- ------------------------------------------------------------------------------------------------------------------------------------
Income before extraordinary item                                                                  12,589     7,377     3,099     
Early extinguishment of debt, net of applicable taxes                                               (138)     (463)     (253)    
- ------------------------------------------------------------------------------------------------------------------------------------
Net income                                                                                      $ 12,451   $ 6,914   $ 2,846     
====================================================================================================================================

Per common share:                                                                                                                
  Basic:                                                                                                                         
     Income before extraordinary item                                                           $   0.70   $  0.53   $  0.38     
     Extraordinary item                                                                            (0.01)    (0.03)    (0.03)    
- ------------------------------------------------------------------------------------------------------------------------------------
     Net income                                                                                 $   0.69   $  0.50   $  0.35     
====================================================================================================================================

  Diluted:                                                                                                                       
     Income before extraordinary item                                                           $   0.67   $  0.50   $  0.38     
     Extraordinary item                                                                            (0.01)    (0.03)    (0.03)    
- ------------------------------------------------------------------------------------------------------------------------------------
     Net income                                                                                 $   0.66   $  0.47   $  0.35     
====================================================================================================================================
Weighted average number of common and common equivalent shares outstanding:                                                      
  Basic                                                                                           18,133    13,886     8,082     
  Diluted                                                                                         18,834    15,204     8,186      
 
</TABLE>
  The Notes to Consolidated Financial Statements are an integral part of these
                                  statements.

                                       6
<PAGE>
 
                          Consolidated Balance Sheets
                         (in thousands, except shares)
<TABLE>
<CAPTION>
 
                                                                                                                   December 31,    
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                 1997       1996   
- ----------------------------------------------------------------------------------------------------------------------------------- 
<S>                                                                                                            <C>        <C>      
ASSETS                                                                                                                             
Current assets:                                                                                                                    
  Cash and cash equivalents                                                                                    $ 14,919   $  9,721 
  Short-term investments                                                                                         17,700     41,614 
  Accounts receivable (less allowance for uncollectible accounts                                                                   
    of $4,027 and $1,723)                                                                                        19,341     13,223 
  Inventories                                                                                                     3,838      2,548 
  Prepaid expenses                                                                                                1,165      2,383 
  Other current assets                                                                                              527        724 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                 57,490     70,213 
- ----------------------------------------------------------------------------------------------------------------------------------- 
Property and equipment                                                                                           55,392     44,167 
  Less accumulated depreciation and amortization                                                                (16,047)   (10,805)
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                 39,345     33,362 
- ----------------------------------------------------------------------------------------------------------------------------------- 
Other assets:                                                                                                                      
  Excess of purchase price over net assets acquired (less accumulated                                                              
    amortization of $3,424 and $2,045)                                                                           69,618     32,181 
  Deferred income taxes                                                                                           1,080      3,074 
  Other long-term assets                                                                                          2,418      3,422 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                 73,116     38,677 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                               $169,951   $142,252 
===================================================================================================================================

LIABILITIES AND SHAREHOLDERS' EQUITY                                                                                               
Current liabilities:                                                                                                               
  Current installments of long-term debt                                                                       $  2,671   $  3,464 
  Accounts payable and accrued expenses                                                                           8,653      6,781 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                 11,324     10,245 
- ----------------------------------------------------------------------------------------------------------------------------------- 
Long-term debt, less current installments:                                                                                         
  Long-term debt                                                                                                 10,374      6,353 
  Convertible notes                                                                                                  92        637 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                 10,466      6,990 
- ----------------------------------------------------------------------------------------------------------------------------------- 
Other long-term liabilities                                                                                         686        703 
Minority interests                                                                                               10,680      6,645 
Shareholders' equity:                                                                                                              
  Preferred stock, $.01 par value; authorized 10,000,000 shares;                                                      -          - 
    no shares issued and outstanding                                                                                               
  Non-voting common stock, $.01 par value; authorized 10,000,000                                                                   
    shares; issued and outstanding 654,313 shares in 1996                                                             -          6 
  Common stock, $.01 par value; authorized 40,000,000 shares;                                                                      
    issued and outstanding 18,502,915 shares in 1997 and                                                                           
    11,278,995 shares in 1996                                                                                       185        113 
  Additional paid-in capital                                                                                    156,923    150,314 
  Accumulated deficit                                                                                           (20,313)   (32,764)
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                                136,795    117,669 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                               $169,951   $142,252  
=================================================================================================================================== 
</TABLE>

 The Notes to Consolidated Financial Statements are an integral part of these
                                  statements.
 
                                       7
<PAGE>
 
                Consolidated Statements of Shareholders' Equity
                                (in thousands)
<TABLE>
<CAPTION>

                                                         Common Stock
                                                ------------------------------
                                                Number           Amount          Additional
                                                  of      --------------------    paid-in     Accumulated    Total
                                                shares    Voting    Non-Voting    capital       deficit      equity
- ----------------------------------------------------------------------------------------------------------------------
<S>                                             <C>      <C>        <C>           <C>         <C>            <C>
Balance at January 1, 1995                       9,846   $ 41,016      $ 8,232   $      -       $(42,524)    $  6,724
 Net income                                          -          -            -          -          2,846        2,846
 Stock issued, net of issuance costs                74        318            -          -              -          318
 Exercise of stock options                           7         29            -          -              -           29
 Issuance of warrants                                -          -            -          2              -            2
 1-for-3 stock exchange                         (6,618)         -            -          -              -            -
 Change in par value                                 -    (41,336)      (8,226)    49,562              -            -
 Stock issued, net of issuance costs             2,300         23            -     38,007              -       38,030
 Stock issued in connection with
   acquisitions                                     15          -            -        225              -          225
 Exercise of stock options                           1          -            -         18              -           18
- ----------------------------------------------------------------------------------------------------------------------
Balance at December 31, 1995                     5,625         50            6     87,814        (39,678)      48,192
 Net income                                          -          -            -          -          6,914        6,914
 Exercise of stock options                           4          -            -         51              -           51
 3-for-2 stock dividend                          2,815         25            3        (28)             -            -
 Stock issued, net of issuance costs             2,415         24            -     54,925              -       54,949
 Stock issued upon conversion of
   convertible debt                                512          5            -      6,694              -        6,699
 Exercise of stock options                          20          -            -        185              -          185
 Exercise of warrants                              476          2            3         (5)             -            -
 Conversion of non-voting stock                      -          6           (6)         -              -            -
 Stock issued under employee stock
   ownership plan                                   66          1            -        678              -          679
- ----------------------------------------------------------------------------------------------------------------------
Balance at December 31, 1996                    11,933        113            6    150,314        (32,764)     117,669
 Net income                                          -          -            -          -         12,451       12,451
 Stock issued in connection with
   acquisitions                                    123          1            -      2,951              -        2,952
 Exercise of stock options                          89          1            -        198              -          199
 Stock issuance costs                                -          -            -        (19)             -          (19)
 Stock issued under employee stock
   ownership plan                                    7          -            -         89              -           89
 Conversion of non-voting stock                      -          6           (6)         -              -            -
 Stock issued upon conversion of
   convertible debt                                 42          1            -        633              -          634
 3-for-2 stock dividend                          6,096         61            -        (61)             -            -
 Exercise of stock options                         134          1            -        835              -          836
 Stock issued upon conversion of convertible
   debt                                             47          1            -        707              -          708
 Issuance of warrants                                -          -            -        197              -          197
 Exercise of warrants                                3          -            -          -              -            -
 Income tax benefit from stock options
   exercised                                         -          -            -        511              -          511
 Stock issued in connection with
   acquisitions                                     29          -            -        568              -          568
- ----------------------------------------------------------------------------------------------------------------------
Balance at December 31, 1997                    18,503   $    185      $     -   $156,923       $(20,313)    $136,795
======================================================================================================================
</TABLE>
  The Notes to Consolidated Financial Statements are an integral part of these
                                  statements.

                                       8
<PAGE>
 
                    Consolidated Statements of Cash Flows 
                                (in thousands)
<TABLE>
<CAPTION>
 
                                                                                                     Years ended December 31,     
- ------------------------------------------------------------------------------------------------------------------------------------
                                                                                                    1997       1996       1995    
- ------------------------------------------------------------------------------------------------------------------------------------
<S>                                                                                               <C>        <C>        <C>       
Operating activities:                                                                                                             
  Net income                                                                                      $ 12,451   $  6,914   $  2,846  
  Adjustments to reconcile net income to net cash provided by                                                                     
     operating activities:                                                                                                        
     Depreciation and amortization expense                                                           7,126      5,835      3,581  
     Minority interests                                                                              7,596      3,634      1,382  
     Deferred income taxes                                                                           2,717      1,510      1,480  
     Tax benefit associated with stock options                                                         511          -          -  
     Extraordinary charges                                                                             212          -        383  
  Change in assets and liabilities, net of entities acquired:                                                                     
     Accounts receivable                                                                              (880)    (1,840)    (1,266) 
     Inventories                                                                                      (446)        (8)        17  
     Prepaid expenses                                                                                1,301     (1,275)       102  
     Other current assets                                                                              227        167       (142) 
     Other assets                                                                                      137     (1,319)      (213) 
     Accounts payable and accrued expenses                                                             368     (1,340)     1,531  
     Other                                                                                            (231)       (48)      (793) 
- ------------------------------------------------------------------------------------------------------------------------------------
        Net cash provided by operating activities                                                   31,089     12,230      8,908  
- ------------------------------------------------------------------------------------------------------------------------------------

Investing activities:                                                                                                             
  Payments for entities acquired, net of cash acquired                                             (39,330)   (17,943)    (2,489) 
  Investment in unconsolidated affiliates                                                             (600)    (1,500)         -  
  Purchases of property and equipment                                                               (4,265)    (5,100)    (3,255) 
  Purchases of short-term investments                                                              (16,400)   (41,614)    (8,190) 
  Proceeds from sale of short-term investments                                                      40,314      8,190          -  
  Proceeds from sale of property and equipment                                                         545        984         26  
- ------------------------------------------------------------------------------------------------------------------------------------
        Net cash used in investing activities                                                      (19,736)   (56,983)   (13,908) 
- ------------------------------------------------------------------------------------------------------------------------------------

Financing activities:                                                                                                             
  Proceeds from issuance of long-term debt                                                              74          -          -  
  Payments on long-term debt                                                                        (2,807)   (13,193)   (22,782) 
  Proceeds from issuance of common stock, net of issuance costs                                         70     55,628     38,348  
  Proceeds from issuance of warrants and exercise of options                                         1,044        236         49  
  Distributions to minority interests                                                               (6,318)    (3,103)    (1,343) 
  Proceeds from sale of partnership interests                                                        1,782        253        903  
- ------------------------------------------------------------------------------------------------------------------------------------
        Net cash provided by (used in) financing activities                                         (6,155)    39,821     15,175  
- ------------------------------------------------------------------------------------------------------------------------------------

Net increase (decrease) in cash and cash equivalents                                                 5,198     (4,932)    10,175  
Cash and cash equivalents, beginning of year                                                         9,721     14,653      4,478  
- ------------------------------------------------------------------------------------------------------------------------------------
Cash and cash equivalents, end of year                                                            $ 14,919   $  9,721   $ 14,653  
====================================================================================================================================

Non-cash transactions:                                                                                                            
  Common stock issued in acquisitions, contingent payments and other                              $  3,520   $      -   $    225  
  Long-term debt issued in acquisitions and contingent payments                                        374        240        750  
  Liabilities assumed in acquisitions                                                               10,088     11,411      3,277  
  Capital lease obligations                                                                             81        228        574  
  Common stock issued upon conversion of convertible debt                                            1,342      6,699          -  
  Issuance of warrants                                                                                 188          -          -   
</TABLE>

 The Notes to Consolidated Financial Statements are an integral part of these
                                  statements.

                                       9
<PAGE>
 
                  Notes to Consolidated Financial Statements

Note 1 - Summary of Significant Accounting Policies

Description of Business--National Surgery Centers, Inc. and Subsidiaries (the
"Company") acquires, develops and manages ambulatory surgery centers. Many of
the Company's surgery centers are operated in partnership with physicians or
other health care providers.

Principles of Consolidation--The consolidated financial statements include all
accounts of the Company and its wholly owned subsidiaries and majority owned
partnerships or limited liability companies. All significant intercompany
balances and transactions have been eliminated in consolidation.

  Investments in unconsolidated affiliates in which the Company owns 20% or more
are accounted for using the equity method of accounting and other investments
are stated at cost.

  The Company charges the operating centers a management fee based on the net
revenues of the centers. These fees are to cover administrative, accounting and
other support costs incurred by the Company. These management fees are
eliminated in the consolidated financial statements except for the share
allocated to minority interests.

Revenue Recognition--Net revenue consists of charges by the Company's centers at
established billing rates for services which generally include all fees for
operating room, recovery room, supplies and medications. Net revenue is net of
provisions for contractual adjustments and doubtful accounts.

Excess of Purchase Price Over Net Assets Acquired ("Goodwill") and Long-Lived
Assets--The value of goodwill acquired, including any arising from contingent
payments based upon earnings and performance of the acquired business and the
purchase of limited partners' ownership interest in majority owned partnerships,
is generally amortized using a straight-line method over forty years. The
Company believes that the life of the ambulatory surgery business and the
delivery of such health care services is indeterminate and likely to exceed
forty years.

  The Company periodically evaluates whether events and circumstances subsequent
to acquisition have occurred that would indicate that the remaining unamortized
balance of goodwill may not be fully recoverable or that the remaining useful-
life may warrant revision. When external factors indicate that the carrying
value of goodwill may not be recoverable, the Company performs an analysis over
the remaining life of the related assets to determine if the asset is impaired.
Historically, impairment of goodwill has been measured by comparing discounted
future cash flows to the net carrying value. If this analysis indicated that
goodwill acquired was not fully recoverable, then the Company adjusted the
carrying value to the estimated recoverable value.

  In addition, the Company assesses long-lived assets for impairment under
Statement of Financial Accounting Standards ("SFAS") No. 121, "Accounting for
the Impairment of Long-Lived Assets and for Long-Lived Assets to Be Disposed
Of." Under those rules, goodwill associated with assets acquired in a purchase
business combination is included in impairment evaluations when events or
circumstances exist that indicate the carrying amount of those assets may not be
recoverable.

Common Share Data--Basic income per common share and income per common and
common equivalent share assuming dilution are computed using the weighted
average number of shares outstanding. On a diluted basis, both income and the
weighted average number of shares outstanding are adjusted for the incremental
shares attributed to outstanding options and warrants and the conversion of
convertible subordinated notes, when the effect of such items are dilutive.

  Effective December 15, 1997, the Company adopted SFAS No. 128, "Earnings per
Share". Accordingly, all references in these financial statements to earnings
per share, diluted earnings per share and related weighted average shares have
been restated to reflect adoption of SFAS No. 128. A reconciliation of the
weighted average shares for basic and diluted shares outstanding is as follows:

<TABLE>
<CAPTION>
 
                                                        1997     1996    1995   
- --------------------------------------------------------------------------------
                                                           (in thousands)      
<S>                                                    <C>     <C>      <C>    
Basic weighted average shares outstanding              18,133  13,886   8,082  
Dilutive options and warrants                             690     840     104  
Dilutive convertible debt                                  11     478       - 
- --------------------------------------------------------------------------------
Diluted weighted average shares outstanding            18,834  15,204   8,186  
================================================================================
</TABLE>

Income Taxes--The Company's method of accounting for income taxes is based on an
asset and liability method. Under this method, deferred tax assets and
liabilities are determined based on differences between financial reporting and
tax bases of assets and liabilities and are measured using the enacted tax rates
and laws that will be in effect when the differences are expected to reverse.

Property and Equipment--Property and equipment are stated at cost. Property and
equipment under capital leases are recorded at the lower of the present value of
the minimum lease payments or the fair market value of the leased property.

  Depreciation and amortization are computed using the straight-line method over
the estimated useful lives or the terms of the leases of the related assets. The
general range of estimated useful lives is forty years for buildings; seven to
ten years for medical, surgical and capital leased equipment; terms of the
leases for leasehold improvements; and five to ten years for furniture and
fixtures.

                                      10
<PAGE>
 
Inventories--Inventories, comprised principally of medical supplies, drugs and
gases, are stated at the lower of cost (first-in, first-out method) or market.

Cash Equivalents--The Company considers all investments in highly liquid
investments with maturities of three months or less to be cash equivalents.
Investments in cash equivalents are carried at cost which approximates market
with any associated discount or premium amortized over the period to maturity.

Short-Term Investments--Short-term investments consist primarily of highly
liquid debt securities or investments in pooled investment accounts. Management
considers these investments to be available-for-sale and these securities are
carried at cost which approximates market.

Management Estimates--The preparation of financial statements in conformity with
generally accepted accounting principles requires management to make estimates
and assumptions that affect reported amounts. These estimates and assumptions
are based on knowledge and experience about past and current events and on
assumptions about future events. Management will accrue estimated liabilities
when the financial impact is probable and estimable, however, actual results
could differ from these estimates.

Off-Balance Sheet Risk and Concentrations of Credit Risk--Financial instruments
which potentially subject the Company to concentrations of credit risk consist
principally of cash, cash equivalents, short-term investments and trade
receivables. The Company places its cash, cash equivalents and short-term
investments with high credit quality financial institutions and instruments.

  Concentrations of credit risk with respect to trade receivables is limited due
to the large number of customers comprising the Company's customer base and
their dispersion across many different insurance companies, health maintenance
and preferred provider organizations, individuals and geographic locations.

  For all periods presented, the Company had no significant concentrations of
credit risk or financial instruments with off-balance sheet risk.

Recent Accounting Standards--In June 1997, the Financial Accounting Standards
Board ("FASB") issued SFAS No. 130 "Reporting Comprehensive Income", which
establishes standards for reporting and displaying comprehensive income and its
components (revenue, expenses, gains and losses) in a full set of general-
purpose financial statements. The Company will adopt SFAS 130 in fiscal 1998.

  In June 1997, the FASB issued SFAS No. 131 "Disclosures about Segments of an
Enterprise and Related Information," which changes the way public companies
report information about operating segments. The Company will adopt SFAS No. 131
in fiscal 1998. This statement, which is based on the management approach to
segment reporting, establishes requirements to report selected segment
information quarterly and to report entity-wide disclosures about products and
services, major customers and the major countries in which the Company holds
assets and reports revenues.

  Management believes that the adoption of these new standards will have no
impact on the Company's financial position or results of operations.

Note 2--Acquisitions

During 1997, the Company acquired six surgery centers and increased its
ownership in one surgery center to a majority ownership. The total cost of $42.9
million included $39.0 million in cash, $374,000 in promissory notes, and the
issuance of 213,998 shares of the Company's common stock. Of the $42.9 million
purchase price, $39.0 million was recorded as goodwill.

  During 1996, the Company acquired sixteen surgery centers for cash totaling
$17.9 million. Of the $17.9 million purchase price, $15.7 million was recorded
as goodwill.

  During August and October 1995, the Company acquired two surgery centers. The
total cost of $3.2 million included $2.5 million in cash, $450,000 in a
promissory note and the issuance of 22,500 shares of the Company's common stock.
Of the $3.2 million purchase price, $2.6 million was recorded as goodwill.

  The acquisitions have been accounted for under the purchase method of
accounting.

  The following unaudited pro forma results of operations give effect to the
operations of the entities acquired in fiscal 1997, 1996 and 1995 as if the
respective transactions had occurred as of the first day of the fiscal year
immediately preceding the year of the transactions.

                                      11
<PAGE>
 
The unaudited pro forma results of operations do not purport to represent what
the Company's results would have been had such transactions in fact occurred at
the beginning of the years presented or to project the Company's results of
operations in any future period.

<TABLE>
<CAPTION>
 
                                              Years ended December 31,/a/
- --------------------------------------------------------------------------------
                                              1997          1996          1995
- --------------------------------------------------------------------------------
                                       (in thousands, except per share amounts)
<S>                                         <C>           <C>           <C>
Net revenues                                $117,027      $111,372      $73,801
Income before extraordinary item              14,293        10,069        3,684
Net income                                    14,155         9,606        3,431
 
Per common share:
  Basic:                              
     Income before extraordinary item       $   0.78      $   0.71      $  0.46
     Net income                                 0.77          0.68         0.42
  Diluted:                            
     Income before extraordinary item       $   0.75      $   0.66      $  0.45
     Net income                                 0.75          0.63         0.42
</TABLE>

/a/  The above pro forma operating results include adjustments to conform the
accounting policy of the acquired businesses for the amortization of certain
intangible assets, interest expense, minority interests and provision for income
taxes.

Note 3--Shareholders' Equity

Public Offerings--In October 1996, the Company completed a public offering of
3,623,267 shares of common stock at $16.17 per share (the "Offering"). The net
proceeds of the Offering, after deducting applicable issuance costs and
expenses, was $54.9 million. The net proceeds were used to repay $9.2 million of
debt and capital leases, with excess funds to be used for general corporate
purposes. Pro forma net income and earnings per share assuming the debt and
capital leases had been paid at the beginning of the year or when the debt was
acquired, if later, would not have been materially different from that reported
for the year.

  In November 1995, the Company completed an initial public offering of
5,175,000 shares of common stock at $8.00 per share (the "Initial Offering").
Prior to the Initial Offering, there was no public market for the Company's
common stock. The net proceeds of the Initial Offering, after deducting
applicable issuance costs and expenses, were $38.0 million. The net proceeds
were used to repay $20.0 million of 10.5% subordinated notes, plus accrued
interest, with excess funds used for general corporate purposes.

Stock Dividends--On July 22, 1997, the Board of Directors of the Company
declared a 3-for-2 stock split for all holders of record of the Company's common
stock on August 15, 1997, which was effected as a stock dividend on August 29,
1997. Accordingly, all references in these financial statements to average
number of shares outstanding and related prices, per share amounts, and the
stock option plan and warrant data have been restated to reflect this stock
dividend. On April 18, 1996, the Board of Directors of the Company declared a 3-
for-2 stock split for all holders of record of the Company's common stock on May
15, 1996, which was effected as a stock dividend on May 31, 1996.

Employee Stock Purchase Plan--In November 1995, the Company implemented an
employee stock purchase plan. The Company's plan provides that eligible
employees may annually contribute up to 10% of their base earnings towards the
purchase of the Company's common stock, up to $10,000 of common stock. The
employee's purchase price is 85% of the lessor of the fair market value of the
stock on the first day or the last business day of the period. No compensation
expense is recorded in connection with the plan. The total number of shares
issuable under the plan is 1,125,000. During 1997 and 1996, the Company issued
7,924 and 99,869 shares under the plan, respectively.

Stock Options--The Company maintains several stock option plans under which the
Company may grant incentive stock options or non-qualified stock options to
officers, key employees and non-employee directors. The plans provide for
options to purchase up to 3,375,000 shares of the Company's common stock. The
plans are administered by a committee of the Board of Directors which has the
authority to determine the individuals or directors to whom awards will be made,
the amount of the awards, and the other terms and conditions of the awards. Each
option allows the individual or director to purchase one share of the Company's
common stock for each option granted. All options are granted at not less than
fair market value at the date of the grant and generally vest and expire
according to terms established at the grant date.

                                      12
<PAGE>
 
  A summary of the Company's stock option activity, and related information for
the years ended December 31 is as follows (options in thousands):
<TABLE>
<CAPTION>
                                             1997                1996                 1995
                                    -------------------  -------------------  -------------------
                                              Weighted-            Weighted-            Weighted-
                                               average              average              average
                                              exercise             exercise             exercise
                                    Options     price    Options     price    Options     price
- -------------------------------------------------------------------------------------------------
<S>                                <C>       <C>        <C>       <C>        <C>       <C>
Outstanding - beginning of year       1,759      $12.97      942      $ 7.85      156       $6.26
Granted                                 730       22.29      876       18.23      823        8.03
Exercised                              (429)      11.26      (38)       6.37       (7)       5.67
Forfeited                              (165)      16.93      (21)      11.40      (30)       5.79
                                      -----                -----                  --- 
Outstanding - end of year             1,895       16.60    1,759       12.97      942        7.83
                                      =====                =====                  === 
Exercisable at end of year              527      $13.05      273      $ 7.64       75       $6.37
 
Weighted-average fair value of
 options granted during the year                 $ 6.59               $ 4.55                $1.89
</TABLE>
  The following table reflects the weighted average exercise price and weighted
average contractual life of various price ranges of the 1,895,000 options
outstanding as of December 31, 1997:

<TABLE>
<CAPTION>
 
   Exercise      Shares   Weighted-average     Weighted-average
  price range   (000's)    exercise price   contractual life (years)
- -------------------------------------------------------------------
<S>            <C>      <C>               <C>       
$  5   to  $10     586        $ 8.04                2.86           
  10   to   15       3         10.78                3.04           
  15   to   20     847         18.62                3.65           
  20   to   25     459         23.84                4.78           
</TABLE>

Pro Forma Effects of Options--The fair value for stock options was estimated at
the date of grant using the Black-Scholes option pricing model with the
following weighted-average assumptions for 1997, 1996 and 1995, respectively:
risk-free interest rates of 5.97%, 6.35% and 5.53%; volatility factor of the
expected market price of the Company's common stock of 30%, 20%, and 20%; a
weighted-average expected life of the option of 3.5 years; and no dividend
yield. SFAS No. 123, "Accounting for Stock Based Compensation", which
establishes a fair value based method of accounting for stock-based
compensation, does not require that a fair value be determined for any options
granted prior to January 1, 1995.

  The Black-Scholes option valuation model was developed for use in estimating
the fair value of traded options which have no vesting restrictions and are
fully transferable. In addition, option valuation models require the input of
highly subjective assumptions including the expected stock price volatility. The
Company does not have a market tradable option and because stock options have
characteristics significantly different from those of similarly traded options,
and because changes in the subjective input assumptions can materially affect
the fair value estimate, in management's opinion, the existing models do not
necessarily provide a reliable single measure of the fair value of its stock
options.

                                      13
<PAGE>
 
  The Company continues to account for stock based compensation under APB No.
25, "Accounting for Stock Issued to Employees", as allowed by SFAS No. 123. Had
compensation cost for these plans been determined consistent with SFAS No. 123,
the Company's net income and earnings per share would have been reduced to the
following amounts:

<TABLE>
<CAPTION>
 
                                             1997          1996         1995
- --------------------------------------------------------------------------------
                                        (in thousands, except per share amounts)

<S>                                        <C>            <C>          <C>
Net income:
  As reported:                       
     Income before extraordinary item      $12,589        $7,377       $3,099
     Net income                             12,451         6,914        2,846
  Pro forma:                         
     Income before extraordinary item      $11,088        $6,390       $3,029
     Net income                             10,950         5,927        2,776
 
Basic income per common share:
  As reported:                      
     Income before extraordinary item      $  0.70        $ 0.53       $ 0.38
     Net income                               0.69          0.50         0.35
  Pro forma:                        
     Income before extraordinary item      $  0.61        $ 0.46       $ 0.37
     Net income                               0.60          0.43         0.34
 
Diluted income per common share:
  As reported:                       
     Income before extraordinary item      $  0.67        $ 0.50       $ 0.38
     Net income                               0.66          0.47         0.35
  Pro forma:                         
     Income before extraordinary item      $  0.59        $ 0.43       $ 0.37
     Net income                               0.58          0.40         0.34
</TABLE>

Warrants--The Company has outstanding warrants at December 31, 1997 providing
for the purchase of 54,750 shares of the Company's common stock. The warrants
are exercisable at an average price of $11.11 and expire through the year 2000.

Shares Reserved--The Company has reserved 3,977,818 shares of the Company's
common stock for issuance in conjunction with warrants, convertible notes, stock
purchase plan and stock option plans.

Note 4--Long-Term Debt and Lease Commitments

Long Term Debt--On November 17, 1997, the Company entered into a bank loan
agreement which provides for revolving loans of up to $60.0 million to be used
by the Company for funding acquisition or development of surgical services or
related businesses. As of December 31, 1997, $60.0 million was available under
the terms of the loan agreement. Borrowings under the loan agreement are secured
by substantially all of the capital stock of the Company's subsidiaries and
mature on November 17, 2000. The loan agreement provides for payments of
interest only until maturity, at which time a balloon payment of outstanding
principal is due. Borrowings under the loan agreement are denominated at the
Company's option as either Eurodollar Tranches (loans bearing interest at a rate
of 0.625% above a Eurodollar rate quoted by the lender) or Base Rate Tranches
(loans bearing interest at the lenders prime rate or Federal Funds Rate plus
0.5%, whichever is greater), subject to adjustment based on certain financial
ratios. An annual fee of 0.20% exists on the used portion of the commitment.
Additionally, the loan agreement prohibits the payment of dividends or other
distributions on the Company's common stock.

  In November and December, 1996, the Company prepaid certain loans and capital
leases, which by their terms were not prepayable. The $4.2 million in loans had
interest rates ranging from 8% to 12.8% and matured through the year 2010. The
$5.0 million of capital leases had imputed interest rates ranging from 9% to
13.4% and matured through the year 2000.

  The convertible notes mature five to seven years from the date of issuance.
Certain notes are redeemable at the option of the Company on or after three
years from the date of issuance, or earlier under certain circumstances, at a
price equal to 100% of the principal amount thereof. During 1997, the Company
converted $1,342,000 of its convertible subordinated notes into 110,229 shares
of common stock and redeemed $24,000 of such notes. During 1996, the Company
converted $6.7 million of its convertible subordinated notes into 768,059 of
common stock and redeemed $71,000 of such notes. The remaining $92,000 of
outstanding notes are convertible into shares of the Company's common stock at
any time prior to and including the maturity date of the note at an average
conversion price of $16.67 per share.

                                      14
<PAGE>
 
  A 7.5% subordinated note was payable to a member of the Company's board of
directors as part of the payment for the acquisition of a center previously
owned by him and was repaid in full on January 2, 1997.

 Long-term debt consists of the following:

<TABLE>
<CAPTION>
 
                                                                                                              December 31,   
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                             1997      1996  
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                             (in thousands)  
<S>                                                                                                        <C>       <C>     
Revolving and term notes due 2000 (unamortized discount of $108,000 at December 31, 1996)                  $     -   $  (108)
Convertible notes, interest ranging from 7% to 9.5%, due through 2001, interest payable                                      
 quarterly or annually                                                                                          92     1,458 
7.5% subordinated note paid in 1997                                                                              -     1,200 
Installment notes payable, interest ranging from 7% to 13.25%, due through 2010                              8,144     4,755 
Notes payable, interest rate at 6% to 7%, due through 2001                                                   2,880     2,867 
Obligations under capital leases, interest ranging from 7% to 16% due through 2002                           2,021       282 
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                            13,137    10,454 
Less current installments                                                                                   (2,671)   (3,464)
- ----------------------------------------------------------------------------------------------------------------------------------- 
                                                                                                           $10,466   $ 6,990  
===================================================================================================================================
</TABLE>

Lease Commitments--The Company leases corporate office space, operating
facilities and various equipment under operating leases. The facilities in which
the Company's surgical centers are located are generally leased on terms whereby
all costs associated with maintaining the property are paid by the Company. The
lease agreements usually have lease terms ranging from five to twenty-five
years, excluding renewal option periods, and have payment increases based on
scheduled or consumer price index adjustments.

  Lease expenses for operating leases aggregated $7,345,000, $6,104,000, and
$4,748,000 for the years ended December 31, 1997, 1996, and 1995, respectively.

Scheduled Long-Term Debt and Lease Payments--Future minimum lease payments under
non-cancelable capital and operating leases and long-term debt payments as of
December 31, 1997 are as follows:

<TABLE>
<CAPTION>
                                                                                                                                    
                                                                                                 Capital   Operating  Long-term     
                                                                                                  leases    leases      debt        
- -----------------------------------------------------------------------------------------------------------------------------------
                                                                                                         (in thousands)             
<S>                                                                                               <C>        <C>        <C>    
1998                                                                                              $1,002     $ 5,098    $ 2,671     
1999                                                                                                 808       5,102      2,441     
2000                                                                                                 434       4,874      2,478     
2001                                                                                                  71       4,795      1,332     
2002                                                                                                  19       4,318        380     
Thereafter                                                                                             -      12,566      3,835     
- -----------------------------------------------------------------------------------------------------------------------------------
Total payments                                                                                     2,334     $36,753    $13,137     
                                                                                                             ======================
Less amount representing interest                                                                   (313)  
- -----------------------------------------------------------------------------------------------------------
Present value of minimum lease payments                                                           $2,021  
===========================================================================================================
</TABLE> 

Interest Payments--Total interest paid was $1,018,000, $2,606,000, and
$4,084,000 for the years ended December 31, 1997, 1996, and 1995, respectively.

Note 5--Extraordinary Charge

During November 1997, the Company negotiated a new bank loan agreement. As a
result of the cancellation of its previous credit facility, the Company recorded
an extraordinary charge of $212,000 with associated tax benefits of $74,000. The
extraordinary charge was due to accelerated amortization of unamortized loan and
commitment costs and unamortized discount for warrants issued in connection with
the credit facility.

  In 1996, as a result of prepayment of certain debt and capital leases, the
Company incurred an extraordinary charge of $701,000 with associated tax
benefits of $238,000. The extraordinary charge was due to prepayment penalties.

  In 1995, as a result of prepayment of $20,000,000 of subordinated debentures,
the Company incurred an extraordinary charge of $383,000 with associated tax
benefits of $130,000. The extraordinary charge was due to accelerated
amortization of unamortized debt issuance costs and discounts.

                                      15
<PAGE>

Note 6--Income Taxes

Deferred income taxes reflect the net tax effects of temporary differences
between the carrying amounts of assets and liabilities for financial reporting
purposes and the amounts used for income tax purposes.  Significant components
of the Company's deferred tax liabilities and assets are as follows:

<TABLE>
<CAPTION>
                                                             December 31,
- ------------------------------------------------------------------------------------
                                                    1997          1996        1995
- ------------------------------------------------------------------------------------
                                                            (in thousands)
<S>                                               <C>           <C>         <C>
Deferred tax assets (liabilities):
 Book over tax amortization of intangibles        $ 1,977       $ 3,127     $ 4,623
 Tax over book depreciation                        (2,976)       (2,558)     (1,749)
 Bad debt allowances                                  503           586         397
 Capital loss carryforwards                           295           802         205
 Other                                              1,281         1,117         949
- ------------------------------------------------------------------------------------
                                                    1,080         3,074       4,425
Deferred tax liabilities                              226           341         181
- ------------------------------------------------------------------------------------
Net deferred tax asset                            $   854       $ 2,733     $ 4,244
====================================================================================
</TABLE>
Capital Loss Carryforwards--The Company has capital loss carryforwards
available for income tax reporting purposes of approximately $856,000 expiring
in 1999 through 2002, which upon recognition, based on current tax rates, may
result in future tax benefits of approximately $295,000.

  A reconciliation of income tax expenses computed at the Federal statutory tax
rate to reported income tax expense is as follows:
<TABLE>
<CAPTION>
                                                        Years ended December 31,
- ------------------------------------------------------------------------------------
                                                     1997          1996        1995
- ------------------------------------------------------------------------------------
                                                             (in thousands)
<S>                                                  <C>           <C>         <C>
Tax at statutory rate                                35.0%         35.0%       35.0%
Non-deductible goodwill amortization                  0.9           0.9         1.5
State income taxes, net of federal tax benefits       3.2           4.0         3.8
Tax-exempt interest                                  (1.3)         (0.9)       (1.2)
Other                                                (0.4)         (0.5)       (0.1)
- ------------------------------------------------------------------------------------
                                                     37.4%         38.5%       39.0%
====================================================================================
</TABLE>
  The provision for income taxes is as follows:


<TABLE> 
<CAPTION> 
                                                         Years ended December 31,
- ------------------------------------------------------------------------------------
                                                    1997          1996        1995
- ------------------------------------------------------------------------------------
                                                            (in thousands)
<S>                                                  <C>           <C>         <C>
Current:
 State                                             $  653        $  681      $  173
 Federal                                            4,145         2,425         328
- ------------------------------------------------------------------------------------
                                                    4,798         3,106         501
- ------------------------------------------------------------------------------------
Deferred:
 State                                                321            49         215
 Federal                                            2,396         1,461       1,265
- ------------------------------------------------------------------------------------
                                                    2,717         1,510       1,480
- ------------------------------------------------------------------------------------
Tax provisions before extraordinary item            7,515         4,616       1,981
Tax benefit of extraordinary item                     (74)         (238)       (130)
- ------------------------------------------------------------------------------------
                                                   $7,441        $4,378      $1,851
====================================================================================
</TABLE>
Income Taxes Paid--Total income taxes paid, net of refunds received, were
$2,937,000, $4,237,000, and $211,000 for the years ended December 31, 1997, 1996
and 1995, respectively.

                                      16
<PAGE>
 
Note 7--Property and Equipment

Property and equipment consists of the following:

<TABLE>
<CAPTION>
                                                               December 31,
- --------------------------------------------------------------------------------
                                                            1997          1996
- --------------------------------------------------------------------------------
                                                              (in thousands)
<S>                                                       <C>           <C>
Land and land improvements                                $ 2,173       $ 2,318
Buildings                                                   8,674         4,560
Medical and surgical equipment                             29,465        23,973
Leasehold improvements                                     10,931        10,432
Furniture and fixtures                                      3,699         2,858
Construction in progress                                      450            26
- --------------------------------------------------------------------------------
                                                          $55,392       $44,167
================================================================================
</TABLE>

     Included in property and equipment is capitalized leased property and
equipment which aggregated $3,053,000 and $603,000 with accumulated depreciation
of $366,000 and $73,000 at December 31, 1997 and 1996, respectively.

Note 8--Accounts Payable and Accrued Expenses

Accounts payable and accrued expenses consist of the following:

<TABLE>
<CAPTION>
 
                                                               December 31,
- --------------------------------------------------------------------------------
                                                            1997          1996
- --------------------------------------------------------------------------------
                                                              (in thousands)
<S>                                                        <C>           <C>
Accounts payable                                           $1,766        $1,837
Accrued payroll                                             3,055         1,884
Accrued rent                                                  997           810
Accrued other                                               2,835         2,250
- --------------------------------------------------------------------------------
                                                           $8,653        $6,781
================================================================================
</TABLE>

Note 9--Disclosure About Fair Value of Financial Instruments

The Company evaluates the carrying amounts of significant classes of financial
instruments on the consolidated balance sheets for disclosure of fair values for
which it is practicable.  The following methods and assumptions were used to
estimate the fair value of each class of financial instruments for which it is
practicable to estimate that value.

     The carrying amounts of cash and cash equivalents, short-term investments,
accounts receivable, other current assets, accounts payable, and accrued
expenses approximate fair value because of the short maturity of those
instruments.  The fair value of the Company's outstanding debt is estimated
based on similar issues or on the current rates offered to the Company for debt
of the same remaining maturities and the carrying value is a reasonable estimate
of its fair market value.

     The fair value of the Company's convertible notes is estimated based on the
current price of the Company's common stock.  The carrying value and estimated
fair value of the Company's convertible notes at December 31, 1997, were $92,000
and $145,000, respectively.

Note 10--Related Party Transactions

The Company leases one of its operating facilities under a long-term non-
cancelable lease arrangement from a partnership controlled by a director of the
Company.  In addition to the minimum annual lease payments, the lease provides
for a percentage rental based on gross receipts subject to certain minimum
exclusions.  Lease payments to this partnership for each of the three years in
the period ended December 31, 1997, 1996 and 1995 were $1,131,000, $979,000, and
$995,000, respectively.  Total future minimum lease payments payable to this
partnership are $2,075,000.

     One director of the Company is an officer and shareholder in a corporation
which provides day-to-day management services at one of the Company's limited
partnership centers.  Management fees paid to this corporation were $201,000,
$186,000, and $163,000 for the years ended December 31, 1997, 1996 and 1995,
respectively.

                                      17
<PAGE>
 
Note 11--Commitments and Contingencies

Employment Agreements--The Company has entered into employment agreements with
certain of its executive officers, which include provisions for salary and
benefits continuation under certain circumstances.

Litigation--The Company is subject to various claims and legal actions which
arise in the ordinary course of business.  The Company has malpractice and other
insurance to protect against such claims or legal actions.  In the opinion of
management, the ultimate resolution of such matters will be adequately covered
by the insurance and will not have a material adverse effect on the Company's
financial position, results of operation or liquidity.

Insurance--The Company, its subsidiaries and affiliated partnership or limited
liability corporations are insured with respect to medical malpractice risks on
a claims-made basis.  There are known claims and incidents that may result in
the assertion of additional claims, as well as claims from unknown incidents
that may be asserted.  Management is not aware of any claims against the Company
which might have a material impact on the Company's financial position.

Contingent Consideration--In connection with the acquisition of surgery center
assets, the Company is contingently obligated to pay an estimated additional
$23.5 million in future years, depending on the achievement of certain financial
and operational objectives by the related surgery centers.  Obligations related
to these contingencies are reflected as increases to goodwill in the period such
contingencies are resolved if conditions and facts permit capitalization.

Debt Guarantees--The Company has directly guaranteed various debt obligations
for certain affiliated companies of $1,068,000 at December 31, 1997.  No
material loss is anticipated by reason of such guarantees.

Note 12--Quarterly Financial Information (Unaudited)
Quarterly financial information for the two years ended December 31, 1997 is
summarized below:

<TABLE>
<CAPTION>
 
                                                                     Quarter
- -------------------------------------------------------------------------------------------
                                                        1st       2nd       3rd      4th
- -------------------------------------------------------------------------------------------
                                                     (in thousands, except per share data)
<S>                                                  <C>       <C>       <C>       <C>
1997
- -------------------------------------------------------------------------------------------
Net revenue                                           $22,116   $24,246   $26,933  $29,337
Income before income taxes and extraordinary item       4,161     5,206     5,014    5,723
Income before extraordinary item                        2,611     3,267     3,134    3,577
Net income                                              2,611     3,267     3,134    3,439
 
Diluted income per common share:
  Income before extraordinary item                    $  0.14   $  0.17   $  0.17  $  0.19
  Extraordinary item                                      --        --        --     (0.01)
- -------------------------------------------------------------------------------------------
  Net Income                                          $  0.14   $  0.17   $  0.17  $  0.18
=========================================================================================== 
 
1996
- -------------------------------------------------------------------------------------------
Net revenue                                           $16,159   $19,752   $20,101  $21,347
Income before income taxes and extraordinary item       2,364     3,037     2,813    3,779
Income before extraordinary item                        1,455     1,838     1,704    2,380
Net income                                              1,455     1,838     1,704    1,917
 
Diluted income per common share:
  Income before extraordinary item                    $  0.11   $  0.13   $  0.12  $  0.14
  Extraordinary item                                      --        --        --     (0.03)
- -------------------------------------------------------------------------------------------
  Net income                                          $  0.11   $  0.13   $  0.12  $  0.11
===========================================================================================
</TABLE>

                                      18
<PAGE>
 
                        Report of Independent Auditors


The Board of Directors and Shareholders
National Surgery Centers, Inc.

We have audited the accompanying consolidated balance sheets of National Surgery
Centers, Inc. and Subsidiaries as of December 31, 1997 and 1996 and the related 
consolidated statements of income, shareholders' equity, and cash flows for each
of the three years in the period ended December 31, 1997. These financial 
statements are the responsibility of the Company's management. Our 
responsibility is to express an opinion on these financial statements based on 
our audits.

     We conducted our audits in accordance with generally accepted auditing 
standards. Those standards require that we plan and perform the audit to obtain 
reasonable assurance about whether the financial statements are free of material
misstatement. An audit includes examining on a test basis, evidence supporting 
the amounts and disclosures in the financial statements. An audit also includes 
assessing the accounting principles used and significant estimates made by 
management, as well as evaluating the overall financial statement presentation. 
We believe that our audits provide a reasonable basis for our opinion.

     In our opinion, the consolidated financial statements referred to above 
present fairly, in all material respects, the consolidated financial position of
National Surgery Centers, Inc. and Subsidiaries at December 31, 1997 and 1996 
and the consolidated results of their operations and their cash flows for each 
of the three years in the period ended December 31, 1997, in conformity with 
generally accepted accounting principles.



                                                        Ernst & Young LLP


February 6, 1998
Chicago, Illinois

                                      19

<PAGE>
 
                                  EXHIBIT 21.1
                          Subsidiaries of the Company

Corporations  (Jurisdiction)
- ----------------------------
Bettom Medical Management, Inc. (Connecticut)
Connecticut Surgical Center, Inc. (Connecticut)
Endoscopy Center Affiliates, Inc. (Delaware)
Eye Micro Surgery Center, Inc. (Montana)
KPSC, Inc. (Washington)
National Surgery Centers - Bakersfield, Inc. (California)
National Surgery Centers - Santa Monica, Inc. (California)
Northern Rockies Surgicenter, Inc. (Montana)
NSC Atlanta, Inc. (Delaware)
NSC Auburn, Inc. (California)
NSC Brownsville, Inc. (Texas)
NSC Channel Islands, Inc. (California)
NSC Connecticut, Inc. (Connecticut)
NSC Dallas, Inc. (Texas)
NSC Edmond, Inc. (Oklahoma)
NSC Elizabethtown, Inc. (Kentucky)
NSC Fayetteville, Inc. (North Carolina)
NSC Greensboro, Inc. doing business as Surgical Center of Greensboro (North
  Carolina)
NSC Greensboro West, Inc. (North Carolina)
NSC Houston, Inc. (Texas)
NSC Kent, Inc. (Ohio)
NSC Lancaster, Inc. (California)
NSC Las Vegas East, Inc. (Nevada)
NSC Las Vegas, Inc. (Nevada)
NSC Manahawkin, Inc. (New Jersey)
NSC Miami, Inc. (Florida)
NSC Midwest City, Inc. (Oklahoma)
NSC Norman, Inc. (Oklahoma)
NSC Oklahoma City, Inc. (Oklahoma)
NSC Phoenix, Inc. (Arizona)
NSC Port St. Lucie, Inc. (Florida)
NSC Provo, Inc. doing business as Provo Surgical Center (Utah)
NSC Sarasota, Inc. (Delaware)
NSC Seattle, Inc. (Washington)
Walk In and Out Surgery Center, Inc. (Kentucky)

Partnerships (Jurisdiction)
- ---------------------------
2121 Surgery Center, Limited Partnership doing business as Surgery Center of
  Santa Monica (California)
Ambulatory Surgical Centre of Miami, Limited Partnership (Florida)
Antelope Valley Surgery Center, Limited Partnership (California)
Auburn Surgical Center, Limited Partnership (California)
Bakersfield Surgery Center Limited Partnership (California)
Brownsville Surgery Center, Limited Partnership doing business as Brownsville
  Surgicare (Texas)


<PAGE>
 
Channel Islands Surgical Services, Limited Partnership (California)
Channel Islands Surgicenter, Limited Partnership (California)
Day Surgery Center, Ltd. (Florida)
Desert Surgery Center, Limited Partnership (Nevada)
Endoscopy West, General Partnership (California)
Fayetteville Ambulatory Surgery Center, Limited Partnership (North Carolina)
Fort Worth Endoscopy Center, General Partnership (California)
Greater Long Beach Endoscopy Center, General Partnership (California)
Greensboro Specialty Surgery Center, Limited Partnership (North Carolina)
Kitsap Peninsula Surgery Center Limited Partnership doing business as Olympic
  Ambulatory Surgery Center (Washington)
Laser Northwest, Ltd. (Washington)
Mid-Peninsula Endoscopy Center, General Partnership (California)
Newport Beach Endoscopy Center, General Partnership (California)
North Atlanta Endoscopy Center, Limited Partnership (Georgia)
Northeast Surgery Center, Limited Partnership (Texas)
NSCSM, Ltd. (California)
Physicians of Edmond, General Partnership (Oklahoma)
Physicians Surgical Center Limited Partnership (Oklahoma)
San Diego Endoscopy Center, General Partnership (California)
San Mateo Endoscopy Center, General Partnership doing business as Mid-Peninsula
  Endoscopy Center (California)
Sarasota Endoscopy Center, Limited Partnership (Georgia)
Seattle Surgery Center, Limited Partnership (Washington)
Somerset Surgery Center, Limited Partnership (Kentucky)
South Bay Endoscopy Center, General Partnership (California)
Southwest Surgical Center of Bakersfield, Limited Partnership (California)
Suburban Endoscopy Center, General Partnership (Illinois)
Surgical Center of Elizabethtown, Limited Partnership (Kentucky)
Thousand Oaks Endoscopy Center, General Partnership (California)
Valley View Surgery Center, Limited Partnership (Nevada)
Western Reserve Surgery Center, Limited Partnership (Ohio)
Westside Surgery Center, Ltd. (Texas)

Limited Liability Companies (Jurisdiction)
- ------------------------------------------
Cape Fear Laser Eye Center, Limited Liability Company (North Carolina)
Heritage Park Surgery Center, Limited Liability Company (Oklahoma)
Medical Plaza Endoscopy Unit, Limited Liability Company (Oklahoma)
Southern Ocean Surgery Center, Limited Liability Company (New Jersey)
Surgery Center of Edmond, Limited Liability Company (Oklahoma)
Surgical Hospital of South Oklahoma City, Limited Liability Company (Oklahoma)
Utah County Management Service, Limited Liability Company (Utah)

Limited Liability Partnerships
- ------------------------------
Physicians of Edmond, Limited Liability Partnership (Oklahoma)


                                       2


<PAGE>
 
                                 EXHIBIT 23.1


CONSENT OF INDEPENDENT ACCOUNTANTS
- ----------------------------------

We consent to the incorporation by reference in this Form 10-K of National
Surgery Centers, Inc. of our report dated February 6, 1998, included in the 1997
Annual Report to Shareholders of National Surgery Centers, Inc.

Our audits also included the financial statement schedule of National Surgery
Centers, Inc. listed in Item 14(a).  This schedule is the responsibility of the
Company's management.  Our responsibility is to express an opinion based on our
audits.  In our opinion, the financial statement schedule referred to above,
when considered in relation to the basic financial statements taken as a whole,
presents fairly in all material respects the information set forth therein.



                                           Ernst & Young
 

February 6, 1998
Chicago, Illinois



<TABLE> <S> <C>

<PAGE>
 
<ARTICLE> 5
<LEGEND> This schedule contains summary financial information extracted from 
the financial statements of National Surgery Centers for the year ended December
31, 1997 and is qualified in its entirety by reference to such financial 
statements. 
</LEGEND>
       
<S>                             <C>                       <C>                      <C> 
<PERIOD-TYPE>                   YEAR                      YEAR                     YEAR
<FISCAL-YEAR-END>                         DEC-31-1997               DEC-31-1996              DEC-31-1995
<PERIOD-START>                            JAN-01-1997               JAN-01-1996              JAN-01-1995
<PERIOD-END>                              DEC-31-1997               DEC-31-1996              DEC-31-1995
<CASH>                                     14,919,000                 9,721,000               14,653,000
<SECURITIES>                               17,700,000                41,614,000                8,190,000
<RECEIVABLES>                              23,368,000                14,946,000                9,931,000
<ALLOWANCES>                                4,027,000                 1,723,000                1,167,000
<INVENTORY>                                 3,838,000                 2,548,000                2,154,000
<CURRENT-ASSETS>                           57,490,000                70,213,000               34,601,000
<PP&E>                                     55,392,000                44,167,000               32,310,000
<DEPRECIATION>                             16,047,000                10,805,000                6,758,000
<TOTAL-ASSETS>                            169,951,000               142,252,000               82,287,000
<CURRENT-LIABILITIES>                      11,324,000                10,245,000               12,456,000
<BONDS>                                    10,466,000                 6,990,000               17,005,000
                               0                         0                        0
                                         0                         0                        0
<COMMON>                                      185,000                   119,000                   56,000
<OTHER-SE>                                136,610,000               117,550,000               48,136,000
<TOTAL-LIABILITY-AND-EQUITY>              169,951,000               142,252,000               82,287,000
<SALES>                                   102,632,000                77,359,000               53,165,000
<TOTAL-REVENUES>                          102,632,000                77,359,000               53,165,000
<CGS>                                      75,712,000                60,154,000               42,928,000
<TOTAL-COSTS>                              75,712,000                60,154,000               42,928,000
<OTHER-EXPENSES>                            5,791,000                 2,596,000                1,018,000
<LOSS-PROVISION>                                    0                         0                        0
<INTEREST-EXPENSE>                          1,025,000                 2,616,000                4,139,000
<INCOME-PRETAX>                            20,104,000                11,993,000                5,157,000
<INCOME-TAX>                                7,515,000                 4,616,000                1,981,000
<INCOME-CONTINUING>                        12,589,000                 7,377,000                3,099,000
<DISCONTINUED>                                      0                         0                        0
<EXTRAORDINARY>                               138,000                   463,000                  253,000
<CHANGES>                                           0                         0                        0
<NET-INCOME>                               12,451,000                 6,914,000                2,846,000
<EPS-PRIMARY>                                    0.69                      0.50                     0.35
<EPS-DILUTED>                                    0.66                      0.47                     0.35
        

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