INTEGRATED HEALTH SERVICES INC
S-3, 1997-12-11
SKILLED NURSING CARE FACILITIES
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   As Filed with the Securities and Exchange Commission on December 11, 1997
                                                     REGISTRATION NO. 333-
    
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
                      SECURITIES AND EXCHANGE COMMISSION
                            WASHINGTON, D.C. 20549
                               ----------------
   
                                   FORM S-3
    
                            REGISTRATION STATEMENT
                                     UNDER
                          THE SECURITIES ACT OF 1933
                               ----------------
                       INTEGRATED HEALTH SERVICES, INC.
            (Exact name of registrant as specified in its charter)



<TABLE>
<S>                                               <C>
                             DELAWARE                          23-2428312
               (State or other jurisdiction of     (I.R.S. Employer Identification No.)
               incorporation or organization)
</TABLE>

                               ----------------
     10065 Red Run Boulevard, Owings Mills, Maryland 21117, (410) 998-8400
(Address, including zip code, and telephone number, including area code, of
                   registrant's principal executive offices)
                               ----------------
    Marshall A. Elkins, Esq., Executive Vice President and General Counsel
Integrated Health Services, Inc., 10065 Red Run Boulevard, Owings Mills,
                        Maryland 21117, (410) 998-8400

(Name, address, including zip code, and telephone number, including area code,
                             of agent for service)
                               ----------------
Copies of all communications, including all communications sent to the agent
                        for service, should be sent to:



   
<TABLE>
<S>                                       <C>
                 Carl E. Kaplan, Esq.                     Leslie A. Glew, Esq.
             Fulbright & Jaworski L.L.P.   Senior Vice President and Associate General Counsel
                    666 Fifth Avenue                Integrated Health Services, Inc.
              New York, New York 10103                  10065 Red Run Boulevard
                     (212) 318-3000                   Owings Mills, Maryland 21117
                  (212) 752-5958(FAX)                        (410) 998-8400
                                                          (410) 998-8500(FAX)
</TABLE>
    

   
                               ----------------
       Approximate Date of Commencement of Proposed Sale to the Public:
  From time to time after the effective date of this Registration Statement.
                               ----------------
     If the only securities being registered on this Form are being offered
pursuant to dividend or interest reinvestment plans, please check the following
box: [ ]

     If any of the securities being registered on this Form are to be offered
on a delayed or continuous basis pursuant to Rule 415 under the Securities Act
of 1933, other than securities offered only in connection with dividend or
interest reinvestment plans, check the following box: [X]

     If this Form is filed to register additional securities for an offering
pursuant to Rule 462(b) under the Securities Act, please check the following
box and list the Securities Act registration statement number of the earlier
effective registration statement for the same offering. [ ]

     If this Form is a post-effective amendment filed pursuant to Rule 462(c)
under the Securities Act, check the following box and list the Securities Act
registration statement number of the earlier effective registration statement
for the same offering. [ ]

     If delivery of the prospectus is expected to be made pursuant to Rule 434,
please check the following box: [ ]
                               ----------------
                        CALCULATION OF REGISTRATION FEE
- --------------------------------------------------------------------------------
    
<PAGE>
   
<TABLE>
<CAPTION>
         TITLE OF EACH CLASS OF           AMOUNT OF SHARES
      SECURITIES TO BE REGISTERED         TO BE REGISTERED
<S>                                      <C>
Common Stock, $.001 par value per share
 (including the Preferred Stock Purchase
 Rights)(2)  ...........................     1,813,434
</TABLE>


<TABLE>
<CAPTION>
         TITLE OF EACH CLASS OF           PROPOSED MAXIMUM OFFERING   PROPOSED MAXIMUM AGGREGATE      AMOUNT OF
      SECURITIES TO BE REGISTERED            PRICE PER SHARE(1)           OFFERING PRICE(1)        REGISTRATION FEE
<S>                                      <C>                         <C>                          <C>
Common Stock, $.001 par value per share
 (including the Preferred Stock Purchase
 Rights)(2)  ...........................           $29.875                  $54,176,340.75           $15,982.02
</TABLE>
    

   
- --------------------------------------------------------------------------------
(1) Pursuant to Rule 457(c), the proposed maximum offering price per share and
    proposed maximum aggregate offering price have been calculated on the
    basis of the average of the high and low sale prices of the Common Stock
    as reported on the New York Stock Exchange on December 9, 1997.

(2) The Preferred Stock Purchase Rights, which are attached to the shares of
    IHS Common Stock being registered, will be issued for no additional
    consideration; no additional registration fee is required.
    


     THE REGISTRANT HEREBY AMENDS THIS REGISTRATION STATEMENT ON SUCH DATE OR
DATES AS MAY BE NECESSARY TO DELAY ITS EFFECTIVE DATE UNTIL THE REGISTRANT
SHALL FILE A FURTHER AMENDMENT WHICH SPECIFICALLY STATES THAT THIS REGISTRATION
STATEMENT SHALL THEREAFTER BECOME EFFECTIVE IN ACCORDANCE WITH SECTION 8(A) OF
THE SECURITIES ACT OF 1933 OR UNTIL THE REGISTRATION STATEMENT SHALL BECOME
EFFECTIVE ON SUCH DATE AS THE COMMISSION, ACTING PURSUANT TO SECTION 8(A), MAY
DETERMINE.
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------


<PAGE>

   
                 SUBJECT TO COMPLETION, DATED DECEMBER 11, 1997
    
PROSPECTUS



   
                                1,813,434 SHARES
    




                        INTEGRATED HEALTH SERVICES, INC.


                                  COMMON STOCK

                                  ---------
   
     This Prospectus relates to 1,813,434 shares (the "Shares") of Common Stock,
par value $0.001 per share  (together with the Preferred  Stock Purchase  Rights
associated therewith,  the "Common Stock"), of Integrated Health Services,  Inc.
("IHS" or the  "Company")  which are being  offered for sale by certain  selling
stockholders  (the  "Selling  Stockholders").  See "Selling  Stockholders."  The
Company's  Common Stock is traded on the New York Stock Exchange  ("NYSE") under
the symbol "IHS." On December 9, 1997, the closing price of the Common Stock, as
reported in the NYSE consolidated reporting system, was $29.8125 per share.     

     The Company will not receive any of the  proceeds  from sales of the Shares
by the Selling Stockholders.  The Shares may be offered from time to time by the
Selling  Stockholders (and their donees and pledgees) through ordinary brokerage
transactions,   in  negotiated  transactions  or  otherwise,  at  market  prices
prevailing  at  the  time  of  sale  or  at  negotiated  prices.  See  "Plan  of
Distribution."

     The Selling  Stockholders may be deemed to be  "Underwriters" as defined in
the  Securities  Act  of  1933,  as  amended  (the  "Securities  Act").  If  any
broker-dealers  are used to effect sales, any commissions paid to broker-dealers
and, if  broker-dealers  purchase any of the Shares as  principals,  any profits
received by such broker-dealers on the resale of the Shares, may be deemed to be
underwriting discounts or commissions under the Securities Act. In addition, any
profits  realized by the Selling  Stockholders  may be deemed to be underwriting
commissions. All costs, expenses and fees in connection with the registration of
the  Shares  will  be  borne  by the  Company.  Brokerage  commissions,  if any,
attributable to the sale of the Shares will be borne by the Selling Stockholders
(or their donees and pledgees).


                                  ---------
   
     SEE "RISK FACTORS," WHICH BEGINS ON PAGE 7 OF THIS PROSPECTUS,  FOR CERTAIN
INFORMATION THAT SHOULD BE CONSIDERED BY PROSPECTIVE INVESTORS.
    
                                  ---------

THESE  SECURITIES  HAVE NOT BEEN APPROVED OR  DISAPPROVED  BY THE SECURITIES AND
EXCHANGE  COMMISSION OR ANY STATE  SECURITIES  COMMISSION NOR HAS THE SECURITIES
AND  EXCHANGE  COMMISSION  OR ANY STATE  SECURITIES  COMMISSION  PASSED UPON THE
ACCURACY OR ADEQUACY OF THIS PROSPECTUS. ANY REPRESENTATION TO THE CONTRARY IS A
CRIMINAL OFFENSE.

                                   ---------
   
                 The date of this Prospectus is December , 1997

Information   contained  herein  is  subject  to  completion  or  amendment.   A
registration  statement  relating  to these  securities  has been filed with the
Securities  and Exchange  Commission.  These  securities may not be sold nor may
offers to buy be accepted prior to the time the registration  statement  becomes
effective.  This  prospectus  shall  not  constitute  an  offer  to  sell or the
solicitation of an offer to buy nor shall there be any sale of these  securities
in any State in which such offer,  solicitation  or sale would be unlawful prior
to registration or qualification under the securities laws of any such State.
    


<PAGE>

                             AVAILABLE INFORMATION

     The Company is subject to the informational  requirements of the Securities
Exchange  Act of 1934,  as amended  (the  "Exchange  Act"),  and, in  accordance
therewith,  files  reports,  proxy  statements  and other  information  with the
Securities  and Exchange  Commission  (the  "Commission").  The  reports,  proxy
statements and other information filed by the Company with the Commission can be
inspected and copied at the public  reference  facilities  of the  Commission at
Room  1024,  450  Fifth  Street,  N.W.,  Washington,  D.C.  20549,  and  at  the
Commission's Regional Offices at 7 World Trade Center, 13th Floor, New York, New
York 10048, and Citicorp Center, 500 West Madison Street,  Suite 1400,  Chicago,
Illinois  60661.  Copies of such  material also may be obtained by mail from the
Public Reference Section of the Commission,  Room 1024, 450 Fifth Street,  N.W.,
Washington,  D.C.  20549,  at  prescribed  rates.  In addition,  reports,  proxy
materials and other  information  concerning the Company may be inspected at the
offices of the NYSE, 20 Broad Street,  New York,  New York 10005.  Additionally,
the Commission maintains a Web site on the Internet that contains reports, proxy
and information statements and other information regarding registrants that file
electronically with the Commission and that is located at http://www.sec.gov.

     This Prospectus  constitutes a part of a Registration Statement on Form S-3
(herein,  together  with  all  amendments  and  exhibits,  referred  to  as  the
"Registration  Statement")  filed by the Company with the  Commission  under the
Securities  Act. This  Prospectus  does not contain all of the  information  set
forth in the  Registration  Statement,  certain  parts of which are  omitted  in
accordance  with the  rules  and  regulations  of the  Commission.  For  further
information  with  respect to the Company  and the Common  Stock,  reference  is
hereby  made  to  the  Registration   Statement.   Statements  contained  herein
concerning the  provisions of any contract,  agreement or other document are not
necessarily complete, and in each instance reference is made to the copy of such
contract,  agreement or other document  filed as an exhibit to the  Registration
Statement  or  otherwise  filed  with the  Commission.  Each such  statement  is
qualified  in its  entirety  by  such  reference.  Copies  of  the  Registration
Statement  together  with  exhibits  may  be  inspected  at the  offices  of the
Commission as indicated  above without charge and copies thereof may be obtained
therefrom upon payment of a prescribed fee.

     Private  Securities  Litigation  Reform  Act Safe  Harbor  Statement.  This
Prospectus  (including the documents  incorporated by reference herein) contains
certain  forward-looking  statements  (as such term is  defined  in the  Private
Securities  Litigation Reform Act of 1995) and information  relating to IHS that
are based on the beliefs of the management of IHS, as well as  assumptions  made
by and  information  currently  available to the management of IHS. When used in
this  Prospectus,  the words  "estimate,"  "project,"  "believe,"  "anticipate,"
"intend,"   "expect"   and  similar   expressions   are   intended  to  identify
forward-looking  statements.  Such  statements  reflect the current views of IHS
with  respect  to future  events  and are  subject  to risks and  uncertainties,
including  those discussed under "Risk Factors," that could cause actual results
to differ materially from those contemplated in such forward-looking statements.
Readers  are  cautioned  not to place undue  reliance  on these  forward-looking
statements,  which speak only as of the date hereof.  IHS does not undertake any
obligation to publicly release any revisions to these forward-looking statements
to reflect  events or  circumstances  after the date  hereof or to  reflect  the
occurrence of unanticipated events.



                                       2
<PAGE>

                INCORPORATION OF CERTAIN DOCUMENTS BY REFERENCE

     The information in the following documents filed by IHS with the Commission
(File No. 1-12306)  pursuant to the Exchange Act is incorporated by reference in
this Prospectus:

       (a) The Company's  Annual Report on Form 10-K for the year ended December
   31, 1996;

       (b) The  Company's  Quarterly  Report on Form 10-Q for the quarter  ended
   March 31, 1997;

       (c) The  Company's  Quarterly  Report on Form 10-Q for the quarter  ended
   June 30, 1997;

       (d) The  Company's  Quarterly  Report on Form 10-Q for the quarter  ended
   September 30, 1997;

       (e) The  Company's  Current  Report on Form 8-K dated  October  17,  1996
   reporting the acquisition of First American Health Care of Georgia,  Inc., as
   amended by Form 8-K/A filed  November  26, 1996 and  Amendment  No. 1 to Form
   8-K/A filed July 11, 1997;
   
       (f) The  Company's  Current  Report on Form 8-K dated  October  19,  1996
   reporting  the  execution  of the  Agreement  and Plan of Merger  (the "Coram
   Merger  Agreement")  among the Company,  IHS Acquisition  XIX, Inc. and Coram
   Healthcare  Corporation  ("Coram"),  as amended by Form 8-K/A filed April 11,
   1997, reporting the termination of the Coram Merger Agreement;
    
       (g) The Company's Current Report on Form 8-K dated May 23, 1997 reporting
   the  Company's  agreement  to issue  privately  an  aggregate of $450 million
   principal amount of 9 1/2% Senior Subordinated Notes due 2007;

       (h) The Company's Current Report on Form 8-K dated May 30, 1997 reporting
   (i) the Company's  issuance of an aggregate of $450 million  principal amount
   of 9  1/2%  Senior  Subordinated  Notes  due  2007  and  (ii)  the  Company's
   acceptance for payment of an aggregate of  $114,975,000  principal  amount of
   its 9 5/8% Senior  Subordinated  Notes due 2002, Series A and an aggregate of
   $99,893,000  principal  amount of its 10 3/4% Senior  Subordinated  Notes due
   2004 pursuant to cash tender offers;

   
       (i) The Company's Current Report on Form 8-K dated July 6, 1997 reporting
   the  execution of the  Agreement  and Plan of Merger  among the Company,  IHS
   Acquisition XXIV, Inc. and RoTech Medical Corporation
   ("RoTech");

       (j) The  Company's  Current  Report on Form 8-K dated  September 9,  1997
   reporting  the  Company's  agreement to issue  privately an aggregate of $500
   million  principal  amount of its 9 1/4% Senior  Subordinated  Notes due 2008
   (the "9 1/4% Senior Notes");
    
       (k) The Company's Current Report on Form 8-K dated September 15, 1997, as
   amended, reporting the Company's $1.75 billion revolving credit and term loan
   facility (the "New Credit Facility");
   
       (l) The Company's Current Report on Form 8-K dated September 25, 1997, as
   amended, reporting the Company's  acquisition  of Community  Care of America,
   Inc. and the Lithotripsy Division of Coram;

       (m) The Company's  Current  Report on Form 8-K dated October 21, 1997, as
   amended, reporting the Company's acquisition of RoTech;

       (n) The Company's  Current Report on Form 8-K dated November  3, 1997, as
   amended, reporting the Company's  agreement to purchase 139 owned,  leased or
   managed long-term care facilities,  12 specialty  hospitals and certain other
   businesses from HEALTHSOUTH Corporation;
    

       (o) The description of the Company's  Common Stock contained in Item 1 of
   the Company's Registration Statement on Form 8-A dated September 1, 1993; and

       (p) The  description of the Company's  Preferred  Stock  Purchase  Rights
   contained in Item 1 of the Company's Registration Statement on Form 8-A dated
   September 28, 1995.


                                       3
<PAGE>



     All documents filed by the Company with the Commission pursuant to Sections
13(a),  13(c), 14 or 15(d) of the Exchange Act after the date of this Prospectus
and prior to the filing of a  post-effective  amendment which indicates that all
Shares  offered have been sold or which  deregisters  all Shares then  remaining
unsold shall be deemed to be incorporated by reference in this Prospectus and to
be a part  hereof  from the date of  filing  of such  documents.  Any  statement
contained herein or in a previously filed document  incorporated or deemed to be
incorporated  by reference  herein shall be deemed to be modified or  superseded
for purposes of this Prospectus to the extent that a statement  contained herein
or in any other  subsequently  filed  document which also is or was deemed to be
incorporated by reference herein modifies or supersedes such statement. Any such
statement so modified or superseded  shall not be deemed,  except as so modified
or superseded, to constitute a part of this Prospectus.

     The information relating to IHS contained in this Prospectus should be read
together with the information in the documents incorporated by reference.

     THIS PROSPECTUS INCORPORATES BY REFERENCE DOCUMENTS WHICH ARE NOT PRESENTED
HEREIN OR  DELIVERED  HEREWITH.  SUCH  DOCUMENTS  (OTHER  THAN  EXHIBITS TO SUCH
DOCUMENTS UNLESS SUCH EXHIBITS ARE  SPECIFICALLY  INCORPORATED BY REFERENCE) ARE
AVAILABLE  WITHOUT  CHARGE TO ANY PERSON TO WHOM THIS  PROSPECTUS  IS DELIVERED,
UPON WRITTEN OR ORAL REQUEST.  REQUESTS FOR SUCH DOCUMENTS SHOULD BE DIRECTED TO
INTEGRATED  HEALTH  SERVICES,  INC.,  10065  RED RUN  BOULEVARD,  OWINGS  MILLS,
MARYLAND  21117,  ATTENTION:  MARC B. LEVIN,  EXECUTIVE VICE  PRESIDENT-INVESTOR
RELATIONS, TELEPHONE: (410) 998-8400.


                                       4
<PAGE>


                                  THE COMPANY
   
     Integrated  Health  Services,  Inc.  ("IHS" or the "Company") is one of the
nation's leading providers of post-acute healthcare services. Post-acute care is
the  provision of a continuum of care to patients  following  discharge  from an
acute care hospital.  IHS' post-acute care services  include subacute care, home
care, skilled nursing facility care and inpatient and outpatient rehabilitation,
hospice and  diagnostic  services.  The  Company's  post-acute  care  network is
designed to address the fact that the cost containment  measures  implemented by
private  insurers and managed care  organizations  and limitations on government
reimbursement of hospital costs have resulted in the discharge from hospitals of
many  patients  who continue to require  medical and  rehabilitative  care.  The
Company's  post-acute  healthcare  system is intended to provide  cost-effective
continuity  of care for its patients in multiple  settings and enable  payors to
contract  with one  provider  to  provide  all of a  patient's  needs  following
discharge from acute care  hospitals.  The Company  believes that its post-acute
care network can be extended beyond post-acute care to also provide  "pre-acute"
care,  i.e.,  services to patients  which reduce the  likelihood of a need for a
hospital stay. IHS' post-acute care network currently  consists of approximately
1,900 service locations in 47 states and the District of Columbia.
    
     The Company's post-acute care network strategy is to provide cost-effective
continuity of care for its patients in multiple  settings,  using geriatric care
facilities  as  platforms  to provide a wide  variety of  subacute  medical  and
rehabilitative  services  more  typically  delivered in the acute care  hospital
setting and using home  healthcare to provide  those medical and  rehabilitative
services which do not require  24-hour  monitoring.  To implement its post-acute
care network  strategy,  the Company has focused on (i)  expanding  the range of
home healthcare and related services it offers to patients  directly in order to
provide patients with a continuum of care throughout  their recovery,  to better
control  costs and to meet the growing  desire by payors for one-stop  shopping;
(ii)  developing  market  concentration  for its  post-acute  care  services  in
targeted  states  due  to  increasing  payor  consolidation  and  the  increased
preference of payors,  physicians and patients for dealing with only one service
provider;  and (iii)  developing  subacute  care  units.  Given  the  increasing
importance of managed care in the healthcare  marketplace and the continued cost
containment  pressures from Medicare,  Medicaid and private payors, IHS has been
restructuring its operations to enable IHS to focus on obtaining  contracts with
managed care organizations and to provide capitated  services.  IHS' strategy is
to become a preferred  or  exclusive  provider of  post-acute  care  services to
managed care organizations and other payors.

     In  implementing  its  post-acute  care network  strategy,  the Company has
recently focused on expanding its home healthcare  services to take advantage of
healthcare payors' increasing focus on having healthcare  provided in the lowest
cost  setting  possible,  recent  advances  in  medical  technology  which  have
facilitated the delivery of medical services in alternative  sites and patients'
desires to be treated  at home.  Consistent  with the  Company's  strategy,  the
Company in October  1996  acquired  (the  "First  American  Acquisition")  First
American Health Care of Georgia,  Inc.  ("First  American"),  a provider of home
health services,  principally  home nursing,  in 21 states,  primarily  Alabama,
California,  Florida,  Georgia,  Michigan,  Pennsylvania  and Tennessee.  IHS in
October 1997 acquired RoTech Medical Corporation ("RoTech"),  a provider of home
healthcare  products and services,  with an emphasis on home  respiratory,  home
medical  equipment and infusion  therapy,  principally  to patients in non-urban
areas (the "RoTech Acquisition"). In October 1997, IHS also acquired (the "Coram
Lithotripsy  Acquisition")  the  lithotripsy  division  (the "Coram  Lithotripsy
Division")  of  Coram,  which  provides   lithotripsy   services  and  equipment
maintenance  in 180  locations  in 18  states,  in order to  expand  the  mobile
diagnostic  treatment  and  services  it offers to  patients,  payors  and other
providers.  Lithotripsy is a non-invasive technique that utilizes shock waves to
disintegrate  kidney stones.  IHS intends to use the home healthcare setting and
the delivery  franchise of its home healthcare  branch and agency network to (i)
deliver  sophisticated care, such as skilled nursing care, home infusion therapy
and rehabilitation, outside the hospital or nursing home; (ii) serve as an entry
point for patients into the IHS  post-acute  care  network;  and (iii) provide a
cost-effective  site for case  management  and patient  direction. 
   
     IHS has also continued to expand its post-acute  care network by increasing
the number of facilities it operates or manages. In September 1997, IHS acquired
Community Care of America,  Inc.  ("CCA"),  which develops and operates  skilled
nursing facilities in medically underserved rural communities (the
    

                                       5
<PAGE>


"CCA  Acquisition").  IHS  believes  that CCA will broaden its  post-acute  care
network to include more rural markets and will complement its existing home care
locations  in rural  markets  as well as  RoTech's  business.  In  addition,  in
November   1997,   IHS   agreed  to   acquire   from   HEALTHSOUTH   Corporation
("HEALTHSOUTH")  139 owned,  leased or managed  long-term care facilities and 12
specialty  hospitals,  as well as a contract  therapy business having over 1,000
contracts and an institutional  pharmacy business serving  approximately  38,000
beds (the "Proposed Facility Acquisition").

     The  Company  provides   subacute  care  through  medical  specialty  units
("MSUs"),  which  are  typically  20 to 75 bed  specialty  units  with  physical
identities,   specialized  medical  technology  and  staffs  separate  from  the
geriatric  care  facilities  in which they are  located.  MSUs are  designed  to
provide comprehensive medical services to patients who have been discharged from
acute  care  hospitals  but  who  still  require  subacute  or  complex  medical
treatment.  The levels and quality of care  provided in the  Company's  MSUs are
similar to those provided in the hospital but at per diem treatment  costs which
the Company  believes  are  generally  30% to 60% below the cost of such care in
acute care  hospitals.  Because of the high level of specialized  care provided,
the  Company's  MSUs  generate  substantially  higher net revenue and  operating
profit per patient day than traditional geriatric care services.

     The Company presently  operates 216 geriatric care facilities (169 owned or
leased and 47 managed), including the facilities acquired in the CCA Acquisition
(of which 19 facilities are being held for sale), and 158 MSUs located within 84
of these facilities.  Specialty medical services revenues, which include all MSU
charges, all revenue from providing rehabilitative  therapies,  pharmaceuticals,
medical supplies and durable medical equipment to all its patients,  all revenue
from its  Alzheimer's  programs and all revenue from its  provision of pharmacy,
rehabilitation  therapy,  home healthcare,  hospice care and similar services to
third-parties, constituted approximately 57%, 65% and 70% of net revenues during
the years ended December 31, 1994, 1995 and 1996, respectively. The Company also
offers a wide range of basic medical  services as well as a comprehensive  array
of respiratory, physical, speech, occupational and physiatric therapy in all its
geriatric care facilities.  For the year ended December 31, 1996,  approximately
17%  of  IHS'   revenues  were  derived  from  home  health  and  hospice  care,
approximately  53% were derived  from  subacute  and other  ancillary  services,
approximately  27%  were  derived  from  basic  nursing  home  services  and the
remaining approximately 3% were derived from management and other services. On a
pro forma basis after giving effect to the acquisition of First American and the
RoTech Acquisition,  for the year ended December 31, 1996,  approximately 44% of
IHS' revenues were derived from home health and hospice care,  approximately 36%
were derived from subacute and other ancillary services,  approximately 18% were
derived  from  traditional   basic  nursing  home  services  and  the  remaining
approximately 2% were derived from management and other services.

     Integrated  Health  Services,  Inc.  was  incorporated  in March  1986 as a
Pennsylvania  corporation and reorganized as a Delaware  corporation in November
1986. IHS' principal  executive  offices are located at 10065 Red Run Boulevard,
Owings Mills, Maryland 21117 and its telephone number is (410) 998-8400.  Unless
the context  indicates  otherwise,  the term "IHS"  includes  Integrated  Health
Services, Inc. and its subsidiaries.


                                       6
<PAGE>


                                 RISK FACTORS

     In addition to the other  information  in this  Prospectus,  the  following
factors  should be  considered  carefully  in  evaluating  the  Company  and its
business  before  purchasing  the shares of Common Stock  offered  hereby.  This
Prospectus  contains,  in addition to  historical  information,  forward-looking
statements that involve risks and  uncertainties.  The Company's  actual results
could  differ  materially.  Factors  that  could  cause  or  contribute  to such
differences  include,  but are not limited to, those discussed below, as well as
those discussed elsewhere in this Prospectus.


RISKS RELATED TO SUBSTANTIAL INDEBTEDNESS
   
     The Company's  indebtedness is substantial in relation to its stockholders'
equity.  At September 30, 1997,  IHS' total long-term  debt,  including  current
portion,  accounted  for  77.8%  of  its  total  capitalization.  IHS  also  has
significant lease  obligations with respect to the facilities  operated pursuant
to long-term leases, which aggregated  approximately $200.3 million at September
30,  1997.  For the year  ended  December  31,  1996 and the nine  months  ended
September 30, 1997,  the Company's rent expense was $77.8 million ($84.5 million
on a pro forma basis after giving effect to the First American Acquisition,  the
sale by IHS of a majority interest in its assisted living services subsidiary in
October 1996 (the "ILC Offering"),  the sale by IHS of its pharmacy  division in
July 1996 (the "Pharmacy  Sale"),  the CCA  Acquisition,  the Coram  Lithotripsy
Acquisition,  the RoTech Acquisition and certain other acquisitions  consummated
in 1996 and 1997) and $75.3  million  ($81.6  million on a pro forma basis after
giving effect to the CCA Acquisition,  the Coram  Lithotripsy  Acquisition,  the
RoTech  Acquisition  and  certain  other  acquisitions   consummated  in  1997),
respectively.  In addition,  IHS is obligated  to pay up to an  additional  $155
million in respect of the  acquisition  of First  American  during  2000 to 2004
under  certain  circumstances,  of which  $36.1  million  has been  recorded  at
September 30, 1997.  The Company's  strategy of expanding its specialty  medical
services and growing through  acquisitions may require additional  borrowings in
order to finance working capital, capital expenditures and the purchase price of
any acquisitions.  The degree to which the Company is leveraged,  as well as its
rent expense, could have important consequences to stockholders,  including: (i)
IHS' ability to obtain  additional  financing in the future for working capital,
capital  expenditures,   acquisitions  or  general  corporate  purposes  may  be
impaired,  (ii) a substantial  portion of IHS' cash flow from  operations may be
dedicated to the payment of principal and interest on its  indebtedness and rent
expense,  thereby reducing the funds available to IHS for its operations,  (iii)
certain of IHS'  borrowings  bear, and will continue to bear,  variable rates of
interest,  which expose IHS to increases in interest rates,  and (iv) certain of
IHS' indebtedness contains financial and other restrictive covenants,  including
those  restricting  the incurrence of additional  indebtedness,  the creation of
liens,  the payment of dividends  and sales of assets and  imposing  minimum net
worth  requirements.  In addition,  IHS' leverage may also adversely affect IHS'
ability to respond to changing business and economic  conditions or continue its
growth strategy.  There can be no assurance that IHS' operating  results will be
sufficient  for the  payment of IHS'  indebtedness.  If IHS were  unable to meet
interest,  principal or lease payments, or satisfy financial covenants, it could
be required to seek  renegotiation  of such payments and/or  covenants or obtain
additional  equity or debt financing.  If additional funds are raised by issuing
equity securities, the Company's stockholders may experience dilution.  Further,
such equity  securities  may have rights,  preferences  or privileges  senior to
those of the Common  Stock.  To the  extent IHS  finances  its  activities  with
additional  debt,  IHS may become  subject to certain  additional  financial and
other  covenants that may restrict its ability to pursue its growth strategy and
to pay  dividends on the Common Stock.  There can be no assurance  that any such
efforts would be successful or timely or that the terms of any such financing or
refinancing  would be  acceptable  to IHS.  See "--  Risks  Related  to  Capital
Requirements."
    
     In  connection  with the  offering of the 9 1/4% Senior  Notes,  Standard &
Poors  ("S&P")   confirmed  its  B  rating  of  IHS'  other   subordinated  debt
obligations,  but with a negative outlook, and assigned the same rating to the 9
1/4% Senior  Notes.  S&P stated  that the  Company's  speculative-grade  ratings
reflect the  Company's  aggressive  transition  toward  becoming a  full-service
alternate-site  healthcare  provider,  and its limited cash flow relative to its
heavy debt burden.  S&P noted that IHS would be greatly  challenged  to control,
integrate  and  further  expand  operations  that were  only a quarter  of their
current  size just three years ago,  and also noted the  continuing  uncertainty
with regard to the adequacy of reimburse-


                                       7
<PAGE>


ment from government  sponsored programs for the indigent and elderly.  S&P also
noted that there is the potential that a large  debt-financed  acquisition could
lead to a ratings  downgrade.  In November 1997, S&P placed the Company's senior
credit and subordinated  debt ratings on CreditWatch with negative  implications
due to the Proposed Facility Acquisition. In connection with the offering of the
9 1/4% Senior Notes, Moody's Investors Service ("Moody's")  downgraded to B2 the
Company's other senior subordinated debt obligations, but noted that the outlook
for the rating was  stable,  and  assigned  the new rating to the 9 1/4%  Senior
Notes.  Moody's stated that the rating action reflects Moody's concern about the
Company's  continued  rapid growth through  acquisitions,  which has resulted in
negative  tangible  equity of $114 million,  making no  adjustment  for the $259
million of  convertible  debt of IHS  outstanding.  Moody's also stated that the
availability  provided by the New Credit  Facility  and the 9 1/4% Senior  Notes
positioned the Company to complete sizable acquisition transactions using solely
debt.  Moody's further noted that the rating reflects that there are significant
changes underway in the  reimbursement of services rendered by IHS, and that the
exact impact of these changes is uncertain.

RISKS ASSOCIATED WITH GROWTH THROUGH ACQUISITIONS AND INTERNAL DEVELOPMENT

     IHS' growth  strategy  involves  growth through  acquisitions  and internal
development  and, as a result,  IHS is subject to various risks  associated with
this growth strategy.  The Company's  planned  expansion and growth require that
the Company  expand its home  healthcare  services  through the  acquisition  of
additional home healthcare  providers and that the Company acquire, or establish
relationships  with,  third parties which provide  post-acute  care services not
currently  provided by the Company,  that  additional MSUs be established in the
Company's existing facilities and that the Company acquire, lease or acquire the
right  to  manage  for  others  additional  facilities  in  which  MSUs  can  be
established.  Such expansion and growth will depend on the Company's  ability to
create demand for its post-acute  care programs,  the  availability  of suitable
acquisition, lease or management candidates and the Company's ability to finance
such  acquisitions and growth.  The successful  implementation  of the Company's
post-acute healthcare system,  including the capitation of rates, will depend on
the Company's ability to expand the amount of post-acute care services it offers
directly to its patients rather than through third-party providers. There can be
no  assurance  that  suitable  acquisition  candidates  will  be  located,  that
acquisitions can be consummated,  that acquired  facilities and companies can be
successfully  integrated  into  the  Company's  operations,  that  MSUs  can  be
successfully established in acquired facilities or that the Company's post-acute
healthcare  system,  including  the  capitation  of rates,  can be  successfully
implemented.  The post-acute care market is highly competitive,  and the Company
faces   substantial   competition  from  hospitals,   subacute  care  providers,
rehabilitation  providers and home healthcare  providers,  including competition
for  acquisitions.  The Company  anticipates  that  competition  for acquisition
opportunities will intensify due to the ongoing  consolidation in the healthcare
industry. See "-- Risks Related to Managed Care Strategy" and "-- Competition."

     The  successful   integration  of  acquired  businesses,   including  First
American,  RoTech,  CCA and the Coram Lithotripsy  Division and, if the Proposed
Facility  Acquisition  is  consummated,  the  facilities  and  other  businesses
acquired  from  HEALTHSOUTH,  is important  to the  Company's  future  financial
performance.  The anticipated benefits from any of these acquisitions may not be
achieved  unless the  operations  of the acquired  businesses  are  successfully
combined with those of the Company in a timely  manner.  The  integration of the
Company's recent acquisitions,  including,  if the Proposed Facility Acquisition
is consummated,  the facilities and other businesses  acquired from HEALTHSOUTH,
will  require  substantial  attention  from  management.  The  diversion  of the
attention of  management,  and any  difficulties  encountered  in the transition
process,  could have a material  adverse effect on the Company's  operations and
financial  results.  In  addition,   the  process  of  integrating  the  various
businesses  could  cause the  interruption  of, or a loss of  momentum  in,  the
activities  of some or all of these  businesses,  which  could  have a  material
adverse effect on the Company's  operations and financial results.  There can be
no assurance that the Company will realize any of the anticipated  benefits from
its acquisitions.  The acquisition of service companies that are not profitable,
or the  acquisition  of new facilities  that result in  significant  integration
costs  and   inefficiencies,   could  also   adversely   affect  the   Company's
profitability. 

     IHS' current and anticipated future growth has placed, and will continue to
place,  significant  demands  on  the  management,   operational  and  financial
resources of IHS. IHS' ability to manage its growth


                                       8
<PAGE>


effectively  will require it to continue to improve its  operational,  financial
and management information systems and to continue to attract,  train, motivate,
manage and retain key employees. There can be no assurance that IHS will be able
to manage its expanded operations effectively.  See "-- Risks Related to Capital
Requirements."

     There  can  be  no  assurance  that  the  Company  will  be  successful  in
implementing  its strategy or in responding to ongoing changes in the healthcare
industry  which  may  require  adjustments  to its  strategy.  If IHS  fails  to
implement its strategy successfully or does not respond timely and adequately to
ongoing changes in the healthcare  industry,  the Company's business,  financial
condition and results of operations will be materially adversely affected.


RISKS RELATED TO MANAGED CARE STRATEGY

     Managed care payors and  traditional  indemnity  insurers have  experienced
pressure from their  policyholders to curb or reduce the growth in premiums paid
to such  organizations  for healthcare  services.  This pressure has resulted in
demands on  healthcare  service  providers to reduce their prices or to share in
the financial  risk of providing care through  alternate fee structures  such as
capitation or fixed case rates. Given the increasing  importance of managed care
in the healthcare  marketplace and the continued cost containment pressures from
Medicare and Medicaid,  IHS has been  restructuring its operations to enable IHS
to focus on obtaining  contracts with managed care  organizations and to provide
capitated services.  The Company believes that its home healthcare  capabilities
will  be an  important  component  of its  ability  to  provide  services  under
capitated and other alternate fee arrangements.  However, to date there has been
limited  demand among managed care  organizations  for  post-acute  care network
services,  and there can be no  assurance  that  demand for such  services  will
increase.  Further,  IHS has limited  experience  in  providing  services  under
capitated and other alternate fee arrangements and setting the applicable rates.
Accordingly,  there can be no assurance that the fees received by IHS will cover
the cost of services provided. If revenue for capitated services is insufficient
to cover  the  treatment  costs,  IHS'  operating  results  could  be  adversely
affected.  As a result, the success of IHS' managed care strategy will depend in
large part on its ability to increase  demand for post-acute care services among
managed care  organizations,  to obtain  favorable  agreements with managed care
organizations  and to manage  effectively its operating and healthcare  delivery
costs through various methods,  including utilization management and competitive
pricing for purchased  services.  Additionally,  there can be no assurance  that
pricing pressures faced by healthcare providers will not have a material adverse
effect on the Company's business, results of operations and financial condition.

     Further,  pursuing a  strategy  focused on  risk-sharing  fee  arrangements
entails certain  regulatory risks. Many states impose  restrictions on a service
provider's  ability  to  provide  capitated  services  unless  it meets  certain
financial  criteria,  and may view  capitated fee  arrangements  as an insurance
activity,  subjecting the entity accepting the capitated fee to regulation as an
insurance company rather than merely a licensed  healthcare provider accepting a
business  risk in  connection  with the manner in which it is  charging  for its
services.  The laws  governing  risk-sharing  fee  arrangements  for  healthcare
service  providers  are  evolving  and are not  certain  at  this  time.  If the
risk-sharing  activities of IHS require licensure as an insurance company, there
can be no assurance  that IHS could obtain or maintain the necessary  licensure,
or that IHS would be able to meet any financial  criteria imposed by a state. If
the Company were  precluded  from  providing  services  under  risk-sharing  fee
arrangements,  its managed care strategy  would be adversely  affected.  See "--
Uncertainty of Government Regulation."


RISKS RELATED TO CAPITAL REQUIREMENTS

     IHS' growth strategy  requires  substantial  capital for the acquisition of
additional  home  healthcare  and related  service  providers and geriatric care
facilities and the  establishment  of new, and expansion of existing,  MSUs. The
effective  integration,  operation and expansion of the existing businesses will
also  require   substantial   capital.   The  Company  expects  to  finance  new
acquisitions  from a combination of funds from operations,  borrowings under its
bank credit  facility  and the issuance of debt and equity  securities.  IHS may
raise  additional  capital  through the  issuance  of  long-term  or  short-term
indebtedness  or the  issuance of  additional  equity  securities  in private or
public transactions, at such times as manage-


                                       9
<PAGE>


ment deems  appropriate  and the market  allows.  Any of such  financings  could
result  in  dilution  of  existing  equity  positions,  increased  interest  and
amortization expense or decreased income to fund future expansion.  There can be
no  assurance  that  acceptable  financing  for future  acquisitions  or for the
integration and expansion of existing businesses and operations can be obtained.
The  Company's  bank  credit  facility  limits  the  Company's  ability  to make
acquisitions,   and  certain  of  the  indentures   under  which  the  Company's
outstanding senior  subordinated debt securities were issued limit the Company's
ability to incur additional indebtedness unless certain financial tests are met.
See "-- Risks Related to Substantial Indebtedness."


RISKS RELATED TO RECENT ACQUISITIONS AND THE PROPOSED FACILITY ACQUISITION

     IHS has  recently  completed  several  major  acquisitions,  including  the
acquisitions of First American,  RoTech, CCA and the Coram Lithotripsy Division,
and is still in the process of integrating  those acquired  businesses.  The IHS
Board of Directors and senior management of IHS face a significant  challenge in
their efforts to integrate the acquired  businesses,  including  First American,
RoTech,  CCA and the Coram  Lithotripsy  Division and, if the Proposed  Facility
Acquisition is consummated,  the facilities and other  businesses  acquired from
HEALTHSOUTH.  The  dedication of management  resources to such  integration  may
detract  attention  from the  day-to-day  business of IHS. The  difficulties  of
integration  may be increased by the  necessity of  coordinating  geographically
separated   organizations,   integrating   personnel  with  disparate   business
backgrounds  and  combining  different  corporate  cultures.  There  can  be  no
assurance  that  there  will  not be  substantial  costs  associated  with  such
activities  or that there will not be other  material  adverse  effects of these
integration  efforts.  Further,  there  can be no  assurance  that  management's
efforts to integrate the operations of IHS and newly acquired  companies will be
successful or that the anticipated  benefits of the recent  acquisitions will be
fully realized.
   
     IHS has recently  expanded  significantly  its home healthcare  operations.
During the year ended December 31, 1996 and the nine months ended  September 30,
1996 and 1997,  home  healthcare  accounted for  approximately  16.3%,  8.1% and
32.1%, respectively,  of IHS' total revenues. On a pro forma basis, after giving
effect to the  acquisitions of First American (which derives  substantially  all
its revenues from Medicare),  RoTech,  CCA and the Coram  Lithotripsy  Division,
approximately  70.7%,  76.5%  and 65.0% of IHS' home  healthcare  revenues  were
derived  from  Medicare in the year ended  December 31, 1996 and the nine months
ended  September 30, 1996 and 1997,  respectively.  On a pro forma basis,  after
giving effect to the acquisitions of First American,  RoTech,  CCA and the Coram
Lithotripsy  Division,  home nursing services accounted for approximately 64.2%,
67.0%  and  55.1%,  respectively,  of IHS'  home  healthcare  revenues  in these
periods.  Medicare has  developed a national fee schedule for infusion  therapy,
respiratory  therapy and home medical equipment which provides  reimbursement at
80% of the amount of any fee on the schedule. The remaining 20% is paid by other
third  party  payors  (including  Medicaid in the case of  "medically  indigent"
patients)  or  patients;  with  respect  to  home  nursing,  Medicare  generally
reimburses for the cost (including a rate of return) of providing such services,
up to a regionally  adjusted allowable maximum per visit and per discipline with
no fixed limit on the number of visits.  There  generally  is no  deductible  or
coinsurance. As a result, there is no reward for efficiency, provided that costs
are below the cap, and traditional home healthcare services carry relatively low
margins. However, IHS expects that Medicare will implement a prospective payment
system for home nursing services in the next several years,  and  implementation
of a  prospective  payment  system will be a critical  element to the success of
IHS'  expansion  into  home  nursing  services.  Based  upon  prior  legislative
proposals,  IHS believes  that a  prospective  payment  system would most likely
provide a healthcare  provider a  predetermined  rate for a given service,  with
providers  that have costs below the  predetermined  rate being entitled to keep
some or all of this  difference.  There can be no assurance  that  Medicare will
implement a  prospective  payment  system for home nursing  services in the next
several years or at all. The implementation of a prospective payment system will
require  IHS  to  make  contingent   payments  related  to  the  First  American
Acquisition  of $155  million  over a period of five  years.  In  addition,  the
Balanced  Budget  Act of 1997,  enacted in August  1997,  reduces  the  Medicare
national payment limits for oxygen and oxygen equipment used in home respiratory
therapy  by 25% in 1998 and 30% (from 1997  levels) in 1999 and each  subsequent
year.  Approximately  22% of RoTech's total revenues for the year ended July 31,
1997 were derived from the  provision of oxygen  services to Medicare  patients.
The
    

                                       10
<PAGE>


inability of IHS to realize  operating  efficiencies and provide home healthcare
services at a cost below the  established  Medicare  fee  schedule  could have a
material  adverse effect on IHS' home  healthcare  operations and its post-acute
care network. See "-- Risk of Adverse Effect of Healthcare Reform."


RISKS RELATED TO HISTORICAL FINANCIAL PERFORMANCE OF FIRST AMERICAN

     During the year ended December 31, 1995 and the nine months ended September
30,  1996,  First  American  recorded  a net loss of  $110.4  million  and $36.2
million,   respectively.   Numerous   factors  have  affected  First  American's
performance and financial  condition prior to its acquisition by IHS, including,
among  others,  high  administrative  costs and the  settlement  of  claims  for
reimbursement  of certain  overpayments  and  unallowable  reimbursements  under
Medicare (which  settlement  resulted in a reduction to patient service revenues
of $54.6 million for the year ended  December 31, 1995 and $10.4 million for the
nine months ended  September  30,  1996).  In  addition,  in February  1996,  in
response to the stoppage by the Health Care Financing Administration ("HCFA") of
its  bi-weekly  periodic  interim  payments  ("PIP")  to First  American,  First
American was forced to declare  bankruptcy.  In March 1996, the bankruptcy court
ordered HCFA to resume PIP payments to First American.  However,  the bankruptcy
filing and operation of First  American in bankruptcy  until its  acquisition by
IHS  adversely  affected  the  business,  results of  operations  and  financial
condition of First American. There can be no assurance that these factors or the
First American  bankruptcy  will not continue to have an adverse effect on First
American's and IHS' business,  financial  condition and results of operations in
the future.  There can be no assurance  that the historical  losses  incurred by
First American will not continue.


RELIANCE ON REIMBURSEMENT BY THIRD PARTY PAYORS
   
     The Company receives payment for services rendered to patients from private
insurers and patients  themselves,  from the Federal  government under Medicare,
and from the states in which it operates under Medicaid. The healthcare industry
is experiencing a trend toward cost  containment,  as government and other third
party  payors  seek to impose  lower  reimbursement  and  utilization  rates and
negotiate  reduced  payment  schedules  with  service   providers.   These  cost
containment  measures,  combined with the  increasing  influence of managed care
payors  and  competition  for  patients,   has  resulted  in  reduced  rates  of
reimbursement  for services provided by IHS, which has adversely  affected,  and
may continue to adversely  affect,  IHS'  margins,  particularly  in its skilled
nursing and subacute facilities. Aspects of certain healthcare reform proposals,
such as cutbacks in the Medicare and Medicaid  programs,  reductions in Medicare
reimbursement   rates  and/or   limitations  on  reimbursement  rate  increases,
containment of healthcare  costs on an interim basis by means that could include
a short-term  freeze on prices charged by healthcare  providers,  and permitting
greater state  flexibility in the  administration  of Medicaid,  could adversely
affect the Company. See "-- Risk of Adverse Effect of Healthcare Reform." During
the years ended  December  31,  1994,  1995 and 1996 and the nine  months  ended
September 30, 1996 and 1997, the Company  derived  approximately  56%, 55%, 60%,
57% and 66%,  respectively,  of its patient revenues from Medicare and Medicaid.
On a pro forma basis after giving effect to the  acquisitions  of First American
(which derives  substantially all its revenues from Medicare),  RoTech,  CCA and
the Coram Lithotripsy Division and the ILC  Offering,approximately  66.7%, 67.6%
and 64.2% of the Company's  patient revenues have been derived from Medicare and
Medicaid  during the year ended  December  31,  1996 and the nine  months  ended
September 30, 1996 and 1997, respectively.
    
     The sources and amounts of the Company's  patient revenues derived from the
operation of its geriatric care  facilities and MSU programs are determined by a
number of factors, including licensed bed capacity of its facilities,  occupancy
rate, the mix of patients and the rates of reimbursement  among payor categories
(private,  Medicare and Medicaid).  Changes in the mix of the Company's patients
among the private pay, Medicare and Medicaid categories can significantly affect
the  profitability of the Company's  operations.  The Company's cost of care for
its MSU patients  generally exceeds regional  reimbursement  limits  established
under Medicare. The success of the Company's MSU strategy will depend in part on
its  ability  to obtain  per diem rate  approvals  for costs  which  exceed  the
Medicare  established  per diem rate  limits and by  obtaining  waivers of these
limitations.  There can be no assurance  that the Company will be able to obtain
the waivers necessary to enable the Company to recover its excess costs.


                                       11
<PAGE>


     Managed care  organizations  and other third party payors have continued to
consolidate  to enhance  their  ability to influence  the delivery of healthcare
services. Consequently, the healthcare needs of a large percentage of the United
States  population are provided by a small number of managed care  organizations
and third  party  payors.  These  organizations  generally  enter  into  service
agreements with a limited number of providers for needed services. To the extent
such  organizations  terminate  IHS as a preferred  provider  and/or engage IHS'
competitors as a preferred or exclusive  provider,  the business of IHS could be
materially adversely affected.

RISK OF ADVERSE EFFECT OF HEALTHCARE REFORM
   
     In addition to extensive existing government healthcare  regulation,  there
are  numerous  initiatives  on the  federal and state  levels for  comprehensive
reforms  affecting  the payment for and  availability  of  healthcare  services,
including a number of proposals  that would  significantly  limit  reimbursement
under  Medicare and Medicaid.  It is not clear at this time what  proposals,  if
any, will be adopted or, if adopted,  what effect such  proposals  would have on
the Company's business.  Aspects of certain of these healthcare proposals,  such
as cutbacks in the Medicare and Medicaid  programs,  containment  of  healthcare
costs on an interim  basis by means that could  include a  short-term  freeze on
prices charged by healthcare providers, and permitting greater state flexibility
in the  administration  of Medicaid,  could  adversely  affect the  Company.  In
addition,  there have been  proposals to convert the current cost  reimbursement
system for home nursing services covered under Medicare to a prospective payment
system.  The  prospective   payment  system  proposals   generally  provide  for
prospectively  established  per  visit  payments  to be  made  for  all  covered
services, which are then subject to an annual aggregate per episode limit at the
end of the year. Home health agencies that are able to keep their total expenses
per visit during the year below their per episode  annual limits will be able to
retain a specified  percentage of the difference,  subject to certain  aggregate
limitations.  Such changes could have a material  adverse  effect on the Company
and its growth strategy. The implementation of a prospective payment system will
require the Company to make  contingent  payments  related to the First American
Acquisition of $155 million over a period of five years. The inability of IHS to
provide home  healthcare  and/or  skilled  nursing  services at a cost below the
established  Medicare fee schedule could have a material  adverse effect on IHS'
home healthcare operations,  post-acute care network and business generally. The
Balanced  Budget Act of 1997,  enacted in August  1997,  provides,  among  other
things, for a prospective  payment system for home nursing to be implemented for
cost  reporting  periods  beginning on or after  October 1, 1999, a reduction in
current cost  reimbursement  for home  healthcare  pending  implementation  of a
prospective payment system,  reductions  (effective January 1, 1998) in Medicare
reimbursement for oxygen and oxygen equipment for home respiratory therapy and a
shift of the bulk of home health coverage from Part A to Part B of Medicare. The
failure to implement a prospective  payment system for home nursing  services in
the next  several  years could  adversely  affect IHS'  post-acute  care network
strategy. IHS expects that there will continue to be numerous initiatives on the
federal and state levels for comprehensive reforms affecting the payment for and
availability of healthcare services, including proposals that will further limit
reimbursement  under  Medicare and  Medicaid.  It is not clear at this time what
proposals,  if any, will be adopted or, if adopted,  what effect such  proposals
will have on IHS' business. See "-- Risks Related to Recent Acquisitions and the
Proposed Facility Acquisition" and "-- Reliance on Reimbursement by Third  Party
Payors." There can be no assurance that currently  proposed or future healthcare
legislation  or  other  changes  in  the  administration  or  interpretation  of
governmental  healthcare programs will not have an adverse effect on the Company
or that payments under governmental programs will remain at levels comparable to
present  levels or will be sufficient  to cover the costs  allocable to patients
eligible  for  reimbursement  pursuant  to  such  programs.  Concern  about  the
potential  effects  of the  proposed  reform  measures  has  contributed  to the
volatility  of prices of  securities  of  companies  in  healthcare  and related
industries,  including the Company,  and may  similarly  affect the price of the
Common Stock in the future. See "-- Uncertainty of Government Regulation." 
    
UNCERTAINTY OF GOVERNMENT REGULATION

     The Company and the healthcare  industry generally are subject to extensive
federal,   state  and  local  regulation  governing  licensure  and  conduct  of
operations at existing facilities,  construction of new facilities,  acquisition
of existing facilities, additions of new services, certain capital expenditures,
the quality


                                       12
<PAGE>


of services  provided  and the manner in which such  services  are  provided and
reimbursement for services rendered.  Changes in applicable laws and regulations
or new  interpretations  of existing laws and regulations  could have a material
adverse  effect  on  licensure,   eligibility  for  participation,   permissible
activities,  operating costs and the levels of reimbursement  from  governmental
and other sources.  There can be no assurance that regulatory  authorities  will
not adopt  changes or new  interpretations  of existing  regulations  that could
adversely  affect the  Company.  The failure to  maintain or renew any  required
regulatory  approvals  or  licenses  could  prevent the  Company  from  offering
existing  services or from obtaining  reimbursement.  In certain  circumstances,
failure  to comply at one  facility  may affect  the  ability of the  Company to
obtain or maintain licenses or approvals under Medicare and Medicaid programs at
other  facilities.  In addition,  in the conduct of its  business the  Company's
operations are subject to review by federal and state  regulatory  agencies.  In
the course of these reviews,  problems are from time to time identified by these
agencies.  Although the Company has to date been able to resolve these  problems
in a manner  satisfactory to the regulatory  agencies without a material adverse
effect on its business,  there can be no assurance that it will be able to do so
in the future.

     Recently effective  provisions of the regulations adopted under the Omnibus
Budget  Reconciliation Act of 1987 ("OBRA") have implemented stricter guidelines
for annual state  surveys of long-term  care  facilities  and expanded  remedies
available to HCFA to enforce compliance with the detailed regulations  mandating
minimum  healthcare  standards and may significantly  affect the consequences to
the Company if annual or other HCFA facility surveys identify noncompliance with
these  regulations.  Remedies include fines, new patient admission  moratoriums,
denial of reimbursement,  federal or state monitoring of operations,  closure of
facilities  and  termination  of  provider   reimbursement   agreements.   These
provisions  eliminate  the ability of operators to appeal the scope and severity
of any  deficiencies  and grant state  regulators  the  authority  to impose new
remedies,  including monetary  penalties,  denial of payments and termination of
the right to participate in the Medicare and/or Medicaid  programs.  The Company
believes  these new  guidelines  may  result  in an  increase  in the  number of
facilities  that will not be in  "substantial  compliance"  with the regulations
and,  as a result,  subject to  increased  disciplinary  actions  and  remedies,
including  admission  holds and  termination  of the right to participate in the
Medicare  and/or  Medicaid  programs.  In  ranking  facilities,  survey  results
subsequent  to  October  1990  are  considered.   As  a  result,  the  Company's
acquisition of poorly performing facilities could adversely affect the Company's
business to the extent remedies are imposed at such facilities.

     In September 1997, President Clinton, in an attempt to curb Medicare fraud,
imposed a moratorium on the certification  under Medicare of new home healthcare
companies,  which moratorium is expected to last  approximately six months,  and
implemented  rules requiring home  healthcare  providers to reapply for Medicare
certification  every three years.  In  addition,  HCFA will double the number of
detailed audits of home healthcare providers it completes each year and increase
by 25% the number of home  healthcare  claims it reviews  each year.  IHS cannot
predict what effect,  if any, these new rules will have on IHS' business and the
expansion of its home healthcare operations.

     The  Company  is also  subject  to  federal  and state  laws  which  govern
financial and other arrangements between healthcare providers.  These laws often
prohibit  certain  direct and indirect  payments or  fee-splitting  arrangements
between  healthcare  providers  that are  designed  to induce or  encourage  the
referral of patients to, or the  recommendation  of, a  particular  provider for
medical  products and services.  These laws include the federal  "Stark  Bills,"
which  prohibit,  with  limited  exceptions,   financial  relationships  between
ancillary   service  providers  and  referring   physicians,   and  the  federal
"anti-kickback  law," which prohibits,  among other things, the offer,  payment,
solicitation  or receipt of any form of  remuneration in return for the referral
of  Medicare  and  Medicaid  patients.  The Office of  Inspector  General of the
Department  of Health and Human  Services,  the  Department of Justice and other
federal  agencies  interpret  these  fraud and abuse  provisions  liberally  and
enforce them  aggressively.  Members of Congress have proposed  legislation that
would significantly  expand the federal  government's  involvement in curtailing
fraud and abuse and  increase  the  monetary  penalties  for  violation of these
provisions.  In addition,  some states restrict certain  business  relationships
between  physicians  and other  providers of  healthcare  services.  Many states
prohibit business  corporations from providing,  or holding  themselves out as a
provider of,  medical  care.  Possible  sanctions  for violation of any of these
restrictions  or  prohibitions  include  loss of  licensure  or  eligibility  to
participate in reimbursement programs (including Medi-


                                       13
<PAGE>


care and Medicaid),  asset forfeitures and civil and criminal  penalties.  These
laws vary from state to state,  are often vague and have seldom been interpreted
by the  courts or  regulatory  agencies.  The  Company  seeks to  structure  its
business  arrangements in compliance with these laws and, from time to time, the
Company has sought  guidance  as to the  interpretation  of such laws;  however,
there can be no assurance  that such laws  ultimately  will be  interpreted in a
manner consistent with the practices of the Company.

     Many  states  have  adopted  certificate  of need  or  similar  laws  which
generally require that the appropriate state agency approve certain acquisitions
or capital  expenditures  in excess of defined  levels and determine that a need
exists for certain new bed additions,  new services and the  acquisition of such
medical equipment or capital  expenditures or other changes prior to beds and/or
services  being  added.  Many  states  have  placed  a  moratorium  on  granting
additional  certificates  of need or otherwise  stated their intent not to grant
approval  for new beds.  To the  extent  certificates  of need or other  similar
approvals are required for expansion of the Company's operations, either through
facility  acquisitions  or  expansion  or  provision  of new  services  or other
changes,  such expansion could be adversely affected by the failure or inability
to obtain the necessary  approvals,  changes in the standards applicable to such
approvals and possible delays in, and the expenses  associated  with,  obtaining
such approvals.

     The  Company is unable to predict the future  course of  federal,  state or
local regulation or legislation,  including  Medicare and Medicaid  statutes and
regulations.  Further changes in the regulatory  framework could have a material
adverse  effect on the Company's  business,  results of operations and financial
condition. See "-- Risk of Adverse Effect of Healthcare Reform."


COMPETITION

     The healthcare  industry is highly competitive and is subject to continuing
changes in the  provision  of services and the  selection  and  compensation  of
providers.  The  Company  competes  on a local and  regional  basis  with  other
providers on the basis of the breadth and quality of its  services,  the quality
of its  facilities  and, to a more  limited  extent,  price.  The  Company  also
competes with other  providers in the  acquisition and development of additional
facilities  and  service   providers.   The  Company's   current  and  potential
competitors  include  national,  regional and local  operators of geriatric care
facilities,  acute care hospitals and  rehabilitation  hospitals,  extended care
centers,  retirement  centers and  community  home health  agencies,  other home
healthcare companies and similar institutions,  many of which have significantly
greater financial and other resources than the Company. In addition, the Company
competes with a number of tax-exempt  nonprofit  organizations which can finance
acquisitions  and  capital   expenditures  on  a  tax-exempt  basis  or  receive
charitable  contributions  unavailable to the Company. New service introductions
and  enhancements,   acquisitions,  continued  industry  consolidation  and  the
development  of  strategic  relationships  by  IHS'  competitors  could  cause a
significant  decline in sales or loss of market  acceptance  of IHS' services or
intense  price  competition  or  make  IHS'  services  noncompetitive.  Further,
technological  advances  in drug  delivery  systems and the  development  of new
medical  treatments  that cure certain  complex  diseases or reduce the need for
healthcare  services could adversely impact the business of IHS. There can be no
assurance  that IHS will be able to  compete  successfully  against  current  or
future  competitors  or that  competitive  pressures  will not  have a  material
adverse effect on IHS' business,  financial condition and results of operations.
IHS also competes with various  healthcare  providers with respect to attracting
and retaining qualified management and other personnel.  Any significant failure
by IHS to attract and retain  qualified  employees could have a material adverse
effect on its business, results of operations and financial condition.


EFFECT OF CERTAIN ANTI-TAKEOVER PROVISIONS

     IHS' Third Restated  Certificate of Incorporation  and By-laws,  as well as
the Delaware General  Corporation Law (the "DGCL"),  contain certain  provisions
that  could  have the effect of making it more  difficult  for a third  party to
acquire,  or discouraging a third party from  attempting to acquire,  control of
IHS.  These  provisions  could limit the price that certain  investors  might be
willing  to pay in the  future  for  shares of Common  Stock.  Certain  of these
provisions allow IHS to issue,  without  stockholder  approval,  preferred stock
having  voting  rights  senior to those of the Common  Stock.  Other  provisions
impose  various  procedural  and  other  requirements  that  could  make it more
difficult for stockholders to effect


                                       14
<PAGE>


certain corporate actions. In addition, the IHS Stockholders' Rights Plan, which
provides  for  discount  purchase  rights to  certain  stockholders  of IHS upon
certain  acquisitions of 20% or more of the outstanding  shares of Common Stock,
may also inhibit a change in control of IHS. As a Delaware  corporation,  IHS is
subject to Section 203 of the DGCL,  which, in general,  prevents an "interested
stockholder"  (defined  generally  as  a  person  owning  15%  or  more  of  the
corporation's   outstanding   voting   stock)  from   engaging  in  a  "business
combination"  (as defined) for three years following the date such person became
an interested stockholder unless certain conditions are satisfied.


POSSIBLE VOLATILITY OF STOCK PRICE

     There may be  significant  volatility  in the  market  price of the  Common
Stock.  Quarterly operating results of IHS, changes in general conditions in the
economy, the financial markets or the healthcare industry, or other developments
affecting  IHS or its  competitors,  could cause the market  price of the Common
Stock to fluctuate substantially.  In addition, in recent years the stock market
and, in particular, the healthcare industry segment, has experienced significant
price and volume fluctuations.  This volatility has affected the market price of
securities  issued by many  companies for reasons  unrelated to their  operating
performance. In the past, following periods of volatility in the market price of
a  company's  securities,  securities  class  action  litigation  has often been
initiated  against such company.  Such  litigation  could result in  substantial
costs and a diversion of management's attention and resources,  which could have
a material  adverse effect upon IHS' business,  operating  results and financial
condition. 


                                       15
<PAGE>


                              RECENT DEVELOPMENTS


PROPOSED FACILITY ACQUISITION

     On November 3, 1997, IHS and HEALTHSOUTH entered into an agreement pursuant
to which IHS agreed to acquire  from  HEALTHSOUTH  139 owned,  leased or managed
long-term care facilities,  12 specialty hospitals,  a contract therapy business
having over 1,000  contracts  and an  institutional  pharmacy  business  serving
approximately  38,000 beds.  The  businesses  being  acquired,  which had annual
revenues of approximately  $925 million for the 12 months ended August 31, 1997,
were acquired by HEALTHSOUTH in its recent acquisition of Horizon/CMS Healthcare
Corporation.

     Under the terms of the  agreement,  IHS will pay $1.15  billion in cash and
assume approximately $100 million in debt. IHS will fund the purchase price with
available cash from term loan  borrowings  under the New Credit Facility and the
sale of the 9 1/4%  Senior  Notes  and  borrowings  under the  revolving  credit
portion of the New Credit Facility.  On a pro forma basis after giving effect to
the acquisition of these businesses from HEALTHSOUTH, the RoTech Acquisition and
the Coram Lithotripsy  Acquisition,  IHS' total debt, including current portion,
accounted  for  approximately  74% of its total pro forma  capitalization  as of
September 30, 1997. Consummation of the transaction,  which is expected to close
by December 31, 1997,  is subject to,  among other  things,  receipt of required
regulatory  approvals,  consent  of IHS'  senior  lenders  and  other  customary
conditions. IHS has deposited with HEALTHSOUTH $50 million, which amount will be
credited  against the purchase  price at the closing or retained by  HEALTHSOUTH
under certain circumstances if the transaction is not consummated.

     There can be no assurance that this  transaction will close on these terms,
on different terms or at all.


NEW CREDIT FACILITY

     On September 15, 1997, the Company  entered into a $1.75 billion  revolving
credit and term loan facility with Citibank,  N.A., as Administrative Agent, and
certain other  lenders (the "New Credit  Facility") to replace its existing $700
million  revolving credit facility.  The New Credit Facility  consists of a $750
million term loan  facility  (the "Term  Facility")  and a $1 billion  revolving
credit facility, including a $100 million letter of credit subfacility and a $10
million swing line  subfacility (the "Revolving  Facility").  The Term Facility,
all of which was borrowed on September  17, 1997,  matures on September 30, 2004
and will be  amortized  beginning  December  31, 1998 as  follows:  1998 -- $7.5
million;  each of 1999,  2000,  2001 and 2002 -- $7.5 million  (payable in equal
quarterly  installments);  2003 -- $337.5  million  (payable in equal  quarterly
installments);   and  2004  --  $375   million   (payable  in  equal   quarterly
installments).  Any unpaid  balance will be due on the maturity  date.  The Term
Facility bears interest at a rate equal to, at the option of IHS,  either (i) in
the case of Eurodollar loans, the sum of (x) one and  three-quarters  percent or
two percent (depending on the ratio of the Company's Debt (as defined in the New
Credit Facility) to earnings before interest, taxes, depreciation,  amortization
and rent, pro forma for any acquisitions or divestitures  during the measurement
period  (the  "Debt/EBITDAR  Ratio"))  and (y) the  interest  rate in the London
interbank  market  for loans in an amount  substantially  equal to the amount of
borrowing and for the period of borrowing selected by IHS or (ii) the sum of (a)
the higher of (1) Citibank,  N.A.'s base rate or (2) one percent plus the latest
overnight  federal  funds  rate  plus  (b)  a  margin  of  one-half  percent  or
three-quarters of one percent  (depending on the Debt/EBITDAR  Ratio).  The Term
Facility can be prepaid at any time in whole or in part without penalty.

     The  Revolving  Facility  will reduce to $800 million on September 30, 2001
and $500 million on September 30, 2002,  with a final  maturity on September 15,
2004;  however,  the $100 million letter of credit  subfacility  and $10 million
swing  line   subfacility   will  remain  at  $100   million  and  $10  million,
respectively,  until final maturity.  The Revolving Facility bears interest at a
rate equal to, at the option of IHS, either (i) in the case of Eurodollar loans,
the sum of (x) between  three-quarters of one percent and one and three-quarters
percent  (depending on the Debt/EBITDAR  Ratio) and (y) the interest rate in the
London interbank market for loans in an amount substantially equal to the amount
of borrowing and for the period of borrowing  selected by IHS or (ii) the sum of
(a) the higher of (1) Citibank, N.A.'s 


                                       16
<PAGE>


base rate or (2) one percent plus the latest  overnight  federal funds rate plus
(b) a margin of between  zero  percent and one-half  percent  (depending  on the
Debt/EBITDAR  Ratio).  Amounts  repaid  under  the  Revolving  Facility  may  be
reborrowed prior to the maturity date.

     The New  Credit  Facility  limits  IHS'  ability to incur  indebtedness  or
contingent obligations,  to make additional acquisitions,  to sell or dispose of
assets,  to create or incur liens on assets,  to pay  dividends,  to purchase or
redeem  IHS'  stock  and to  merge or  consolidate  with any  other  person.  In
addition,  the New Credit  Facility  requires  that IHS meet  certain  financial
ratios,  and  provides  the banks with the right to require  the  payment of all
amounts  outstanding under the facility,  and to terminate all commitments under
the facility, if there is a change in control of IHS or if any person other than
Dr. Robert N. Elkins,  IHS'  Chairman and Chief  Executive  Officer,  or a group
managed by Dr. Elkins, owns more than 40% of IHS' stock. The New Credit Facility
is guaranteed by all of IHS' subsidiaries (other than inactive subsidiaries) and
secured  by a  pledge  of  all  of  the  stock  of  substantially  all  of  IHS'
subsidiaries.

     The New Credit  Facility  replaced the  Company's  $700  million  revolving
credit facility (the "Prior Credit Facility"). As a result, the Company recorded
an extraordinary  loss on extinguishment  of debt of approximately  $2.4 million
(net of related tax benefit of approximately  $1.5 million) in the third quarter
of 1997 resulting from the write-off of deferred financing costs of $3.9 million
related to the Prior Credit Facility.

RECENT ACQUISITIONS
   
     RoTech Acquisition. On October 21, 1997, IHS acquired RoTech through merger
of a  wholly-owned  subsidiary  of IHS into RoTech (the "RoTech  Merger"),  with
RoTech  becoming  a  wholly-owned   subsidiary  of  IHS.  RoTech  provides  home
healthcare  products and services,  with an emphasis on home  respiratory,  home
medical  equipment  and  infusion  therapy,  primarily  to patients in non-urban
areas.  RoTech  currently  operates  613 home health  locations in 35 states and
approximately  26 primary  care  physicians  practices.  According  to  RoTech's
filings with the Commission,  RoTech had revenues of $422.7  million,  (earnings
before  interest,  taxes,  depreciation  and  amortization) ("EBITDA") of $108.2
million and net income of $30.8 million for the fiscal year ended July 31, 1997.
    
     Under the terms of the  RoTech  Merger,  holders  of  RoTech  common  stock
("RoTech Common Stock") received for each share of RoTech Common Stock 0.5806 of
a share of Common Stock of the Company (the "Exchange  Ratio"),  having a market
value of $19.16 based on the $33.00 closing price of the Common Stock on October
21, 1997, the effective date of the RoTech  Merger.  Options to purchase  RoTech
Common Stock  ("RoTech  Options")  were converted at the closing into options to
purchase  Common Stock of the Company  based on the Exchange  Ratio.  IHS issued
approximately  15,598,400  shares  of Common  Stock in the  RoTech  Merger,  and
reserved for issuance  approximately  1,841,700  shares of Common Stock issuable
upon exercise of RoTech Options. In addition,  RoTech's outstanding $110 million
of  convertible   subordinated   debentures  (the  "RoTech  Debentures")  became
convertible into  approximately  2,433,000 shares of Common Stock of the Company
at a conversion  price of $45.21 per share of Common Stock. At October 20, 1997,
IHS had  outstanding  26,852,396  shares of Common Stock. At September 30, 1997,
IHS had  outstanding  options and warrants to purchase  approximately  9,000,000
shares of Common  Stock,  and had reserved for  issuance  7,989,275  shares upon
conversion  of  $258,750,000   principal   amount  of  outstanding   convertible
debentures.  The RoTech Merger  consideration  aggregated  approximately  $514.8
million,   substantially  all  of  which  will  be  recorded  as  goodwill.  The
transaction will be treated as a purchase for accounting and financial reporting
purposes.

     IHS  repaid  the  $199.7  million  of  RoTech  bank  debt  assumed  in  the
transaction  with the proceeds of the term loans under its New Credit  Facility.
Under the terms of the indenture under which the RoTech  Debentures were issued,
RoTech was obligated to offer to repurchase the RoTech  Debentures at a purchase
price  equal  to 100% of the  aggregate  principal  amount  thereof  immediately
following the RoTech Merger.  Holders of  $107,836,000  principal  amount of the
RoTech Debentures accepted the repurchase offer;  $2,164,000 principal amount of
RoTech Debentures, convertible into approximately 47,865 shares of Common Stock,
remains  outstanding.  IHS used the  proceeds  of the term  loans  under its New
Credit  Facility  and the  proceeds  from the sale of the 9 1/4% Senior Notes to
make a capital  contribution to RoTech in the amount  necessary to enable RoTech
to finance the repurchase of the RoTech Debentures.



                                       17
<PAGE>


     Coram Lithotripsy Acquisition.  IHS acquired, effective September 30, 1997,
substantially all of the assets of Coram's Lithotripsy Division,  which operates
20 mobile  lithotripsy  units and 13 fixed-site  machines in 180 locations in 18
states. The Coram Lithotripsy Division also provides maintenance services to its
own and  third-party  equipment.  Lithotripsy is a  non-invasive  technique that
utilizes shock waves to disintegrate kidney stones.

     IHS paid  approximately  $131.0  million in cash for the Coram  Lithotripsy
Division,  including the payment of $1.0 million of intercompany  debt to Coram.
The Coram Lithotripsy Division had revenues of $49.0 million and EBITDA of $28.8
million  (before  minority  interest)  for the year ended  December 31, 1996 and
revenues of $23.9 million and EBITDA of $14.3 million (before minority interest)
for the six months ended June 30, 1997.

     IHS has assumed Coram's  agreements with its  lithotripsy  partners,  which
contemplate that IHS will acquire the remaining  interest in each partnership at
a defined  price in the event  that  legislation  is passed or  regulations  are
adopted or interpreted that would prevent the physician  partners from owning an
interest in the partnership and using the  partnership's  lithotripsy  equipment
for the treatment of his or her patients.  Coram has represented to IHS that its
partnership  arrangements  with  physicians in its  lithotripsy  business are in
compliance with current law.

     Within the last three years,  HCFA  released a proposed  rule  defining the
rate at  which  ambulatory  surgery  centers  and  certain  hospitals  would  be
reimbursed for the technical component of a lithotripsy procedure. This proposed
rule has not been  finalized.  IHS cannot  predict  what the final rate for such
reimbursement will be or what effect, if any, the adoption of this proposed rule
would have on lithotripsy revenue and whether this decreased  reimbursement rate
will be  applied to  lithotripsy  procedures  performed  at  hospitals,  where a
majority of IHS' lithotripsy machines are currently utilized.

     CCA  Acquisition.  On September 25, 1997, the Company  acquired,  through a
cash  tender  offer  and  subsequent   merger,  CCA  for  a  purchase  price  of
approximately  $34.3  million in cash. In addition,  in connection  with the CCA
Acquisition IHS repaid  approximately  $58.5 million of indebtedness  assumed in
the CCA  Acquisition  (including  restructuring  fees of $4.9  million) with the
proceeds  of  the  term  loans  under  its  New  Credit   Facility  and  assumed
approximately  $27.0 million of indebtedness.  CCA develops and operates skilled
nursing  facilities in medically  underserved rural  communities.  CCA currently
operates 54 licensed  long-term  care  facilities  with 4,450  licensed beds (of
which 19 facilities are being held for sale), one rural healthcare  clinic,  two
outpatient  rehabilitation  centers  (one of which is being held for sale),  one
child  day  care  center  and 124  assisted  living  units  within  seven of the
facilities  which CCA  operates.  CCA currently  operates in Alabama,  Colorado,
Florida, Georgia, Iowa, Kansas, Louisiana, Maine, Missouri,  Nebraska, Texas and
Wyoming.  According to CCA's  filings with the  Commission,  CCA had revenues of
$127.5  million,  EBITDA of $2.1 million and a net loss of $18.9 million for the
year ended  December  31,  1996 and  revenues of $65.5  million,  EBITDA of $4.0
million and a net loss of $2.4  million for the six months  ended June 30, 1997.
Dr. Robert N. Elkins,  Chairman of the Board and Chief Executive Officer of IHS,
beneficially  owned  approximately  21.0%  of  CCA's  outstanding  common  stock
(excluding warrants owned by IHS to purchase approximately 13.5% of CCA's common
stock).


OTHER ACQUISITIONS AND DIVESTITURES

     The  Company  continues  to acquire  and lease  additional  geriatric  care
facilities, enter into new management agreements,  acquire rehabilitation,  home
healthcare and related service companies and implement its strategy of expanding
the range of related  services it offers  directly  to its  patients in order to
serve the full spectrum of patients' post-acute care needs. See "Risk Factors --
Risks Associated with Growth Through Acquisitions and Internal Development."

     From  January 1 through  October  31,  1997,  IHS has,  in  addition to the
acquisitions  described  above,  acquired nine home healthcare  companies,  five
mobile diagnostic companies and two rehabilitation companies and a home infusion
company. The total cost for these acquisitions was approximately $115.1 million.
In July  1997,  IHS sold its  remaining  37%  interest  in its  assisted  living
services  subsidiary  pursuant to a cash tender offer.  IHS recognized a gain of
approximately  $4.6 million during the third quarter of 1997 as a result of this
transaction.  IHS has reached  agreements-in-principle  to purchase three mobile
diagnostic companies 


                                       18
<PAGE>


for  approximately  $8.2 million,  eight home health companies for approximately
$52.4 million,  a rehabilitation  company for approximately  $11.1 million and a
lithotripsy  company for  approximately  $11.2  million.  IHS has also agreed in
principle to assume leases of three skilled nursing facility companies for $73.1
million.  There can be no assurance that any of these pending  acquisitions will
be consummated on the proposed terms, on different terms or at all.

     In developing its post-acute healthcare system, IHS continuously  evaluates
whether  owning  and  operating   businesses  which  provide  certain  ancillary
services,  or  contracting  with  third  parties  for  such  services,  is  more
cost-effective. As a result, the Company is continuously evaluating its existing
operations to determine whether to retain or divest operations. To date, IHS has
divested its pharmacy  division and its assisted living services  division,  and
may divest additional divisions or assets in the future.

SALE OF 9 1/4% SENIOR SUBORDINATED NOTES DUE 2008

     On  September  11,  1997,  IHS sold  privately an aggregate of $500 million
principal  amount  of its 9 1/4%  Senior  Subordinated  Notes  due 2008 to Smith
Barney Inc.,  Morgan Stanley & Co.  Incorporated,  Donaldson,  Lufkin & Jenrette
Securities  Corporation  and  Citicorp  Securities,  Inc.  (the "9 1/4%  Initial
Purchasers").  The 9 1/4% Senior  Notes were  subsequently  resold by the 9 1/4%
Initial  Purchasers  pursuant to Rule 144A under the  Securities  Act.  IHS used
approximately   $319.5  million  of  the  net  proceeds  to  repay  all  amounts
outstanding  under the Company's Prior Credit  Facility.  The Company intends to
use the  remaining  approximately  $166.9  million of net  proceeds  for general
corporate purposes, including working capital. 

                                USE OF PROCEEDS

     The Company will not receive any proceeds  from the sale of Common Stock by
the Selling Stockholders.

                             SELLING STOCKHOLDERS

     The following  table sets forth certain  information as of October 27, 1997
(except as  otherwise  indicated)  and as  adjusted  to reflect  the sale of the
Common  Stock in the  offering,  as to the  security  ownership  of the  Selling
Stockholders.  Except as set forth below,  none of the Selling  Stockholders has
held any  position  or office or had any other  material  relationship  with the
Company or any of its predecessors or affiliates within the past three years.

<TABLE>
<CAPTION>
                                               SHARES OF                       SHARES OF
                                              COMMON STOCK                    COMMON STOCK
                                              BENEFICIALLY                    BENEFICIALLY
                                               OWNED PRIOR       SHARES        OWNED AFTER
                                               TO OFFERING     BEING SOLD       OFFERING
                                              --------------   ------------   -------------
<S>                                           <C>              <C>            <C>
AMBULATORY PHARMACEUTICAL SERVICES, INC.(1)
 Gigi Jordan ..............................      473,510         473,510            0
APS AMERICA, INC.(2)
 Raymond A. Mirra, Jr.   ..................       21,730          21,730            0
 James Kuo   ..............................       14,683          14,683            0
 Edward Kramm   ...........................       15,270          15,270            0
 Sirrom Capital Corporation ...............        7,047           7,047            0
ARCADIA SERVICES, INC.(3)
 Dale G. Rands  ...........................          356             356            0
 Joseph F. Galvin  ........................          356             356            0
 Stuart Sinai   ...........................          356             356            0
 Ronald H. Riback  ........................          356             356            0
 James C. Foresman ........................          356             356            0
 Lawrence N. Dudek ........................          178             178            0
</TABLE>


                                       19
<PAGE>


   
<TABLE>
<CAPTION>
                                                         SHARES OF                       SHARES OF
                                                        COMMON STOCK                    COMMON STOCK
                                                        BENEFICIALLY                    BENEFICIALLY
                                                        OWNED PRIOR        SHARES       OWNED AFTER
                                                        TO OFFERING     BEING SOLD       OFFERING
                                                       --------------   ------------   -------------
<S>                                                       <C>             <C>                   <C>
 Phillip J. Shefferly ..............................           178            178               0
 David B. Gunsberg .................................           178            178               0
 David J. Gould and Laura Gould   ..................           178            178               0
 Howard Zoller and Beth Zoller .....................           178            178               0
 Michael J. Eizelman and Shelley E. Eizelman  ......           178            178               0
 Robert J. Sandler .................................           713            713               0
 Herbert J. Graebner  ..............................       139,564        139,564               0
 Barbara Brewer ....................................         6,303          6,303               0
 Leonard Bellinson .................................       145,261        145,261               0
 Lawrence S. Jackier  ..............................           356            356               0
 Conbet Associates .................................        16,807         16,807               0
 Beth Elaine Lowenstein  ...........................         8,403          8,403               0
 Rita M. Lord   ....................................         6,303          6,303               0
 Jill Bader  .......................................        12,605         12,605               0
 Charles Bader  ....................................        12,605         12,605               0
 James C. Foresman and Cheryl A. Busbey ............           356            356               0
 Robert M. Egren   .................................           485            485               0
 Morris Rochlin ....................................        12,120         12,120               0
 Nicholas J. Pyett .................................           970            970               0
 Lawrence S. Jackier  ..............................           357            357               0
 Cameron D. Hosner .................................        10,714         10,714               0
 James L. Bellinson   ..............................        11,684         11,684               0
 Gregory G. Glaesmer  ..............................         4,363          4,363               0
 Gerald Vargo   ....................................           970            970               0
 Arcadia Bidco Corporation  ........................        41,348         41,348               0
 James L. Bellinson   ..............................        22,858         22,858               0
 Mark E. Schlussel .................................           356            356               0
 Donald B. Lifton  .................................           356            356               0
 Joel M. Shere  ....................................           178            178               0
 Daniel D. Swanson .................................           178            178               0
 Carol Simon .......................................           356            356               0
 CoreStates Bank, N.A., as Escrow Agent ............        71,777         71,777               0

Stephen P. Griggs(4)  ..............................     1,363,545        750,000         613,545
</TABLE>
    

   
- ----------
(1) The shares  offered  hereby  represent  shares  received in exchange for the
    stock of  Ambulatory  Pharmaceutical  Services,  Inc.  pursuant to the Stock
    Purchase Agreement dated as of August 29, 1997.


(2) The shares offered hereby   represent  shares  received in exchange  for the
    stock of APS America, Inc. pursuant to the Stock Purchase Agreement dated as
    of August 29, 1997.


(3) The shares offered hereby   represent  shares  received in exchange  for the
    stock of Arcadia Services,  Inc.  ("Arcadia")  pursuant to the Agreement and
    Plan of  Reorganization  dated as of July 24, 1997.  Of the shares of Common
    Stock being registered hereunder,  71,777 are currently being held in escrow
    to secure indemnification obligations, accounts receivable with respect to a
    litigated  matter  and  merger  consideration  adjustments  pursuant  to the
    Agreement and Plan of Reorganization.  Merger consideration  adjustments may
    be based on a review of the working  capital and  long-term  liabilities  of
    Arcadia as of the closing date,  all on the terms set forth in the Agreement
    and Plan of Reorganization.


(4) The shares  offered  hereby  consist of shares  issuable  upon exercise of a
    warrant (the "Warrant") issued to Mr. Griggs in connection with his entering
    into an employment  agreement  with RoTech upon  consummation  of the RoTech
    Acquisition. Of the 1,363,545 shares beneficially owned by Mr. Griggs, 1,261
    are beneficially  owned by his wife, 8,402 are beneficially  owned by L&G of
    Orlando,  Inc.,  110,372 shares are owned by Mr. Griggs,  493,510 shares are
    issuable upon the exercise of options to purchase Common Stock at an average
    exercise price of $23.98 per share and 750,000 shares are issuable upon
    


                                       20
<PAGE>

   
    exercise of the Warrant. The Warrant is exercisable at a price of $33.16 per
    share of Common  Stock  (equal to the  average  closing  sales  price of the
    Common Stock on the NYSE for the 15 business  days prior to the closing date
    of the RoTech Acquisition) and vest at the rate of 20% per year beginning on
    October 21, 1998  (subject to  acceleration  upon Mr.  Griggs'  death or the
    occurrence of a change in control of IHS).


TRANSACTIONS INVOLVING SELLING STOCKHOLDERS

     On August 29, 1997, the Company  acquired all of the  outstanding  stock of
Ambulatory   Pharmaceutical   Services,  Inc.   ("Ambulatory"),   a  New  Jersey
corporation which provides infusion services, including blood fractions services
and chronic infusion therapies. The purchase price was $34.25 million, including
$16.125  million paid through the  issuance of 473,510  shares of the  Company's
Common Stock (the "Ambulatory Shares").  The Ambulatory Shares are being offered
hereby.

     On August 29, 1997, the Company  acquired all of the  outstanding  stock of
APS America,  Inc.  ("APS"),  a Delaware  corporation  which  provides  infusion
services, including blood fractions services and chronic infusion therapies. The
purchase  price was $2.0 million,  which was paid through the issuance of 58,730
shares of the  Company's  Common  Stock (the "APS  Shares").  The APS Shares are
being offered hereby.

     On  August  29,  1997,  the  Company  acquired  through  merger  all of the
outstanding stock of Arcadia Services, Inc. ("Arcadia"),  a Michigan corporation
which provides home health care services, medical staffing services and clerical
and light  industrial  staffing  services.  The merger  consideration  was $18.7
million,  which was paid though the issuance of 531,194  shares of the Company's
Common  Stock (the  "Arcadia  Shares").  The  Arcadia  Shares are being  offered
hereby.

     On October 21, 1997, the Company  acquired all of the outstanding  stock of
RoTech. See "Recent  Developments -- Recent Acquisitions -- RoTech Acquisition."
In connection with the  acquisition of RoTech,  the Company issued to Stephen P.
Griggs,  President  of RoTech,  warrants  to purchase  750,000  shares of Common
Stock. These shares of Common Stock are being offered hereby.
    


                                       21

<PAGE>

                             PLAN OF DISTRIBUTION

     The   Company  is   registering   the  Shares  on  behalf  of  the  Selling
Stockholders.  All costs,  expenses and fees in connection with the registration
of  the  Shares  offered  hereby  will  be  borne  by  the  Company.   Brokerage
commissions,  if any,  attributable  to the sale of Shares  will be borne by the
Selling Stockholders (or their donees and pledgees).

     Sales of Shares may be effected  from time to time in  transactions  (which
may include block  transactions)  on the New York Stock Exchange,  in negotiated
transactions,  or a  combination  of such methods of sale, at fixed prices which
may be  changed,  at  market  prices  prevailing  at the  time  of  sale,  or at
negotiated prices.  The Selling  Stockholders have advised the Company that they
have not entered into any agreements,  understandings  or arrangements  with any
underwriters  or  broker-dealers  regarding  the sale of their  securities.  The
Selling  Stockholders  may effect  such  transactions  by selling  Common  Stock
directly to purchasers or to or through  broker-dealers  which may act as agents
or  principals.  Such  broker-dealers  may receive  compensation  in the form of
discounts,  concessions or commissions from the Selling  Stockholder  and/or the
purchasers of Common Stock for whom such  broker-dealers may act as agents or to
whom they sell as  principal,  or both (which  compensation  as to a  particular
broker-dealer  might  be  in  excess  of  customary  commissions).  The  Selling
Stockholders and any broker-dealers  that act in connection with the sale of the
Common Stock might be deemed to be "underwriters"  within the meaning of Section
2(11) of the Securities  Act and any commission  received by them and any profit
on the resale of the shares of Common Stock as  principal  might be deemed to be
underwriting  discounts and  commissions  under the Securities  Act. The Selling
Stockholders  may agree to indemnify  any agent,  dealer or  broker-dealer  that
participates  in  transactions  involving  sales of the shares  against  certain
liabilities, including liabilities arising under the Securities Act. Liabilities
under the federal securities laws cannot be waived.

     The  Ambulatory  Group has agreed not to sell in excess of 70,000 shares of
Common Stock  during any thirty day period and to effect  sales  solely  through
Smith  Barney  Inc.  The APS  Group has  agreed  not to sell in excess of 30,000
shares of Common  Stock  during any thirty day period and to effect sales solely
through  Smith Barney Inc. The Arcadia Group has agreed not to sell in excess of
100,000  shares of Common Stock during any thirty day period and to effect sales
solely through Smith Barney Inc. 

     Because the Selling Stockholders may be deemed to be "underwriters"  within
the meaning of Section  2(11) of the  Securities  Act, the Selling  Stockholders
will be subject to prospectus  delivery  requirements  under the Securities Act.
Furthermore,  in the  event of a  "distribution"  of the  Shares,  such  Selling
Stockholder, any selling broker or dealer and any "affiliated purchasers" may be
subject to Regulation M under the  Securities  Exchange Act of 1934, as amended,
which Regulation would prohibit,  with certain exceptions,  any such person from
bidding for or purchasing any security which is the subject of such distribution
until  his  participation  in  that  distribution  is  completed.  In  addition,
Regulation M under the  Exchange Act  prohibits,  with certain  exceptions,  any
"stabilizing bid" or "stabilizing  purchase" for the purpose of pegging,  fixing
or stabilizing the price of Common Stock in connection with this offering.

     The Selling Stockholders may be entitled under agreements entered into with
the Company to indemnification against liabilities under the Securities Act.


                                 LEGAL MATTERS

   
     Certain  legal  matters  with  respect to the  validity of the Common Stock
offered  hereby have been  passed  upon for the Company by  Fulbright & Jaworski
L.L.P.,  New York,  New York.  At October  31,  1997,  partners  of  Fulbright &
Jaworski L.L.P. owned an aggregate of 300 shares of Common Stock.
    

                                    EXPERTS

     The consolidated  financial statements of Integrated Health Services,  Inc.
and  subsidiaries  as of December 31, 1995 and 1996 and for each of the years in
the  three-year  period  ended  December  31,  1996  have been  incorporated  by
reference in this Prospectus and elsewhere in the Registration State-


                                       22
<PAGE>

ment in reliance upon the report of KPMG Peat Marwick LLP, independent certified
public accountants,  incorporated by reference herein, and upon the authority of
said firm as experts in accounting and auditing. The report of KPMG Peat Marwick
LLP refers to changes in  accounting  methods,  in 1995,  to adopt  Statement of
Financial  Accounting  Standards  No. 121 related to  impairment  of  long-lived
assets and, in 1996, from deferring and amortizing  pre-opening costs of Medical
Specialty Units to recording them as expenses when incurred.

     The  consolidated  financial  statements of First  American  Health Care of
Georgia,  Inc. as of December 31, 1994 and 1995 and for each of the years in the
three-year  period ended December 31, 1995, have been  incorporated by reference
in this Prospectus and in the Registration Statement from IHS' Current Report on
Form 8-K/A,  as amended (dated October 17, 1996 and filed with the Commission on
July 11, 1997) in reliance upon the report of KPMG Peat Marwick LLP, independent
certified public  accountants,  incorporated by reference  herein,  and upon the
authority of said firm as experts in accounting and auditing. The report of KPMG
Peat Marwick LLP contains an  explanatory  paragraph  regarding the  uncertainty
with  respect  to  certain  contingent  payments  which may be  payable  under a
settlement agreement with the Health Care Financing Administration.

     The consolidated financial statements of Community Care of America, Inc. as
of December 31, 1995 and 1996 and for each of the years in the three-year period
ended December 31, 1996 have been  incorporated  by reference in this Prospectus
and in the  Registration  Statement  from IHS' Current Report on Form 8-K (dated
September  25,  1997) in  reliance  upon the  report of KPMG Peat  Marwick  LLP,
independent certified public accountants,  incorporated by reference herein, and
upon the  authority  of said firm as experts in  accounting  and  auditing.  The
report of KPMG Peat  Marwick  LLP refers to the change in  accounting  method in
1996 to adopt  Statement of Financial  Accounting  Standards No. 121 relating to
the impairment of long-lived assets.

     The financial  statements of RoTech Medical Corporation as of July 31, 1996
and 1997 and for each of the years in the three year period  ended July 31, 1997
incorporated in this Prospectus and in the  Registration  Statement by reference
from IHS' Current  Report on Form 8-K (dated October 21, 1997) have been audited
by Deloitte & Touche LLP, independent auditors, as stated in their report, which
is incorporated  herein by reference,  and have been so incorporated in reliance
upon the report of such firm given upon their authority as experts in accounting
and auditing.


                                       23


<PAGE>
<TABLE>
<CAPTION>
<S>                                                          <C>
   
=====================================================        ====================================================
   NO PERSON IS  AUTHORIZED  IN  CONNECTION  WITH ANY                       
OFFERING  MADE HEREBY TO GIVE ANY  INFORMATION  OR TO                       
MAKE  ANY   REPRESENTATION   NOT  CONTAINED  IN  THIS
PROSPECTUS,  AND, IF GIVEN OR MADE, SUCH  INFORMATION                             1,813,434
OR  REPRESENTATION  MUST NOT BE RELIED UPON AS HAVING
BEEN AUTHORIZED BY THE COMPANY.  THIS PROSPECTUS DOES                               SHARES
NOT CONSTITUTE AN OFFER TO SELL OR A SOLICITATION  OF
AN OFFER TO BUY ANY  SECURITY  OTHER  THAN THE COMMON
STOCK OFFERED HEREBY, NOR DOES IT CONSTITUTE AN OFFER                           
TO SELL OR A  SOLICITATION  OF AN OFFER TO BUY ANY OF
THE  SECURITIES  OFFERED  HEREBY TO ANY PERSON IN ANY
JURISDICTION  IN WHICH IT IS UNLAWFUL TO MAKE SUCH AN
OFFER OR  SOLICITATION.  NEITHER THE DELIVERY OF THIS
PROSPECTUS  NOR ANY SALE MADE  HEREUNDER  SHALL UNDER                          INTEGRATED HEALTH
ANY  CIRCUMSTANCES  CREATE ANY  IMPLICATION  THAT THE                           SERVICES,  INC.
INFORMATION  CONTAINED  HEREIN IS  CORRECT  AS OF ANY
DATE SUBSEQUENT TO THE DATE HEREOF.
</TABLE>
    




         --------------------------
             TABLE OF CONTENTS
<TABLE>   
<CAPTION> 
                                                                                   COMMON STOCK



                                                PAGE
                                                -----
<S>                                             <C>
Available Information    ..................      2

Incorporation of Certain Documents by
   Reference    ..........................       3

The Company  .............................       5
   
Risk Factors .............................       7
                                                                                 -------------------
Recent Developments ......................      16                                   PROSPECTUS
                                                                                 -------------------
Use of Proceeds ..........................      19

Selling Stockholders  ....................      19

Plan of Distribution  ....................      22

Legal Matters   ..........................      22

Experts   ................................      22
                                                                                   DECEMBER 10, 1997
    

=====================================================        ====================================================
</TABLE>


<PAGE>


                                    PART II

                    INFORMATION NOT REQUIRED IN PROSPECTUS


ITEM 14. OTHER EXPENSES OF ISSUANCE AND DISTRIBUTION.

     The  following  is an itemized  statement of the  estimated  amounts of all
expenses  payable by the Registrant in connection  with the  registration of the
Shares:





   
<TABLE>
<CAPTION>
                               ITEM                                       AMOUNT
- ------------------------------------------------------------------   ----------------
<S>                                                                  <C>
     Registration Fee - Securities and Exchange Commission  ......     $  15,982.02
     Legal, accounting and printing fees and expenses ............        35,000.00 *
     Miscellaneous   .............................................         1,017.98 *
                                                                       -------------
        Total  ...................................................     $  52,000.00 *
                                                                       =============
</TABLE>
    

- ----------
* Estimated.


ITEM 15. INDEMNIFICATION OF DIRECTORS AND OFFICERS.

     Under the DGCL, a corporation may include  provisions in its certificate of
incorporation that will relieve its directors of monetary liability for breaches
of their fiduciary duty to the corporation,  except under certain circumstances,
including a breach of the director's  duty of loyalty,  acts or omissions of the
director not in good faith or which involve intentional  misconduct or a knowing
violation  of law,  the  approval  of an  improper  payment of a dividend  or an
improper  purchase by the corporation of stock or any transaction from which the
director  derived an improper  personal  benefit.  The Company's  Third Restated
Certificate of Incorporation,  as amended, provides that the Company's directors
are not liable to the  Company or its  stockholders  for  monetary  damages  for
breach of their fiduciary duty, subject to the described exceptions specified by
the DGCL.

     Section 145 of the DGCL grants to the Company the power to  indemnify  each
officer and director of the Company against liabilities and expenses incurred by
reason of the fact that he is or was an officer or director of the Company if he
acted in good  faith  and in a manner  he  reasonably  believed  to be in or not
opposed to the best  interests of the Company and,  with respect to any criminal
action or  proceeding,  had no  reasonable  cause to  believe  his  conduct  was
unlawful. The Company's Third Restated Certificate of Incorporation, as amended,
and  By-laws,  as  amended,  provide  for  indemnification  of each  officer and
director  of the  Company  to the  fullest  extent  permitted  by the  DGCL.  In
addition,  IHS has entered into  indemnity  agreements  with its  directors  and
executive  officers,  a form of  which is  included  as  Exhibit  10.72 to IHS's
Registration  Statement on Form S-1,  No.  33-39339,  effective  March 31, 1992.
Section  145 of the DGCL also  empowers  the Company to  purchase  and  maintain
insurance  on behalf of any person who is or was an officer or  director  of the
Company  against  liability  asserted  against  or  incurred  by him in any such
capacity,  whether or not the  Company  would have the power to  indemnify  such
officer or director  against such liability under the provisions of Section 145.
The Company has  purchased and  maintains a directors'  and officers'  liability
policy for such purposes.

     The agreements  pursuant to which the Signature  Shares,  the Mediq Shares,
the Total Rehab Shares and the Lifeway Shares were issued  (Exhibits 10.1, 10.2,
10.3  and  10.4,  respectively)  provide  for  indemnification  by  the  sellers
thereunder of the Company and its  controlling  persons,  directors and officers
for certain liabilities, including liabilities arising under the Securities Act.


   
ITEM 16. EXHIBITS.
    



   
<TABLE>
<S>    <C>
 5     Opinion of Fulbright & Jaworski L.L.P.
10.1   Stock Purchase Agreement, dated as of August 29, 1997, among the Company, Ambulatory
       Pharmaceutical Services, Inc. and Gigi Jordan.
10.2   Stock Purchase Agreement, dated as of August 29, 1997, among the Company, APS America,
       Inc., Raymond A. Mirra, Jr., James Kuo, Edward Kramm and Sirrom Capital Corporation.
</TABLE>
    

                                      II-1

<PAGE>


10.3   Agreement and Plan of  Reorganization,  dated as of July 24, 1997,  among
       the Company, Integrated AG Acquisition,  Inc., Arcadia Services, Inc. and
       the other parties thereto.
10.4   Warrant,  dated as of October 21, 1997, issued by  the Company to Stephen
       P. Griggs.
23.1   Consents of KPMG Peat Marwick LLP.
23.2   Consent of Deloitte & Touche LLP.
23.3   Consent of Fulbright & Jaworski L.L.P. (included in Exhibit 5).
24     Power of Attorney (included on signature page).


ITEM 17. UNDERTAKINGS.

     (a) The undersigned registrant hereby undertakes:

       (1) To file, during any period in which offers or sales are being made, a
   post-effective amendment to this registration statement:

          (i) To include any prospectus required by Section 10(a)(3) of the
Securities Act of 1933;

          (ii) To reflect in the  prospectus  any facts or events  arising after
       the  effective  date of the  registration  statement  (or the most recent
       post-effective   amendment   thereof)  which,   individually  or  in  the
       aggregate, represent a fundamental change in the information set forth in
       the registration statement;

          (iii) To include any material  information with respect to the plan of
       distribution not previously  disclosed in the  registration  statement or
       any material change to such information in the registration statement;

     Provided, however, that paragraphs (a)(1)(i) and (a)(1)(ii) do not apply if
the information  required to be included in a post-effective  amendment by those
paragraphs is contained in periodic reports filed by the registrant  pursuant to
Section  13 or Section  15(d) of the  Securities  Exchange  Act of 1934 that are
incorporated by reference in the registration statement.

       (2)  That,  for the  purpose  of  determining  any  liability  under  the
   Securities Act of 1933, each such post-effective amendment shall be deemed to
   be a new registration  statement  relating to the securities offered therein,
   and the  offering of such  securities  at that time shall be deemed to be the
   initial bona fide offering thereof.

       (3) To remove from  registration by means of a  post-effective  amendment
   any of the securities being registered which remain unsold at the termination
   of the offering.

     (b) The  undersigned  registrant  hereby  undertakes  that, for purposes of
determining  any liability  under the Securities Act of 1933, each filing of the
registrant's  annual  report  pursuant to Section  13(a) or Section 15(d) of the
Securities  Exchange  Act of  1934  that is  incorporated  by  reference  in the
registration  statement  shall  be  deemed  to be a new  registration  statement
relating to the securities offered therein,  and the offering of such securities
at that time shall be deemed to be the initial bona fide offering thereof.

     (c) Insofar as indemnification for liabilities arising under the Securities
Act of 1933 may be permitted to directors,  officers and controlling  persons of
the registrant  pursuant to the  provisions  described  under Item 15 above,  or
otherwise, the registrant has been advised that in the opinion of the Securities
and  Exchange  Commission  such  indemnification  is  against  public  policy as
expressed in the Act and is, therefore, unenforceable. In the event that a claim
for  indemnification  against  such  liabilities  (other than the payment by the
registrant of expenses  incurred or paid by a director,  officer or  controlling
person of the  registrant  in the  successful  defense  of any  action,  suit or
proceeding)  is  asserted by such  director,  officer or  controlling  person in
connection with the securities being registered,  the registrant will, unless in
the opinion of its counsel the matter has been settled by controlling precedent,
submit  to a  court  of  appropriate  jurisdiction  the  question  whether  such
indemnification  by it is against public policy as expressed in the Act and will
be governed by the final adjudication of such issue.


                                      II-2
<PAGE>

                                   SIGNATURES

   
     Pursuant to the requirements of the Securities Act of 1933, as amended, the
Registrant certifies that it has reasonable grounds to believe that it meets all
of the requirements for filing on Form S-3 and has duly caused this Registration
Statement  to be  signed  on its  behalf  by  the  undersigned,  thereunto  duly
authorized, in the City of Owings Mills, State of Maryland on December 10, 1997.


                                        INTEGRATED HEALTH SERVICES, INC.



                                        By: /s/ ROBERT N. ELKINS
    
                                           ------------------------------------
                              
   
                                           Robert N. Elkins, Chairman of the
                                           Board and  Chief Executive Officer
    


                               POWER OF ATTORNEY

     KNOW ALL MEN BY THESE PRESENTS,  that each person whose  signature  appears
below  constitutes  and  appoints  Robert N.  Elkins,  Lawrence  P. Cirka and W.
Bradley Bennett,  jointly and severally,  his true and lawful  attorneys-in-fact
and agents, each with full power of substitution and resubstitution, for him and
in his name,  place and stead,  in any and all  capacities,  to sign any and all
amendments to this registration  statement,  and to file the same, with exhibits
thereto,  and other documents in connection  therewith,  with the Securities and
Exchange Commission,  granting unto said  attorneys-in-fact and agents, and each
of them, full power and authority to do and perform each and every act and thing
requisite  or necessary  to be done in and about the  premises,  as fully to all
intents and  purposes as he might or could do in person,  hereby  ratifying  and
confirming all that each of said attorneys-in-fact and agents, or his substitute
or substitutes, may lawfully do or cause to be done by virtue hereof.

     Pursuant to the  requirements  of the  Securities  Act of 1933, as amended,
this  Registration  Statement has been signed below by the following  persons in
the capacities and on the dates indicated.



   
<TABLE>
<CAPTION>
           SIGNATURE                          TITLE                       DATE
- -------------------------------   ------------------------------   ------------------
<S>                               <C>                              <C>
        /s/ ROBERT N. ELKINS      Chairman of the Board and         December 10, 1997
- -----------------------------
                                  Chief Executive Officer
         (Robert N. Elkins)
                                  (Principal Executive Officer)
       /s/ LAWRENCE P. CIRKA      President and Director            December 10, 1997
- -----------------------------
         (Lawrence P. Cirka)
       /s/ EDWIN M. CRAWFORD      Director                          December 10, 1997
- -----------------------------
        (Edwin M. Crawford )
       /s/ KENNETH M. MAZIK       Director                          December 10, 1997
- -----------------------------
         (Kenneth M. Mazik)
      /s/ ROBERT A. MITCHELL      Director                          December 10, 1997
- -----------------------------
        (Robert A. Mitchell)
   /s/ CHARLES W. NEWHALL, III    Director                          December 10, 1997
- -----------------------------
    (Charles W. Newhall, III)
</TABLE>
    

                                      II-3

<PAGE>


   
<TABLE>
<CAPTION>
           SIGNATURE                           TITLE                       DATE
- -------------------------------   -------------------------------   ------------------
<S>                               <C>                               <C>
     /s/ TIMOTHY F. NICHOLSON     Director                          December 10, 1997
- -----------------------------
       (Timothy F. Nicholson)
       /s/ JOHN L. SILVERMAN      Director                          December 10, 1997
- -----------------------------
         (John L. Silverman)
       /s/ GEORGE H. STRONG       Director                          December 10, 1997
- -----------------------------
         (George H. Strong)
      /s/ W. BRADLEY BENNETT      Executive Vice President-         December 10, 1997
- -----------------------------
                                  Chief Accounting Officer
        (W. Bradley Bennett)
                                  (Principal Accounting Officer)
      /s/ ELEANOR C. HARDING      Executive Vice President-          December 10, 1997
- -----------------------------
                                  Finance (Principal Financial
        (Eleanor C. Harding)
                                  Officer)
</TABLE>
    

                                      II-4

<PAGE>

                               INDEX TO EXHIBITS



<TABLE>
<CAPTION>
 EXHIBIT
   NO.                                       DESCRIPTION                                      PAGE NO.
- --------   -------------------------------------------------------------------------------   ---------
<S>        <C>                                                                               <C>
    5      Opinion of Fulbright & Jaworski L.L.P.
  10.1     Stock  Purchase  Agreement,  dated as of August 29,  1997,  among the
           Company, Ambulatory Pharmaceutical Services, Inc. and Gigi Jordan.
  10.2     Stock  Purchase  Agreement,  dated as of August 29,  1997,  among the
           Company, APS America,  Inc., Raymond A. Mirra, Jr., James Kuo, Edward
           Kramm and Sirrom Capital Corporation.
  10.3     Agreement  and Plan of  Reorganization,  dated  as of July 24,  1997,
           among the Company, Integrated AG Acquisition, Inc., Arcadia Services,
           Inc. and the other parties thereto.
  10.4     Warrant,  dated as of  October  21,  1997,  issued by the  Company to
           Stephen P. Griggs.
  23.1     Consents of KPMG Peat Marwick LLP.
  23.2     Consent of Deloitte & Touche L.L.P.
  23.3     Consent of Fulbright & Jaworski L.L.P. (included in Exhibit 5).
   24      Power of Attorney (included on signature page).
</TABLE>




The Board of Directors
Integrated Health Services, Inc.
10065 Red Run Boulevard
Owings Mills, Maryland 21117

Dear Sirs: 


     We  refer to the  Registration  Statement  on Form  S-3 (the  "Registration
Statement"), filed by Integrated Health Services, Inc. (the "Company") on behalf
of certain selling stockholders (the "Selling Stockholders") with the Securities
and Exchange  Commission under the Securities Act of 1933, as amended,  relating
to 1,813,434 shares of Common Stock,  $.001 par value (the "Shares"),  including
750,000 shares of Common Stock issuable upon exercise of a warrant (the "Warrant
Shares"), to be sold by the Selling Stockholders named therein.

     As counsel  for the  Company,  we have  examined  such  corporate  records,
documents  and  such  questions  of  law  as we  have  considered  necessary  or
appropriate   for  purposes  of  this  opinion  and,  upon  the  basis  of  such
examination,  advise you that in our opinion the Shares  (other than the Warrant
Shares)  to be sold by the  Selling  Stockholders  have  been  duly and  validly
authorized and are legally issued, fully paid and non-assessable and the Warrant
Shares have been duly and validly  authorized  and, upon exercise of the warrant
and payment of the exercise price therunder,  will be legally issued, fully paid
and non-assessable.

     We consent to the filing of this opinion as an exhibit to the  Registration
Statement  and the reference to this firm under the caption  "Legal  Matters" in
the prospectus contained therein and elsewhere in the Registration Statement and
prospectus.  This consent is not to be  construed as an admission  that we are a
party  whose  consent is required  to be filed with the  Registration  Statement
under the provisions of the Securities Act of 1933, as amended.

                                                Very truly yours,

                                                /s/  Fulbright & Jaworski L.L.P.


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

                            STOCK PURCHASE AGREEMENT

                           DATED AS OF AUGUST 29, 1997

                                      AMONG

                        INTEGRATED HEALTH SERVICES, INC.

                                       AND

                    AMBULATORY PHARMACEUTICAL SERVICES, INC.

                                       AND

                                   GIGI JORDAN




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



<PAGE>


<TABLE>
<CAPTION>

                                TABLE OF CONTENTS
                                                                               PAGE

<S>                                                                             <C>
ARTICLE I:  SALE AND PURCHASE OF COMPANY STOCK.................................  1
    1.1      Sale and Purchase of Company Stock................................  1

ARTICLE II:  PURCHASE PRICE....................................................  1
    2.1      Determination and Payment of Purchase Price.......................  1
    2.2      Adjustments to the Purchase Price.................................  2
    2.3      Liabilities.......................................................  3

ARTICLE III:  IHS STOCK........................................................  3
    3.1      IHS Stock.........................................................  3

ARTICLE IV:  THE CLOSING.......................................................  8
    4.1      Time and Place of Closing.........................................  8

ARTICLE V:  REPRESENTATIONS AND WARRANTIES OF THE SELLER AND
    COMPANY....................................................................  8
    5.1      Organization and Standing of the Company..........................  8
    5.2      Absence of Conflicting Agreements.................................  8
    5.3      Consents..........................................................  9
    5.4      Company Stock.....................................................  9
    5.5      Assets............................................................  9
    5.6      Trademarks........................................................  9
    5.7      Contracts......................................................... 10
    5.8      Financial Statements.............................................. 11
    5.9      Material Changes.................................................. 11
    5.10     Licenses; Permits; Certificates of Need........................... 12
    5.11     Title, Condition of Personal Property............................. 12
    5.12     Legal Proceedings................................................. 13
    5.13     Employees......................................................... 14
    5.14     Collective Bargaining, Labor Contracts, Employment Practices, Etc. 14
    5.15     ERISA............................................................. 15
    5.16     Insurance and Surety Agreements................................... 15
    5.17     Relationships..................................................... 16
    5.18     Absence of Certain Events......................................... 16
    5.19     Compliance with Laws.............................................. 17
    5.20     Finders........................................................... 17
    5.21     Tax Returns....................................................... 17
    5.22     Encumbrances Created by this Agreement............................ 17
    5.23     Subsidiaries and Joint Ventures................................... 17


                                      (i)

<PAGE>



    5.24     No Untrue Statement............................................... 18
    5.25     Medicare and Medicaid Programs.................................... 18
    5.26     Leasehold Interests............................................... 18
    5.27     Power and Authority............................................... 18
    5.28     Binding Effect.................................................... 18
    5.29     Questionnaires.................................................... 18
    5.30     Questionable Payments............................................. 18

ARTICLE VI:  REPRESENTATIONS AND WARRANTIES OF SELLER ......................... 19
    6.1      Authority......................................................... 19
    6.2      Binding Effect.................................................... 19
    6.3      Absence of Conflicting Agreements................................. 19
    6.4      Consents.......................................................... 19
    6.5      Ownership of Company Stock........................................ 19

ARTICLE VII:  REPRESENTATIONS AND WARRANTIES OF BUYER.......................... 19
    7.1      Organization and Standing......................................... 19
    7.2      Power and Authority............................................... 20
    7.3      Binding Agreement................................................. 20
    7.4      Absence of Conflicting Agreements................................. 20
    7.5      Consents.......................................................... 20
    7.6      Securities and Exchange Commission Filings........................ 20
    7.7      Material Changes.................................................. 21
    7.8      Finders........................................................... 21
    7.9      Capital Stock..................................................... 21
    7.10     Compliance with Laws.............................................. 21
    7.11     Questionable Payments............................................. 21
    8.1      Buyer's Access to Information and Records before Closing.......... 22

ARTICLE IX:  OBLIGATIONS OF THE PARTIES UNTIL CLOSING.......................... 22
    9.1      Conduct of Business Pending Closing............................... 22
    9.2      Negative Covenants of the Company and its Subsidiaries............ 22
    9.3      Affirmative Covenants............................................. 23
    9.4      Pursuit of Consents and Approvals................................. 24
    9.5      Exclusivity....................................................... 24

ARTICLE X:  CONDITIONS PRECEDENT TO BUYER'S OBLIGATIONS........................ 24
    10.1     Representations and Warranties.................................... 24
    10.2     Performance of Covenants.......................................... 24
    10.3     Delivery of Closing Certificate................................... 25
    10.4     Opinion of Counsel................................................ 25
    10.5     Legal Matters..................................................... 25
    10.6     Authorization Documents........................................... 25


                                      (ii)

<PAGE>


    10.7     Material Change................................................... 25
    10.8     Approvals......................................................... 25
    10.9     Employment Agreement.............................................. 25
    10.10    Consents.......................................................... 26
    10.11    Estimated Closing Date Balance Sheet.............................. 26
    10.12    Company's Subsidiaries and Options................................ 26
    10.13    Cost and Expenses................................................. 26
    10.14    Resignation of Company Boards of Directors and Officers........... 26
    10.15    Affiliated Company................................................ 26
    10.16    Other Documents................................................... 26

ARTICLE XI:  CONDITIONS PRECEDENT TO SELLER'S OBLIGATIONS...................... 26
    11.1     Representations and Warranties.................................... 26
    11.2     Performance of Covenants.......................................... 27
    11.3     Delivery of Closing Certificate................................... 27
    11.4     Opinion of Counsel................................................ 27
    11.5     Legal Matters..................................................... 27
    11.6     Authorization Documents........................................... 27
    11.7     Employment Agreement.............................................. 27
    11.8     Material Change................................................... 27
    11.9     Other Documents................................................... 27

ARTICLE XII:  SURVIVAL AND INDEMNIFICATION..................................... 27
    12.1     Survival of Representations and Warranties........................ 27
    12.2     Indemnification by Seller......................................... 28
    12.3     Indemnification by Buyer.......................................... 28
    12.4     Assertion of Claims............................................... 29
    12.6     Control of Defense of Indemnifiable Claims........................ 29
    12.7     Restrictions...................................................... 30
    12.8     Records........................................................... 31

ARTICLE XIII:  TERMINATION..................................................... 31
    13.1     Termination....................................................... 31
    13.2     Effect of Termination............................................. 31

ARTICLE XIV:  MISCELLANEOUS.................................................... 32
    14.1     Costs and Expenses................................................ 32
    14.2     Performance....................................................... 32
    14.3     Benefit and Assignment............................................ 32
    14.4     Effect and Construction of this Agreement......................... 32
    14.5     Cooperation - Further Assistance.................................. 32
    14.6     Notices........................................................... 32
    14.7     Waiver, Discharge, Etc............................................ 33


                                      (iii)

<PAGE>



    14.8     Rights of Persons Not Parties..................................... 33
    14.9     Governing Law..................................................... 33
    14.10    Amendments, Supplements, Etc...................................... 34
    14.11    Severability...................................................... 34
    14.12    Counterparts...................................................... 34
    14.13    Arbitration....................................................... 34
    14.14    Public Announcements.............................................. 34
</TABLE>



                                      (iv)

<PAGE>



                                 SCHEDULES & EXHIBITS

Schedule 5.3         -       Consent List of Seller
Schedule 5.4         -       Company Stock
Schedule 5.6         -       Trademarks
Schedule 5.7         -       Contracts
Schedule 5.8(a)      -       Unaudited Financial Statement
Schedule 5.8(b)      -       Unaudited Interim Financial Statements
Schedule 5.8(c)      -       Material Liabilities
Schedule 5.9         -       Material Changes
Schedule 5.10        -       Licenses, Permits, Certificates of Need
Schedule 5.11(a)     -       Liens on Personal Property
Schedule 5.11(b)     -       Leases of Personal Property
Schedule 5.12        -       Legal Proceedings
Schedule 5.13        -       Employees
Schedule 5.15(b)     -       Employee Benefit Plans
Schedule 5.15(c)     -       Employees on Leave of Absence
Schedule 5.16        -       Insurance and Surety Agreements
Schedule 5.17        -       Relationships
Schedule 5.18        -       Absence of Certain Events
Schedule 5.19        -       Compliance with Laws
Schedule 5.21        -       Tax Returns
Schedule 5.23        -       Subsidiaries, Joint Ventures, etc.
Schedule 5.25        -       Medicare and Medicaid Programs
Schedule 6.5         -       Ownership of Company Stock

Exhibit 5.29         -       Questionnaire
Exhibit 10.4         -       Opinion of Seller's Counsel
Exhibit 10.9         -       Employment Agreement
Exhibit 11.4         -       Opinion of Buyer's Counsel



                                       (v)

<PAGE>



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

                            STOCK PURCHASE AGREEMENT
                           --------------------------


                  This Stock Purchase  Agreement (the "Agreement") is made as of
the 29th day of August, 1997, among INTEGRATED HEALTH SERVICES, INC., a Delaware
corporation   ("Buyer"),   and  GIGI  JORDAN  (the   "Seller")  and   AMBULATORY
PHARMACEUTICAL SERVICES, INC., a New Jersey corporation (the "Company").

                  WHEREAS,  the Company is in the business of providing infusion
services,  including without  limitation,  blood fractions  services and chronic
infusion therapies (the "Business" or "Services"); and

                  WHEREAS,  the  Seller  is the  owner or  holder  of all of the
issued and outstanding  shares of the capital stock of the Company (the "Company
Stock"); and

                  WHEREAS,  Buyer  wishes to acquire the Company  Stock from the
Seller,  and the Seller wishes to sell the Company Stock to Buyer, in accordance
with the terms and conditions hereinafter set forth.

                  NOW,  THEREFORE,  Seller,  Buyer, and Company  intending to be
legally bound, agree as follows:

                  ARTICLE I: SALE AND PURCHASE OF COMPANY STOCK

     1.1 SALE AND PURCHASE OF COMPANY STOCK. Subject to the terms and conditions
of this Agreement, at the Closing (as hereinafter defined),  Buyer shall acquire
from the Seller,  and the Seller  shall  sell,  assign,  transfer  and convey to
Buyer,  the Company Stock.  The number of shares of Company Stock (and the class
or series of such  shares)  being  sold by Seller is set forth on  Schedule  5.4
hereto.

                           ARTICLE II: PURCHASE PRICE

     2.1  DETERMINATION  AND PAYMENT OF PURCHASE  PRICE.  Subject to  adjustment
pursuant to Section 2.2 hereof, the aggregate purchase price to be paid by Buyer
to the Seller for the Company Stock (the "Purchase Price"), shall be THIRTY-FOUR
MILLION TWO HUNDRED FIFTY THOUSAND AND 00/100 ($34,250,000.00)  DOLLARS, payable
at the Closing as follows:

       (a)  EIGHTEEN  MILLION ONE  HUNDRED  TWENTY-FIVE  THOUSAND  ($18,125,000)
DOLLARS to be paid in cash by wire transfer of immediately available funds;



<PAGE>



       (b)  SIXTEEN  MILLION  ONE  HUNDRED  TWENTY-FIVE  THOUSAND  ($16,125,000)
DOLLARS by the delivery of newly issued  shares of the Common  Stock,  par value
$.001, of Buyer (the "IHS Stock").

     2.2 ADJUSTMENTS TO THE PURCHASE PRICE.

       (a) At the Closing, the Company shall deliver a certificate signed by its
Chief Financial Officer certifying the amount of the Company's aggregate working
capital (as defined herein) as of the Closing Date on a consolidated  basis (the
"Estimated  Closing  Date  Working  Capital").  In the event that the  Estimated
Closing Date  Working  Capital is less than  $4,000,000  (the  "Minimum  Working
Capital"),  the Purchase  Price payable to the Seller at Closing will be reduced
on a dollar-for-dollar basis by an amount equal to the amount of such deficiency
in cash. For the purposes hereof,  "working capital" means the excess of current
assets over current  liabilities,  as determined in  accordance  with  generally
accepted accounting  principles,  consistently  applied ("GAAP");  provided that
current  liabilities  shall  include  any  deferred  taxes  resulting  from  the
conversion  of the Company as of the  Closing  Date from an  S-corporation  to a
C-corporation.  Additionally, at the Closing, the Company shall deliver to Buyer
the balance sheet of the Company on a consolidated basis dated as of the Closing
Date,  certified by the Company's Chief Financial  Officer to be his or her best
good faith estimate thereof (the "Estimated Closing Date Balance Sheet"). In the
event that the Estimated Closing Date Balance Sheet discloses that the aggregate
amount of the Company's  long-term  liabilities as determined in accordance with
GAAP exceeds zero,  the Purchase  Price payable to the Seller at Closing will be
reduced  by an amount  equal to the  amount  of such  excess.  For the  purposes
hereof,  "long-term  liability" means any liability that would be set forth as a
long-term  liability on a balance sheet in accordance  with GAAP;  provided that
long-term  liabilities  shall  include any  deferred  taxes  resulting  from the
conversion  of the Company as of the  Closing  Date from an  S-corporation  to a
C-corporation,  except  that in no event  will the same  deferred  tax amount be
included as both a current liability and long-term liability.

       (b) As soon as is reasonably practicable,  but in any event within ninety
(90) days  following  the Closing  Date,  Buyer  shall  complete a review of the
Company's  Estimated Closing Date Balance Sheet. If such review reveals that the
Company's working capital as of the Closing Date was less than the lesser of (i)
the  Minimum  Working  Capital,  and (ii) the  Estimated  Closing  Date  Working
Capital,  the Purchase  Price shall be deemed to have been reduced by the amount
of such  deficiency,  and the  Seller  shall pay over to Buyer cash in an amount
equal to such  deficiency.  Furthermore,  if such review  reveals the  aggregate
amount of the Company's  long-term  liabilities  as of the Closing Date exceeded
the  greater  of (w)  zero,  or  (x)  the  amount  of  the  Company's  long-term
liabilities  as indicated on the  Estimated  Closing  Date  Balance  Sheet,  the
Purchase  Price  shall be  deemed  to have been  reduced  by the  amount of such
excess,  and the Seller  shall  deliver over to Buyer cash in an amount equal to
such excess.  If there shall be any dispute  regarding  the  calculation  of the
working capital as of the Closing Date or the amount of long-term liabilities as
of the Closing Date,  such dispute  shall be submitted to a mutually  acceptable
"big six" accounting firm other than KPMG Peat Marwick LLP and Deloitte & Touche
LLP (the  "Accountants")  for final  resolution  and the party  against whom the
Accountants  shall rule shall pay the costs and expenses of the  Accountants  in
connection therewith.


                                        2

<PAGE>



     2.3  LIABILITIES.  As of the Closing  Date,  the Company  will not have any
Liabilities other than such long-term liabilities and current liabilities as are
reflected on the  Estimated  Closing Date  Balance  Sheet.  For purposes of this
Agreement the term "Liability" means any claim, lawsuit,  liability,  obligation
or debt of any kind or nature whatsoever, whether absolute, accrued, due, direct
or indirect,  contingent or liquidated,  matured or unmatured, joint or several,
whether or not for a sum  certain,  whether  for the payment of money or for the
performance or observance of any obligation or condition,  and whether or not of
a type which would be reflected as a liability on a balance  sheet in accordance
with GAAP,  including,  without  limitation (i)  malpractice  claims asserted by
patients or any other tort claims  asserted,  claims for breach of contract,  or
any claims of any kind asserted by patients,  former patients,  employees or any
other  party  that are based on acts or  omissions  occurring  on or before  the
Closing Date; (ii) amounts due or that may become due to Medicare or Medicaid or
any other  health  care  reimbursement  or  payment  intermediary  on account of
Medicare cost report  adjustments or other payment  adjustments  attributable to
any period on or prior to the  Closing  Date,  or any other form of  Medicare or
other health care reimbursement recapture, adjustment or overpayment whatsoever,
including  fines and  penalties,  with  respect to any period on or prior to the
Closing Date ("Excess Reimbursement Liabilities"); (iii) any accounts payable or
employment  or other taxes;  and (iv) accrued but unpaid  compensation  or other
benefits to any of the Company's  employees,  agents,  consultants  or advisers,
including accrued vacation.


                             ARTICLE III: IHS STOCK

     3.1 IHS STOCK. A portion of the Purchase Price equal to SIXTEEN MILLION ONE
HUNDRED TWENTY-FIVE THOUSAND  ($16,125,000) DOLLARS shall be payable by means of
the delivery to the Seller of IHS Stock in accordance with the following:

       (a) SHARE  VALUE.  The number of shares of IHS Stock  issuable at Closing
pursuant to Section  2.1(b) shall be calculated  based upon a price per share of
such stock equal to the average  closing NYSE price of such stock for the thirty
(30) trading day period immediately  preceding the date which is two (2) trading
days before the Closing Date.

       (b) REGISTRATION  RIGHTS.  Buyer will prepare and use its best efforts to
cause  to be  filed  and  declared  effective  by the  Securities  and  Exchange
Commission  (the  "Commission")  within  ninety (90) days  following the Closing
Date, a registration  statement for the registration under the Securities Act of
1933 (the  "Securities  Act") of the IHS Stock issued to Seller pursuant to this
Agreement,  and Buyer shall  maintain  the  effectiveness  of such  registration
statement  for a period of one (1) year  following  the date on which it becomes
effective (the  "Registration  Date"),  or until Seller shall not own any of the
IHS Stock issued  pursuant to this  Agreement,  whichever  shall occur first, in
each case except to the extent that an exemption from  registration  would allow
Seller to sell all of her stock without restrictions (other than as set forth in
Section 3.1(d), below) is available.



                                        3

<PAGE>



     (c) REGISTRATION  EXPENSES.  Seller shall not be responsible for, and Buyer
shall bear, all of the reasonable expenses of Buyer related to such registration
including,  without limitation,  the fees and expenses of Seller's counsel in an
amount of up to $5,000,  the fees and  expenses of its counsel and  accountants,
all of its other costs, fees and expenses incident to the preparation, printing,
registration and filing under the Securities Act of the  registration  statement
and all amendments and  supplements  thereto,  the cost of furnishing  copies of
each  preliminary  prospectus,  each  final  prospectus  and each  amendment  or
supplement  thereto to  underwriters,  dealers and other purchasers of IHS Stock
and the costs and expenses  (including  fees and  disbursements  of its counsel)
incurred in connection  with the  qualification  of IHS Stock under the Blue Sky
laws of various  jurisdictions.  Buyer,  however,  shall not be  required to pay
underwriter's  or brokerage  discounts,  commissions or expenses,  or to pay any
costs or expenses arising out of Seller's or any transferee's  failure to comply
with its obligations under this Article III.

     (d) RESALE  LIMITATIONS.  All resales of IHS Stock issued  pursuant to this
Agreement  shall be effected  solely  through Smith Barney Inc., as broker,  and
sales by  Seller  and,  if any,  her  transferees  of such  shares  (other  than
transferees  acquiring  shares  pursuant to market  transactions  through  Smith
Barney Inc. and in accordance with this subsection  (d)), shall not at any time,
in the aggregate, exceed Seventy Thousand (70,000) shares during any thirty (30)
day period.

     (e)  REGISTRATION  PROCEDURES,  ETC. In  connection  with the  registration
rights  granted to the Seller with  respect to the IHS Stock as provided in this
Section 3.1, Buyer covenants and agrees as follows:

          (i)  At  Buyer's  expense,   Buyer  will  keep  the  registration  and
qualification  under this  Section 3.1  effective  (and in  compliance  with the
Securities  Act) by such action as may be  necessary  or  appropriate  until the
Registration  Date or for a period of one (1) year  following  the date on which
the registration  becomes  effective,  in each case except to the extent that an
exemption from registration may be available.  Buyer will immediately notify the
Seller, at any time when a prospectus relating to a registration statement under
this Section 3.1 is required to be delivered  under the  Securities  Act, of the
happening  of any  event  known to Buyer as a  result  of which  the  prospectus
included in such registration  statement,  as then in effect, includes an untrue
statement of a material  fact or omits to state any material fact required to be
stated  therein or necessary to make the  statements  therein not  misleading in
light of the circumstances then existing.

          (ii) Buyer shall  furnish the Seller with such number of  prospectuses
as shall reasonably be requested.

          (iii) Buyer shall take all  necessary  action which may be required in
qualifying or registering  IHS Stock  included in a  registration  statement for
offering  and sale  under  the  securities  or Blue Sky laws of such  states  as
reasonably  are  requested  by the  Seller,  provided  that  Buyer  shall not be
obligated to qualify as a foreign corporation or dealer to do business under the
laws of any such jurisdiction.



                                        4

<PAGE>



          (iv) The  information  included or  incorporated  by  reference in the
registration  statement filed pursuant to this Section 3.1 will not, at the time
any such registration statement becomes effective,  contain any untrue statement
of a material  fact,  or omit to state any material  fact  required to be stated
therein as necessary in order to make the  statements  therein,  in light of the
circumstances under which they were made, not misleading or necessary to correct
any  statement  in any  earlier  filing of such  registration  statement  or any
amendments  thereto.  The  registration  statement  will comply in all  material
respects with the provisions of the Securities Act and the rules and regulations
thereunder. Buyer shall indemnify the Seller of IHS Stock to be sold pursuant to
the registration  statement,  their successors and assigns,  and each person, if
any, who controls such Seller within the meaning of ss.15 of the  Securities Act
or ss.20(a) of the Securities Exchange Act of 1934 ("Exchange Act"), against all
loss,  claim,  damage expense or liability  (including  all expenses  reasonably
incurred in investigating,  preparing or defending against any claim whatsoever)
to which any of them may become subject under the  Securities  Act, the Exchange
Act or any other statute, common law or otherwise,  arising out of or based upon
any untrue statement or alleged untrue statement of a material fact contained in
such registration  statement executed by Buyer or based upon written information
furnished by Buyer filed in any jurisdiction in order to qualify IHS Stock under
the securities laws thereof or filed with the Commission,  any state  securities
commission  or agency,  NYSE or any  securities  exchange;  or the  omission  or
alleged  omission  therefrom of a material fact required to be stated therein or
necessary to make the statements  contained therein not misleading,  unless such
statement or omission was made in reliance upon and in  conformity  with written
information  furnished  to  Buyer  by the  Seller  expressly  for  use  in  such
registration statement,  any amendment or supplement thereto or any application,
as the  case  may be.  If any  action  is  brought  against  the  Seller  or any
controlling  person of the Seller in respect  of which  indemnity  may be sought
against  Buyer  pursuant  to this  subsection  3.1(e)(iv),  the  Seller  or such
controlling  person shall within thirty (30) days after the receipt thereby of a
summons or complaint,  notify Buyer in writing of the institution of such action
and Buyer shall assume the defense of such actions, including the employment and
payment of reasonable fees and expenses of counsel  (reasonably  satisfactory to
the Seller or such controlling  person).  The Seller or such controlling  person
shall have the right to employ its or her own counsel in any such case,  but the
fees and expenses of such counsel  shall be at the expense of the Seller or such
controlling  person  unless (A) the  employment  of such counsel shall have been
authorized in writing by Buyer in connection with the defense of such action, or
(B) Buyer shall not have employed  counsel to have charge of the defense of such
action, or (C) such indemnified party or parties shall have reasonably concluded
that there may be defenses  available to it or them which are different  from or
additional to those available to Buyer (in which case,  Buyer shall not have the
right to direct the defense of such action on behalf of the indemnified party or
parties),  in any of which  events  the fees and  expenses  of not more than one
additional firm of attorneys for the Seller and/or such controlling person shall
be  borne  by  Buyer.  Buyer  agrees  promptly  to  notify  the  Seller  of  the
commencement  of any  litigation  or  proceedings  against  Buyer  or any of its
officers,  directors or controlling persons in connection with the resale of IHS
Stock or in connection with such registration statement.



                                        5

<PAGE>



          (v) The  Seller of IHS  Stock to be sold  pursuant  to a  registration
statement,  and their successors and assigns, shall severally,  and not jointly,
indemnify  Buyer,  its  officers  and  directors  and each  person,  if any, who
controls  Buyer within the meaning of ss.15 of the Securities Act or ss.20(a) of
the  Exchange  Act  against all loss,  claim,  damage,  or expense or  liability
(including  all  expenses  reasonably  incurred in  investigating,  preparing or
defending  against any claim  whatsoever) to which they may become subject under
the  Securities  Act,  the  Exchange  Act or any other  statute,  common  law or
otherwise,  to the extent arising from information  furnished by or on behalf of
Seller, or her successors or assigns for specific inclusion in such registration
statement.

     (f) NOTICE OF SALE. If the Seller desires to transfer all or any portion of
IHS Stock,  the Seller  will  deliver  written  notice to Buyer,  describing  in
reasonable  detail her  intention  to effect the  transfer and the manner of the
proposed  transfer.   If  the  transfer  is  to  be  pursuant  to  an  effective
registration statement as provided herein, the Seller will sell the IHS Stock in
compliance  with the  disclosure  therein and  discontinue  any offers and sales
thereunder upon notice from Buyer that the  registration  statement  relating to
the IHS Stock being  transferred  is not  "current"  until  Buyer gives  further
notice that offers and sales may be recommenced. In the event of any such notice
from  Buyer,   Buyer  agrees  to  file  expeditiously  such  amendments  to  the
registration statement as may be necessary to bring it current during the period
specified  in Section  3.1(b) and to give  prompt  notice to the Seller when the
registration statement has again become current. If the Seller delivers to Buyer
an opinion of counsel reasonably  acceptable to Buyer and its counsel and to the
effect that the proposed transfer of IHS Stock may be made without  registration
under the  Securities  Act, the Seller will be entitled to transfer IHS Stock in
accordance with the terms of the notice and opinion of their counsel.

     (g)  FURNISH  INFORMATION.  It  shall  be  a  condition  precedent  to  the
obligations  of the Buyer to take any action  pursuant to this  Article III that
the Seller shall furnish to the Buyer such information  regarding  herself,  the
IHS Stock held by her, and the intended method of disposition of such securities
as shall be  required  to effect  the  registration  of her IHS  Stock.  In that
connection,  each  transferee  of Seller  shall be required to  represent to the
Buyer that all such information  which is given is both complete and accurate in
all material respects.  Seller shall deliver to the Buyer a statement in writing
from the  beneficial  owners of such  securities  that they bona fide  intend to
sell,  transfer or otherwise  dispose of such securities.  Each transferee will,
severally,  promptly  notify  IHS at any time when a  prospectus  relating  to a
registration  statement covering such transferee's shares under this Section 3.1
is required to be delivered  under the  Securities  Act, of the happening of any
event known to such  transferee as a result of which the prospectus  included in
such registration  statement, as then in effect, includes an untrue statement of
a  material  fact or omits to state  any  material  fact  required  to be stated
therein or necessary to make the  statements  therein not misleading in light of
the statements as then existing.




                                        6

<PAGE>



     (h)  INVESTMENT  REPRESENTATIONS.  All  shares  of IHS  Stock to be  issued
hereunder  will be newly  issued  shares of Buyer.  The  Seller  represents  and
warrants to Buyer that the IHS Stock being issued  hereunder is being  acquired,
and will be acquired,  by the Seller for  investment for her own account and not
with a view to or for sale in connection  with any  distribution  thereof within
the meaning of the Securities Act or the applicable  state  securities  law; the
Seller acknowledges that the IHS Stock constitutes  restricted  securities under
Rule 144  promulgated by the Commission  pursuant to the Securities Act, and may
have to be held indefinitely,  and the Seller agrees that no shares of IHS Stock
may be sold,  transferred,  assigned,  pledged or  otherwise  disposed of except
pursuant  to  an  effective   registration   statement  or  an  exemption   from
registration under the Securities Act, the rules and regulations thereunder, and
under all  applicable  state  securities  laws. The Seller has the knowledge and
experience  in financial  and business  matters,  is capable of  evaluating  the
merits and risks of the  investment,  and is able to bear the  economic  risk of
such  investment.  The Seller has had the  opportunity  to make inquiries of and
obtain from  representatives and employees of Buyer such other information about
Buyer as she deems necessary in connection with such investment. Buyer will file
all Exchange Act reports on a timely basis, including any permitted extensions.

     (i) LEGEND. It is understood that, prior to sale of any shares of IHS Stock
pursuant to an effective  registration  pursuant to  subsection  (b) above,  the
certificates  evidencing such shares of IHS Stock shall bear the following (or a
similar) legend (in addition to any legends which may be required in the opinion
of IHS's counsel by the applicable  securities laws of any state), and upon sale
of such shares  pursuant to such an  effective  registration,  new  certificates
shall be issued for the shares sold  without  such  legends  except as otherwise
required by law.

                  THE  SHARES  REPRESENTED  BY THIS  CERTIFICATE  HAVE  NOT BEEN
                  REGISTERED  UNDER THE  SECURITIES ACT OF 1933. THE SHARES HAVE
                  BEEN ACQUIRED FOR INVESTMENT AND MAY NOT BE SOLD,  TRANSFERRED
                  OR  ASSIGNED  IN  THE  ABSENCE  OF AN  EFFECTIVE  REGISTRATION
                  STATEMENT FOR THESE SHARES UNDER THE SECURITIES ACT OF 1933 OR
                  AN OPINION OF THE COMPANY'S  COUNSEL THAT  REGISTRATION IS NOT
                  REQUIRED UNDER SAID ACT.

     (j) CERTAIN TRANSFEREES. Prior to the effective date of registration of the
IHS Stock, no transferee shall transfer any shares of IHS Stock to any person or
entity  unless such  transferee  shall have agreed in writing to be bound by the
provisions applicable to the Seller under this Article III.






                                        7

<PAGE>



                             ARTICLE IV: THE CLOSING

     4.1  TIME  AND  PLACE  OF  CLOSING.  The  closing  (the  "Closing")  of the
transactions  contemplated  by this  Agreement  shall  be held  as  promptly  as
practicable,   but  not  more  than  seven  (7)  business  days   following  the
satisfaction of all conditions precedent specified in this Agreement,  including
receipt of all necessary regulatory  approvals,  unless duly waived by the party
entitled to satisfaction thereof. The Closing shall take place at the offices of
the Buyer, or at such other time and place upon which the parties may agree. The
date on which the Closing is held is hereinafter called the "Closing Date."


           ARTICLE V: REPRESENTATIONS AND WARRANTIES OF THE SELLER AND
                                     COMPANY

     The  Company and the Seller  hereby  jointly and  severally  represent  and
warrant to Buyer as follows (it being  understood that, for the purposes of this
Article V, except where the content would otherwise require,  "Company" shall be
deemed to refer  collectively  to the  Company  and any  subsidiaries  listed on
Schedule  5.23 and "to the  knowledge of the  Company"  shall be deemed to refer
collectively to the Company's knowledge and the Seller's knowledge):

     5.1  ORGANIZATION  AND STANDING OF THE COMPANY.  The Company and NJ Medical
Corporation  are  corporations  duly  organized,  validly  existing  and in good
standing  under the laws of the  State of New  Jersey.  Copies of the  Company's
Articles of Incorporation and ByLaws,  and all amendments  thereof to date, have
been delivered to Buyer and are complete and accurate. The Company has the power
and  authority to own the property and assets now owned by it and to conduct the
business  presently  being  conducted  by it.  The  Company is  qualified  to do
business  as a foreign  corporation  in each state  where the  ownership  of its
assets or the conduct of its business renders such qualification necessary.

     5.2 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement  including all Schedules and Exhibits hereto, or any of the other
instruments  and  documents   required  or   contemplated   hereby  and  thereby
("Transaction  Documents") by the Company, nor the performance by Seller and the
Company of the transactions contemplated hereby and thereby,  conflicts with, or
constitutes a breach of or a default under (i) the Articles of  Incorporation or
By-Laws of the Company; or (ii) any applicable law, rule, judgment, order, writ,
injunction,  or decree of any  court,  currently  in effect,  provided  that the
consents set forth in Schedule 5.3 are obtained  prior to the Closing;  or (iii)
any  applicable  rule  or  regulation  of any  administrative  agency  or  other
governmental  authority  currently in effect;  or (iv) any  material  agreement,
indenture,  contract  or  instrument  to which the  Company is now a party or by
which any of the assets of the Company is bound.




                                        8

<PAGE>



     5.3  CONSENTS.  Except  as set forth in  Schedule  5.3,  no  authorization,
consent, approval,  license, exemption by, filing or registration with any court
or   governmental   department,    commission,    board,   bureau,   agency   or
instrumentality, domestic or foreign, is or will be necessary in connection with
the  execution,  delivery  and  performance  of  this  Agreement  or  any of the
Transaction Documents by the Seller or the Company.

     5.4 COMPANY STOCK.  Schedule 5.4 sets forth a complete list and description
of the  authorized  capital stock of the Company and the number of shares issued
and  outstanding of each class or series of such capital stock. No shares of the
Company Stock are held in the treasury of the Company.  The Seller is the record
owner of all of the issued and  outstanding  shares of the Company Stock and all
of  such  stock  is  duly  authorized,   validly  issued,  and  fully  paid  and
non-assessable.  On the  Closing  Date,  there  will be no  preemptive  or first
refusal  rights to  purchase  or  otherwise  acquire  from the Company or Seller
shares of capital  stock of the Company  pursuant to any provision of law or the
Articles  of  Incorporation  or  By-Laws  of  the  Company  or by  agreement  or
otherwise.  On the Closing  Date there shall not be  outstanding  any  warrants,
options,  or other rights to subscribe  for or purchase  from any of the Company
any shares of capital stock of the Company,  nor shall there be outstanding  any
securities convertible into or exchangeable for such shares.

     5.5 ASSETS. As of the Closing Date, the consolidated  assets of the Company
(the  "Assets")  will  include  its  ownership  interest  in all of its  current
operating  subsidiaries,  as well as all of the tangible and  intangible  assets
necessary  to operate  the  Business  of the  Company  and its  subsidiaries  as
presently  constituted,  including,  without  limitation,  all contract  rights,
leasehold  interests,  fixed  and  moveable  equipment,  vehicles,  furnishings,
tangible  personal  property,  inventory  and  supplies  (other than  inventory,
supplies,  and other  assets  disposed of in the  ordinary  course of  business,
consistent with prior practice),  goodwill, trade names, trademarks, all patient
records,  books and files,  Certificates of Need, Medicare and Medicaid provider
agreements and provider  numbers;  provider  agreements with third party payors,
telephone numbers, and to the extent permitted by law, all permits, licenses and
other governmental  approvals.  The Assets of the Company as of the Closing Date
shall also include cash, accounts receivable,  and prepaid expenses.  The Assets
shall not  include  inventory,  supplies  and other  assets  disposed  of in the
ordinary course of business, consistent with the prior practice of the Company's
business.  The  quantities  of  inventory  items  included  in  the  Assets  are
reasonable  in light of the  present  and  anticipated  volume of the  Company's
business and the  inventory is good,  usable,  merchantable,  and salable in the
ordinary  course of the Company's  business,  in each case, as determined by the
Company in good faith and consistent with past practice. The accounts receivable
of the Company  are  reflected  properly on its books and records in  accordance
with GAAP,  and have been billed or invoiced in the ordinary  course of business
consistent  with past  practice.  The  Assets  are not  subject to any Liens (as
defined in Section  5.11),  except for  Permitted  Liens (as  defined in Section
5.11).

     5.6 TRADEMARKS. Schedule 5.6 sets forth a complete and accurate list of all
trademarks,  service marks, or applications for any of the same, copyrights, and
other items of  intellectual  property that are owned,  possessed or used by the
Company.  There are no claims or proceedings pending or, to the knowledge of the
Company, overtly threatened against the Company


                                        9

<PAGE>



asserting  that  the  use  of any of the  aforementioned  properties  or  rights
infringes  the rights of any other  person,  and, to the knowledge of the Seller
and Company,  the Company is not infringing on the intellectual  property rights
of any other person.

     5.7 CONTRACTS.  Schedule 5.7 sets forth a complete and accurate list of all
agreements, contracts and commitments of the following type to which the Company
is a party or by which the Company or any of the Company's assets is bound or as
to which the Company has any  outstanding  material  obligations  as of the date
hereof (the "Contracts"):

       (a) each  contract or agreement  for the  employment  or retention of, or
collective  bargaining,  severance or termination  agreement with, any director,
officer, employee, consultant, agent or group of employees of the Company;

       (b) each profit sharing, thrift, bonus, incentive, deferred compensation,
stock   option,   stock   purchase,    severance   pay,   pension,   retirement,
hospitalization, insurance or other similar plan, agreement or arrangement;

       (c) each agreement or arrangement  for the purchase or sale of any of the
Company's  assets,  properties or rights outside the ordinary course of business
(by purchase or sale of assets,  purchase or sale of stock, merger or otherwise)
which is currently in effect which involves consideration of more than $25,000;

       (d) each  contract  currently  in effect which  contains  any  provisions
requiring the Company to indemnify or act for, or guarantee the  obligation  of,
any other person or entity;

       (e) each  agreement  restricting  the Company  from  conducting  business
anywhere in the world;

       (f) each partnership or joint venture contract or similar  arrangement or
agreement which involves a sharing of profits or future payments with respect to
the Company's business or any portion thereof;

       (g)   each   licensing,   distributor,   dealer,   franchise,   sales  or
manufacturer's  representative,  agency, purchasing, supply, and rebate or other
similar contract, arrangement or commitment which involves consideration of more
than $15,000;

       (h) each contract under which the Company performs the Services;

       (i) each lease of real property; or

       (j) any other  agreement  not made in the ordinary  and normal  course of
business which involves consideration of more than $15,000.


                                       10

<PAGE>



     Except as indicated on Schedule 5.7, each of the Contracts was entered into
and requires performance in the ordinary course of business and is in full force
and effect.  The Company is not in material default under any Contract and there
has not been asserted,  either by or against the Company under any Contract, any
written notice of default,  set-off or claim of default. To the knowledge of the
Company, the parties to the Contracts other than the Company are not in material
default of any of their respective  obligations  under the Contracts,  and there
has not  occurred  any event  which  with the  passage  of time or the giving of
notice (or both) would  constitute a material  default or material  breach under
any  Contract.  All  amounts  payable  under the  Contracts  are, or will at the
Closing  Date, be on a current  basis.  Except as set forth on Schedule 5.7, the
change of control in the Company to Buyer will not be deemed an  assignment  of,
or require consent under, any Contract.

     5.8 FINANCIAL STATEMENTS.

       (a)  The  unaudited  consolidated  balance  sheet  of the  Company  as of
December 31, 1996,  and the related  statements of operations  for the year then
ended, annexed hereto as Schedule 5.8(a) (the "Unaudited Financial  Statement"),
presents fairly in all material respects the financial  condition and results of
operations  of the Company at and for the period then ended  specified  and were
prepared in accordance with GAAP.

       (b) The unaudited  consolidated  monthly  statements of operations of the
Company  for each  calendar  month  since  January  1, 1997,  and the  unaudited
consolidated balance sheet of the Company as of July 31, 1997, annexed hereto as
Schedule 5.8(b) (the "Unaudited Interim Financial  Statements"),  present fairly
in all material  respects the  financial  condition and results of operations of
the Company at and for the periods therein specified (except for normal year-end
adjustments  and such  statements do not contain  footnote  disclosure) and were
prepared in accordance with GAAP.

       (c) Except as set forth on Schedule  5.8(c) or as expressly  set forth on
the  Unaudited  Interim  Financial  Statements,  the  Company  has  no  material
non-recurring  or  extraordinary  income or  expense  reduction  not  identified
therein or material  liabilities  or  obligations  (whether  absolute,  accrued,
contingent  or otherwise  and whether due or to become due,  including,  without
limitation,  any guarantees of any obligations of any other person or entity) of
any  kind or  nature  whether  or not  required  by GAAP  to be  reflected  on a
consolidated  balance sheet and/or the notes  thereto,  except for current trade
payables incurred since the date of the Unaudited  Interim Financial  Statements
in the ordinary course of business consistent with past practice.

     5.9 MATERIAL CHANGES.  Except as noted on Schedule 5.9, between the date of
the Unaudited Financial Statement and the date of this Agreement,  there has not
been any material  adverse  change in the condition  (financial or otherwise) of
the Company or any damage or destruction  of any of the Company's  Assets or its
place  of  business  by  fire or  other  casualty,  whether  or not  covered  by
insurance, and during such period of time the Company has conducted its business
in the ordinary and normal course.  Seller has identified  and  communicated  to
Buyer all material information with respect to this transaction.


                                       11

<PAGE>



     5.10 LICENSES;  PERMITS;  CERTIFICATES OF NEED.  Schedule 5.10 sets forth a
description  of (a) all  material  licenses  and  other  governmental  or  other
regulatory  permits,  authorizations or approvals  required for the operation of
the Company's  business that are now in effect,  including all  certificates  of
occupancy  issued  with  respect  to  the  Company's   business;   and  (b)  all
Certificates  of Need  issued with  respect to the Company and its  subsidiaries
that are now in effect (a  "License"  and  collectively,  the  "Licenses").  The
Licenses  constitute all of the material  governmental,  quasi-governmental  and
regulatory  licenses,  permits and authorizations  necessary to the operation of
the businesses of the Company and its  subsidiaries  as they are operated on the
date hereof.  The Company has  delivered to Buyer copies of all of the Licenses.
The Company and its  subsidiaries  own,  possess or otherwise have the exclusive
legal right to use the Licenses  (subject to the terms thereof) , free and clear
of all liens,  pledges,  claims or other  encumbrances of any nature whatsoever.
The Company is not in material  default under any such License,  and the Company
and its subsidiaries have not received any notice of any material default or any
other material claim or proceeding relating to any such License. Each License is
in full force and effect,  and  neither the Company nor any of its  subsidiaries
has  received  written  notice of any  proceeding  to  terminate  or suspend any
License or of any  condition  or event  which,  if uncured,  would result in the
termination  or  suspension  of any  License.  None  of the  Licenses  are:  (a)
provisional,  probationary,  or  restricted  in any  way  except  to the  extent
qualified by any  outstanding  deficiencies  or citations,  particulars of which
have been set forth on  Schedule  5.10;  or (b)  subject  to any  investigation,
cancellation,   impairment,   limitation,   order,  complaint,   proceeding,  or
suspension nor is such  threatened or pending.  No Seller,  director or officer,
employee or former employee of the Company,  or any person,  firm or corporation
other than the Company owns or has any proprietary, financial or other interest,
direct or indirect (other than through the Company),  in whole or in part in any
of the Licenses.

     5.11 TITLE, CONDITION OF PERSONAL PROPERTY.

       (a) Except for the liens listed and  described on Schedule  5.11(a),  the
Company has good and marketable  title to all of the personal  property owned by
the Company  located at its places of business  or used in  connection  with the
operation of its businesses,  subject to no mortgage, security interest, pledge,
lien,  claim,  encumbrance or charge,  or restraint on transfer  whatsoever (the
"Liens") other than  Permitted  Liens (as defined below) and except for personal
property leased by the Company as set forth on Schedule 5.11(b). No other person
has any right to the use or possession  of any of such  property  which is owned
and, except as set forth on Schedule 5.11(a),  no currently  effective financing
statement  with  respect to such  personal  property  has been  filed  under the
Uniform Commercial Code in any jurisdiction,  and the Company has not signed any
such financing statement or any security agreement authorizing any secured party
thereunder to file any such financing  statement.  All of such personal property
comprising  equipment,  improvements,  furniture  and  other  tangible  personal
property in use by the Company,  whether owned or leased,  is in good  operating
condition  and repair,  subject to normal wear and tear,  and is  sufficient  to
enable the  Company to operate  its  business  in a manner  consistent  with its
operation during the immediately preceding twelve (12) months.



                                       12

<PAGE>



     (b) Except as set forth on Schedule 5.11(b),  no tangible personal property
used by the Company in connection  with the operation of its business is subject
to a lease,  conditional sale or similar arrangement.  The Company has delivered
to Buyer a complete and correct copy of each of the leases and other  agreements
listed on Schedule 5.11(b). The Company has a valid leasehold interest in all of
the property  covered by any leases  included on Schedule  5.11(b).  All of said
personal  property leases are valid,  binding and enforceable in accordance with
their respective terms and are in full force and effect,  subject to bankruptcy,
insolvency,  and  other  similar  laws or  equitable  principles  affecting  the
enforcement  of  creditors  rights  generally.  The  Company is not in  material
default under any of such leases and there has not been  asserted,  either by or
against the Company  under any of such  leases,  any written  notice of default,
set-off,  or claim of default.  To the best knowledge of Seller and the Company,
the  parties to such  leases  other than the Company are not in default of their
respective  obligations under any of such leases, and there has not occurred any
event  which  with the  passage  of time or  giving of  notice  (or both)  would
constitute such a default or breach under any of such leases.

     (c) "Permitted Liens" shall mean:

       (i) carriers', warehouseman's,  mechanics, materialmen's,  repairmen's or
other like liens  arising in the ordinary  course of business  which are (i) not
overdue for a period of more than 30 days or (ii) which are being  contested  in
good faith and by appropriate  proceedings,  provided that if such contest shall
continue for more than 30 days,  the amount  thereof shall be bonded or properly
reserved against at the end of such 30-day period;

       (ii) deposits to secure the performance of bids,  trade contracts  (other
than for  borrowed  money),  leases,  statutory  obligations,  surety and appeal
bonds,  performance  bonds and other  obligations of like nature incurred in the
ordinary course of business;

       (iii) rights of lessors under leases set forth on Schedule 5.11(b);

       (iv)  pledges or  deposits  in  connection  with  worker's  compensation,
unemployment insurance, and other social security legislation;

       (v) taxes not yet due or those taxes being contested.

     5.12 LEGAL PROCEEDINGS. Other than as set forth on Schedule 5.12, there are
no claims, actions, suits or proceedings or arbitrations,  either administrative
or judicial,  pending,  or, to the knowledge of the Company,  overtly threatened
against or affecting  the Company,  or the Company's  ability to consummate  the
transactions contemplated herein, at law or in equity or otherwise, before or by
any court or  governmental  agency or body,  domestic or  foreign,  or before an
arbitrator of any kind.



                                       13

<PAGE>



     5.13  EMPLOYEES.  Attached hereto as Schedule 5.13 is the payroll report of
the Company dated as of August 10, 1997,  indicating the names,  positions,  and
compensation  of each of its  employees.  All of such  information is materially
correct as of such date and there has been no material  changes  since then.  To
the knowledge of Seller and Company, none of the employees,  while in the employ
of the Company,  has ever had his or her  professional  license or certification
denied, suspended, revoked, terminated, or voluntarily relinquished under threat
of disciplinary  action,  or has ever been restricted in any way from performing
the duties he or she is to provide for the Company,  and there is no  proceeding
pending, or threatened, pursuant to which any of the foregoing may occur.

     5.14 COLLECTIVE  BARGAINING,  LABOR CONTRACTS,  EMPLOYMENT PRACTICES,  ETC.
During  the two years  prior to the  Closing  Date,  there has been no  material
adverse change in the relationship between the Company and its employees nor any
strike or material labor  disturbance by such employees  affecting the Company's
business and, to the knowledge of the Company,  there is no indication that such
a change, strike or labor disturbance is threatened. The Company's employees are
not represented by any labor union or similar  organization  and the Company has
no reason to believe that there are pending or threatened  any  activities,  the
purpose  of  which  is to  achieve  such  representation,  of all or some of the
Company's  employees.  Except as set forth on Schedule 5.7 or Schedule  5.15(b),
the Company has no collective  bargaining or other labor  contracts,  employment
contracts,  pension,  profit-sharing,  retirement,  insurance,  bonus,  deferred
compensation or other employee  benefit plans,  agreements or arrangements  with
respect to their  employees.  The  Company is in  material  compliance  with the
requirements  prescribed by all Federal,  state and local  statutes,  orders and
governmental rules and regulations ("Government Requirements") applicable to any
of the  employee  benefit  plans,  agreements  and  arrangements  identified  on
Schedule 5.7 and Schedule 5.15(b),  including,  without limitation, the Employee
Retirement  Income Security Act of 1974, as amended  ("ERISA"),  the Immigration
Reform and Control Act, the Worker Adjustment and Retraining Notification Act of
1988, any such  Government  Requirements  respecting  employment  determination,
equal opportunity,  affirmative action,  employee privacy,  wrongful or unlawful
termination, workers' compensation, occupational safety and health requirements,
labor management  relations and unemployment  insurance,  or related matters and
there are no threatened or pending claims relating thereto, in each case. In the
event of  termination  of employment of an employee of the Company,  the Company
will not,  after the  Closing,  pursuant  to any  agreement  with  Seller or the
Company or by reason of any representation made or plan adopted by Seller or the
Company  prior to the  Closing,  be liable to any  employee  of the  Company for
so-called  "severance pay",  parachute payments or any other similar payments or
benefits, including, without limitation,  post-employment healthcare (other than
pursuant to the  continuation  health care  provisions  of Section  4980B of the
Internal  Revenue  Code of 1986,  as amended or Section 601 through 608 of ERISA
("COBRA")),  insurance  benefits,  accrued  vacation  and sick  days,  except as
properly  accrued for on the Estimated  Closing Date Balance Sheet in accordance
with GAAP.






                                       14

<PAGE>



     5.15 ERISA.

       (a) The Company does not maintain or make  contributions  to and have not
at any  time in the past  maintained  or made  contributions  to,  any  employee
benefit plan which is subject to the minimum  funding  standards  of ERISA.  The
Company does not now maintain or make  contributions to, and has not at any time
in the past maintained or made contributions to, any multi-employer plan subject
to the  terms of the  Multi-employer  Pension  Plan  Amendment  Act of 1980 (the
"Multi-employer Act").

       (b) Schedule 5.15(b) sets forth each severance agreement,  and each plan,
agreement or arrangement,  bonus plan, deferred compensation agreement, employee
pension,  profit sharing,  savings or retirement  plan, group life,  health,  or
accident  insurance or other employee  benefit plan,  agreement,  arrangement or
commitment,   including,   without  limitation,  any  commitment  arising  under
severance, holiday, vacation, Christmas or other bonus plans (including, but not
limited  to,  "employee  benefit  plans",  as defined  in Section  3(3) of ERISA
maintained by the Company for any  employees of the Company,  or with respect to
which the Company has liability with respect to any employees of the Company, or
make or have an obligation to make  contributions  on behalf of employees of the
Company ("Plans").

       (c) Schedule 5.15(c)  identifies all employees of the Company on leave of
absence eligible to receive health benefits, as required by COBRA. Notice of the
availability of COBRA coverage has been provided to all employees of the Company
on leave of absence entitled thereto, and all persons electing such coverage are
being (or have been, if applicable) provided such coverage.

     5.16  INSURANCE  AND SURETY  AGREEMENTS.  Schedule 5.16 contains a true and
accurate  list of:  (a) all  policies  of fire,  liability  and  other  forms of
insurance  held or owned by the  Company  (including  but not limited to medical
malpractice  insurance,  and any state  sponsored  plan or program for  worker's
compensation);  and (b) all bonds,  indemnity agreements and other agreements of
suretyship made for or held by the Company, including a brief description of the
character  of the bond or agreement  and the name of the surety or  indemnifying
party.  Schedule 5.16 sets forth for each such insurance  policy the name of the
insurer, the amount of coverage,  the type of insurance,  the policy number, the
annual premium and a brief description of the nature of insurance included under
each such  policy and of any claims made  thereunder  during the past two years.
Such policies are owned by and payable solely to the Company,  and said policies
or renewals or replacements thereof will be outstanding and duly in force at the
Closing Date. All insurance  policies  listed on Schedule 5.16 are in full force
and effect,  all premiums due on or before the Closing Date have been or will be
paid,  financed  or accrued on or before the Closing  Date.  The Company has not
been  advised by any of its  insurance  carriers of an intention to terminate or
modify any such policies  other than under  circumstances  where the Company has
received a commitment  for a replacement  policy,  nor has the Company failed to
comply with any of the material conditions contained in any such policies.



                                       15

<PAGE>



     5.17 RELATIONSHIPS. Except as disclosed on Schedule 5.17 hereto, the Seller
has not and no partner or any affiliate of Seller has, or at any time within the
last two (2) years has had,  a  material  ownership  interest  in any  business,
corporate  or  otherwise,  that is a party  to, or in any  property  that is the
subject of, business  relationships  or arrangements of any kind relating to the
operation of the Company or its businesses.

     5.18 ABSENCE OF CERTAIN EVENTS. Except as set forth on Schedule 5.18, since
the date of the Unaudited Financial Statement, the Company has not, and from the
date of this Agreement through the Closing Date the Company will not have:

       (a) sold,  assigned or  transferred  any of their  assets or  properties,
except in the ordinary course of business;

       (b)  mortgaged,  pledged  or  subjected  to any lien,  pledge,  mortgage,
security interest, conditional sales contract or other encumbrance of any nature
whatsoever, other than a Permitted Lien, any of the Company's assets;

       (c) made or suffered any termination of any Services contract;

       (d)  sold or  assigned,  or  made  or  suffered  any  termination  of any
Contract,  or made or suffered  any  modification  or  amendment of any Contract
except for  terminations,  modifications and amendments of Contracts made in the
ordinary  course of business  consistent  with past practice and which would not
adversely  affect earnings or otherwise be material,  and the Seller and Company
have not  received  notice  (written  or oral)  and have no  knowledge  that any
Contract has been  terminated  or will be  terminated or modified or amended (as
aforesaid);

       (e) except in the ordinary course of business,  or otherwise as necessary
to comply with any applicable  minimum wage law, increased the salaries or other
compensation  of any of  their  employees,  or  made  any  increase  in,  or any
additions to, other benefits to which any of such employees may be entitled;

       (f) failed to pay or discharge when due any  liabilities,  the failure to
pay or discharge  which has caused or will cause any actual  damage or give rise
to the risk of a loss to the Company;

       (g) changed any of the accounting  principles  followed by the Company or
the methods of applying such principles; and

       (h) entered into any  transaction  other than in the  ordinary  course of
business involving consideration in excess of $15,000.



                                       16

<PAGE>



     5.19  COMPLIANCE  WITH LAWS.  The Company is in  compliance in all material
respects with all  Governmental  Requirements  (as defined  herein).  Except for
notices of  non-compliance  as to which the Company has taken corrective  action
acceptable to the applicable  governmental  agency, and as set forth in Schedule
5.19, the Company has not, within the period of twelve months preceding the date
of this  Agreement,  received any written  notice that the Company or any of the
Assets  fail to comply in any  material  respect  with any  applicable  Federal,
state, local or other governmental laws or ordinances,  or any applicable order,
rule or regulation of any Federal,  state,  local or other  governmental  agency
having  jurisdiction over their businesses  ("Governmental  Requirements").  The
Company  shall  report to Buyer,  within five (5)  business  days after  receipt
thereof,  any  written  notices  that the  Company is not in  compliance  in any
material respect with any of the foregoing.

     5.20  FINDERS.  No broker or finder has acted for the Seller or the Company
in connection with the transactions contemplated by this Agreement, and no other
broker or finder is entitled to any broker's or finder's fee or other commission
in  respect  thereof  based  in  any  way  on  agreements,   understandings   or
arrangements with the Seller or the Company.

     5.21 TAX RETURNS.

       (a) Except as set forth in Schedule  5.21, (i) all Tax (as defined below)
returns,  statements,  reports  and forms or  extensions  with  respect  thereto
required  to be  filed  with any  Federal,  state,  local or other  governmental
department   or  court  or  other   authority   having   jurisdiction   over  it
("Governmental  Authority") on or before the Closing Date by or on behalf of the
Company (collectively,  the "Tax Returns"), have been or will be timely filed on
or before the Closing  Date in  accordance  in all  material  respects  with all
applicable Governmental  Requirements;  and (ii) the Company has timely paid all
Taxes payable by them.

       (b) For  purposes of this  Agreement,  "Tax" means any net income,  gross
income, sales, use, franchise,  personal,  employment,  pension or real property
tax.

     5.22 ENCUMBRANCES CREATED BY THIS AGREEMENT.  The execution and delivery of
this Agreement, or any of the Company's Transaction Documents, does not, and the
consummation of the transactions contemplated hereby or thereby will not, create
any liens or other encumbrances on any of the Company's assets in favor of third
parties.

     5.23  SUBSIDIARIES AND JOINT VENTURES.  Schedule 5.23 sets forth a complete
list of all  subsidiaries,  joint ventures and partnerships in which the Company
is a record or beneficial owner. All of the issued and outstanding capital stock
of the  subsidiaries  listed  on  Schedule  5.23  hereto  is owned of  record or
beneficially  by the  Company or by one of the listed  subsidiaries  on Schedule
5.23.



                                       17

<PAGE>



     5.24 NO UNTRUE STATEMENT.  The representations and warranties made pursuant
to this  Agreement  taken as a whole do not  contain  any  untrue  statement  of
material  fact or omit to  state a  material  fact  necessary,  in  light of the
circumstance under which it was made, in order to make the  representations  not
misleading in any material respect.

     5.25 MEDICARE AND MEDICAID PROGRAMS.  The Company,  to the extent necessary
to conduct its business in a manner consistent with past practice,  is qualified
for participation in the Medicare and Medicaid programs.  Except as reflected on
Schedule 5.25, (a) neither the Seller nor the Company has received any notice of
recoupment  with  respect  to the  Company's  operations  from the  Medicare  or
Medicaid programs,  or any other third party reimbursement  source, (b) there is
no basis for the assertion after the Closing Date of any such  recoupment  claim
against Buyer, Company or Seller which arose out of any transactions on the part
of the Company  prior to the  Closing or against  Seller for which Buyer will be
liable,  and (c) to the  knowledge  of Seller and the  Company,  no Medicare and
Medicaid investigation,  survey or audit is pending, threatened or imminent with
respect to the operation of the Company prior to the Closing.

     5.26  LEASEHOLD  INTERESTS.  Each of the Company and its  subsidiaries  has
valid leasehold interests in all real property, subject to leases, identified on
Schedule 5.7(i), free and clear of all liens,  claims,  charges and encumbrances
of any kind whatsoever, except for Permitted Liens.

     5.27 POWER AND AUTHORITY. The Company has all requisite power and authority
to execute,  deliver and perform  this  Agreement,  and as of the  Closing,  the
Company and Seller will have all  requisite  power and  authority to execute and
deliver the Transaction  Documents required to be delivered by each party to the
Buyer at the Closing.

     5.28 BINDING EFFECT. This Agreement and all Transaction  Documents executed
by the  Company  constitute  the legal,  valid and  binding  obligations  of the
Company,  enforceable  against the Company in accordance  with their  respective
terms.

     5.29 QUESTIONNAIRES. The health care law questionnaire heretofore delivered
to the Company by Buyer (the "Questionnaire") will be attached hereto as Exhibit
5.29 and will as of the Closing Date have been accurately completed and will not
contain any  material  misstatement  of any fact and will not omit any fact that
would  have  to  be  stated  in  order  not  to  render  any  response  to  such
questionnaire materially misleading.

     5.30  QUESTIONABLE  PAYMENTS.  The Company nor any  shareholder,  director,
officer,  controlling  person or employee of Company,  and no  affiliate  of any
Company,  (a) has used any  corporate  funds of Company  to make any  illegal or
unlawful  payment  to  any  officer,  employee,  representative,  agent  of  any
government,  or to any political party or official thereof,  including,  without
limitation,  any of same that would violate the Foreign Corrupt Practices Act of
1977,  as amended;  or (b) has made or  received  any  illegal  payment,  bribe,
kickback,  political  contribution or other similar questionable payment for any
referrals or  recommendations  or otherwise in connection  with the operation of
the Company's business.


                                       18

<PAGE>



              ARTICLE VI: REPRESENTATIONS AND WARRANTIES OF SELLER

     The Seller hereby represents and warrants to Buyer as follows:

     6.1  AUTHORITY.  Seller has the full  legal  power and  authority  to make,
execute, deliver and perform this Agreement and the Transaction Documents.  Such
execution,  delivery,  performance and  consummation has been duly authorized by
all necessary  action,  corporate or otherwise,  on the part of Seller,  and any
necessary consents of holders of indebtedness of Seller have been obtained.

     6.2 BINDING EFFECT.  This Agreement and all Transaction  Documents executed
by Seller  constitute  the legal,  valid and binding  obligations of the Seller,
enforceable against Seller in accordance with their respective terms.

     6.3 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement or any of the Transaction Documents by Seller nor the performance
by Seller of the transactions contemplated hereby and thereby conflicts with, or
constitutes a breach of or a default under (i) any law, rule,  judgment,  order,
writ,  injunction,  or decree of any court  currently  in effect  applicable  to
Seller,  or (ii) any rule or  regulation of any  administrative  agency or other
governmental  authority  currently in effect  applicable to Seller, or (iii) any
material agreement, indenture, contract or instrument to which such party is now
a party or by which any of the assets of Seller is bound.

     6.4 CONSENTS. No authorization,  consent, approval,  license, exemption by,
filing or registration  with any court or governmental  department,  commission,
board,  bureau,  agency or  instrumentality,  domestic or foreign, is or will be
necessary in connection  with the  execution,  delivery and  performance of this
Agreement or any of the Transaction Documents by Seller.

     6.5 OWNERSHIP OF COMPANY STOCK. Except as disclosed on Schedule 6.5 hereto,
Seller is the lawful  record and  beneficial  owner of all of the Company  Stock
shown as owned by Seller in  Schedule  5.4,  with  good and  indefeasible  title
thereto, free and clear of all liens and encumbrances,  claims and other charges
thereon of any kind.  Seller has the full legal  power to  transfer  and deliver
such  Company  Stock in  accordance  with this  Agreement,  and delivery of such
Company Stock to Buyer pursuant hereto will convey good and  indefeasible  title
thereto, free and clear of all liens and encumbrances,  claims and other charges
thereon or any kind.  The shares of Company  Stock  indicated on Schedule 5.4 as
being owned by the Seller constitute all of the issued and outstanding shares of
the capital stock of the Company.

              ARTICLE VII: REPRESENTATIONS AND WARRANTIES OF BUYER

     Buyer represents and warrants to the Company and the Seller as follows:

     7.1  ORGANIZATION  AND  STANDING.  Buyer is a corporation  duly  organized,
validly existing and in good standing under the laws of the State of Delaware.


                                       19

<PAGE>



     7.2 POWER AND  AUTHORITY.  Buyer has the  corporate  power and authority to
execute,  deliver and perform this Agreement,  and as of the Closing, Buyer will
have the corporate  power and  authority to execute and deliver the  Transaction
Documents required to be delivered by it to the Seller at the Closing.

     7.3  BINDING  AGREEMENT.  This  Agreement  and  all  Transaction  Documents
executed by Buyer constitute the legal,  valid and binding  obligation of Buyer,
enforceable against Buyer in accordance with their respective terms.

     7.4 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement or any of the Transaction  Documents by Buyer nor the performance
by the Buyer of the transactions contemplated hereby and thereby conflicts with,
or constitutes a breach of or a default under (i) the formation documents of the
Buyer, or (ii) any law, rule, judgment,  order, writ,  injunction,  or decree of
any  court  currently  in  effect  applicable  to  Buyer,  or (iii)  any rule or
regulation  of  any  administrative  agency  or  other  governmental   authority
currently  in  effect  applicable  to  Buyer,  or (iv) any  material  agreement,
indenture,  contract or instrument to which the Buyer is now a party or by which
any of the assets of the Buyer is bound.

     7.5 CONSENTS. No authorization,  consent, approval,  license, exemption by,
filing or registration  with any court or governmental  department,  commission,
board,  bureau,  agency or  instrumentality,  domestic or foreign, is or will be
necessary in connection  with the  execution,  delivery and  performance of this
Agreement or any of the Transaction Documents by Buyer.

     7.6 SECURITIES AND EXCHANGE COMMISSION FILINGS. Buyer has made available to
the Seller a correct and complete  copy of each report,  schedule,  registration
statement and definitive  proxy  statement filed by Buyer with the Commission on
or after  January  1, 1997 (the "SEC  Documents"),  which are all the  documents
(other than  preliminary  material) that Buyer was thereon required to file with
the SEC on or after January 1, 1997. As of their respective  dates,  none of the
SEC  Documents  (including  all exhibits  and  schedules  thereto and  documents
incorporated by reference  therein) contained any untrue statements or omissions
of a  material  fact  necessary  so as  not to  render  the  statements  therein
misleading,  in light of the  circumstances  under which they were made, and the
SEC  Documents  complied  when  filed  in all  material  respects  with the then
applicable  requirements  of the Securities Act or the Exchange Act, as the case
may be. The  financial  statements  of the Buyer  included in the SEC  Documents
complied  in  all  material   respects  with  the  then  applicable   accounting
requirements  and the published  rules and  regulations of the  Commission  with
respect  thereto,  were  prepared  in  accordance  with GAAP  during the periods
involved (except as may have been indicated in the notes thereto or, in the case
of the unaudited  statements,  as permitted by Form 10-Q promulgated by the SEC)
and fairly present (subject, in the case of the unaudited statements, to normal,
recurring audit  adjustments) the consolidated  financial  position of the Buyer
and its  consolidated  subsidiaries as at the dates thereof and the consolidated
results of their operations and cash flows for the periods then ended.


                                       20

<PAGE>



     7.7 MATERIAL CHANGES. Since the Form 10-Q (as defined below), there has not
been any material  adverse  change in the condition  (financial or otherwise) of
the Buyer or any material  damage or destruction of any of the Buyer's  material
assets  or its  place of  business  by fire or other  casualty,  whether  or not
covered by insurance, and during such period of time the Buyer has conducted its
business  in the  ordinary  and normal  course.  Buyer is willing to make itself
available to identify and  communicate to Seller all material  information  with
respect to any fact or condition that is reasonably  likely to adversely  affect
the future prospects (financial or otherwise) of the Buyer.

     7.8 FINDERS. No broker or finder has acted for the Buyer in connection with
the transactions  contemplated by this Agreement,  and no other broker or finder
is entitled  to any  broker's or  finder's  fee or other  commission  in respect
thereof based in any way on agreements,  understandings or arrangements with the
Buyer.

     7.9 CAPITAL STOCK. Buyer's Form 10-Q filed with the Commission with respect
to the fiscal  quarter ended June 30, 1997 (the "Form 10-Q"),  sets forth a true
and complete  description of the authorized  and  outstanding  shares of capital
stock of Buyer as of such date. All outstanding  shares of IHS Stock are validly
issued,  fully paid and  non-assessable  and not subject to  preemptive  rights.
Buyer has duly  authorized  and reserved for issuance the IHS Stock,  and,  when
issued  in  accordance  with the terms of  Article  III,  the IHS Stock  will be
validly issued,  fully paid and  nonassessable  and free and clear of preemptive
rights, liens, encumbrances, claims and other charges thereon.

     7.10  COMPLIANCE  WITH LAWS.  The Buyer is in  compliance  in all  material
respects with all Governmental  Requirements (as defined in Section 5.19) except
where the failure to be in  compliance  could  reasonably  be expected to have a
material adverse effect on the Buyer and its subsidiaries  collectively.  Except
for notices of  non-compliance as to which the Buyer has taken corrective action
acceptable to the applicable  governmental  agency or which would not reasonably
be expected to have a material  adverse effect on the Buyer and its subsidiaries
collectively,  the Buyer has not,  within the period of twelve months  preceding
the date of this Agreement, received any written notice that the Buyer or any of
the assets fail to comply in any material  respect with any applicable  Federal,
state, local or other governmental laws or ordinances,  or any applicable order,
rule or regulation of any Federal,  state,  local or other  governmental  agency
having jurisdiction over their businesses.

     7.11  QUESTIONABLE  PAYMENTS.   Neither  the  Buyer  nor  any  shareholder,
director, officer,  controlling person or employee of Buyer, and no affiliate of
Buyer, (a) has used any corporate funds of Buyer to make any illegal or unlawful
payment to any officer, employee, representative, agent of any government, or to
any political party or official thereof,  including,  without limitation, any of
same that would violate the Foreign  Corrupt  Practices Act of 1977, as amended;
or (b) has made or received  any illegal  payment,  bribe,  kickback,  political
contribution  or  other  similar  questionable  payment  for  any  referrals  or
recommendations  or otherwise in  connection  with the  operation of the Buyer's
business which could reasonably be expected to have a material adverse effect on
the Buyer and its subsidiaries collectively.



                                       21

<PAGE>



           ARTICLE VIII: INFORMATION AND RECORDS CONCERNING THE OTHER
                                     PARTIES

     8.1 BUYER'S ACCESS TO INFORMATION AND RECORDS BEFORE CLOSING.  Prior to the
Closing Date,  Buyer may make, or cause to be made,  such  investigation  of the
Company's  (it being  understood  that,  for the purpose of this  Article  VIII,
"Company"  shall  be  deemed  to  refer  collectively  to the  Company  and  its
subsidiaries  listed on Schedule  5.23)  financial and legal  condition as Buyer
deems  necessary  or  advisable to  familiarize  itself with the Company  and/or
matters relating to its history or operation. The Company shall permit Buyer and
its authorized  representatives  (including legal counsel and  accountants),  to
have full access to the Company's books and records upon  reasonable  notice and
during  normal  business  hours,  and the Company will  furnish,  or cause to be
furnished,  to Buyer such financial and operating data and other information and
copies of documents with respect to the Company's products, services, operations
and assets as Buyer shall from time to time reasonably request. The documents to
which  Buyer  shall  have  access  shall  include,  but not be  limited  to, the
Company's  tax returns and related  work papers since their  inception;  and the
Company  shall  make,  or cause to be made,  extracts  thereof as Buyer or their
representatives  may  request  from  time to  time to  enable  Buyer  and  their
representatives  to  investigate  the affairs of the Company and the accuracy of
the  representations  and warranties made in this  Agreement.  The Company shall
cause their  accountants  to cooperate with Buyer and to disclose the results of
audits  relating  to the Company  and to produce  the  working  papers  relating
thereto.  Without  limiting any of the  foregoing,  it is agreed that Buyer will
have full access to any and all  agreements  between and among the  previous and
current  shareholders  regarding  their ownership of shares or the management or
operation of the Company.

     8.2  SELLER'S  AND  COMPANY'S  ACCESS TO  INFORMATION  AND  RECORDS  BEFORE
CLOSING.  Prior to the Closing  Date,  Buyer shall make  available to Seller and
Company any public  information  related to the Buyer and provide  access to the
senior management of Buyer.


              ARTICLE IX: OBLIGATIONS OF THE PARTIES UNTIL CLOSING

     9.1 CONDUCT OF BUSINESS PENDING CLOSING. Between the date of this Agreement
and the Closing, the Company and its subsidiaries shall maintain their existence
and shall  conduct their  businesses  in the  customary  and ordinary  course of
business consistent with past practice.

     9.2  NEGATIVE  COVENANTS OF THE COMPANY AND ITS  SUBSIDIARIES.  Without the
prior written approval of Buyer, neither the Company nor any of its subsidiaries
shall, between the date hereof and the Closing:

       (a) cause or permit to occur any of the events or  occurrences  described
in Section 5.18 (Absence of Certain Events) of this Agreement;


                                       22

<PAGE>



       (b) dissolve, merge or enter into a share exchange with or into any other
entity;

       (c)  enter  into  any  contract  or  agreement  with  any  union or other
collective  bargaining  representative  representing  any employees  without the
prior  written  consent  of  Buyer,  which  consent  shall  not be  unreasonably
withheld;

       (d) sell off any Assets other than in the ordinary course of business; or

       (e) make any change to their by-laws or articles of incorporation.

     9.3  AFFIRMATIVE  COVENANTS.  Between the date hereof and the Closing,  the
Company and each of its subsidiaries shall:

       (a) maintain their businesses in substantially  the same state of repair,
order and  condition  as on the date  hereof  consistent  with  past  practices,
reasonable wear and tear or loss by casualty excepted;

       (b) maintain in full force and effect all material Licenses  currently in
effect  with  respect  to their  businesses  unless  such  License  is no longer
necessary for the operation of the Company and its subsidiaries;

       (c) maintain in full force and effect the insurance  policies and binders
currently in effect, or the replacements  thereof,  including without limitation
those listed on Schedule 5.16;

       (d)  utilize  their  reasonable  efforts to  preserve  intact the present
business  organization of the Company and its  subsidiaries;  keep available the
services of the Company's and its  subsidiaries'  present  employees and agents;
and maintain the  Company's  and its  subsidiaries'  relations and goodwill with
suppliers,  employees,  affiliated  medical  personnel  and  any  others  having
business relating to the Company and its subsidiaries;

       (e) maintain all of the books and records in  accordance  with their past
practices;

       (f) comply in all material  respects with all provisions of the Contracts
listed in Schedule 5.7 and with any other material  agreements  that the Company
and its subsidiaries  have entered into in the ordinary course of business since
the  date of this  Agreement,  and  comply  in all  material  respects  with the
provisions  of all  material  laws,  rules  and  regulations  applicable  to the
Company's and its subsidiaries' businesses;

       (g) cause to be paid when due,  all  taxes,  assessments  and  charges or
levies  imposed  upon  them or on any of their  properties  for  which  they are
required to withhold  and pay over,  other than their  being  contested  in good
faith;

                                       23

<PAGE>



       (h)  promptly  advise  Buyer in  writing  of the  threat or  commencement
against  the  Company  and  its  subsidiaries  of any  claim,  action,  suit  or
proceeding,   arbitration  or  investigation  or  any  other  event  that  would
materially adversely affect the operations,  properties,  assets or prospects of
the Company and its subsidiaries; and

       (i) notify the Buyer in writing of any event  involving  the  Company and
its subsidiaries which has had or may be reasonably  expected to have a material
adverse  effect on the  business or  financial  condition of the Company and its
subsidiaries or may involve the loss of contracts which involve revenues of more
than $50,000 per year  individually  or $250,000 per year in the aggregate  with
any of the Company's or its subsidiaries' customers.

     9.4 PURSUIT OF CONSENTS AND  APPROVALS.  Prior to the Closing,  Buyer shall
use its reasonable  efforts to obtain all consents and approvals of governmental
agencies and all other  parties  necessary  for the lawful  consummation  of the
transactions  contemplated hereby and the lawful use, occupancy and enjoyment of
the Company's and its subsidiaries'  businesses by Buyer in accordance  herewith
("Required  Approvals").  The Company and its subsidiaries  shall cooperate with
and use  their  reasonable  efforts  to  assist  Buyer  in  obtaining  all  such
approvals.

     9.5  EXCLUSIVITY.  Until the earlier of Closing or the  termination of this
Agreement  pursuant to Section  13.1,  the Company nor Seller,  nor any of their
respective   affiliates,   representatives  or  brokers  shall  enter  into  any
agreement,  commitment  or  understanding  with  respect  to,  or  engage in any
discussions or negotiations directly or indirectly with, or encourage or respond
to any  solicitations  from, any other party with respect to the sale,  lease or
management  of any of the  Assets,  or in  respect  of the sale of any shares of
capital stock in the Company.


             ARTICLE X: CONDITIONS PRECEDENT TO BUYER'S OBLIGATIONS

     Buyer's  obligations  to  consummate  the purchase of the Company  Stock is
subject to the fulfillment, prior to or at the Closing, of each of the following
conditions,  any one or more of which may be waived  by Buyer in  writing.  Upon
failure of any of the following  conditions,  Buyer may terminate this Agreement
pursuant to and in accordance with Article XIII herein.

       10.1  REPRESENTATIONS AND WARRANTIES.  The representations and warranties
of Company and Seller made pursuant to this Agreement  shall be true and correct
in all  material  respects  at  and  as of the  Closing  Date,  as  though  such
representations  and  warranties  were  made at and as of such  time  (except  a
representation  made as of a  specified  date shall be true and  accurate in all
material  respects  as of  that  date)  except  to the  extent  affected  by the
transactions herein contemplated.

       10.2  PERFORMANCE  OF  COVENANTS.  The Seller and the Company  shall have
performed or complied in all material respects with their respective  agreements
and covenants  required by this Agreement to be performed or complied with by it
prior to or at the Closing.



                                       24

<PAGE>



     10.3 DELIVERY OF CLOSING CERTIFICATE. The Seller and the Company shall have
executed  and  delivered  to Buyer a  certificate  of its  president,  dated the
Closing  Date,  upon  which  Buyer  may  rely,  certifying  that the  conditions
contemplated by Sections 10.1 and 10.2 applicable to it have been satisfied.

     10.4  OPINION OF COUNSEL.  Seller and the Company  shall have  delivered to
Buyer an opinion, dated the Closing Date, of their counsel, in substantially the
form attached hereto as Exhibit 10.4.

     10.5 LEGAL MATTERS.  No preliminary or permanent  injunction or other order
(including a temporary  restraining  order) of any governmental  authority which
prevents the  consummation  of the  transactions  contemplated by this Agreement
shall have been issued and remain in effect.

     10.6  AUTHORIZATION  DOCUMENTS.  Buyer shall have received a certificate of
the Secretary or other officer of the Company  certifying as of the Closing Date
a copy of Resolutions of their Boards of Directors  authorizing  their execution
and full  performance  of the  Transaction  Documents and the  incumbency of its
respective officers.

     10.7 MATERIAL CHANGE.  Since the date of the Unaudited  Financial Statement
there  shall  not  have  been  any  material  adverse  change  in the  condition
(financial or otherwise) of the assets,  properties or operations of the Company
and its subsidiaries.

     10.8 APPROVALS.

       (a) The consent or approval of all persons necessary for the consummation
of the  transactions  contemplated  hereby  shall have been  granted,  including
without limitation, the Required Approvals;

       (b) None of the  foregoing  consents  or  approvals  (i) shall  have been
conditioned upon the  modification,  cancellation or termination of any material
lease,  contract,  commitment,  agreement,  license,  easement,  right  or other
authorization  with respect to the Company's and its  subsidiaries'  businesses,
other than as disclosed or approved hereunder, or (ii) shall impose on the Buyer
any material condition or provision or requirement with respect to the Company's
and its  subsidiaries'  businesses or their  operation that is more  restrictive
than or  different  from the  conditions  imposed upon such  operation  prior to
Closing.

     10.9 EMPLOYMENT AGREEMENT. Gigi Jordan shall have executed and delivered to
Buyer  her  employment  agreement  in the  form  of  Exhibit  10.9  hereto  (the
"Employment Agreement").




                                       25

<PAGE>



     10.10 CONSENTS. Buyer shall have received the written consent to assignment
from each of those  parties  with whom the  Company  or its  subsidiaries  has a
Contract as listed on Schedule 5.7,  where such consent is required by reason of
the change of control of the Company  and its  subsidiaries  contemplated  under
this Agreement.

     10.11 ESTIMATED  CLOSING DATE BALANCE SHEET.  Seller and Company shall have
delivered the Estimated Closing Date Balance Sheet to Buyer.

     10.12 COMPANY'S  SUBSIDIARIES AND OPTIONS.  Each of the subsidiaries of the
Company as of the Closing Date will be one hundred  (100%)  percent owned by the
Company and there shall not be  outstanding  as of the Closing Date any options,
warrants or rights for the purchase of any capital stock of the  subsidiaries of
the Company.

     10.13 COST AND  EXPENSES.  The Seller  shall have paid all costs,  fees and
expenses  (including  without  limitation,  filing fees,  transfer taxes,  stamp
taxes, legal fees and broker,  audit and appraisal fees) incurred by the Company
or any of its subsidiaries in connection with the  transactions  contemplated by
this Agreement.

     10.14  RESIGNATION  OF  COMPANY  BOARDS OF  DIRECTORS  AND  OFFICERS.  Each
director  and  officer of the Company  and each of its  subsidiaries  shall have
submitted his or her resignation to be effective no later than the Closing Date.

     10.15  AFFILIATED   COMPANY.   Buyer  shall  have  closed  its  acquisition
simultaneously with APS America, Inc. and each of their respective shareholders.

     10.16  OTHER  DOCUMENTS.  The Seller and the Company  shall have  furnished
Buyer with all other documents,  certificates and other instruments  required to
be  furnished  to Buyer by the  Seller  and the  Company  pursuant  to the terms
hereof.


            ARTICLE XI: CONDITIONS PRECEDENT TO SELLER'S OBLIGATIONS

     Seller's  obligation to consummate the sale of the Company Stock is subject
to the  fulfillment,  prior  to or at the  Closing,  of  each  of the  following
conditions,  any one or more of which may be waived by Seller in  writing.  Upon
failure of any of the following conditions,  Seller may terminate this Agreement
pursuant to and in accordance with Article XIII herein:

     11.1 REPRESENTATIONS AND WARRANTIES.  The representations and warranties of
Buyer in this  Agreement  shall be true and correct in all material  respects at
and as of the Closing Date as though such  representations  and warranties  were
made at and as of such time (except a representation made as of a specified date
shall be true and accurate in all  material  respects as of that date) except to
the extent affected by the transactions herein contemplated.



                                       26

<PAGE>



     11.2 PERFORMANCE OF COVENANTS.  Buyer shall have performed or complied with
each of its agreements and conditions required by this Agreement to be performed
or complied with by it prior to or at the Closing.

     11.3 DELIVERY OF CLOSING CERTIFICATE.  Buyer shall have delivered to Seller
a  certificate  of an executive  vice  president of Buyer dated the Closing Date
upon which  Seller can rely,  certifying  that the  conditions  contemplated  by
Sections 11.1 and 11.2 applicable to it have been satisfied.

     11.4 OPINION OF COUNSEL.  Buyer shall have  delivered to Seller an opinion,
dated the Closing Date, of Blass & Driggs, Esqs., counsel for Buyer, in the form
attached as Exhibit 11.4.

     11.5 LEGAL MATTERS.  No preliminary or permanent  injunction or other order
(including a temporary  restraining  order) of any governmental  authority which
prevents the  consummation  of the  transactions  contemplated by this Agreement
shall have been issued and remain in effect.

     11.6 AUTHORIZATION  DOCUMENTS.  Seller shall have received a certificate of
the Secretary or other officer of Buyer  certifying a copy of Resolutions of the
Board of Directors of Buyer  authorizing  Buyer's execution and full performance
of the Transaction Documents and the incumbency of the officers of Buyer.

     11.7 EMPLOYMENT AGREEMENT. The Buyer shall have entered into the Employment
Agreement with Gigi Jordan.

     11.8 MATERIAL  CHANGE.  Since the Form 10-Q,  there shall not have been any
material adverse change in the condition (financial or otherwise) of the assets,
properties or operations of Buyer.

     11.9 OTHER DOCUMENTS. Buyer shall have furnished Seller with all documents,
certificates and other  instruments  required to be furnished to Seller by Buyer
pursuant to the terms hereof.


                    ARTICLE XII: SURVIVAL AND INDEMNIFICATION

     12.1  SURVIVAL  OF  REPRESENTATIONS  AND  WARRANTIES.   Absent  fraud,  all
representations  and warranties made by each party in this Agreement and in each
Schedule  and  Transaction  Document  shall  survive the Closing  Date and for a
period of one (1) year after the Closing,  notwithstanding  any investigation at
any  time  made  by  or  on  behalf  of  the  other  party,  provided  that  the
representations   and  warranties   contained  in  Section  5.30   (Questionable
Payments),  Section 5.25  (Medicare and Medicaid) and Section 5.21 (Tax),  shall
survive until thirty (30) days after the applicable  period of  limitations  for
audits by the applicable Governmental Authority shall


                                       27

<PAGE>



have   expired,   including   extensions   for  any   necessary   appeals.   All
representations and warranties related to any claim asserted in writing prior to
the  expiration of the applicable  survival  period shall survive (but only with
respect to such claim) until such claim shall be resolved and payment in respect
thereof, if any is owing, shall be made.

     12.2  INDEMNIFICATION  BY SELLER.  The Seller (and the Company unless there
shall be a  Closing)  shall  indemnify  and  defend  Buyer and hold it  harmless
against and with  respect to any and all damage,  loss,  liability,  deficiency,
cost and expense (including, without limitation,  reasonable attorney's fees and
expenses) (all of the foregoing hereinafter  collectively referred to as "Loss")
resulting from:

       (a) any inaccuracy in any  representation or certification,  or breach of
any warranty, made by the Seller or Company pursuant to this Agreement; or

       (b) the  breach of any  covenant  or  undertaking  made by the  Seller or
Company in this Agreement; or

       (c) the ownership or operation of the Company or its  subsidiaries or its
business or assets prior to the Closing Date, including, without limitation, (i)
any Excess Reimbursement Liabilities (as defined in Section 2.4); (ii) any Taxes
resulting  from the operation of the business of the Company or ownership of any
of the Assets for any period  ending on or before the  Closing  Date;  (iii) any
Loss  arising out of the  noncompliance  of the  Company  with COBRA or any like
statute;  (iv) any  claim of the  type  that  would  be  covered  by a  standard
liability   insurance  policy,   including  without   limitation,   professional
liability,   malpractice,  general  liability,  automobile  liability,  worker's
compensation or employer's liability insurance,  arising out of the operation of
the  Company's  business  prior to the Closing Date,  including  payments of any
deductibles  applicable to the aforesaid  policies;  (v) any Loss arising out of
the OIG investigation of the Company and its subsidiaries  pursuant to the OIG's
subpoena of the Company,  dated  August 19, 1997;  and (vi) any and all actions,
suits, proceedings, demands, assessments,  judgments, settlements (to the extent
approved by the Company, such approval not to be unreasonably withheld,  delayed
or conditioned),  costs and legal expenses incident to any of the foregoing; but
excluding  current  liabilities and long-term  liabilities that are reflected on
the  Estimated  Closing  Date  Balance  Sheet or that  otherwise  are taken into
account in any adjustment to the Purchase Price under Section 2.2; or

       (d)  any  failure  on the  part of the  Company  or any  Seller  to be in
compliance with applicable  legal  requirements  for any License relating to the
Company's  business  in the State of  Connecticut,  or the failure to obtain any
necessary consent, or to give any required notice, in connection with the change
of control hereunder affecting the Connecticut Licenses.

     12.3  INDEMNIFICATION BY BUYER. Buyer shall indemnify and defend Seller and
hold them harmless against and with respect to any and all Loss resulting from:

       (a) any inaccuracy in any  representation or certification,  or breach of
any warranty, made by Buyer pursuant to this Agreement; or


                                       28

<PAGE>



       (b) the  breach  of any  covenant  or  undertaking  made by Buyer in this
Agreement; or

       (c) the ownership or operation of the Company or its  subsidiaries or its
business or assets on and after the Closing Date.

     12.4  ASSERTION OF CLAIMS.  Any claims for  indemnification  under Sections
12.2(a)  or 12.3(a)  must be  asserted  by written  notice by a date which is no
later than one (1) year following the Closing Date,  except that any claim based
upon a breach of the  representations  and warranties  contained in Section 5.30
(Questionable  Payments),  Section 5.25  (Medicare and Medicaid) or Section 5.21
(Tax) may be  asserted  until  thirty (30) days after the  applicable  period of
limitations  for  audits by the  applicable  Governmental  Authority  shall have
expired, including extensions for any necessary appeals.

     12.5 INDEMNITY BASKET.  Notwithstanding any other provision of this Article
XII, no claim for  indemnification  made under Sections 12.2(a) or 12.3(a) shall
be made unless and until Buyer or Seller,  as the case may be, has incurred Loss
in excess of Fifty Thousand  ($50,000) Dollars in the aggregate,  in which case,
the party seeking  indemnification  shall be entitled to assert claims including
such initial Fifty Thousand ($50,000) Dollars.

     12.6 CONTROL OF DEFENSE OF INDEMNIFIABLE CLAIMS.

       (a)  Each  indemnified  party  (each,  an  "Indemnitee")  shall  give the
indemnifying party (the  "Indemnitor")  prompt notice of each claim for which it
seeks indemnification.  Failure to give such prompt notice shall not relieve any
Indemnitor of its indemnification obligation, provided that such indemnification
obligation  shall be reduced by any damages the Indemnitor  demonstrates  it has
suffered  resulting  from a failure  to receive  prompt  notice  hereunder.  The
Indemnitors shall be entitled to participate in the defense of such claim. If at
any  time  the  Indemnitor  acknowledges  in  writing  that  the  claim is fully
indemnifiable  by it under this Agreement,  and, if requested by the Indemnitee,
the Indemnitor  posts adequate bond or security,  the Indemnitor  shall have the
right to assume control of the defense (but not the settlement) of such claim at
its own expense;  unless (i) Indemnitee shall have been authorized in writing by
the  Indemnitor  to  defend  such  action  with  counsel  of its own  choice  in
connection  with the defense of such action,  or (ii) the  Indemnitor  shall not
have employed counsel to have charge of the defense of such action within twenty
(20) days  after the date of  notice of the claim for which  indemnification  is
sought is given to the Indemnitor or (iii) the  Indemnitor  shall have failed to
undertake  and  reasonably  pursue  the  defense  of such  action,  or (iv)  the
Indemnitee shall have reasonably  concluded that there may be material  defenses
available  to it or them  which  are  different  from  or  additional  to  those
available to the Indemnitor.  If any event described in clauses (i) through (iv)
above shall occur,  then the  Indemnitor  shall not have the right to direct the
defense  of such  action on behalf of the  Indemnitee  with  counsel  of its own
choice, and the reasonable fees and expenses of the Indemnitee shall be borne by
the Indemnitor, provided that such counsel shall be reasonably acceptable to the
Indemnitor. If the Indemnitors do assume control of the defense


                                       29

<PAGE>



of any such claim in accordance  with the  foregoing,  then:  (x) the Indemnitor
shall not  defend  the claim for which  indemnification  is being  sought in any
manner that would likely have a material  adverse effect on the Indemnitee or on
any  relationship  that the  Indemnitee  may have with any  customers,  vendors,
suppliers or others,  and (y) the Indemnitee shall not settle such claim without
the written consent of the  Indemnitor,  which consent shall not be unreasonably
withheld,  delayed or conditioned.  Nothing contained in this Section 12.6 shall
prevent either party from assuming  control of the defense  and/or  settling any
claim against it for which indemnification is not sought under this Agreement.

       (b) Notwithstanding anything to the contrary contained in this Agreement,
if there shall be any claim for Excess Reimbursement Liabilities with respect to
which Buyer shall be seeking indemnification,  Buyer will have the sole right to
contest or appeal  such claim  (using at least the same  standard  of care as it
would apply to contests or appeals with respect to reimbursement  liabilities in
general) in accordance  with its  customary  procedures  diligently  and in good
faith. Buyer may, in its sole and absolute  discretion,  at any time discontinue
any such contest or appeal or enter into a settlement with respect thereto prior
to the final determination thereof (a "Final Determination"); provided, however,
that if it intends to  discontinue or settle any such appeal or contest prior to
Final  Determination,  then it must provide Seller with reasonable prior written
notice of such  intent  and of the  current  status of the  appeal or contest or
proposed  settlement,  and will  consult  with Seller in good faith with respect
thereto.

     12.7 RESTRICTIONS.

       (a) From and after the  Closing  Date,  the  Seller  shall not  disclose,
directly or  indirectly,  to any person  outside of Buyer's  employ  without the
express  authorization of the Buyer, any patient lists,  customer lists, pricing
strategies,  customer files, or patient files and records of the Company and its
subsidiaries, any proprietary data or trade secrets owned by the Company and its
subsidiaries  or any  financial or other  information  about the Company and its
subsidiaries not then in the public domain; provided, however, that Seller shall
be permitted to make such disclosures as may be required by law or by a court or
governmental authority.

       (b) After the Closing Date, the Seller shall not engage or participate in
any  effort  or act to  induce  any of  the  customers,  physicians,  suppliers,
associates,  employees  or  independent  contractors  of  the  Company  and  its
subsidiaries to cease doing business,  or their association or employment,  with
the Company and its subsidiaries.

       (c) Seller  shall not,  for a period of five (5) years  after the Closing
Date,  directly,  or  indirectly,  for or on behalf of himself or herself or any
other person, firm, entity or other enterprise, be employed by, be a director or
manager  of,  act as a  consultant  for,  be a partner  in,  have a  proprietary
interest in, give advice to, loan money to or  otherwise  associate  with,  in a
business fashion, any person, enterprise, partnership, association, corporation,
joint venture or other entity which is directly or indirectly in the business of
owning,  operating or managing any entity of any type,  licensed or  unlicensed,
which, anywhere within the United States, (i) is engaged in or provides


                                       30

<PAGE>



the  Services,  (ii)  compounds  or  dispenses  pharmaceutical   admixtures  for
intravenous therapies to patients at sites other than hospitals,  (iii) provides
medical supplies, equipment or non-professional services usually and customarily
associated  with the  provision of  intravenous  therapies to patients,  or (iv)
provides professional nursing services usually and customarily rendered with the
provision  of  intravenous  therapies,  provided  that  nothing in this  Section
12.7(c)  shall  restrict any Seller form having any  involvement  with a nursing
agency business.

       (d) The  Seller  acknowledges  that the  restrictions  contained  in this
Section 12.7 are  reasonable  and necessary to protect the  legitimate  business
interests of Buyer and that any violation thereof by any of them would result in
irreparable harm to Buyer. Accordingly, Seller agrees that upon the violation by
her of any of the  restrictions  contained in this Section 12.7,  Buyer shall be
entitled to obtain from any court of competent  jurisdiction  a preliminary  and
permanent  injunction  as well as any other  relief  provided  at law or equity,
under  this  Agreement  or  otherwise.   In  the  event  any  of  the  foregoing
restrictions are adjudged unreasonable in any proceeding, then the parties agree
that the  period of time or the scope of such  restrictions  (or both)  shall be
adjusted  in such a manner  or for such a time (or  both) as is  adjudged  to be
reasonable.

     12.8 RECORDS.  On the Closing Date,  Seller and Company shall  deliver,  or
cause to be  delivered,  to Buyer all  records  and  files  not then in  Buyer's
possession relating to the operations of the Company and its subsidiaries.

                            ARTICLE XIII: TERMINATION

     13.1 TERMINATION.  This Agreement may be terminated at any time at or prior
to the Closing by:

       (a) Buyer, if any condition precedent to Buyer's  obligations  hereunder,
including  without  limitation  those  conditions set forth in Article X hereof,
have not been satisfied by the Closing Date;

       (b) Seller,  if any condition  precedent to the  obligations of Seller or
the Company  hereunder,  including without limitation those conditions set forth
in Article XI hereof, have not been satisfied by the Closing Date; or

       (c) the mutual consent of Buyer and Seller.

     13.2 EFFECT OF TERMINATION.  If a party  terminates this Agreement  because
one of its conditions precedent has not been fulfilled,  or if this Agreement is
terminated by mutual consent,  this Agreement shall become null and void without
any  liability  of any  party  to the  other;  provided,  however,  that if such
termination   is  by  reason  of  the   breach  by  any  party  of  any  of  its
representations, warranties or obligations under this Agreement, the other party
shall be  entitled  to be  indemnified  for any Losses  incurred by it by reason
thereof in  accordance  with  Article  XII hereof  (and for such  purposes  such
Article XII shall survive the termination of this Agreement).  Further,  nothing
in this Section 13.2 shall affect  Buyer's right to specific  performance of the
obligations of the Company and Seller at Closing hereunder.



                                       31

<PAGE>




                           ARTICLE XIV: MISCELLANEOUS

     14.1 COSTS AND  EXPENSES.  Except as expressly  otherwise  provided in this
Agreement,  Buyer  and  Seller  shall  bear  their own  costs  and  expenses  in
connection  with  this  Agreement  and  the  transactions  contemplated  hereby;
provided,  however,  that no such  costs and  expenses  shall be  charged to the
Company and its subsidiaries.

     14.2 PERFORMANCE.  In the event of a breach by any party of its obligations
hereunder,  the other  party  shall have the  right,  in  addition  to any other
remedies which may be available,  to obtain specific performance of the terms of
this Agreement, and the breaching party hereby waives the defense that there may
be an adequate  remedy at law. Should any party default in its  performance,  or
other  remedy,  the  prevailing  party  shall  be  entitled  to  its  reasonable
attorneys' fees.

     14.3 BENEFIT AND ASSIGNMENT. This Agreement binds and inures to the benefit
of each party hereto and its  successors and proper  assigns.  Neither Buyer nor
Seller may assign its  interest  under  this  Agreement  to any other  person or
entity without the prior written consent of the other party; provided,  however,
that Buyer may assign its rights,  duties and  obligations  hereunder  to one or
more  subsidiaries  or  affiliates  of Buyer;  and further  provided that in the
instance of such assignment Buyer shall guaranty the performance of its assignee
hereunder.

     14.4 EFFECT AND  CONSTRUCTION  OF THIS  AGREEMENT.  This  Agreement and the
Exhibits and Schedules hereto embody the entire  agreement and  understanding of
the  parties  and  supersede  any and all  prior  agreements,  arrangements  and
understandings relating to matters provided for herein. The captions used herein
are for  convenience  only and  shall  not  control  or affect  the  meaning  or
construction of the provisions of this Agreement. This Agreement may be executed
in one or more counterparts,  and all such counterparts shall constitute one and
the same instrument.

     14.5  COOPERATION  - FURTHER  ASSISTANCE.  From  time to time,  as and when
reasonably  requested by Buyer after the Closing, the other parties will (at the
expense  of the  Buyer)  execute  and  deliver,  or  cause  to be  executed  and
delivered, all such documents,  instruments and consents and will use reasonable
efforts to take all such action as may be  reasonably  requested or necessary to
carry out the intent and purposes of this Agreement.

     14.6  NOTICES.  All notices  required or  permitted  hereunder  shall be in
writing  and  shall be  deemed  to be  properly  given or made  when  personally
delivered to the party or parties  entitled to receive the notice or within five
(5) days when sent by certified or registered mail,  postage prepaid,  or on the
next  business  day if sent for next day  delivery  by a  nationally  recognized
overnight  courier,  in either case,  properly addressed to the party or parties
entitled to receive such notice at the address stated below:



                                       32

<PAGE>



If to the Company:                      Ambulatory Pharmaceutical Services, Inc.
                                        2932 North Atlantic Boulevard
                                        Fort Lauderdale, FL 33308
                                        Attn: Gigi Jordan

If to the Seller:                       Gigi Jordan
                                        2932 North Atlantic Boulevard
                                        Fort Lauderdale, FL 33308

with a copy to:                         Alexander Bono, Esq.
                                        Blank, Rome, Comisky & McCauley
                                        2000 One Logan Square
                                        Philadelphia, PA 19103

If to the Buyer:                        Integrated Health Services, Inc.
                                        10065 Red Run Boulevard
                                        Owings Mills, MD 21117
                                        Attn: Brian K. Davidson
                                              Elizabeth B. Kelly
                                        cc:  Marshall A. Elkins, General Counsel

with a copy to:                         Michael S. Blass, Esq.
                                        Blass & Driggs, Esqs.
                                        461 Fifth Avenue, 19th Floor
                                        New York, NY 10017

     14.7  WAIVER,  DISCHARGE,  ETC.  This  Agreement  shall  not  be  released,
discharged,  abandoned,  changed  or  modified  in  any  manner,  except  by  an
instrument in writing  executed by or on behalf of each of the parties hereto by
their duly  authorized  officer or  representative.  The failure of any party to
enforce at any time any of the provisions of this  Agreement  shall in no way be
construed  to be a waiver of any such  provision,  nor in any way to affect  the
validity  of this  Agreement  or any  part  hereof  or the  right  of any  party
thereafter to enforce each and every such provision.  No waiver of any breach of
this Agreement shall be held to be a waiver of any other or subsequent breach.

     14.8 RIGHTS OF PERSONS NOT PARTIES.  Nothing  contained  in this  Agreement
shall be deemed to create rights in persons not parties  hereto,  other than the
successors and proper assigns of the parties hereto.

     14.9 GOVERNING  LAW. This  Agreement  shall be governed by and construed in
accordance  with  the laws of the  State of New  York,  disregarding  any  rules
relating to the choice or conflict of laws.



                                       33

<PAGE>



     14.10  AMENDMENTS,  SUPPLEMENTS,  ETC.  At any time  before  or  after  the
execution and delivery of this Agreement by the parties  hereto,  this Agreement
may  be  amended  or   supplemented  by  additional   agreements,   articles  or
certificates,  as may be mutually  determined  by the  parties to be  necessary,
appropriate or desirable to further the purposes of this  Agreement,  to clarify
the intention of the parties, or to add to or to modify the covenants,  terms or
conditions  hereof or thereof.  This  Agreement may not be amended  except by an
instrument in writing signed by each of the parties.

     14.11  SEVERABILITY.  Any  provision,  or  distinguishable  portion  of any
provision,   of  this   Agreement   which  is  determined  in  any  judicial  or
administrative  proceeding to be prohibited or unenforceable in any jurisdiction
shall, as to such jurisdiction, be ineffective to the extent of such prohibition
or unenforceability  without  invalidating the remaining  provisions hereof, and
any  such  prohibition  or   unenforceability  in  any  jurisdiction  shall  not
invalidate or render unenforceable such provision in any other jurisdiction.  It
is the  intention of the parties that if any  provision of Section 12.7 shall be
determined to be overly broad in any respect,  then it should be  enforceable to
the  maximum  extent  permissible  under the law.  To the  extent  permitted  by
applicable law, the parties waive any provision of law which renders a provision
hereof prohibited or unenforceable in any respect.

     14.12 COUNTERPARTS. This Agreement may be executed in several counterparts,
each of which  shall be  deemed an  original,  and all of which  shall  together
constitute one and the same instrument.

     14.13  ARBITRATION.  Any dispute or controversy  between any of the parties
hereto  pertaining to the performance or  interpretation of this Agreement shall
be  settled  by  binding  arbitration  pursuant  to the  rules  of the  American
Arbitration Association.  The cost of such proceeding shall be shared equally by
all parties thereto,  and each such party shall bear its own costs incurred as a
result of its participation in any such arbitration.

     14.14 PUBLIC  ANNOUNCEMENTS.  Any general public  announcements  or similar
media publicity with respect to this Agreement or the transactions  contemplated
herein  shall be at such  time and in such  manner  as Buyer  and  Seller  shall
determine; provided that nothing herein shall prevent either party, upon as much
prior notice as shall be possible  under the  circumstances  to the other,  from
making such written announcements as such party's counsel may consider advisable
in order to  satisfy  the  party's  legal and  contractual  obligations  in such
regard.







                       [SIGNATURES ON THE FOLLOWING PAGE]


                                       34

<PAGE>


     IN  WITNESS  WHEREOF,  each  of the  parties  hereto  and  in the  capacity
indicated  below has executed this  Agreement as of the day and year first above
written.

                                               COMPANY:
                                               AMBULATORY PHARMACEUTICAL
                                               SERVICES, INC.

WITNESS:

 By:                                           By: /s/ Gigi Jordan
    -------------------------------            ---------------------------------
                                               Its:  President


                                               SELLER:

 WITNESS:


By:                                            /s/ Gigi Jordan
    -------------------------------            ---------------------------------
                                               Gigi Jordan


                                               BUYER:
                                               INTEGRATED HEALTH SERVICES, INC.


                                               By:/s/
                                               ---------------------------------
                                               Executive Vice President
                                               Corporate Development


                                       35

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

                            STOCK PURCHASE AGREEMENT

                           DATED AS OF AUGUST 29, 1997

                                      AMONG

                        INTEGRATED HEALTH SERVICES, INC.

                                       AND

                                APS AMERICA, INC.

                                       AND

                             RAYMOND A. MIRRA, JR.,
                                   JAMES KUO,

                                  EDWARD KRAMM,

                                       AND

                           SIRROM CAPITAL CORPORATION



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



<PAGE>



                                TABLE OF CONTENTS
                                                                            PAGE

ARTICLE I:  SALE AND PURCHASE OF COMPANY STOCK.................................1
         1.1      Sale and Purchase of Company Stock...........................1

ARTICLE II:  PURCHASE PRICE....................................................1
         2.1      Determination and Payment of Purchase Price..................1
         2.2      Adjustments to the Purchase Price............................2
         2.3      Liabilities..................................................3

ARTICLE III:  IHS STOCK........................................................3
         3.1      IHS Stock....................................................3

ARTICLE IV:  THE CLOSING.......................................................8
         4.1      Time and Place of Closing....................................8

ARTICLE V:  REPRESENTATIONS AND WARRANTIES OF THE SELLERS AND
         COMPANY...............................................................8
         5.1      Organization and Standing of the Company.....................8
         5.2      Absence of Conflicting Agreements............................8
         5.3      Consents.....................................................9
         5.4      Company Stock................................................9
         5.5      Assets.......................................................9
         5.6      Trademarks..................................................10
         5.7      Contracts...................................................10
         5.8      Financial Statements........................................11
         5.9      Material Changes............................................12
         5.10     Licenses; Permits; Certificates of Need.....................12
         5.11     Title, Condition of Personal Property.......................12
         5.12     Legal Proceedings...........................................14
         5.13     Employees...................................................14
         5.14     Collective Bargaining, Labor Contracts, Employment
                  Practices, Etc..............................................14
         5.15     ERISA.......................................................15
         5.16     Insurance and Surety Agreements.............................15
         5.17     Relationships...............................................16
         5.18     Absence of Certain Events...................................16
         5.19     Compliance with Laws........................................17
         5.20     Finders.....................................................17
         5.21     Tax Returns.................................................17
         5.22     Encumbrances Created by this Agreement......................17
         5.23     Subsidiaries and Joint Ventures.............................17


                                       (i)

<PAGE>



         5.24     No Untrue Statement.........................................17
         5.25     Medicare and Medicaid Programs..............................18
         5.26     Leasehold Interests.........................................18
         5.27     Power and Authority.........................................18
         5.28     Binding Effect..............................................18
         5.29     Questionnaires..............................................18
         5.30     Questionable Payments.......................................18

ARTICLE VI:  REPRESENTATIONS AND WARRANTIES OF SELLERS .......................19
         6.1      Authority...................................................19
         6.2      Binding Effect..............................................19
         6.3      Absence of Conflicting Agreements...........................19
         6.4      Consents....................................................19
         6.5      Ownership of Company Stock..................................19

ARTICLE VII:  REPRESENTATIONS AND WARRANTIES OF BUYER.........................19
         7.1      Organization and Standing...................................19
         7.2      Power and Authority.........................................20
         7.3      Binding Agreement...........................................20
         7.4      Absence of Conflicting Agreements...........................20
         7.5      Consents....................................................20
         7.6      Material Changes............................................20
         7.7      Finders.....................................................20
         7.8      Capital Stock...............................................20
         7.10     Compliance with Laws........................................21
         7.11     Questionable Payments.......................................21

ARTICLE VIII:  INFORMATION AND RECORDS CONCERNING THE OTHER
         PARTIES..............................................................21
         8.1      Buyer's Access to Information and Records before Closing....21
         8.2      Sellers' and Company's Access to Information and Records
                  Before Closing..............................................22

ARTICLE IX:  OBLIGATIONS OF THE PARTIES (OTHER THAN SIRROM) UNTIL
         CLOSING..............................................................22
         9.1      Conduct of Business Pending Closing.........................22
         9.2      Negative Covenants of the Company and its Subsidiaries......22
         9.3      Affirmative Covenants.......................................22
         9.4      Pursuit of Consents and Approvals...........................23
         9.5      Exclusivity.................................................24



                                      (ii)

<PAGE>



ARTICLE X:  CONDITIONS PRECEDENT TO BUYER'S OBLIGATIONS.......................24
         10.1     Representations and Warranties..............................24
         10.2     Performance of Covenants....................................24
         10.3     Delivery of Closing Certificate.............................24
         10.4     Opinion of Counsel..........................................24
         10.5     Legal Matters...............................................24
         10.6     Authorization Documents.....................................25
         10.7     Material Change.............................................25
         10.8     Approvals...................................................25
         10.9     Employment Agreement........................................25
         10.10    Consents....................................................25
         10.11    Estimated Closing Date Balance Sheet........................25
         10.12    Company's Subsidiaries and Options..........................25
         10.13    Cost and Expenses...........................................26
         10.14    Resignation of Company Boards of Directors and Officers.....26
         10.15    Affiliated Company..........................................26
         10.16    Lien Releases...............................................26
         10.17    Other Documents.............................................26

ARTICLE XI:  CONDITIONS PRECEDENT TO SELLERS' OBLIGATIONS.....................26
         11.1     Representations and Warranties..............................26
         11.2     Performance of Covenants....................................26
         11.3     Delivery of Closing Certificate.............................26
         11.4     Opinion of Counsel..........................................27
         11.5     Legal Matters...............................................27
         11.6     Authorization Documents.....................................27
         11.7     Employment Agreement........................................27
         11.8     Material Change.............................................27
         11.9     Other Documents.............................................27

ARTICLE XII:  SURVIVAL AND INDEMNIFICATION....................................27
         12.1     Survival of Representations and Warranties..................27
         12.2     Indemnification by Sellers..................................27
         12.3     Indemnification by Buyer....................................28
         12.4     Assertion of Claims.........................................28
         12.5     Indemnity Basket............................................29
         12.6     Control of Defense of Indemnifiable Claims..................29
         12.7     Restrictions................................................30
         12.8     Records.....................................................31

ARTICLE XIII:  TERMINATION....................................................31
         13.1     Termination.................................................31
         13.2     Effect of Termination.......................................31




                                      (iii)

<PAGE>



ARTICLE XIV:  MISCELLANEOUS...................................................31
         14.1     Costs and Expenses..........................................31
         14.2     Performance.................................................31
         14.3     Benefit and Assignment......................................32
         14.4     Effect and Construction of this Agreement...................32
         14.5     Cooperation - Further Assistance............................32
         14.6     Notices.....................................................32
         14.7     Waiver, Discharge, Etc......................................33
         14.8     Rights of Persons Not Parties...............................33
         14.9     Governing Law...............................................34
         14.10    Amendments, Supplements, Etc................................34
         14.11    Severability................................................34
         14.12    Counterparts................................................34
         14.13    Arbitration.................................................34
         14.14    Public Announcements........................................34



                                      (iv)

<PAGE>



                              SCHEDULES & EXHIBITS

Schedule 2.1(b)          -       Allocation among Sellers
Schedule 5.3             -       Consent List of Sellers
Schedule 5.4             -       Company Stock
Schedule 5.6             -       Trademarks
Schedule 5.7             -       Contracts
Schedule 5.8(a)          -       Unaudited Financial Statement
Schedule 5.8(b)          -       Unaudited Interim Financial Statements
Schedule 5.8(c)          -       Material Liabilities
Schedule 5.9             -       Material Changes
Schedule 5.10            -       Licenses, Permits, Certificates of Need
Schedule 5.11(a)         -       Liens on Personal Property
Schedule 5.11(b)         -       Leases of Personal Property
Schedule 5.12            -       Legal Proceedings
Schedule 5.13            -       Employees
Schedule 5.15 (b)        -       Employee Benefit Plans
Schedule 5.15 (c)        -       Employees on Leave of Absence
Schedule 5.16            -       Insurance and Surety Agreements
Schedule 5.17            -       Relationships
Schedule 5.18            -       Absence of Certain Events
Schedule 5.19            -       Compliance with Laws
Schedule 5.21            -       Tax Returns
Schedule 5.23            -       Subsidiaries, Joint Ventures, etc.
Schedule 5.25            -       Medicare and Medicaid Programs
Schedule 6.5             -       Ownership of Company Stock

Exhibit 5.29             -       Questionnaire
Exhibit 10.4             -       Opinion of Sellers' Counsel
Exhibit 10.9             -       Employment Agreement
Exhibit 11.4             -       Opinion of Buyer's Counsel



                                       (v)

<PAGE>



                           --------------------------
                            STOCK PURCHASE AGREEMENT
                           --------------------------


     This Stock Purchase  Agreement (the "Agreement") is made as of the 29th day
of August, 1997, among SIRROM CAPITAL CORPORATION ("Sirrom"),  RAYMOND A. MIRRA,
JR.,  JAMES KUO, and EDWARD KRAMM (the said  individuals,  together with Sirrom,
being collectively  referred to herein as the "Sellers",  and each individually,
the "Seller"),  and INTEGRATED  HEALTH  SERVICES,  INC., a Delaware  corporation
("Buyer"), and APS AMERICA, INC., a Delaware corporation (the "Company").

     WHEREAS,  the Company is in the  business of providing  infusion  services,
including  without  limitation,  blood fractions  services and chronic  infusion
therapies (the "Business" or "Services"); and

     WHEREAS,  the  Sellers  are the  owners or holders of all of the issued and
outstanding  shares of the capital stock of the Company (the  "Company  Stock");
and

     WHEREAS,  Buyer wishes to acquire the Company  Stock from the Sellers,  and
the Sellers  wish to sell the Company  Stock to Buyer,  in  accordance  with the
terms and conditions hereinafter set forth.

     NOW, THEREFORE,  Sellers, Buyer, and Company intending to be legally bound,
agree as follows:


                  ARTICLE I: SALE AND PURCHASE OF COMPANY STOCK

     1.1 SALE AND PURCHASE OF COMPANY STOCK. Subject to the terms and conditions
of this Agreement, at the Closing (as hereinafter defined),  Buyer shall acquire
from the Sellers,  and the Sellers  shall sell,  assign,  transfer and convey to
Buyer,  the Company Stock.  The number of shares of Company Stock (and the class
or series of such shares) being sold by each Seller is set forth on Schedule 5.4
hereto.


                           ARTICLE II: PURCHASE PRICE

     2.1 DETERMINATION AND PAYMENT OF PURCHASE PRICE.

       (A) Subject to adjustment  pursuant to Section 2.2 hereof,  the aggregate
purchase  price to be paid by Buyer to the Sellers  for the  Company  Stock (the
"Purchase  Price"),  shall be TWO  MILLION  AND 00/100  (2,000,000.00)  DOLLARS,
payable at the  Closing by the  delivery  of newly  issued  shares of the Common
Stock, par value $.001, of Buyer (the "IHS Stock").



<PAGE>




       (B) The  Purchase  Price  payable to the  Sellers at the  Closing,  after
taking into account the  adjustments in Section 2.2,  below,  shall be allocated
among the Sellers on the basis set forth on Schedule 2.1(b).

     2.2 ADJUSTMENTS TO THE PURCHASE PRICE.

       (A) At the Closing, the Company shall deliver a certificate signed by its
Chief Financial Officer certifying the amount of the Company's aggregate working
capital (as defined herein) as of the Closing Date on a consolidated  basis (the
"Estimated  Closing  Date  Working  Capital").  In the event that the  Estimated
Closing Date Working Capital is less than zero (the "Minimum Working  Capital"),
the  Purchase  Price  payable to the  Sellers  at  Closing  will be reduced on a
dollar-for-dollar  basis by an amount equal to the amount of such  deficiency in
cash.  For the purposes  hereof,  "working  capital" means the excess of current
assets over current  liabilities,  as determined in  accordance  with  generally
accepted accounting  principles,  consistently  applied ("GAAP");  provided that
current  liabilities  shall  include  any  deferred  taxes  resulting  from  the
conversion  of the Company as of the  Closing  Date from an  S-corporation  to a
C-corporation.  Additionally, at the Closing, the Company shall deliver to Buyer
the balance sheet of the Company on a consolidated basis dated as of the Closing
Date,  certified by the Company's Chief Financial  Officer to be his or her best
good faith estimate thereof (the "Estimated Closing Date Balance Sheet"). In the
event that the Estimated Closing Date Balance Sheet discloses that the aggregate
amount of the Company's  long-term  liabilities as determined in accordance with
GAAP exceeds zero,  the Purchase Price payable to the Sellers at Closing will be
reduced  by an amount  equal to the  amount  of such  excess.  For the  purposes
hereof,  "long-term  liability" means any liability that would be set forth as a
long-term  liability on a balance sheet in accordance  with GAAP;  provided that
long-term  liabilities  shall  include any  deferred  taxes  resulting  from the
conversion  of the Company as of the  Closing  Date from an  S-corporation  to a
C-corporation,  except  that in no event  will the same  deferred  tax amount be
included as both a current liability and long-term liability.

       (B) As soon as is reasonably practicable,  but in any event within ninety
(90) days  following  the Closing  Date,  Buyer  shall  complete a review of the
Company's  Estimated Closing Date Balance Sheet. If such review reveals that the
Company's working capital as of the Closing Date was less than the lesser of (i)
the  Minimum  Working  Capital,  and (ii) the  Estimated  Closing  Date  Working
Capital,  the Purchase  Price shall be deemed to have been reduced by the amount
of such  deficiency,  and the Sellers  shall pay over to Buyer cash in an amount
equal to such  deficiency.  Furthermore,  if such review  reveals the  aggregate
amount of the Company's  long-term  liabilities  as of the Closing Date exceeded
the  greater  of (w)  zero,  or  (x)  the  amount  of  the  Company's  long-term
liabilities  as indicated on the  Estimated  Closing  Date  Balance  Sheet,  the
Purchase  Price  shall be  deemed  to have been  reduced  by the  amount of such
excess,  and the Sellers  shall deliver over to Buyer cash in an amount equal to
such excess.  If there shall be any dispute  regarding  the  calculation  of the
working capital as of the Closing Date or the amount of long-term liabilities as
of the Closing Date,  such dispute  shall be submitted to a mutually  acceptable
"big six" accounting firm other than KPMG Peat Marwick LLP and Deloitte & Touche
LLP (the  "Accountants")  for final  resolution  and the party  against whom the
Accountants  shall rule shall pay the costs and expenses of the  Accountants  in
connection therewith.


                                        2

<PAGE>



     2.3  LIABILITIES.  As of the Closing  Date,  the Company  will not have any
Liabilities other than such long-term liabilities and current liabilities as are
reflected on the  Estimated  Closing Date  Balance  Sheet.  For purposes of this
Agreement the term "Liability" means any claim, lawsuit,  liability,  obligation
or debt of any kind or nature whatsoever, whether absolute, accrued, due, direct
or indirect,  contingent or liquidated,  matured or unmatured, joint or several,
whether or not for a sum  certain,  whether  for the payment of money or for the
performance or observance of any obligation or condition,  and whether or not of
a type which would be reflected as a liability on a balance  sheet in accordance
with GAAP,  including,  without  limitation (i)  malpractice  claims asserted by
patients or any other tort claims  asserted,  claims for breach of contract,  or
any claims of any kind asserted by patients,  former patients,  employees or any
other  party  that are based on acts or  omissions  occurring  on or before  the
Closing Date; (ii) amounts due or that may become due to Medicare or Medicaid or
any other  health  care  reimbursement  or  payment  intermediary  on account of
Medicare cost report  adjustments or other payment  adjustments  attributable to
any period on or prior to the  Closing  Date,  or any other form of  Medicare or
other health care reimbursement recapture, adjustment or overpayment whatsoever,
including  fines and  penalties,  with  respect to any period on or prior to the
Closing Date ("Excess Reimbursement Liabilities"); (iii) any accounts payable or
employment  or other taxes;  and (iv) accrued but unpaid  compensation  or other
benefits to any of the Company's  employees,  agents,  consultants  or advisers,
including accrued vacation.


                             ARTICLE III: IHS STOCK

     3.1 IHS STOCK. The entire Purchase Price equal to TWO MILLION  ($2,000,000)
DOLLARS shall be payable by means of the delivery to the Sellers of IHS Stock in
accordance with the following:

       (A) SHARE  VALUE.  The number of shares of IHS Stock  issuable at Closing
pursuant to Section  2.1(b) shall be calculated  based upon a price per share of
such stock equal to the average  closing NYSE price of such stock for the thirty
(30) trading day period immediately  preceding the date which is two (2) trading
days before the Closing Date.

       (B) REGISTRATION  RIGHTS.  Buyer will prepare and use its best efforts to
cause  to be  filed  and  declared  effective  by the  Securities  and  Exchange
Commission  (the  "Commission")  within  ninety (90) days  following the Closing
Date, a registration  statement for the registration under the Securities Act of
1933 (the "Securities  Act") of the IHS Stock issued to Sellers pursuant to this
Agreement,  and Buyer shall  maintain  the  effectiveness  of such  registration
statement  for a period of one (1) year  following  the date on which it becomes
effective (the "Registration Date"), or until no Seller shall own any of the IHS
Stock issued  pursuant to this  Agreement,  whichever shall occur first, in each
case  except to the extent  that an  exemption  from  registration  would  allow
Sellers to sell all of their stock without restrictions (other than as set forth
in Section 3.1(d), below) is available.


                                        3

<PAGE>



       (C)  REGISTRATION  EXPENSES.  Sellers shall not be  responsible  for, and
Buyer  shall  bear,  all of the  reasonable  expenses  of Buyer  related to such
registration including, without limitation, the fees and expenses of its counsel
and  accountants,  all of its other  costs,  fees and  expenses  incident to the
preparation,  printing,  registration and filing under the Securities Act of the
registration  statement and all amendments and supplements  thereto, the cost of
furnishing copies of each preliminary prospectus, each final prospectus and each
amendment or supplement thereto to underwriters, dealers and other purchasers of
IHS Stock and the costs and expenses  (including fees and  disbursements  of its
counsel)  incurred in connection with the  qualification  of IHS Stock under the
Blue Sky laws of various jurisdictions. Buyer, however, shall not be required to
pay underwriter's or brokerage discounts, commissions or expenses, or to pay any
costs or expenses arising out of Sellers' or any transferee's  failure to comply
with its obligations under this Article III.

       (D) RESALE LIMITATIONS.  All resales of IHS Stock issued pursuant to this
Agreement  shall be effected  solely  through Smith Barney Inc., as broker,  and
sales by Sellers  and, if any,  their  transferees  of such  shares  (other than
transferees  acquiring  shares  pursuant to market  transactions  through  Smith
Barney Inc. and in accordance with this subsection  (d)), shall not at any time,
in the aggregate,  exceed Thirty Thousand (30,000) shares during any thirty (30)
day period.

       (E)  REGISTRATION  PROCEDURES,  ETC. In connection with the  registration
rights  granted to the Sellers with respect to the IHS Stock as provided in this
Section 3.1, Buyer covenants and agrees as follows:

          (I)  At  Buyer's  expense,   Buyer  will  keep  the  registration  and
qualification  under this  Section 3.1  effective  (and in  compliance  with the
Securities  Act) by such action as may be  necessary  or  appropriate  until the
Registration  Date or for a period of one (1) year  following  the date on which
the registration  becomes  effective,  in each case except to the extent that an
exemption from registration may be available.  Buyer will immediately notify the
Sellers,  at any time when a  prospectus  relating to a  registration  statement
under this Section 3.1 is required to be delivered  under the Securities Act, of
the  happening  of any event known to Buyer as a result of which the  prospectus
included in such registration  statement,  as then in effect, includes an untrue
statement of a material  fact or omits to state any material fact required to be
stated  therein or necessary to make the  statements  therein not  misleading in
light of the circumstances then existing.

          (II) Buyer shall furnish the Sellers with such number of  prospectuses
as shall reasonably be requested.

          (III) Buyer shall take all  necessary  action which may be required in
qualifying or registering  IHS Stock  included in a  registration  statement for
offering  and sale  under  the  securities  or Blue Sky laws of such  states  as
reasonably  are  requested  by the  Sellers,  provided  that Buyer  shall not be
obligated to qualify as a foreign corporation or dealer to do business under the
laws of any such jurisdiction.


                                        4

<PAGE>



          (IV) The  information  included or  incorporated  by  reference in the
registration  statement filed pursuant to this Section 3.1 will not, at the time
any such registration statement becomes effective,  contain any untrue statement
of a material  fact,  or omit to state any material  fact  required to be stated
therein as necessary in order to make the  statements  therein,  in light of the
circumstances under which they were made, not misleading or necessary to correct
any  statement  in any  earlier  filing of such  registration  statement  or any
amendments  thereto.  The  registration  statement  will comply in all  material
respects with the provisions of the Securities Act and the rules and regulations
thereunder.  Buyer shall  indemnify the Sellers of IHS Stock to be sold pursuant
to the registration statement, their successors and assigns, and each person, if
any, who controls such Sellers within the meaning of ss.15 of the Securities Act
or ss.20(a) of the Securities Exchange Act of 1934 ("Exchange Act"), against all
loss,  claim,  damage expense or liability  (including  all expenses  reasonably
incurred in investigating,  preparing or defending against any claim whatsoever)
to which any of them may become subject under the  Securities  Act, the Exchange
Act or any other statute, common law or otherwise,  arising out of or based upon
any untrue statement or alleged untrue statement of a material fact contained in
such registration  statement executed by Buyer or based upon written information
furnished by Buyer filed in any jurisdiction in order to qualify IHS Stock under
the securities laws thereof or filed with the Commission,  any state  securities
commission  or agency,  NYSE or any  securities  exchange;  or the  omission  or
alleged  omission  therefrom of a material fact required to be stated therein or
necessary to make the statements  contained therein not misleading,  unless such
statement or omission was made in reliance upon and in  conformity  with written
information  furnished to Buyer by any of the Sellers  expressly for use in such
registration statement,  any amendment or supplement thereto or any application,
as the  case may be.  If any  action  is  brought  against  the  Sellers  or any
controlling  person of the Sellers in respect of which  indemnity  may be sought
against  Buyer  pursuant  to this  subsection  3.1(e)(iv),  the  Sellers or such
controlling  person shall within thirty (30) days after the receipt thereby of a
summons or complaint,  notify Buyer in writing of the institution of such action
and Buyer shall assume the defense of such actions, including the employment and
payment of reasonable fees and expenses of counsel  (reasonably  satisfactory to
the Sellers or such controlling  person). The Sellers or such controlling person
shall  have the right to employ its or their own  counsel in any such case,  but
the fees and expenses of such counsel  shall be at the expense of the Sellers or
such  controlling  person  unless (A) the  employment of such counsel shall have
been  authorized  in writing  by Buyer in  connection  with the  defense of such
action,  or (B) Buyer  shall not have  employed  counsel  to have  charge of the
defense of such  action,  or (C) such  indemnified  party or parties  shall have
reasonably  concluded  that there may be defenses  available to it or them which
are different  from or  additional  to those  available to Buyer (in which case,
Buyer shall not have the right to direct the defense of such action on behalf of
the indemnified party or parties),  in any of which events the fees and expenses
of not more than one  additional  firm of attorneys for the Sellers  and/or such
controlling  person shall be borne by Buyer. Buyer agrees promptly to notify the
Sellers of the  commencement  of any litigation or proceedings  against Buyer or
any of its officers,  directors or  controlling  persons in connection  with the
resale of IHS Stock or in connection with such registration statement.


                                        5

<PAGE>



          (V) The  Sellers of IHS Stock to be sold  pursuant  to a  registration
statement,  and their successors and assigns, shall severally,  and not jointly,
indemnify  Buyer,  its  officers  and  directors  and each  person,  if any, who
controls  Buyer within the meaning of ss.15 of the Securities Act or ss.20(a) of
the  Exchange  Act  against all loss,  claim,  damage,  or expense or  liability
(including  all  expenses  reasonably  incurred in  investigating,  preparing or
defending  against any claim  whatsoever) to which they may become subject under
the  Securities  Act,  the  Exchange  Act or any other  statute,  common  law or
otherwise,  to the extent arising from information  furnished by or on behalf of
such  Sellers,  or their  successors  or assigns for specific  inclusion in such
registration statement.

       (F) NOTICE OF SALE. If the Sellers  desire to transfer all or any portion
of IHS Stock,  the Sellers will deliver  written notice to Buyer,  describing in
reasonable  detail their  intention to effect the transfer and the manner of the
proposed  transfer.   If  the  transfer  is  to  be  pursuant  to  an  effective
registration  statement as provided herein,  the Sellers will sell the IHS Stock
in compliance  with the disclosure  therein and discontinue any offers and sales
thereunder upon notice from Buyer that the  registration  statement  relating to
the IHS Stock being  transferred  is not  "current"  until  Buyer gives  further
notice that offers and sales may be recommenced. In the event of any such notice
from  Buyer,   Buyer  agrees  to  file  expeditiously  such  amendments  to  the
registration statement as may be necessary to bring it current during the period
specified  in Section  3.1(e) and to give prompt  notice to the Sellers when the
registration statement has again become current. If the Sellers deliver to Buyer
an opinion of counsel reasonably  acceptable to Buyer and its counsel and to the
effect that the proposed transfer of IHS Stock may be made without  registration
under the Securities  Act, the Sellers will be entitled to transfer IHS Stock in
accordance with the terms of the notice and opinion of their counsel.

       (G)  FURNISH  INFORMATION.  It  shall  be a  condition  precedent  to the
obligations  of the Buyer to take any action  pursuant to this  Article III that
the Sellers shall furnish to the Buyer such  information  regarding  themselves,
the IHS Stock  held by them,  and the  intended  method of  disposition  of such
securities as shall be required to effect the  registration  of their IHS Stock.
In that connection, each transferee of any Seller shall be required to represent
to the  Buyer  that all such  information  which is given is both  complete  and
accurate in all material  respects.  Such Sellers  shall  deliver to the Buyer a
statement in writing from the  beneficial  owners of such  securities  that they
bona fide intend to sell, transfer or otherwise dispose of such securities. Each
transferee  will,  severally,  promptly notify IHS at any time when a prospectus
relating to a registration  statement  covering such  transferee's  shares under
this Section 3.1 is required to be delivered  under the  Securities  Act, of the
happening  of any  event  known  to such  transferee  as a result  of which  the
prospectus included in such registration  statement, as then in effect, includes
an untrue  statement  of a  material  fact or omits to state any  material  fact
required to be stated  therein or necessary to make the  statements  therein not
misleading in light of the statements as then existing.


                                        6

<PAGE>



       (H)  INVESTMENT  REPRESENTATIONS.  All  shares  of IHS Stock to be issued
hereunder  will be newly  issued  shares of Buyer.  The  Sellers  represent  and
warrant to Buyer that the IHS Stock being issued  hereunder  is being  acquired,
and will be acquired,  by the Sellers for  investment for their own accounts and
not  with a view to or for sale in  connection  with  any  distribution  thereof
within the meaning of the Securities Act or the applicable state securities law;
the Sellers  acknowledge that the IHS Stock  constitutes  restricted  securities
under Rule 144 promulgated by the Commission pursuant to the Securities Act, and
may have to be held  indefinitely,  and the Sellers  agree that no shares of IHS
Stock may be sold,  transferred,  assigned,  pledged or  otherwise  disposed  of
except  pursuant to an effective  registration  statement  or an exemption  from
registration under the Securities Act, the rules and regulations thereunder, and
under all applicable  state  securities laws. The Sellers have the knowledge and
experience in financial  and business  matters,  are capable of  evaluating  the
merits and risks of the  investment,  and are able to bear the economic  risk of
such  investment.  The Sellers have had the opportunity to make inquiries of and
obtain from  representatives and employees of Buyer such other information about
Buyer as it deems necessary in connection with such investment.  Buyer will file
all Exchange Act Reports on a timely basis, including any permitted extensions.

       (I) LEGEND.  It is  understood  that,  prior to sale of any shares of IHS
Stock  pursuant to an effective  registration  pursuant to subsection (b) above,
the  certificates  evidencing  such shares of IHS Stock shall bear the following
(or a similar)  legend (in addition to any legends  which may be required in the
opinion of IHS's counsel by the applicable  securities  laws of any state),  and
upon  sale of such  shares  pursuant  to such  an  effective  registration,  new
certificates  shall be issued for the shares sold without such legends except as
otherwise required by law:

       THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER
       THE  SECURITIES ACT OF 1933. THE SHARES HAVE BEEN ACQUIRED FOR INVESTMENT
       AND MAY  NOT BE  SOLD,  TRANSFERRED  OR  ASSIGNED  IN THE  ABSENCE  OF AN
       EFFECTIVE  REGISTRATION  STATEMENT FOR THESE SHARES UNDER THE  SECURITIES
       ACT OF 1933 OR AN OPINION OF THE COMPANY'S  COUNSEL THAT  REGISTRATION IS
       NOT REQUIRED UNDER SAID ACT.

       (J) CERTAIN  TRANSFEREES.  Prior to the effective date of registration of
the IHS  Stock,  no  transferee  shall  transfer  any shares of IHS Stock to any
person or entity unless such transferee shall have agreed in writing to be bound
by the provisions applicable to the Sellers under this Article III.


                                        7

<PAGE>



                             ARTICLE IV: THE CLOSING

     4.1  TIME  AND  PLACE  OF  CLOSING.  The  closing  (the  "Closing")  of the
transactions  contemplated  by this  Agreement  shall  be held  as  promptly  as
practicable,   but  not  more  than  seven  (7)  business  days   following  the
satisfaction of all conditions precedent specified in this Agreement,  including
receipt of all necessary regulatory  approvals,  unless duly waived by the party
entitled to satisfaction thereof. The Closing shall take place at the offices of
the Buyer, or at such other time and place upon which the parties may agree. The
date on which the Closing is held is hereinafter called the "Closing Date."


          ARTICLE V: REPRESENTATIONS AND WARRANTIES OF THE SELLERS AND
                                     COMPANY

     The  Company  and the  Sellers  (other  than  Sirrom)  hereby  jointly  and
severally  represent and warrant to Buyer as follows (it being  understood that,
for the  purposes of this Article V, except  where the context  would  otherwise
require  "Company" shall be deemed to refer  collectively to the Company and any
subsidiaries listed on Schedule 5.23 and "to the knowledge of the Company" shall
be deemed to refer  collectively  to the  Company's  knowledge  and the Sellers'
knowledge):

     5.1 ORGANIZATION AND STANDING OF THE COMPANY.  The Company is a corporation
duly  organized,  validly  existing and in good  standing  under the laws of the
State of  Delaware.  Copies  of the  Company's  Articles  of  Incorporation  and
By-Laws,  and all amendments  thereof to date,  have been delivered to Buyer and
are complete and  accurate.  The Company has the power and  authority to own the
property and assets now owned by it and to conduct the business  presently being
conducted  by  it.  The  Company  is  qualified  to  do  business  as a  foreign
corporation  in each state where the  ownership  of its assets or the conduct of
its business renders such qualification necessary.

     5.2 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement  including all Schedules and Exhibits hereto, or any of the other
instruments  and  documents   required  or   contemplated   hereby  and  thereby
("Transaction  Documents")  by Sellers and the Company,  nor the  performance by
Sellers and the Company of the  transactions  contemplated  hereby and  thereby,
conflicts  with, or  constitutes a breach of or a default under (i) the Articles
of  Incorporation  or By-Laws of the Company;  or (ii) any applicable law, rule,
judgment,  order, writ, injunction, or decree of any court, currently in effect,
provided  that the consents set forth in Schedule 5.3 are obtained  prior to the
Closing; or (iii) any applicable rule or regulation of any administrative agency
or other  governmental  authority  currently  in  effect;  or (iv) any  material
agreement, indenture, contract or instrument to which the Company is now a party
or by which any of the assets of the Company is bound.


                                        8

<PAGE>



     5.3  CONSENTS.  Except  as set forth in  Schedule  5.3,  no  authorization,
consent, approval,  license, exemption by, filing or registration with any court
or   governmental   department,    commission,    board,   bureau,   agency   or
instrumentality, domestic or foreign, is or will be necessary in connection with
the  execution,  delivery  and  performance  of  this  Agreement  or  any of the
Transaction Documents by any of the Sellers or the Company.

     5.4 COMPANY STOCK.  Schedule 5.4 sets forth a complete list and description
of the authorized capital stock of the Company,  the number of shares issued and
outstanding of each class or series of such capital  stock,  and the identity of
each  Seller of the  Company,  in each case  indicating  the class and number of
shares  held.  No shares of the  Company  Stock are held in the  treasury of the
Company.  The Sellers are the record owners of all of the issued and outstanding
shares of the Company  Stock and all of such stock is duly  authorized,  validly
issued, and fully paid and non-assessable. On the Closing Date, there will be no
preemptive  or first  refusal  rights to purchase or otherwise  acquire from the
Company  or Sellers  shares of  capital  stock of the  Company  pursuant  to any
provision of law or the Articles of  Incorporation  or By-Laws of the Company or
by agreement or  otherwise.  On the Closing Date there shall not be  outstanding
any warrants,  options, or other rights to subscribe for or purchase from any of
the  Company  any shares of capital  stock of the  Company,  nor shall  there be
outstanding any securities convertible into or exchangeable for such shares. The
shares of Company Stock  indicated on Schedule 5.4 as being owned by the Sellers
constitute all of the issued and outstanding  shares of the capital stock of the
Company.

     5.5 ASSETS. As of the Closing Date, the consolidated  assets of the Company
(the  "Assets")  will  include  its  ownership  interest  in all of its  current
operating  subsidiaries,  as well as all of the tangible and  intangible  assets
necessary  to operate  the  Business  of the  Company  and its  subsidiaries  as
presently  constituted,  including,  without  limitation,  all contract  rights,
leasehold  interests,  fixed  and  moveable  equipment,  vehicles,  furnishings,
tangible  personal  property,  inventory  and  supplies  (other than  inventory,
supplies,  and other  assets  disposed of in the  ordinary  course of  business,
consistent with prior practice),  goodwill, trade names, trademarks, all patient
records,  books and files,  Certificates of Need, Medicare and Medicaid provider
agreements and provider  numbers,  provider  agreements with third party payors,
telephone numbers, and to the extent permitted by law, all permits, licenses and
other governmental  approvals.  The Assets of the Company as of the Closing Date
shall also include cash, accounts receivable,  and prepaid expenses.  The Assets
shall not  include  inventory,  supplies  and other  assets  disposed  of in the
ordinary course of business, consistent with the prior practice of the Company's
business.  The  quantities  of  inventory  items  included  in  the  Assets  are
reasonable  in light of the  present  and  anticipated  volume of the  Company's
business and the  inventory is good,  usable,  merchantable,  and salable in the
ordinary  course of the Company's  business,  in each case, as determined by the
Company in good faith and consistent with past practice. The accounts receivable
of the Company  are  reflected  properly on its books and records in  accordance
with GAAP,  and have been billed or invoiced in the ordinary  course of business
consistent  with past  practice.  The  Assets  are not  subject to any Liens (as
defined in Section  5.11),  except for  Permitted  Liens (as  defined in Section
5.11).


                                        9

<PAGE>



     5.6 TRADEMARKS. Schedule 5.6 sets forth a complete and accurate list of all
trademarks,  service marks, or applications for any of the same, copyrights, and
other items of  intellectual  property that are owned,  possessed or used by the
Company.  There are no claims or proceedings pending or, to the knowledge of the
Company, overtly threatened against the Company asserting that the use of any of
the  aforementioned  properties  or  rights  infringes  the  rights of any other
person, and, to the knowledge of any of the Sellers and Company,  the Company is
not infringing on the intellectual property rights of any other person.

     5.7 CONTRACTS.  Schedule 5.7 sets forth a complete and accurate list of all
agreements, contracts and commitments of the following type to which the Company
is a party or by which the Company or any of the Company's assets is bound or as
to which the Company has any  outstanding  material  obligations  as of the date
hereof (the "Contracts"):

       (A) each  contract or agreement  for the  employment  or retention of, or
collective  bargaining,  severance or termination  agreement with, any director,
officer, employee, consultant, agent or group of employees of the Company;

       (B) each profit sharing, thrift, bonus, incentive, deferred compensation,
stock   option,   stock   purchase,    severance   pay,   pension,   retirement,
hospitalization, insurance or other similar plan, agreement or arrangement;

       (C) each agreement or arrangement  for the purchase or sale of any of the
Company's  assets,  properties or rights outside the ordinary course of business
(by purchase or sale of assets,  purchase or sale of stock, merger or otherwise)
which is currently in effect which involves consideration of more than $25,000;

       (D) each  contract  currently  in effect which  contains  any  provisions
requiring the Company to indemnify or act for, or guarantee the  obligation  of,
any other person or entity;

       (E) each  agreement  restricting  the Company  from  conducting  business
anywhere in the world;

       (F) each partnership or joint venture contract or similar  arrangement or
agreement which involves a sharing of profits or future payments with respect to
the Company's business or any portion thereof;

       (G)   each   licensing,   distributor,   dealer,   franchise,   sales  or
manufacturer's  representative,  agency, purchasing, supply, and rebate or other
similar contract, arrangement or commitment which involves consideration of more
than $15,000;

       (H) each  contract  under which the Company  performs the Services  which
involves consideration of more than $15,000;


                                       10

<PAGE>



       (I) each lease of real property; or

       (J) any other  agreement  not made in the ordinary  and normal  course of
business which involves consideration of more than $15,000.

     Except as indicated on Schedule 5.7, each of the Contracts was entered into
and requires performance in the ordinary course of business and is in full force
and effect.  The Company is not in material default under any Contract and there
has not been asserted,  either by or against the Company under any Contract, any
written notice of default,  set-off or claim of default. To the knowledge of the
Company, the parties to the Contracts other than the Company are not in material
default of any of their respective  obligations  under the Contracts,  and there
has not  occurred  any event  which  with the  passage  of time or the giving of
notice (or both) would  constitute a material  default or material  breach under
any  Contract.  All  amounts  payable  under the  Contracts  are, or will at the
Closing  Date, be on a current  basis.  Except as set forth on Schedule 5.7, the
change of control in the Company to Buyer will not be deemed an  assignment  of,
or require consent under, any Contract.

     5.8 FINANCIAL STATEMENTS.

       (A)  The  unaudited  consolidated  balance  sheet  of the  Company  as of
December 31, 1996,  and the related  statements of operations  for the year then
ended, annexed hereto as Schedule 5.8(a) (the "Unaudited Financial  Statement"),
presents fairly in all material respects the financial  condition and results of
operations  of the Company at and for the period then ended  specified  and were
prepared in accordance with GAAP.

       (B) The unaudited  consolidated monthly statements of operations and cash
flows of the Company for each  calendar  month  since  January 1, 1997,  and the
unaudited consolidated Balance Sheet of the Company as of July 31, 1997, annexed
hereto as  Schedule  5.8(b)  (the  "Unaudited  Interim  Financial  Statements"),
present fairly in all material  respects the financial  condition and results of
operations of the Company at and for the periods therein  specified  (except for
normal  year-end  adjustments  and  such  statements  do  not  contain  footnote
disclosure) and were prepared in accordance with GAAP.

       (C) Except as set forth on Schedule  5.8(c) or as expressly  set forth on
the  Unaudited  Interim  Financial  Statements,  the  Company  has  no  material
non-recurring  or  extraordinary  income or  expense  reduction  not  identified
therein or material  liabilities  or  obligations  (whether  absolute,  accrued,
contingent  or otherwise  and whether due or to become due,  including,  without
limitation,  any guarantees of any obligations of any other person or entity) of
any  kind or  nature  whether  or not  required  by GAAP  to be  reflected  on a
consolidated  balance sheet and/or the notes  thereto,  except for current trade
payables incurred since the date of the Unaudited  Interim Financial  Statements
in the ordinary course of business consistent with past practice.


                                       11

<PAGE>



     5.9 MATERIAL CHANGES.  Except as noted on Schedule 5.9, between the date of
the Unaudited Financial Statement and the date of this Agreement,  there has not
been any material  adverse  change in the condition  (financial or otherwise) of
the Company or any damage or destruction  of any of the Company's  Assets or its
place  of  business  by  fire or  other  casualty,  whether  or not  covered  by
insurance, and during such period of time the Company has conducted its business
in the ordinary and normal course.  Sellers have identified and  communicated to
Buyer all material information with respect to this transaction.

     5.10 LICENSES;  PERMITS;  CERTIFICATES OF NEED.  Schedule 5.10 sets forth a
description  of (a) all  material  licenses  and  other  governmental  or  other
regulatory  permits,  authorizations or approvals  required for the operation of
the Company's  business that are now in effect,  including all  certificates  of
occupancy  issued  with  respect  to  the  Company's   business;   and  (b)  all
Certificates  of Need  issued with  respect to the Company and its  subsidiaries
that are now in effect;  (a "License" and  collectively,  the  "Licenses").  The
Licenses  constitute all of the material  governmental,  quasi-governmental  and
regulatory  licenses,  permits and authorizations  necessary to the operation of
the businesses of the Company and its  subsidiaries  as they are operated on the
date hereof.  The Company has  delivered to Buyer copies of all of the Licenses.
The Company and its  subsidiaries  own,  possess or otherwise have the exclusive
legal right to use the Licenses  (subject to the terms thereof),  free and clear
of all liens,  pledges,  claims or other  encumbrances of any nature whatsoever.
The Company is not in material  default under any such License,  and the Company
and its subsidiaries have not received any notice of any material default or any
other material claim or proceeding relating to any such License. Each License is
in full force and effect,  and  neither the Company nor any of its  subsidiaries
has  received  written  notice of any  proceeding  to  terminate  or suspend any
License or of any  condition  or event  which,  if uncured,  would result in the
termination  or  suspension  of any  License.  None  of the  Licenses  are:  (a)
provisional,  probationary,  or  restricted  in any  way  except  to the  extent
qualified by any  outstanding  deficiencies  or citations,  particulars of which
have been set forth on  Schedule  5.10;  or (b)  subject  to any  investigation,
cancellation,   impairment,   limitation,   order,  complaint,   proceeding,  or
suspension nor is such  threatened or pending.  No Seller,  director or officer,
employee or former employee of the Company,  or any person,  firm or corporation
other than the Company owns or has any proprietary, financial or other interest,
direct or indirect (other than through the Company),  in whole or in part in any
of the Licenses.

     5.11 TITLE, CONDITION OF PERSONAL PROPERTY.

       (A) Except for the liens listed and  described on Schedule  5.11(a),  the
Company has good and marketable  title to all of the personal  property owned by
the Company and located at their places of business or used in  connection  with
the  operation of its  businesses,  subject to no mortgage,  security  interest,
pledge, lien, claim,  encumbrance or charge, or restraint on transfer whatsoever
(the  "Liens")  other than  Permitted  Liens (as  defined  below) and except for
personal  property  leased by the Company as set forth on Schedule  5.11(b).  No
other  person  has any right to the use or  possession  of any of such  property
which is owned  and,  except  as set forth on  Schedule  5.11(a),  no  currently
effective financing statement with respect to such personal property has been


                                       12

<PAGE>



filed under the Uniform Commercial Code in any jurisdiction, and the Company has
not signed any such financing  statement or any security  agreement  authorizing
any secured party thereunder to file any such financing  statement.  All of such
personal  property  comprising  equipment,  improvements,  furniture  and  other
tangible personal property in use by the Company, whether owned or leased, is in
good  operating  condition and repair,  subject to normal wear and tear,  and is
sufficient to enable the Company to operate its business in a manner  consistent
with its operation during the immediately preceding twelve (12) months.

       (B)  Except  as set  forth on  Schedule  5.11(b),  no  tangible  personal
property used by the Company in connection with the operation of its business is
subject to a lease,  conditional  sale or similar  arrangement.  The Company has
delivered  to Buyer a complete  and correct copy of each of the leases and other
agreements  listed  on  Schedule  5.11(b).  The  Company  has a valid  leasehold
interest  in all of the  property  covered by any leases  included  on  Schedule
5.11(b). All of said personal property leases are valid, binding and enforceable
in  accordance  with their  respective  terms and are in full force and  effect,
subject  to  bankruptcy,   insolvency,  and  other  similar  laws  or  equitable
principles affecting the enforcement of creditors rights generally.  The Company
is not in  material  default  under  any of such  leases  and there has not been
asserted, either by or against the Company under any of such leases, any written
notice of  default,  set-off,  or claim of  default.  To the best  knowledge  of
Sellers and the  Company,  the parties to such leases other than the Company are
not in default of their  respective  obligations  under any of such leases,  and
there has not  occurred  any event  which with the  passage of time or giving of
notice (or both)  would  constitute  such a default or breach  under any of such
leases.

       (C) "Permitted Liens" shall mean:

          (I) carriers', warehouseman's,  mechanics, materialmen's,  repairmen's
or other like liens arising in the ordinary course of business which are (i) not
overdue for a period of more than 30 days or (ii) which are being  contested  in
good faith and by appropriate  proceedings,  provided that if such contest shall
continue for more than 30 days,  the amount  thereof shall be bonded or properly
reserved against at the end of such 30-day period;

          (II)  deposits  to secure the  performance  of bids,  trade  contracts
(other than for  borrowed  money),  leases,  statutory  obligations,  surety and
appeal bonds, performance bonds and other obligations of like nature incurred in
the ordinary course of business;

          (III) rights of lessors under leases set forth on Schedule 5.11(b);

          (IV) pledges or deposits in  connection  with  worker's  compensation,
unemployment insurance, and other social security legislation.

          (V) taxes not yet due or those taxes being contested.


                                       13

<PAGE>



     5.12 LEGAL PROCEEDINGS. Other than as set forth on Schedule 5.12, there are
no claims, actions, suits or proceedings or arbitrations,  either administrative
or judicial,  pending,  or, to the knowledge of the Company,  overtly threatened
against or affecting  the Company,  or the Company's  ability to consummate  the
transactions contemplated herein, at law or in equity or otherwise, before or by
any court or  governmental  agency or body,  domestic or  foreign,  or before an
arbitrator of any kind.

     5.13  EMPLOYEES.  Attached hereto as Schedule 5.13 is the payroll report of
the Company dated as of August 10, 1997,  indicating the names,  positions,  and
compensation  of each of its  employees.  All of such  information is materially
correct as of such date and there has been no material change since then. To the
knowledge of Sellers and Company, none of the employees,  while in the employ of
the  Company,  has ever had his or her  professional  license  or  certification
denied, suspended, revoked, terminated, or voluntarily relinquished under threat
of disciplinary  action,  or has ever been restricted in any way from performing
the duties he or she is to provide for the Company,  and there is no  proceeding
pending, or threatened, pursuant to which any of the foregoing may occur.

     5.14 COLLECTIVE  BARGAINING,  LABOR CONTRACTS,  EMPLOYMENT PRACTICES,  ETC.
During  the two years  prior to the  Closing  Date,  there has been no  material
adverse change in the relationship between the Company and its employees nor any
strike or material labor  disturbance by such employees  affecting the Company's
business and, to the knowledge of the Company,  there is no indication that such
a change, strike or labor disturbance is threatened. The Company's employees are
not represented by any labor union or similar  organization  and the Company has
no reason to believe that there are pending or threatened  any  activities,  the
purpose  of  which  is to  achieve  such  representation,  of all or some of the
Company's  employees.  Except as set forth on Schedule 5.7 or Schedule  5.15(b),
the Company has no collective  bargaining or other labor  contracts,  employment
contracts,  pension,  profit-sharing,  retirement,  insurance,  bonus,  deferred
compensation or other employee  benefit plans,  agreements or arrangements  with
respect to their  employees.  The  Company is in  material  compliance  with the
requirements  prescribed by all Federal,  state and local  statutes,  orders and
governmental rules and regulations ("Government Requirements") applicable to any
of the  employee  benefit  plans,  agreements  and  arrangements  identified  on
Schedule 5.7 and Schedule 5.15(b),  including,  without limitation, the Employee
Retirement  Income Security Act of 1974, as amended  ("ERISA"),  the Immigration
Reform and Control Act, the Worker Adjustment and Retraining Notification Act of
1988, any such  Government  Requirements  respecting  employment  determination,
equal opportunity,  affirmative action,  employee privacy,  wrongful or unlawful
termination, workers' compensation, occupational safety and health requirements,
labor management  relations and unemployment  insurance,  or related matters and
there are no threatened or pending claims relating thereto, in each case. In the
event of  termination  of employment of an employee of the Company,  the Company
will not,  after the Closing,  pursuant to any agreement  with any Seller or the
Company or by reason of any representation made or plan adopted by any Seller or
the Company  prior to the Closing,  be liable to any employee of the Company for
so-called  "severance pay",  parachute payments or any other similar payments or
benefits, including, without limitation,  post-employment healthcare (other than
pursuant to the  continuation  health care  provisions  of Section  4980B of the
Internal  Revenue  Code of 1986,  as amended or Section 601 through 608 of ERISA
("COBRA")),  insurance  benefits,  accrued  vacation  and sick  days,  except as
properly  accrued for on the Estimated  Closing Date Balance Sheet in accordance
with GAAP.


                                       14

<PAGE>



     5.15 ERISA.

       (A) The Company does not maintain or make  contributions  to and have not
at any  time in the past  maintained  or made  contributions  to,  any  employee
benefit plan which is subject to the minimum  funding  standards  of ERISA.  The
Company does not now maintain or make  contributions to, and has not at any time
in the past maintained or made contributions to, any multi-employer plan subject
to the  terms of the  Multi-employer  Pension  Plan  Amendment  Act of 1980 (the
"Multi-employer Act").

       (B) Schedule 5.15(b) sets forth each severance agreement,  and each plan,
agreement or arrangement,  bonus plan, deferred compensation agreement, employee
pension,  profit sharing,  savings or retirement  plan, group life,  health,  or
accident  insurance or other employee  benefit plan,  agreement,  arrangement or
commitment,   including,   without  limitation,  any  commitment  arising  under
severance, holiday, vacation, Christmas or other bonus plans (including, but not
limited  to,  "employee  benefit  plans",  as defined  in Section  3(3) of ERISA
maintained by the Company for any  employees of the Company,  or with respect to
which the Company has liability with respect to any employees of the Company, or
make or have an obligation to make  contributions  on behalf of employees of the
Company ("Plans").

       (C) Schedule 5.15(c)  identifies all employees of the Company on leave of
absence eligible to receive health benefits, as required by COBRA. Notice of the
availability of COBRA coverage has been provided to all employees of the Company
on leave of absence entitled thereto, and all persons electing such coverage are
being (or have been, if applicable) provided such coverage.

     5.16  INSURANCE  AND SURETY  AGREEMENTS.  Schedule 5.16 contains a true and
accurate  list of:  (a) all  policies  of fire,  liability  and  other  forms of
insurance  held or owned by the  Company  (including  but not limited to medical
malpractice  insurance,  and any state  sponsored  plan or program for  worker's
compensation);  and (b) all bonds,  indemnity agreements and other agreements of
suretyship made for or held by the Company, including a brief description of the
character  of the bond or agreement  and the name of the surety or  indemnifying
party.  Schedule 4.16 sets forth for each such insurance  policy the name of the
insurer, the amount of coverage,  the type of insurance,  the policy number, the
annual premium and a brief description of the nature of insurance included under
each such  policy and of any claims made  thereunder  during the past two years.
Such policies are owned by and payable solely to the Company,  and said policies
or renewals or replacements thereof will be outstanding and duly in force at the
Closing Date. All insurance  policies  listed on Schedule 5.16 are in full force
and effect,  all premiums due on or before the Closing Date have been or will be
paid,  financed  or accrued on or before the Closing  Date.  The Company has not
been  advised by any of its  insurance  carriers of an intention to terminate or
modify any such policies  other than under  circumstances  where the Company has
received a commitment  for a replacement  policy,  nor has the Company failed to
comply with any of the material conditions contained in any such policies.


                                       15

<PAGE>



     5.17  RELATIONSHIPS.  Except as disclosed on Schedule 5.17 hereto,  none of
the Sellers and no  controlling  Seller,  partner or any affiliate of any Seller
has, or at any time within the last two (2) years has had, a material  ownership
interest in any business,  corporate or otherwise, that is a party to, or in any
property that is the subject of, business  relationships  or arrangements of any
kind relating to the operation of the Company or its businesses.

     5.18 ABSENCE OF CERTAIN EVENTS. Except as set forth on Schedule 5.18, since
the date of the Unaudited Financial Statement, the Company has not, and from the
date of this Agreement through the Closing Date the Company will not have:

       (A) sold,  assigned or  transferred  any of their  assets or  properties,
except in the ordinary course of business;

       (B)  mortgaged,  pledged  or  subjected  to any lien,  pledge,  mortgage,
security interest, conditional sales contract or other encumbrance of any nature
whatsoever, other than a Permitted Lien, any of the Company's assets;

       (C) made or suffered any termination of any Services contract;

       (D)  sold or  assigned,  or  made  or  suffered  any  termination  of any
Contract,  or made or suffered  any  modification  or  amendment of any Contract
except for  terminations,  modifications and amendments of Contracts made in the
ordinary  course of business  consistent  with past practice and which would not
adversely affect earnings or otherwise be material,  and the Sellers and Company
have not  received  notice  (written  or oral)  and have no  knowledge  that any
Contract has been  terminated  or will be  terminated or modified or amended (as
aforesaid);

       (E) except in the ordinary course of business,  or otherwise as necessary
to comply with any applicable  minimum wage law, increased the salaries or other
compensation  of any of  their  employees,  or  made  any  increase  in,  or any
additions to, other benefits to which any of such employees may be entitled;

       (F) failed to pay or discharge when due any  liabilities,  the failure to
pay or discharge  which has caused or will cause any actual  damage or give rise
to the risk of a loss to the Company;

       (G) changed any of the accounting  principles  followed by the Company or
the methods of applying such principles; and

       (H) entered into any  transaction  other than in the  ordinary  course of
business involving consideration in excess of $15,000.


                                       16

<PAGE>



     5.19  COMPLIANCE  WITH LAWS.  The Company is in  compliance in all material
respects with all  Governmental  Requirements  (as defined  herein).  Except for
notices of  non-compliance  as to which the Company has taken corrective  action
acceptable to the applicable  governmental  agency, and as set forth in Schedule
5.19, the Company has not, within the period of twelve months preceding the date
of this  Agreement,  received any written  notice that the Company or any of the
Assets  fail to comply in any  material  respect  with any  applicable  Federal,
state, local or other governmental laws or ordinances,  or any applicable order,
rule or regulation of any Federal,  state,  local or other  governmental  agency
having  jurisdiction over their businesses  ("Governmental  Requirements").  The
Company  shall  report to Buyer,  within five (5)  business  days after  receipt
thereof,  any  written  notices  that the  Company is not in  compliance  in any
material respect with any of the foregoing.

     5.20 FINDERS.  No broker or finder has acted for the Sellers or the Company
in connection with the transactions contemplated by this Agreement, and no other
broker or finder is entitled to any broker's or finder's fee or other commission
in  respect  thereof  based  in  any  way  on  agreements,   understandings   or
arrangements with the Sellers or the Company.

     5.21 TAX RETURNS.

       (A) Except as set forth in Schedule  5.21, (i) all Tax (as defined below)
returns,  statements,  reports  and forms or  extensions  with  respect  thereto
required  to be  filed  with any  Federal,  state,  local or other  governmental
department   or  court  or  other   authority   having   jurisdiction   over  it
("Governmental  Authority") on or before the Closing Date by or on behalf of the
Company (collectively,  the "Tax Returns"), have been or will be timely filed on
or before the Closing  Date in  accordance  in all  material  respects  with all
applicable Governmental  Requirements;  and (ii) the Company has timely paid all
Taxes payable by them.

       (B) For  purposes of this  Agreement,  "Tax" means any net income,  gross
income, sales, use, franchise,  personal,  employment,  pension or real property
tax.

     5.22 ENCUMBRANCES CREATED BY THIS AGREEMENT.  The execution and delivery of
this Agreement, or any of the Company's Transaction Documents, does not, and the
consummation of the transactions contemplated hereby or thereby will not, create
any liens or other encumbrances on any of the Company's assets in favor of third
parties.

     5.23  SUBSIDIARIES AND JOINT VENTURES.  Schedule 5.23 sets forth a complete
list of all  subsidiaries,  joint ventures and partnerships in which the Company
is a record or beneficial owner. All of the issued and outstanding capital stock
of the  subsidiaries  listed  on  Schedule  5.23  hereto  is owned of  record or
beneficially  by the  Company or by one of the listed  subsidiaries  on Schedule
5.23.

     5.24 NO UNTRUE STATEMENT.  The representations and warranties made pursuant
to this  Agreement  taken as a whole do not  contain  any  untrue  statement  of
material  fact or omit to  state a  material  fact  necessary,  in  light of the
circumstance under which it was made, in order to make the  representations  not
misleading in any material respect.


                                       17

<PAGE>



     5.25 MEDICARE AND MEDICAID PROGRAMS.  The Company,  to the extent necessary
to conduct its business in a manner consistent with past practice,  is qualified
for participation in the Medicare and Medicaid programs.  Except as reflected on
Schedule  5.25,  (a) no  Seller  or the  Company  has  received  any  notice  of
recoupment  with  respect  to the  Company's  operations  from the  Medicare  or
Medicaid programs,  or any other third party reimbursement  source, (b) there is
no basis for the assertion after the Closing Date of any such  recoupment  claim
against Buyer,  Company or any Seller which arose out of any transactions on the
part of the  Company  prior to the Closing or against any Seller for which Buyer
will be liable, and (c) to the knowledge of Sellers and the Company, no Medicare
and Medicaid investigation,  survey or audit is pending,  threatened or imminent
with respect to the operation of the Company prior to the Closing.

     5.26  LEASEHOLD  INTERESTS.  Each of the Company and its  subsidiaries  has
valid leasehold interests in all real property,  subject to leases identified on
Schedule 5.7(i), free and clear of all liens,  claims,  charges and encumbrances
of any kind whatsoever, except for Permitted Liens.

     5.27 POWER AND AUTHORITY. The Company has all requisite power and authority
to execute,  deliver and perform  this  Agreement,  and as of the  Closing,  the
Company and Sellers will have all  requisite  power and authority to execute and
deliver the Transaction  Documents required to be delivered by each party to the
Buyer at the Closing.

     5.28 BINDING EFFECT. This Agreement and all Transaction  Documents executed
by the  Company  constitute  the legal,  valid and  binding  obligations  of the
Company,  enforceable  against the Company in accordance  with their  respective
terms.

     5.29 QUESTIONNAIRES. The health care law questionnaire heretofore delivered
to the Company by Buyer (the "Questionnaire") will be attached hereto as Exhibit
5.29 and will as of the Closing Date have been accurately completed and will not
contain any  material  misstatement  of any fact and will not omit any fact that
would  have  to  be  stated  in  order  not  to  render  any  response  to  such
questionnaire materially misleading.

     5.30  QUESTIONABLE  PAYMENTS.  The Company nor any  shareholder,  director,
officer,  controlling  person or employee of Company,  and no  affiliate  of any
Company,  (a) has used any  corporate  funds of Company  to make any  illegal or
unlawful  payment  to  any  officer,  employee,  representative,  agent  of  any
government,  or to any political party or official thereof,  including,  without
limitation,  any of same that would violate the Foreign Corrupt Practices Act of
1977,  as amended;  or (b) has made or  received  any  illegal  payment,  bribe,
kickback,  political  contribution or other similar questionable payment for any
referrals or  recommendations  or otherwise in connection  with the operation of
the Company's business.


                                       18

<PAGE>



              ARTICLE VI: REPRESENTATIONS AND WARRANTIES OF SELLERS

     Each of the Sellers,  each as to himself,  hereby severally  represents and
warrants to Buyer as follows:

     6.1 AUTHORITY.  Such Seller has the full legal power and authority to make,
execute, deliver and perform this Agreement and the Transaction Documents.  Such
execution,  delivery,  performance and  consummation has been duly authorized by
all necessary action,  corporate or otherwise,  on the part of such Sellers, and
any  necessary  consents  of holders of  indebtedness  of such  Seller have been
obtained.

     6.2 BINDING EFFECT.  This Agreement and all Transaction  Documents executed
by such Seller  constitute the legal,  valid and binding  obligations of Seller,
enforceable against such Seller in accordance with their respective terms.

     6.3 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this  Agreement  or any of the  Transaction  Documents  by such  Seller  nor the
performance by such Seller of the transactions  contemplated  hereby and thereby
conflicts with, or constitutes a breach of or a default under (i) any law, rule,
judgment,  order, writ,  injunction,  or decree of any court currently in effect
applicable to such Seller, or (ii) any rule or regulation of any  administrative
agency or other  governmental  authority  currently in effect applicable to such
Seller, or (iii) any material  agreement,  indenture,  contract or instrument to
which such party is now a party or by which any of the assets of such  Seller is
bound.

     6.4 CONSENTS. No authorization,  consent, approval,  license, exemption by,
filing or registration  with any court or governmental  department,  commission,
board,  bureau,  agency or  instrumentality,  domestic or foreign, is or will be
necessary in connection  with the  execution,  delivery and  performance of this
Agreement or any of the Transaction Documents by such Seller.

     6.5 OWNERSHIP OF COMPANY STOCK. Except as disclosed on Schedule 6.5 hereto,
such  Seller is the lawful  record and  beneficial  owners of all of the Company
Stock shown as owned by such Seller in Schedule 5.4, with good and  indefeasible
title thereto,  free and clear of all liens and  encumbrances,  claims and other
charges  thereon of any kind.  Such  Seller has the full legal power to transfer
and deliver such Company Stock in accordance with this  Agreement,  and delivery
of such Company Stock to Buyer pursuant hereto will convey good and indefeasible
title thereto,  free and clear of all liens and  encumbrances,  claims and other
charges thereon or any kind.


              ARTICLE VII: REPRESENTATIONS AND WARRANTIES OF BUYER

     Buyer represents and warrants to the Company and the Sellers as follows:

     7.1  ORGANIZATION  AND  STANDING.  Buyer is a corporation  duly  organized,
validly existing and in good standing under the laws of the State of Delaware.


                                       19

<PAGE>



     7.2 POWER AND  AUTHORITY.  Buyer has the  corporate  power and authority to
execute,  deliver and perform this Agreement,  and as of the Closing, Buyer will
have the corporate  power and  authority to execute and deliver the  Transaction
Documents required to be delivered by it to the Sellers at the Closing.

     7.3  BINDING  AGREEMENT.  This  Agreement  and  all  Transaction  Documents
executed by Buyer constitute the legal,  valid and binding  obligation of Buyer,
enforceable against Buyer in accordance with their respective terms.

     7.4 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement or any of the Transaction  Documents by Buyer nor the performance
by the Buyer of the transactions contemplated hereby and thereby conflicts with,
or constitutes a breach of or a default under (i) the formation documents of the
Buyer, or (ii) any law, rule, judgment,  order, writ,  injunction,  or decree of
any  court  currently  in  effect  applicable  to  Buyer,  or (iii)  any rule or
regulation  of  any  administrative  agency  or  other  governmental   authority
currently  in  effect  applicable  to  Buyer,  or (iv) any  material  agreement,
indenture,  contract or instrument to which the Buyer is now a party or by which
any of the assets of the Buyer is bound.

     7.5 CONSENTS. No authorization,  consent, approval,  license, exemption by,
filing or registration  with any court or governmental  department,  commission,
board,  bureau,  agency or  instrumentality,  domestic or foreign, is or will be
necessary in connection  with the  execution,  delivery and  performance of this
Agreement or any of the Transaction Documents by Buyer.

     7.6 MATERIAL CHANGES. Since the Form 10-Q (as defined below), there has not
been any material  adverse  change in the condition  (financial or otherwise) of
the Buyer or any material  damage or destruction of any of the Buyer's  material
assets  or its  place of  business  by fire or other  casualty,  whether  or not
covered by insurance, and during such period of time the Buyer has conducted its
business  in the  ordinary  and normal  course.  Buyer is willing to make itself
available to identify and communicate to Sellers all material  information  with
respect to any fact or condition that is reasonably  likely to adversely  affect
the future prospects (financial or otherwise) of the Buyer.

     7.7 FINDERS. No broker or finder has acted for the Buyer in connection with
the transactions  contemplated by this Agreement,  and no other broker or finder
is entitled  to any  broker's or  finder's  fee or other  commission  in respect
thereof based in any way on agreements,  understandings or arrangements with the
Buyer.

     7.8 CAPITAL STOCK. Buyer's Form 10-Q filed with the Commission with respect
to the fiscal  quarter ended June 30, 1997 (the "Form 10-Q"),  sets forth a true
and complete  description of the authorized  and  outstanding  shares of capital
stock of Buyer as of such date. All outstanding  shares of IHS Stock are validly
issued,  fully paid and  non-assessable  and not subject to  preemptive  rights.
Buyer has duly  authorized  and reserved for issuance the IHS Stock,  and,  when
issued  in  accordance  with the terms of  Article  III,  the IHS Stock  will be
validly issued,  fully paid and  nonassessable  and free and clear of preemptive
rights, liens, encumbrances, claims and other charges thereon.


                                       20

<PAGE>



     7.10  COMPLIANCE  WITH LAWS.  The Buyer is in  compliance  in all  material
respects with all Governmental  Requirements (as defined in Section 5.19) except
where the failure to be in  compliance  could  reasonably  be expected to have a
material adverse effect on the Buyer and its subsidiaries  collectively.  Except
for notices of  non-compliance as to which the Buyer has taken corrective action
acceptable to the applicable  governmental  agency or which would not reasonably
be expected to have a material  adverse effect on the Buyer and its subsidiaries
collectively,  the Buyer has not,  within the period of twelve months  preceding
the date of this Agreement, received any written notice that the Buyer or any of
the assets fail to comply in any material  respect with any applicable  Federal,
state, local or other governmental laws or ordinances,  or any applicable order,
rule or regulation of any Federal,  state,  local or other  governmental  agency
having jurisdiction over their businesses.

     7.11  QUESTIONABLE  PAYMENTS.   Neither  the  Buyer  nor  any  shareholder,
director, officer,  controlling person or employee of Buyer, and no affiliate of
Buyer, (a) has used any corporate funds of Buyer to make any illegal or unlawful
payment to any officer, employee, representative, agent of any government, or to
any political party or official thereof,  including,  without limitation, any of
same that would violate the Foreign  Corrupt  Practices Act of 1977, as amended;
or (b) has made or received  any illegal  payment,  bribe,  kickback,  political
contribution  or  other  similar  questionable  payment  for  any  referrals  or
recommendations  or otherwise in  connection  with the  operation of the Buyer's
business which could reasonably be expected to have a material adverse effect on
the Buyer and its subsidiaries collectively.


           ARTICLE VIII: INFORMATION AND RECORDS CONCERNING THE OTHER
                                     PARTIES

     8.1 BUYER'S ACCESS TO INFORMATION AND RECORDS BEFORE CLOSING.  Prior to the
Closing Date,  Buyer may make, or cause to be made,  such  investigation  of the
Company's  (it being  understood  that,  for the purpose of this  Article  VIII,
"Company"  shall  be  deemed  to  refer  collectively  to the  Company  and  its
subsidiaries  listed on Schedule  5.23)  financial and legal  condition as Buyer
deems  necessary  or  advisable to  familiarize  itself with the Company  and/or
matters relating to its history or operation. The Company shall permit Buyer and
its authorized  representatives  (including legal counsel and  accountants),  to
have full access to the Company's books and records upon  reasonable  notice and
during  normal  business  hours,  and the Company will  furnish,  or cause to be
furnished,  to Buyer such financial and operating data and other information and
copies of documents with respect to the Company's products, services, operations
and assets as Buyer shall from time to time reasonably request. The documents to
which  Buyer  shall  have  access  shall  include,  but not be  limited  to, the
Company's  tax returns and related  work papers since their  inception;  and the
Company  shall  make,  or cause to be made,  extracts  thereof as Buyer or their
representatives  may  request  from  time to  time to  enable  Buyer  and  their
representatives  to  investigate  the affairs of the Company and the accuracy of
the  representations  and warranties made in this  Agreement.  The Company shall
cause their  accountants  to cooperate with Buyer and to disclose the results of
audits  relating  to the Company  and to produce  the  working  papers  relating
thereto. Without limiting any


                                       21

<PAGE>



of the  foregoing,  it is agreed that Buyer will have full access to any and all
agreements  between and among the  previous and current  shareholders  regarding
their ownership of shares or the management or operation of the Company.

     8.2  SELLERS'  AND  COMPANY'S  ACCESS TO  INFORMATION  AND  RECORDS  BEFORE
CLOSING.  Prior to the Closing Date,  Buyer shall make  available to Sellers and
Company any public information related to Buyer and provide access to the senior
management of Buyer.


        ARTICLE IX: OBLIGATIONS OF THE PARTIES (OTHER THAN SIRROM) UNTIL
                                     CLOSING

     9.1 CONDUCT OF BUSINESS PENDING CLOSING. Between the date of this Agreement
and the Closing, the Company and its subsidiaries shall maintain their existence
and shall  conduct their  businesses  in the  customary  and ordinary  course of
business consistent with past practice.

     9.2  NEGATIVE  COVENANTS OF THE COMPANY AND ITS  SUBSIDIARIES.  Without the
prior written approval of Buyer, neither the Company nor any of its subsidiaries
shall, between the date hereof and the Closing:

       (A) cause or permit to occur any of the events or  occurrences  described
in Section 5.18 (Absence of Certain Events) of this Agreement;

       (B) dissolve, merge or enter into a share exchange with or into any other
entity;

       (C)  enter  into  any  contract  or  agreement  with  any  union or other
collective  bargaining  representative  representing  any employees  without the
prior  written  consent  of  Buyer,  which  consent  shall  not be  unreasonably
withheld;

       (D) sell off any Assets other than in the ordinary course of business; or

       (E) make any change to their by-laws or articles of incorporation.

     9.3  AFFIRMATIVE  COVENANTS.  Between the date hereof and the Closing,  the
Company and each of its subsidiaries shall:

       (A) maintain their businesses in substantially  the same state of repair,
order and  condition  as on the date  hereof  consistent  with  past  practices,
reasonable wear and tear or loss by casualty excepted;


                                       22

<PAGE>



       (B) maintain in full force and effect all material Licenses  currently in
effect  with  respect  to their  businesses  unless  such  License  is no longer
necessary for the operation of the Company and its subsidiaries;

       (C) maintain in full force and effect the insurance  policies and binders
currently in effect, or the replacements  thereof,  including without limitation
those listed on Schedule 5.16;

       (D)  utilize  their  reasonable  efforts to  preserve  intact the present
business  organization of the Company and its  subsidiaries;  keep available the
services of the Company's and its  subsidiaries'  present  employees and agents;
and maintain the  Company's  and its  subsidiaries'  relations and goodwill with
suppliers,  employees,  affiliated  medical  personnel  and  any  others  having
business relating to the Company and its subsidiaries;

       (E) maintain all of the books and records in  accordance  with their past
practices;

       (F) comply in all material  respects with all provisions of the Contracts
listed in Schedule 5.7 and with any other material  agreements  that the Company
and its subsidiaries  have entered into in the ordinary course of business since
the  date of this  Agreement,  and  comply  in all  material  respects  with the
provisions  of all  material  laws,  rules  and  regulations  applicable  to the
Company's and its subsidiaries' businesses;

       (G) cause to be paid when due,  all  taxes,  assessments  and  charges or
levies  imposed  upon  them or on any of their  properties  for  which  they are
required  to  withhold  and pay over other than their  being  contested  in good
faith;

       (H)  promptly  advise  Buyer in  writing  of the  threat or  commencement
against  the  Company  and  its  subsidiaries  of any  claim,  action,  suit  or
proceeding,   arbitration  or  investigation  or  any  other  event  that  would
materially adversely affect the operations,  properties,  assets or prospects of
the Company and its subsidiaries;

       (I) notify the Buyer in writing of any event  involving  the  Company and
its subsidiaries which has had or may be reasonably  expected to have a material
adverse  effect on the  business or  financial  condition of the Company and its
subsidiaries or may involve the loss of contracts which involve revenues of more
than $15,000 per year  individually  or $100,000 per year in the aggregate  with
any of the Company's or its subsidiaries' customers; and

     9.4 PURSUIT OF CONSENTS AND  APPROVALS.  Prior to the Closing,  Buyer shall
use its reasonable  efforts to obtain all consents and approvals of governmental
agencies and all other  parties  necessary  for the lawful  consummation  of the
transactions  contemplated hereby and the lawful use, occupancy and enjoyment of
the Company's and its subsidiaries'  businesses by Buyer in accordance  herewith
("Required  Approvals").  The Company and its subsidiaries  shall cooperate with
and use  their  reasonable  efforts  to  assist  Buyer  in  obtaining  all  such
approvals.


                                       23

<PAGE>





     9.5  EXCLUSIVITY.  Until the earlier of Closing or the  termination of this
Agreement pursuant to Section 13.1, the Company nor any Seller, nor any of their
respective   affiliates,   representatives  or  brokers  shall  enter  into  any
agreement,  commitment  or  understanding  with  respect  to,  or  engage in any
discussions or negotiations directly or indirectly with, or encourage or respond
to any  solicitations  from, any other party with respect to the sale,  lease or
management  of any of the  Assets,  or in  respect  of the sale of any shares of
capital stock in the Company.


             ARTICLE X: CONDITIONS PRECEDENT TO BUYER'S OBLIGATIONS

     Buyer's  obligations  to  consummate  the purchase of the Company  Stock is
subject to the fulfillment, prior to or at the Closing, of each of the following
conditions,  any one or more of which may be waived  by Buyer in  writing.  Upon
failure of any of the following  conditions,  Buyer may terminate this Agreement
pursuant to and in accordance with Article XIII herein.

     10.1 REPRESENTATIONS AND WARRANTIES.  The representations and warranties of
Company and Sellers made pursuant to this Agreement shall be true and correct in
all  material   respects  at  and  as  of  the  Closing  Date,  as  though  such
representations  and  warranties  were  made at and as of such  time  (except  a
representation  made as of a  specified  date shall be true and  accurate in all
material  respects  as of  that  date)  except  to the  extent  affected  by the
transactions herein contemplated.

     10.2  PERFORMANCE  OF COVENANTS.  Each of the Sellers and the Company shall
have  performed  or  complied in all  material  respects  with their  respective
agreements and covenants  required by this Agreement to be performed or complied
with by it prior to or at the Closing.

     10.3 DELIVERY OF CLOSING  CERTIFICATE.  Each of the Sellers and the Company
shall have executed and delivered to Buyer a certificate of its president, dated
the Closing  Date,  upon which Buyer may rely,  certifying  that the  conditions
contemplated by Sections 10.1 and 10.2 applicable to it have been satisfied.

     10.4  OPINION OF COUNSEL.  Each Seller  (other than Sirrom) and the Company
shall have  delivered  to Buyer an  opinion,  dated the Closing  Date,  of their
counsel, in substantially the form attached hereto as Exhibit 10.4.

     10.5 LEGAL MATTERS.  No preliminary or permanent  injunction or other order
(including a temporary  restraining  order) of any governmental  authority which
prevents the  consummation  of the  transactions  contemplated by this Agreement
shall have been issued and remain in effect.


                                       24

<PAGE>



     10.6  AUTHORIZATION  DOCUMENTS.  Buyer shall have received a certificate of
the Secretary or other officer of the Company  certifying as of the Closing Date
a copy of  Resolutions of its Board of Directors  authorizing  its execution and
full  performance  of  the  Transaction  Documents  and  the  incumbency  of its
officers.

     10.7 MATERIAL CHANGE.  Since the date of the Unaudited  Financial Statement
there  shall  not  have  been  any  material  adverse  change  in the  condition
(financial or otherwise) of the assets,  properties or operations of the Company
and its subsidiaries.

     10.8 APPROVALS.

       (A) The consent or approval of all persons necessary for the consummation
of the  transactions  contemplated  hereby  shall have been  granted,  including
without limitation, the Required Approvals;

       (B) None of the  foregoing  consents  or  approvals  (i) shall  have been
conditioned upon the  modification,  cancellation or termination of any material
lease,  contract,  commitment,  agreement,  license,  easement,  right  or other
authorization  with respect to the Company's and its  subsidiaries'  businesses,
other than as disclosed or approved hereunder, or (ii) shall impose on the Buyer
any material condition or provision or requirement with respect to the Company's
and its  subsidiaries'  businesses or their  operation that is more  restrictive
than or  different  from the  conditions  imposed upon such  operation  prior to
Closing.

     10.9 EMPLOYMENT  AGREEMENT.  Raymond A. Mirra,  Jr. shall have executed and
delivered to Buyer his  employment  agreement in the form of Exhibit 10.9 hereto
(the "Employment Agreement").

     10.10 CONSENTS. Buyer shall have received the written consent to assignment
from each of those  parties  with whom the  Company  or its  subsidiaries  has a
Contract as listed on Schedule 5.7,  where such consent is required by reason of
the change of control of the Company  and its  subsidiaries  contemplated  under
this Agreement.

     10.11 ESTIMATED CLOSING DATE BALANCE SHEET. Sellers (other than Sirrom) and
Company shall have delivered the Estimated Closing Date Balance Sheet to Buyer.

     10.12 COMPANY'S  SUBSIDIARIES AND OPTIONS.  Each of the subsidiaries of the
Company as of the Closing Date will be one hundred  (100%)  percent owned by the
Company and there shall not be  outstanding  as of the Closing Date any options,
warrants or rights for the purchase of any capital stock of the  subsidiaries of
the Company.


                                       25

<PAGE>



     10.13 COST AND  EXPENSES.  The Sellers  (other than Sirrom) shall have paid
all  costs,  fees and  expenses  (including  without  limitation,  filing  fees,
transfer taxes,  stamp taxes,  legal fees and broker,  audit and appraisal fees)
incurred  by the  Company  or any of its  subsidiaries  in  connection  with the
transactions contemplated by this Agreement.

     10.14  RESIGNATION  OF  COMPANY  BOARDS OF  DIRECTORS  AND  OFFICERS.  Each
director  and  officer of the Company  and each of its  subsidiaries  shall have
submitted his or her resignation to be effective no later than the Closing Date.

     10.15  AFFILIATED   COMPANY.   Buyer  shall  have  closed  its  acquisition
simultaneously  with Ambulatory  Pharmaceutical  Services,  Inc. and each of its
respective shareholders.

     10.16 LIEN RELEASES.  Healthcare Partners Funding,  Inc. and Sirrom Capital
shall each have  released  their liens against the assets of the Company and its
subsidiaries and the Company shall have delivered to Buyer such releases and UCC
termination statements necessary to evidence that such releases have occurred.

     10.17  OTHER  DOCUMENTS.  The Sellers  (other than  Sirrom) and the Company
shall have  furnished  Buyer with all other  documents,  certificates  and other
instruments  required  to be  furnished  to Buyer by the Sellers and the Company
pursuant to the terms hereof.


            ARTICLE XI: CONDITIONS PRECEDENT TO SELLERS' OBLIGATIONS

     Sellers'  obligation to consummate the sale of the Company Stock is subject
to the  fulfillment,  prior  to or at the  Closing,  of  each  of the  following
conditions,  any one or more of which may be waived by Sellers in writing.  Upon
failure of any of the following conditions, Sellers may terminate this Agreement
pursuant to and in accordance with Article XIII herein:

     11.1 REPRESENTATIONS AND WARRANTIES.  The representations and warranties of
Buyer in this  Agreement  shall be true and correct in all material  respects at
and as of the Closing Date as though such  representations  and warranties  were
made at and as of such time (except a representation made as of a specified date
shall be true and accurate in all  material  respects as of that date) except to
the extent affected by the transactions herein contemplated.

     11.2 PERFORMANCE OF COVENANTS.  Buyer shall have performed or complied with
each of its agreements and conditions required by this Agreement to be performed
or complied with by it prior to or at the Closing.

     11.3 DELIVERY OF CLOSING CERTIFICATE. Buyer shall have delivered to Sellers
a  certificate  of an executive  vice  president of Buyer dated the Closing Date
upon which Sellers can rely,  certifying  that the  conditions  contemplated  by
Sections 11.1 and 11.2 applicable to it have been satisfied.


                                       26

<PAGE>



     11.4 OPINION OF COUNSEL.  Buyer shall have delivered to Sellers an opinion,
dated the Closing Date, of Blass & Driggs, Esqs., counsel for Buyer, in the form
attached as Exhibit 11.4.

     11.5 LEGAL MATTERS.  No preliminary or permanent  injunction or other order
(including a temporary  restraining  order) of any governmental  authority which
prevents the  consummation  of the  transactions  contemplated by this Agreement
shall have been issued and remain in effect.

     11.6 AUTHORIZATION DOCUMENTS.  Sellers shall have received a certificate of
the Secretary or other officer of Buyer  certifying a copy of Resolutions of the
Board of Directors of Buyer  authorizing  Buyer's execution and full performance
of the Transaction Documents and the incumbency of the officers of Buyer.

     11.7 EMPLOYMENT AGREEMENT. The Buyer shall have entered into the Employment
Agreement with Raymond A. Mirra, Jr.

     11.8 MATERIAL  CHANGE.  Since the Form 10-Q,  there shall not have been any
material adverse change in the condition (financial or otherwise) of the assets,
properties or operations of Buyer.

     11.9  OTHER  DOCUMENTS.   Buyer  shall  have  furnished  Sellers  with  all
documents,  certificates  and other  instruments  required  to be  furnished  to
Sellers by Buyer pursuant to the terms hereof.


                    ARTICLE XII: SURVIVAL AND INDEMNIFICATION

     12.1  SURVIVAL  OF  REPRESENTATIONS  AND  WARRANTIES.   Absent  fraud,  all
representations  and warranties made by each party in this Agreement and in each
Schedule  and  Transaction  Document  shall  survive the Closing  Date and for a
period of one (1) year after the Closing,  notwithstanding  any investigation at
any  time  made  by  or  on  behalf  of  the  other  party,  provided  that  the
representations   and  warranties   contained  in  Section  5.30   (Questionable
Payments),  Section 5.25  (Medicare and Medicaid) and Section 5.21 (Tax),  shall
survive until thirty (30) days after the applicable  period of  limitations  for
audits by the applicable  Governmental  Authority shall have expired,  including
extensions for any necessary appeals. All representations and warranties related
to any claim  asserted  in writing  prior to the  expiration  of the  applicable
survival  period shall  survive (but only with respect to such claim) until such
claim shall be resolved and payment in respect thereof,  if any is owing,  shall
be made.

     12.2  INDEMNIFICATION BY SELLERS. The Sellers (and the Company unless there
shall be a Closing), jointly and severally, shall indemnify and defend Buyer and
hold  it  harmless  against  and  with  respect  to any and  all  damage,  loss,
liability,   deficiency,  cost  and  expense  (including,   without  limitation,
reasonable  attorney's  fees and  expenses)  (all of the  foregoing  hereinafter
collectively  referred  to as  "Loss")  resulting  from  any of  the  following,
provided that, for the purpose of this Section 12.2, "Sellers" shall not include
Sirrom Capital Corporation:


                                       27

<PAGE>



       (A) any inaccuracy in any  representation or certification,  or breach of
any warranty, made by the Sellers or Company pursuant to this Agreement; or

       (B) the breach of any  covenant  or  undertaking  made by the  Sellers or
Company in this Agreement; or

       (C) the ownership or operation of the Company or its  subsidiaries or its
business or assets prior to the Closing Date, including, without limitation, (i)
any Excess Reimbursement Liabilities (as defined in Section 2.4); (ii) any Taxes
resulting  from the operation of the business of the Company or ownership of any
of the Assets for any period  ending on or before the  Closing  Date;  (iii) any
Loss  arising out of the  noncompliance  of the  Company  with COBRA or any like
statute;  (iv) any  claim of the  type  that  would  be  covered  by a  standard
liability   insurance  policy,   including  without   limitation,   professional
liability,   malpractice,  general  liability,  automobile  liability,  worker's
compensation or employer's liability insurance,  arising out of the operation of
the  Company's  business  prior to the Closing Date,  including  payments of any
deductibles  applicable to the aforesaid policies;  and (v) any and all actions,
suits, proceedings, demands, assessments,  judgments, settlements (to the extent
approved by the Company, such approval not to be unreasonably withheld,  delayed
or conditioned),  costs and legal expenses incident to any of the foregoing; but
excluding  current  liabilities and long-term  liabilities that are reflected on
the  Estimated  Closing  Date  Balance  Sheet or that  otherwise  are taken into
account in any adjustment to the Purchase Price under Section 2.2.

     12.3 INDEMNIFICATION BY BUYER. Buyer shall indemnify and defend Sellers and
hold them harmless against and with respect to any and all Loss resulting from:

       (A) any inaccuracy in any  representation or certification,  or breach of
any warranty, made by Buyer pursuant to this Agreement; or

       (B) the  breach  of any  covenant  or  undertaking  made by Buyer in this
Agreement; or

       (C) the ownership or operation of the Company or its  subsidiaries or its
business or assets on and after the Closing Date.

     12.4  ASSERTION OF CLAIMS.  Any claims for  indemnification  under Sections
12.2(a)  or 12.3(a)  must be  asserted  by written  notice by a date which is no
later than one (1) year following the Closing Date,  except that any claim based
upon a breach of the  representations  and warranties  contained in Section 5.30
(Questionable  Payments),  Section 5.25  (Medicare and Medicaid) or Section 5.21
(Tax) may be  asserted  until  thirty (30) days after the  applicable  period of
limitations  for  audits by the  applicable  Governmental  Authority  shall have
expired, including extensions for any necessary appeals.



                                       28

<PAGE>



     12.5 INDEMNITY BASKET. Notwithstanding any other provisions of this Article
XII, no claim for  indemnification  made under Sections 12.2(a) or 12.3(a) shall
be made  unless and until Buyer or  Sellers,  as the case may be, have  incurred
Loss in excess of Fifty Thousand  ($50,000)  Dollars in the aggregate,  in which
case,  the party  seeking  indemnification  shall be entitled  to assert  claims
including such initial Fifty Thousand ($50,000) Dollars.

     12.6 CONTROL OF DEFENSE OF INDEMNIFIABLE CLAIMS.

       (A)  Each  indemnified  party  (each,  an  "Indemnitee")  shall  give the
indemnifying party (the  "Indemnitor")  prompt notice of each claim for which it
seeks indemnification.  Failure to give such prompt notice shall not relieve any
Indemnitor of its indemnification obligation, provided that such indemnification
obligation  shall be reduced by any damages the Indemnitor  demonstrates  it has
suffered  resulting  from a failure  to receive  prompt  notice  hereunder.  The
Indemnitors shall be entitled to participate in the defense of such claim. If at
any  time  the  Indemnitor  acknowledges  in  writing  that  the  claim is fully
indemnifiable  by it under this Agreement,  and, if requested by the Indemnitee,
the Indemnitor  posts adequate bond or security,  the Indemnitor  shall have the
right to assume control of the defense (but not the settlement) of such claim at
its own expense;  unless (i) Indemnitee shall have been authorized in writing by
the  Indemnitor  to  defend  such  action  with  counsel  of its own  choice  in
connection  with the defense of such action,  or (ii) the  Indemnitor  shall not
have employed counsel to have charge of the defense of such action within twenty
(20) days  after the date of  notice of the claim for which  indemnification  is
sought is given to the Indemnitor or (iii) the  Indemnitor  shall have failed to
undertake  and  reasonably  pursue  the  defense  of such  action,  or (iv)  the
Indemnitee shall have reasonably  concluded that there may be material  defenses
available  to it or them  which  are  different  from  or  additional  to  those
available to the Indemnitor.  If any event described in clauses (i) through (iv)
above shall occur,  then the  Indemnitor  shall not have the right to direct the
defense  of such  action on behalf of the  Indemnitee  with  counsel  of its own
choice, and the reasonable fees and expenses of the Indemnitee shall be borne by
the Indemnitor, provided that such counsel shall be reasonably acceptable to the
Indemnitor.  If the  Indemnitors  do assume  control of the  defense of any such
claim in accordance  with the  foregoing,  then:  (x) the  Indemnitor  shall not
defend the claim for which  indemnification  is being  sought in any manner that
would  likely  have  a  material  adverse  effect  on the  Indemnitee  or on any
relationship that the Indemnitee may have with any customers, vendors, suppliers
or others,  and (y) the  Indemnitee  shall not settle  such  claim  without  the
written  consent of the  Indemnitor,  which  consent  shall not be  unreasonably
withheld,  delayed or conditioned.  Nothing contained in this Section 12.6 shall
prevent either party from assuming  control of the defense  and/or  settling any
claim against it for which indemnification is not sought under this Agreement.

       (B) Notwithstanding anything to the contrary contained in this Agreement,
if there shall be any claim for Excess Reimbursement Liabilities with respect to
which Buyer shall be seeking indemnification,  Buyer will have the sole right to
contest or appeal  such claim  (using at least the same  standard  of care as it
would apply to contests or appeals with respect to reimbursement  liabilities in
general) in accordance  with its  customary  procedures  diligently  and in good
faith. Buyer may, in its sole and absolute discretion, at any time


                                       29

<PAGE>



discontinue  any such contest or appeal or enter into a settlement  with respect
thereto  prior to the final  determination  thereof  (a "Final  Determination");
provided,  however,  that if it intends to discontinue or settle any such appeal
or contest  prior to Final  Determination,  then it must  provide  Sellers  with
reasonable  prior written notice of such intent and of the current status of the
appeal or contest or proposed settlement,  and will consult with Sellers in good
faith with respect thereto.

     12.7 RESTRICTIONS.

       (A) From and after the Closing Date,  none of the Sellers shall disclose,
directly or  indirectly,  to any person  outside of Buyer's  employ  without the
express  authorization of the Buyer, any patient lists,  customer lists, pricing
strategies,  customer files, or patient files and records of the Company and its
subsidiaries, any proprietary data or trade secrets owned by the Company and its
subsidiaries  or any  financial or other  information  about the Company and its
subsidiaries  not then in the public  domain;  provided,  however,  that Sellers
shall be  permitted to make such  disclosures  as may be required by law or by a
court or governmental authority.

       (B)  After  the  Closing  Date,  none  of the  Sellers  shall  engage  or
participate  in any  effort or act to induce any of the  customers,  physicians,
suppliers,  associates,  employees or independent contractors of the Company and
its  subsidiaries to cease doing business,  or their  association or employment,
with the Company and its subsidiaries.

       (C) No Seller (which,  for the purposes of this Section  12.7(c) shall be
deemed not to include  Sirrom)  shall,  for a period of five (5) years after the
Closing Date, directly, or indirectly, for or on behalf of himself or herself or
any  other  person,  firm,  entity or other  enterprise,  be  employed  by, be a
director  or manager  of,  act as a  consultant  for,  be a partner  in,  have a
proprietary  interest in, give advice to, loan money to or  otherwise  associate
with, in a business fashion, any person, enterprise,  partnership,  association,
corporation,  joint  venture or other entity which is directly or  indirectly in
the business of owning,  operating or managing any entity of any type,  licensed
or unlicensed,  which , anywhere within the United States,  (i) is engaged in or
provides the Services , (ii)  compounds or dispenses  pharmaceutical  admixtures
for  intravenous  therapies  to patients at sites  other than  hospitals,  (iii)
provides medical supplies,  equipment or  non-professional  services usually and
customarily  associated with the provision of intravenous therapies to patients,
or (iv) provides  professional nursing services usually and customarily rendered
with the  provision  of  intravenous  therapies,  provided  that nothing in this
Section  12.7(c) shall  restrict any Seller from having any  involvement  with a
nursing agency business.

       (D) The  Sellers  acknowledge  that the  restrictions  contained  in this
Section 12.7 are  reasonable  and necessary to protect the  legitimate  business
interests of Buyer and that any violation thereof by any of them would result in
irreparable harm to Buyer. Accordingly, Sellers agree that upon the violation by
any of them of any of the  restrictions  contained in this Section  12.7,  Buyer
shall  be  entitled  to  obtain  from  any  court of  competent  jurisdiction  a
preliminary and permanent injunction as well as any other relief provided at law
or equity, under this Agreement or otherwise.  In the event any of the foregoing
restrictions are adjudged unreasonable in any proceeding, then the parties agree
that the  period of time or the scope of such  restrictions  (or both)  shall be
adjusted  in such a manner  or for such a time (or  both) as is  adjudged  to be
reasonable.


                                       30

<PAGE>



     12.8 RECORDS.  On the Closing Date,  Sellers and Company shall deliver,  or
cause to be  delivered,  to Buyer all  records  and  files  not then in  Buyer's
possession relating to the operations of the Company and its subsidiaries.


                            ARTICLE XIII: TERMINATION

     13.1 TERMINATION.  This Agreement may be terminated at any time at or prior
to the Closing by:

       (A) Buyer, if any condition precedent to Buyer's  obligations  hereunder,
including  without  limitation  those  conditions set forth in Article X hereof,
have not been satisfied by the Closing Date;

       (B) Sellers,  if any condition precedent to the obligations of any Seller
or the Company  hereunder,  including  without  limitation  those conditions set
forth in Article XI hereof, have not been satisfied by the Closing Date; or

       (C) the mutual consent of Buyer and Sellers.

     13.2 EFFECT OF TERMINATION.  If a party  terminates this Agreement  because
one of its conditions precedent has not been fulfilled,  or if this Agreement is
terminated by mutual consent,  this Agreement shall become null and void without
any  liability  of any  party  to the  other;  provided,  however,  that if such
termination   is  by  reason  of  the   breach  by  any  party  of  any  of  its
representations, warranties or obligations under this Agreement, the other party
shall be  entitled  to be  indemnified  for any Losses  incurred by it by reason
thereof in  accordance  with  Article  XII hereof  (and for such  purposes  such
Article XII shall survive the termination of this Agreement).  Further,  nothing
in this Section 13.2 shall affect  Buyer's right to specific  performance of the
obligations of the Company and Sellers at Closing hereunder.

                           ARTICLE XIV: MISCELLANEOUS

     14.1 COSTS AND  EXPENSES.  Except as expressly  otherwise  provided in this
Agreement,  Buyer and  Sellers  shall  bear  their own  costs  and  expenses  in
connection  with  this  Agreement  and  the  transactions  contemplated  hereby;
provided,  however,  that no such  costs and  expenses  shall be  charged to the
Company and its subsidiaries; and provided further that the reasonable costs and
expenses of Sirrom shall be borne by the remaining Sellers.

     14.2 PERFORMANCE.  In the event of a breach by any party of its obligations
hereunder,  the other  party  shall have the  right,  in  addition  to any other
remedies which may be available,  to obtain specific performance of the terms of
this Agreement, and the breaching party hereby waives the defense that there may
be an adequate  remedy at law. Should any party default in its  performance,  or
other  remedy,  the  prevailing  party  shall  be  entitled  to  its  reasonable
attorneys' fees.


                                       31

<PAGE>



     14.3 BENEFIT AND ASSIGNMENT. This Agreement binds and inures to the benefit
of each party hereto and its  successors and proper  assigns.  Neither Buyer nor
Sellers may assign their  interests  under this Agreement to any other person or
entity  without  the  prior  written  consent  of the other  parties;  provided,
however,  that Buyer may assign its rights,  duties and obligations hereunder to
one or more  subsidiaries or affiliates of Buyer;  and further  provided that in
the instance of such  assignment  Buyer shall  guaranty the  performance  of its
assignee hereunder.

     14.4 EFFECT AND  CONSTRUCTION  OF THIS  AGREEMENT.  This  Agreement and the
Exhibits and Schedules hereto embody the entire  agreement and  understanding of
the  parties  and  supersede  any and all  prior  agreements,  arrangements  and
understandings relating to matters provided for herein. The captions used herein
are for  convenience  only and  shall  not  control  or affect  the  meaning  or
construction of the provisions of this Agreement. This Agreement may be executed
in one or more counterparts,  and all such counterparts shall constitute one and
the same instrument.

     14.5  COOPERATION  - FURTHER  ASSISTANCE.  From  time to time,  as and when
reasonably  requested by Buyer after the Closing, the other parties will (at the
expense  of the  Buyer)  execute  and  deliver,  or  cause  to be  executed  and
delivered, all such documents,  instruments and consents and will use reasonable
efforts to take all such action as may be  reasonably  requested or necessary to
carry out the intent and purposes of this Agreement.

     14.6  NOTICES.  All notices  required or  permitted  hereunder  shall be in
writing  and  shall be  deemed  to be  properly  given or made  when  personally
delivered to the party or parties  entitled to receive the notice or within five
(5) days when sent by certified or registered mail,  postage prepaid,  or on the
next  business  day if sent for next day  delivery  by a  nationally  recognized
overnight  courier,  in either case,  properly addressed to the party or parties
entitled to receive such notice at the address stated below:

If to the Company:            APS America, Inc.
                              9812 Pflum Road
                              Lenexa, Kansas 66215

If to the Sellers:            Raymond A. Mirra, Jr.
                              2932 North Atlantic Boulevard
                              Fort Lauderdale, FL 33308

                              James Kuo
                              890 Wises Mill Road
                              Philadelphia, PA 19128

                              Ted Kramm
                              8909 W. 131st Street
                              Overland Park, Kansas 66213


                                       32

<PAGE>




                              John Harrison
                              Sirrom Capital
                              500 Church Street, Suite 200
                              Nashville, TN 37219

with a copy to:               Alexander Bono, Esq.
                              Blank, Rome, Comisky & McCauley
                              2000 Logan Square
                              Philadelphia, PA 19103
                              Attn: J. Patrick Murphy

                              J. Patrick Murphy
                              Chambliss, Bahner & Stophel, P.C.
                              1000 Tallan Building
                              Two Union Square
                              Chattanoogo, TN 37402

If to the Buyer:              Integrated Health Services, Inc.
                              10065 Red Run Boulevard
                              Owings Mills, MD 21117
                              Attn: Brian K. Davidson
                                    Elizabeth B. Kelly
                              cc:  Marshall A. Elkins, General Counsel

with a copy to:               Michael S. Blass, Esq.
                              Blass & Driggs, Esqs.
                              461 Fifth Avenue, 19th Floor
                              New York, NY 10017

     14.7  WAIVER,  DISCHARGE,  ETC.  This  Agreement  shall  not  be  released,
discharged,  abandoned,  changed  or  modified  in  any  manner,  except  by  an
instrument in writing  executed by or on behalf of each of the parties hereto by
their duly  authorized  officer or  representative.  The failure of any party to
enforce at any time any of the provisions of this  Agreement  shall in no way be
construed  to be a waiver of any such  provision,  nor in any way to affect  the
validity  of this  Agreement  or any  part  hereof  or the  right  of any  party
thereafter to enforce each and every such provision.  No waiver of any breach of
this Agreement shall be held to be a waiver of any other or subsequent breach.

     14.8 RIGHTS OF PERSONS NOT PARTIES.  Nothing  contained  in this  Agreement
shall be deemed to create rights in persons not parties  hereto,  other than the
successors and proper assigns of the parties hereto.


                                       33

<PAGE>



     14.9 GOVERNING  LAW. This  Agreement  shall be governed by and construed in
accordance with the laws of the Commonwealth of  Pennsylvania,  disregarding any
rules relating to the choice or conflict of laws.

     14.10  AMENDMENTS,  SUPPLEMENTS,  ETC.  At any time  before  or  after  the
execution and delivery of this Agreement by the parties  hereto,  this Agreement
may  be  amended  or   supplemented  by  additional   agreements,   articles  or
certificates,  as may be mutually  determined  by the  parties to be  necessary,
appropriate or desirable to further the purposes of this  Agreement,  to clarify
the intention of the parties, or to add to or to modify the covenants,  terms or
conditions  hereof or thereof.  This  Agreement may not be amended  except by an
instrument in writing signed by each of the parties.

     14.11  SEVERABILITY.  Any  provision,  or  distinguishable  portion  of any
provision,   of  this   Agreement   which  is  determined  in  any  judicial  or
administrative  proceeding to be prohibited or unenforceable in any jurisdiction
shall, as to such jurisdiction, be ineffective to the extent of such prohibition
or unenforceability  without  invalidating the remaining  provisions hereof, and
any  such  prohibition  or   unenforceability  in  any  jurisdiction  shall  not
invalidate or render unenforceable such provision in any other jurisdiction.  It
is the  intention of the parties that if any  provision of Section 12.7 shall be
determined to be overly broad in any respect,  then it should be  enforceable to
the  maximum  extent  permissible  under the law.  To the  extent  permitted  by
applicable law, the parties waive any provision of law which renders a provision
hereof prohibited or unenforceable in any respect.

     14.12 COUNTERPARTS. This Agreement may be executed in several counterparts,
each of which  shall be  deemed an  original,  and all of which  shall  together
constitute one and the same instrument.

     14.13  ARBITRATION.  Any dispute or controversy  between any of the parties
hereto  pertaining to the performance or  interpretation of this Agreement shall
be  settled  by  binding  arbitration  pursuant  to the  rules  of the  American
Arbitration Association.  The cost of such proceeding shall be shared equally by
all parties thereto,  and each such party shall bear its own costs incurred as a
result of its participation in any such arbitration.

     14.14 PUBLIC  ANNOUNCEMENTS.  Any general public  announcements  or similar
media publicity with respect to this Agreement or the transactions  contemplated
herein  shall be at such time and in such  manner as Buyer and Raymond A. Mirra,
Jr. shall  determine;  provided that nothing  herein shall prevent either party,
upon as much prior notice as shall be possible  under the  circumstances  to the
other,  from making  such  written  announcements  as such  party's  counsel may
consider  advisable  in order to  satisfy  the  party's  legal  and  contractual
obligations in such regard.


                       [SIGNATURES ON THE FOLLOWING PAGE]


                                       34

<PAGE>


     IN  WITNESS  WHEREOF,  each  of the  parties  hereto  and  in the  capacity
indicated  below has executed this  Agreement as of the day and year first above
written.

                                                COMPANY:
                                                APS AMERICA, INC.

WITNESS:

By:/s/                                          By:/s/
   ----------------------------                    -----------------------------
                                                Its:     President


                                                SELLERS:

 WITNESS:


By:/s/                                            /s/
   ----------------------------                 --------------------------------
                                                Raymond A. Mirra, Jr.

WITNESS:


By:                                               /s/
   ----------------------------                 --------------------------------

                                                James Kuo

WITNESS:

By:/s/                                            /s/
   ----------------------------                 --------------------------------

                                                Edward Kramm


                                                SIRROM CAPITAL CORPORATION

                                                By:/s/                          
                                                   -----------------------------
                                                Its:
                                                    ----------------------------
                                                BUYER:
                                                INTEGRATED HEALTH SERVICES, INC.


                                                By:/s/
                                                   -----------------------------
                                                Executive Vice President
                                                Corporate Development


                                       35



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


                      AGREEMENT AND PLAN OF REORGANIZATION

                            DATED AS OF JULY 24, 1997

                                      AMONG

                        INTEGRATED HEALTH SERVICES, INC.,
                         INTEGRATED AG ACQUISITION, INC.

                                       AND

                             ARCADIA SERVICES, INC.

                                       AND

                                HERBERT GRAEBNER

                                       AND

                                LEONARD BELLINSON

                                       AND

                                    COMMITTEE

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



<PAGE>



                                TABLE OF CONTENTS
                                                                            PAGE

ARTICLE I: MERGER..............................................................1
         1.1      Merger.......................................................1
         1.2      Taking of Necessary Action...................................2

ARTICLE II: CONVERSION.........................................................2
         2.1      Conversion of Stock..........................................2
         2.2      Adjustments to the Merger Consideration......................3
         2.3      General Escrow...............................................4
         2.4      Arizona Litigation and Arizona Escrow........................6
         2.5      Assets.......................................................7
         2.6      Liabilities..................................................7

ARTICLE III:  IHS STOCK........................................................8
         3.1      IHS Stock....................................................8

ARTICLE IV:  THE CLOSING......................................................13
         4.1      Time and Place of Closing...................................13
         4.2      Filings at Closing..........................................13
         4.3      Effective Time..............................................13

ARTICLE V:  REPRESENTATIONS AND WARRANTIES OF THE PRINCIPAL
         SELLERS AND ARCADIA..................................................13
         5.1      Organization and Standing of Arcadia........................13
         5.2      Absence of Conflicting Agreements...........................14
         5.3      Consents....................................................14
         5.4      Arcadia Stock...............................................14
         5.5      Assets......................................................14
         5.6      Trademarks..................................................15
         5.7      Contracts...................................................15
         5.8      Financial Statements........................................16
         5.9      Material Changes............................................17
         5.10     Licenses; Permits; Certificates of Need.....................17
         5.11     Title, Condition of Personal Property.......................18
         5.12     Legal Proceedings...........................................19
         5.13     Employees...................................................19
         5.14     Collective Bargaining, Labor Contracts, Employment
                  Practices, Etc..............................................19
         5.15     ERISA.......................................................20
         5.16     Insurance and Surety Agreements.............................21
         5.17     Relationships...............................................21


                                       (i)

<PAGE>



         5.18     Absence of Certain Events...................................21
         5.19     Compliance with Laws........................................23
         5.20     Finders.....................................................23
         5.21     Tax Returns.................................................24
         5.22     Encumbrances Created by this Agreement......................24
         5.23     Subsidiaries and Joint Ventures.............................24
         5.24     No Untrue Statement.........................................24
         5.25     Medicare and Medicaid Programs..............................24
         5.26     Leasehold Interests.........................................24
         5.27     Power and Authority.........................................25
         5.28     Binding Effect..............................................25
         5.29     Questionnaires..............................................25
         5.30     Questionable Payments.......................................25

ARTICLE VI:  REPRESENTATIONS AND WARRANTIES OF PRINCIPAL SELLERS
          ....................................................................25
         6.1      Authority...................................................25
         6.2      Binding Effect..............................................25
         6.3      Absence of Conflicting Agreements...........................25
         6.4      Consents....................................................26
         6.5      Ownership of Arcadia Stock..................................26

ARTICLE VII:  REPRESENTATIONS AND WARRANTIES OF BUYER AND NEWCO
          ....................................................................26
         7.1      Organization and Standing...................................26
         7.2      Power and Authority.........................................26
         7.3      Binding Agreement...........................................26
         7.4      Absence of Conflicting Agreements...........................27
         7.5      Consents....................................................27
         7.6      Securities and Exchange Commission Filings..................27
         7.7      Capital Stock...............................................27

ARTICLE VIII:  INFORMATION AND RECORDS CONCERNING ARCADIA AND ITS
         SUBSIDIARIES.........................................................28
         8.1      Access to Information and Records before Closing............28

ARTICLE IX:  OBLIGATIONS OF THE PARTIES UNTIL CLOSING.........................28
         9.1      Conduct of Business Pending Closing.........................28
         9.2      Negative Covenants of Arcadia and its Subsidiaries..........28
         9.3      Affirmative Covenants.......................................29
         9.4      Pursuit of Consents and Approvals...........................30
         9.5      Exclusivity.................................................30



                                      (ii)

<PAGE>



ARTICLE X:  CONDITIONS PRECEDENT TO BUYER'S OBLIGATIONS.......................30
         10.1     Representations and Warranties..............................30
         10.2     Performance of Covenants....................................30
         10.3     Delivery of Closing Certificate.............................31
         10.4     Opinion of Counsel..........................................31
         10.5     Legal Matters...............................................31
         10.6     Authorization Documents.....................................31
         10.7     Material Change.............................................31
         10.8     Approvals...................................................31
         10.9     Consents....................................................31
         10.10    Estimated Closing Date Balance Sheet........................31
         10.11    Real Property Consents......................................32
         10.12    Arcadia's Subsidiaries and Options..........................32
         10.13    Board Approvals.............................................32
         10.14    Hart-Scott-Rodino...........................................32
         10.15    Employment Agreements.......................................32
         10.16    Required Transactions.......................................32
         10.17    Termination of Non-Retained Agreements......................32
         10.18    Escrow Agreements...........................................32
         10.19    Termination of Certain Contracts............................33
         10.20    Grayrose....................................................33
         10.21    Stock Certificates..........................................33
         10.22    Dissenter's Rights..........................................33
         10.23    Captive Insurance...........................................33
         10.24    Other Documents.............................................33

ARTICLE XI:  CONDITIONS PRECEDENT TO PRINCIPAL SELLERS' OBLIGATIONS...........33
         11.1     Representations and Warranties..............................33
         11.2     Performance of Covenants....................................33
         11.3     Delivery of Closing Certificate.............................34
         11.4     Opinion of Counsel..........................................34
         11.5     Legal Matters...............................................34
         11.6     Authorization Documents.....................................34
         11.7     H-S-R Filings...............................................34
         11.8     Employment Agreements.......................................34
         11.9     Escrow Agreements...........................................34
         11.10    Other Documents.............................................34

ARTICLE XII:  SURVIVAL AND INDEMNIFICATION....................................34
         12.1     Survival of Representations and Warranties..................34
         12.2     Indemnification by Shareholders and/or Principal Sellers....35
         12.3     Indemnification by Buyer....................................36


                                      (iii)

<PAGE>



         12.4     Assertion of Claims.........................................36
         12.5     Indemnity Basket and Cap....................................36
         12.6     Control of Defense of Indemnifiable Claims..................37
         12.7     Restrictions................................................37
         12.8     Records.....................................................38
         12.9     Buyer's Affirmative Covenants...............................38
         12.10    Dissenters' Rights..........................................38
         12.11    Special Provisions with Regard to Indemnification of
                  Representations and Warranties..............................39

ARTICLE XIII:  TERMINATION....................................................39
         13.1     Termination.................................................39
         13.2     Effect of Termination.......................................40

ARTICLE XIV: CASUALTY, RISK OF LOSS...........................................40
         14.1     Casualty, Risk of Loss......................................40

ARTICLE XV:  MISCELLANEOUS....................................................40
         15.1     Costs and Expenses..........................................40
         15.2     Performance.................................................40
         15.3     Benefit and Assignment......................................41
         15.4     Effect and Construction of this Agreement...................41
         15.5     Cooperation - Further Assistance............................41
         15.6     Notices.....................................................41
         15.7     Waiver, Discharge, Etc......................................42
         15.8     Rights of Persons Not Parties...............................42
         15.9     Governing Law...............................................42
         15.10    Amendments, Supplements, Etc................................43
         15.11    Severability................................................43
         15.12    Counterparts................................................43
         15.13    Arbitration.................................................43
         15.14    Public Announcements........................................43



                                      (iv)

<PAGE>



                              SCHEDULES & EXHIBITS

Schedule 2.1(b)            -       Allocation among Shareholders
Schedule 2.6               -       Assumed Liabilities
Schedule 5.3               -       Consent List of Principal Sellers
Schedule 5.4               -       Arcadia Stock
Schedule 5.5               -       Liens on Assets
Schedule 5.6               -       Trademarks
Schedule 5.7               -       Contracts
Schedule 5.8(a)            -       Audited Financial Statement
Schedule 5.8(b)            -       Monthly Financial Statements
Schedule 5.8(c)            -       March 31 Balance Sheets
Schedule 5.8(d)            -       Material Liabilities
Schedule 5.9               -       Material Changes
Schedule 5.10              -       Licenses, Permits, Certificates of Need
Schedule 5.11(a)           -       Liens on Personal Property
Schedule 5.11(b)           -       Leases of Personal Property
Schedule 5.12              -       Legal Proceedings
Schedule 5.13              -       Employees
Schedule 5.15(b)           -       Employee Benefit Plans
Schedule 5.15(c)           -       Employees on Leave of Absence
Schedule 5.16              -       Insurance and Surety Agreements
Schedule 5.17              -       Relationships
Schedule 5.18              -       Absence of Certain Events
Schedule 5.19              -       Compliance with Laws
Schedule 5.21              -       Tax Returns
Schedule 5.23              -       Subsidiaries, Joint Ventures, etc.
Schedule 5.25              -       Medicare and Medicaid Programs
Schedule 5.26              -       Leasehold Interests
Schedule 7.5               -       Consent List of Buyer

Exhibit A                  -       Plan of Merger
Exhibit 2.3                -       Escrow Agreement
Exhibit 2.4                -       Arizona Litigation Escrow Agreement
Exhibit 5.29               -       Questionnaire
Exhibit 10.4               -       Opinion of Shareholders' Counsel
Exhibit 10.15              -       Employment Agreements
Exhibit 11.4               -       Opinion of Buyer's Counsel



                                       (v)

<PAGE>



                     --------------------------------------
                      AGREEMENT AND PLAN OF REORGANIZATION
                     --------------------------------------


     This Agreement and Plan of  Reorganization  (the "Agreement") is made as of
the 24th day of July, 1997, among INTEGRATED  HEALTH SERVICES,  INC., a Delaware
corporation ("Buyer"),  INTEGRATED AG ACQUISITION,  INC., a Delaware corporation
("Newco"), HERBERT GRAEBNER and LEONARD BELLINSON (collectively,  the "Principal
Sellers" and individually,  the "Principal Seller") and the Principal Sellers in
their  collective  capacity  as the  "Committee"  and ARCADIA  SERVICES,  INC. a
Michigan corporation ("Arcadia").

     WHEREAS, Newco is a subsidiary of Buyer; and

     WHEREAS,  Arcadia is in the business of providing home health care services
and medical staffing services and Arcadia's wholly-owned  subsidiary,  Grayrose,
Inc.  ("Grayrose") is in the business of providing clerical and light industrial
staffing services; and

     WHEREAS,  the Principal  Sellers are the owners or holders of a majority of
the issued and outstanding shares of the capital stock of Arcadia; and

     WHEREAS,  all owners or holders of the issued and outstanding shares of the
capital  stock of Arcadia (the  "Shareholders")  (the  "Arcadia  Stock") will be
authorizing  the  Committee  to act as their agent for the purpose of taking any
action under this Agreement; and

     WHEREAS,  the Shareholders and the Boards of Directors of Buyer, Newco, and
Arcadia deem it  advisable  to merge Newco with and into Arcadia (the  "Merger")
pursuant to this  Agreement  and the Plan of Merger  annexed as Exhibit A hereto
(the "Plan of Merger"); and

     WHEREAS,  pursuant  to the  Merger,  all  shares of  Arcadia  Stock will be
converted  into the right to receive  the Merger  Consideration  (as  defined in
Section 2.1(a) of this Agreement).

     NOW,  THEREFORE,  Principal  Sellers,  Committee,  Buyer, Newco and Arcadia
intending to be legally bound, agree as follows:

                                ARTICLE I: MERGER

     1.1 MERGER.  Subject to the terms and conditions of this Agreement,  at the
Effective  Time of Merger (as  defined in Article  IV,  below),  Newco  shall be
merged with and into Arcadia and the separate existence of Newco shall cease.



<PAGE>



     1.2 TAKING OF NECESSARY  ACTION.  Prior to and after the Effective  Time of
Merger,  subject to the provisions of this Agreement,  each of the Shareholders,
Buyer,  Newco,  and Arcadia  shall take all such action as may be  necessary  or
appropriate in order to effect the Merger as contemplated  hereunder. In case at
any time after the Effective  Time of Merger any further  action is necessary or
desirable  to carry out the  purposes of this  Agreement  and to vest Buyer with
full title to Arcadia Stock, the parties shall take all such necessary action.


                             ARTICLE II: CONVERSION

     2.1 CONVERSION OF STOCK. At the Effective Time of Merger:

       (A) the  shares  of  Arcadia  Stock  which  are  issued  and  outstanding
immediately  prior to the Effective Time of Merger shall,  without any action by
the holder thereof, be converted into the right to receive that number of shares
of the common stock,  par value $.001,  of Buyer ("IHS Stock")  determined as of
the Closing Date in  accordance  with Section  3.1(a) as shall have an aggregate
value,  and subject to  adjustment  pursuant to Section 2.2 hereof,  of EIGHTEEN
MILLION SEVEN HUNDRED THOUSAND AND 00/100 ($18,700,000.00)  DOLLARS (the "Merger
Consideration");  provided  that the  aggregate  Merger  Consideration  shall be
reduced by an amount equal to that portion of the Merger  Consideration which is
allocable  to any shares of Arcadia  Stock as to which the holder of such shares
has  exercised  his  or her  dissenter's  rights  under  the  Michigan  Business
Corporation  Act. Each of the  Shareholders  whose shares are converted into the
Merger Consideration (other than those who have exercised  dissenter's rights as
aforesaid) shall receive a portion of the Merger Consideration as shall be equal
to the aggregate Merger Consideration multiplied by a fraction, the numerator of
which is the  number  of  shares  of  Arcadia  Stock  owned by such  Shareholder
immediately prior to the Effective Time of Merger,  and the denominator of which
is the total number of shares of Arcadia  Stock that are issued and  outstanding
immediately prior to the Effective Time of Merger.

       (B) each share of Newco common stock outstanding immediately prior to the
Effective  Time of Merger,  shall be converted into one share of common stock of
Arcadia.

       (C) at the  Effective  Time  of  Merger,  each  holder  of a  certificate
theretofore  evidencing  outstanding  shares of Arcadia Stock, upon surrender of
such  certificate,  shall be entitled to receive in exchange therefor his or her
proportionate share of the Merger Consideration,  calculated pursuant to Section
2.1(a) above,  represented by the  certificate or  certificates  so surrendered.
Until so surrendered,  each such  outstanding  certificate  which,  prior to the
Effective Time of Merger, represented shares of Arcadia Stock, will be deemed to
evidence the right to receive the  proportionate  share of Merger  Consideration
represented  by such  certificate  or  certificates.  Upon the surrender of such
certificates, they shall be duly canceled.




                                        2

<PAGE>



       (D)  Immediately  after the Effective Time of Merger,  Buyer, as the sole
shareholder  of  Newco,  upon  surrender  of  stock  certificate(s)   evidencing
outstanding shares of Newco, shall be entitled to receive in exchange therefor a
certificate representing the shares of Arcadia Stock, calculated on a one-to-one
basis. Until so surrendered, each such certificate which, prior to the Effective
Time of Merger, represented the outstanding shares of Newco stock will be deemed
to  evidence  such  shares  of  Arcadia  Stock.   Upon  the  surrender  of  such
certificate(s), they shall be duly canceled.

     2.2 ADJUSTMENTS TO THE MERGER CONSIDERATION.

       (A) At the Closing,  Arcadia shall  deliver a  certificate  signed by its
Chief  Financial  Officer  certifying  his best good faith estimate of Arcadia's
aggregate  working  capital  (as  defined  herein) as of the  Closing  Date on a
consolidated basis (the "Estimated Closing Date Working Capital").  In the event
that the  Estimated  Closing Date  Working  Capital is less than  $791,000  (the
"Minimum Working Capital"), the Merger Consideration payable to the Shareholders
at Closing  will be reduced on a  dollar-for-dollar  basis by an amount equal to
the amount of such  deficiency.  If the Estimated  Closing Date Working  Capital
exceeds the Minimum Working  Capital,  the Merger  Consideration  payable to the
Shareholders at Closing will be increased by an amount equal to the excess above
the Minimum  Working  Capital,  payable in IHS Stock.  For the purposes  hereof,
"working  capital" means the excess of current assets over current  liabilities,
as determined in  accordance  with  generally  accepted  accounting  principles,
consistently applied ("GAAP");  provided that any prepayment  obligation related
to any accounts receivable factoring arrangements entered into by Arcadia or any
of its  subsidiaries  as of or prior to the  Closing  Date will be included as a
current  liability in the calculation of working capital;  provided further that
any waiver of the Shareholders'  debt shall be treated as a reduction of current
assets in the calculation of working capital;  provided further the Shareholders
will have reserved  $809,000 for the Arizona  Receivables (as defined in Section
2.4,  below) and $50,000 for the Arizona  Litigation (as defined in Section 2.4,
below) on the Estimated Closing Date Balance Sheets; provided further all assets
and liabilities  associated with the Mutual Indemnity  (Bermuda) Limited captive
insurance  (the  "Captive  Insurance")  will be excluded in the  calculation  of
working capital on the Estimated  Closing Date Balance Sheet;  provided  further
all obligations related to terminations of employment agreements with Arcadia or
its subsidiaries  shall be treated as current  liabilities in the calculation of
working  capital on the  Estimated  Closing  Date  Balance  Sheet and;  provided
further any liabilities and obligations, other than Assumed Liabilities, must be
reflected as current  liabilities  to the extent and only to the extent they are
reflected on the  Estimated  Closing Date Balance  Sheet.  Additionally,  at the
Closing,  Arcadia  shall  deliver  to Buyer the  balance  sheet of  Arcadia on a
consolidated  basis dated as of the Closing Date,  certified by Arcadia's  Chief
Financial  Officer to be his best good faith  estimate  thereof (the  "Estimated
Closing  Date  Balance  Sheet").  In the event that the  Estimated  Closing Date
Balance  Sheet  discloses  that the  aggregate  amount  of  Arcadia's  long-term
liabilities  as  determined  in  accordance  with GAAP exceeds  $1,300,000  (the
"Maximum  Long-Term  Liabilities"),  the  Merger  Consideration  payable  to the
Shareholders at Closing will be reduced by an amount equal to the amount of such
excess. For the purposes hereof,  "long-term liability" means any liability that
would be set forth as a long-term  liability  on a balance  sheet in  accordance
with  GAAP,  excluding  any  liabilities   specifically  classified  as  current
liabilities in this Section 2.2(a).


                                        3

<PAGE>



       (B) As soon as is reasonably practicable,  but in any event within ninety
(90) days  following  the  Closing  Date,  Buyer  shall  complete a review  (the
"Post-Closing  Review") of Arcadia's  Estimated  Closing Date Balance Sheet. The
Merger Consideration, after giving effect to any adjustments made at the Closing
pursuant to Section 2.2(a), above, (the "Adjusted Merger Consideration"),  shall
be subject to further  adjustment based upon the Post-Closing  Review indicating
that the  aggregate  working  capital  of Arcadia  as of the  Closing  Date (the
"Actual Working  Capital") was different from the Estimated Closing Date Working
Capital, then the parties shall make such payments to each other as shall result
in the Merger  Consideration  being the  amount  that it would have been had the
Actual  Working  Capital been used at Closing in lieu of the  Estimated  Closing
Date Working Capital. Any increase to the Adjusted Merger Consideration shall be
in IHS Stock by Buyer to Shareholders,  and if the Adjusted Merger Consideration
is reduced,  then the  Escrowee (as defined  below) shall  deliver over to Buyer
shares  of IHS  Stock  having a value  determined  in  accordance  with  Section
2.3(a)(vii),  below,  equal to such  deficiency.  In the  event  the  deficiency
exceeds the Escrow  Deposit (as defined  below) held by Escrowee,  the Principal
Sellers shall refund to Buyer the amount of such  deficiency in IHS Stock valued
in accordance with Section 2.3(a)(vii),  below. Furthermore, if the Post-Closing
Review reveals the aggregate amount of Arcadia's long-term liabilities as of the
Closing Date exceeded the greater of (w) Maximum Long-Term  Liabilities,  or (x)
the amount of Arcadia's  long-term  liabilities  as  indicated on the  Estimated
Closing Date Balance  Sheet,  the Merger  Consideration  shall be deemed to have
been reduced by the amount of such excess,  and the Escrowee  shall deliver over
to Buyer IHS Stock having a value equal to such excess.  In the event the amount
of such  excess  is  greater  than the  Escrow  Deposit  held by  Escrowee,  the
Principal  Sellers shall be jointly and  severally  obligated to refund to Buyer
the  amount  of such  excess  in IHS  Stock.  The  value of any IHS  Stock to be
distributed  to the Buyer  from the  Escrowee  will be as set  forth in  Section
2.3(a)(vii),  below. If there shall be any dispute  regarding the calculation of
the  working  capital  as of  the  Closing  Date  or  the  amount  of  long-term
liabilities  as of the  Closing  Date,  such  dispute  shall be  submitted  to a
mutually  agreed upon "big six" accounting firm other than KPMG Peat Marwick LLP
or Coopers & Lybrand LLP (the  "Accountants") for final resolution and the party
against whom the Accountants  shall rule shall pay the costs and expenses of the
Accountants  in connection  therewith.  Principal  Sellers will have  reasonable
access to such  records as are  necessary  for the  calculation  of the  working
capital in connection with the Post- Closing Review.

                  2.3      GENERAL ESCROW.

       (A) At the Closing, pursuant to an Escrow Agreement to be entered into by
the parties substantially in the form and substance of Exhibit 2.3, a portion of
the Merger  Consideration as shall be equal in value to ONE MILLION FIVE HUNDRED
THOUSAND  ($1,500,000)  DOLLARS (the "Escrow  Deposit") based upon the valuation
described in Section  3.1(a),  below,  shall be delivered by Buyer, on behalf of
the Shareholders, to CoreStates Bank, N.A. as escrow agent (the "Escrowee"). The
Principal  Sellers  shall be  designated by the  Shareholders  as  Shareholders'
Committee under the Escrow  Agreement,  to take any and all action,  and to give
any and all notices,  on behalf of the Shareholders  under the Escrow Agreement.
Subject to the  provisions  of this  Section 2.3,  $1,000,000  (less any amounts
offset for claims  pursuant to Section  2.3(a)(i) and (ii)) shall be released to
the Shareholders one (1) year following


                                        4

<PAGE>



the Closing Date (the "General Indemnification Fund"). The balance of the Escrow
Deposit  shall   continue  to  be  held  solely  to  indemnify   against  Excess
Reimbursement  Liabilities  (as  defined  below)  and shall be  released  to the
Shareholders  three (3) years  following  the Closing Date.  The Escrow  Deposit
shall be held and disbursed by the Escrowee in accordance with the following:

          (I) In the event that the  Shareholders  become obligated to remit IHS
Stock  back to Buyer  pursuant  to the  post-Closing  adjustments  set  forth in
Section  2.2(b),  the Escrowee shall release to Buyer that portion of the Escrow
Deposit  as  shall  have a  value  equal  to the  amount  by  which  the  Merger
Consideration is so reduced.

          (II) In the event that the Buyer becomes  entitled to  indemnification
pursuant to Section  12.2,  the Escrowee  shall release to Buyer that portion of
the Escrow Deposit as shall be equal in value to such indemnification.

          (III) If no claim  for  indemnification  on the part of Buyer  remains
outstanding  upon the expiration of one (1) year following the Closing Date, any
remaining  General  Indemnification  Fund  (less any  amounts  offset for claims
pursuant to Section 2.3(a)(i) and (ii)) shall be released to the Shareholders.

          (IV) If any claim for indemnification on the part of Buyer does remain
outstanding upon the expiration of one (1) year following the Closing Date, then
any General Indemnification Fund (less any amounts offset for claims pursuant to
Section 2.3(a)(i) and (ii)) (including all accrued interest  thereon)  remaining
(after  resolution of the outstanding  claim and payment in respect thereof,  if
any is owing,  shall be made),  shall be released to the  Shareholders  promptly
after resolution of such claim.

          (V) If no claim for indemnification on the part of Buyer in connection
with Excess  Reimbursement  Liabilities  (as defined below) remains  outstanding
upon the  expiration of three (3) years  following  the Closing  Date,  then any
remaining  Escrow  Deposit then held by the Escrowee  shall first be used to pay
off any attorney's fees and expenses in connection with indemnification pursuant
to Section 12.2,  below,  properly  chargeable,  and then any  remaining  Escrow
Deposit shall be released to the Shareholders.

          (VI)  If any  claim  for  indemnification  on the  part  of  Buyer  in
connection with Excess  Reimbursement  Liabilities  remains outstanding upon the
expiration  of three (3) years  following  the  Closing  Date,  then any  Escrow
Deposit  (including all accrued interest thereon) remaining (after resolution of
the outstanding claim and payment in respect thereof,  if any is owing, shall be
made)  shall  first  be used to pay off any  attorney's  fees  and  expenses  in
connection with Excess Reimbursement Liabilities,  properly chargeable, and then
any  remaining  Escrow  Deposit shall be released to the  Shareholders  promptly
after resolution of such claim.



                                        5

<PAGE>



          (VII) The value of any IHS Stock to be  distributed  to Buyer from the
Escrow Deposit shall be calculated  based upon the average closing NYSE price of
such stock for its thirty (30)  business day period  immediately  preceding  the
date of such distribution.

       (B) The costs,  fees and expenses of the Escrowee  shall be borne equally
by Buyer, on the one hand, and the Shareholders, on the other hand.

     2.4 ARIZONA LITIGATION AND ARIZONA ESCROW.

       (A) At the Closing, pursuant to an Escrow Agreement to be entered into by
the parties substantially in the form and substance of Exhibit 2.4, a portion of
the Merger  Consideration  as shall be equal in value to EIGHT  HUNDRED AND NINE
THOUSAND  ($809,000)  DOLLARS  (the  "Arizona  Escrow  Deposit")  based upon the
valuation  described in Section 3.1(a),  below,  shall be delivered by Buyer, on
behalf  of the  Shareholders,  to  Escrowee.  The  Principal  Sellers  shall  be
designated  by the  Shareholders  as  Shareholders'  Committee  under the Escrow
Agreement,  to take  any and all  action,  and to give any and all  notices,  on
behalf of the  Shareholders  under such Escrow  Agreement.  The  Arizona  Escrow
Deposit  shall be held and  disbursed  by the  Escrowee in  accordance  with the
following:

          (I) To the extent Buyer is able to collect any proceeds from Arcadia's
accounts  receivable  with  respect to the matter  currently  in  litigation  in
Maricopa County, Arizona (the "Arizona  Receivables"),  the Buyer shall instruct
the Escrowee to distribute  from the Arizona Escrow Deposit to the  Shareholders
such portion which equals the amount of Arizona  Receivables  actually collected
by Buyer.  Said distribution from the Arizona Escrow Deposit shall be paid first
in shares of IHS Stock (to the extent available) and then in cash, with the form
of such payment to be in the discretion of the Shareholders.

          (II) Upon the expiration of eighteen (18) months following the Closing
Date,  any remaining  Arizona Escrow  Deposit  (including  all accrued  interest
thereon) (less any amounts previously  distributed to the Shareholders  pursuant
to Section 2.4(a)(i), above), shall be released to Buyer.

          (III)  The value of any IHS Stock to be  distributed  to  Shareholders
from the  Arizona  Escrow  Deposit  shall be  calculated  based upon the average
closing  NYSE  price of such  stock for its  thirty  (30)  business  day  period
immediately preceding the date of such distribution.

       (B) The costs,  fees and expenses of the Escrowee  shall be borne equally
by Buyer, on the one hand, and the Shareholders, on the other hand.

       (C) Upon the  expiration  of eighteen  (18) months  following the Closing
Date and the release of any remaining Arizona Escrow Deposit to Buyer,  then, in
such event,  Buyer agrees to assign all of its rights and interests under and to
the  Arizona  Receivables  to  a  liquidating  trust  for  the  benefit  of  the
Shareholders  in order to facilitate the  Shareholders'  efforts with respect to
litigation concerning the Arizona Receivables (the "Arizona Litigation").


                                        6

<PAGE>



       (D)  Principal  Sellers  shall  have the  exclusive  right to direct  the
collection efforts regarding the Arizona Receivables and the Arizona Litigation;
provided; Buyer will not incur any attorneys' fees, costs and expenses in excess
of  $50,000  in  connection  with  the  Arizona   Receivables  and  the  Arizona
Litigation;  and provided further Buyer shall only provide  reasonable access to
Arcadia and its resources, including its employees.

     2.5 ASSETS. As of the Closing Date, the consolidated assets of Arcadia (the
"Assets") will include its ownership  interests in all of its current  operating
subsidiaries,  as well as all of the tangible and intangible assets necessary to
operate the businesses of Arcadia and its subsidiaries as presently constituted,
including,  without limitation,  all contract rights, leasehold interests, fixed
and moveable  equipment,  vehicles,  furnishings,  tangible  personal  property,
inventory  and  supplies  (other  than  inventory,  supplies,  and other  assets
disposed of in the ordinary course of business, consistent with prior practice),
goodwill,  trade  names,  trademarks,  all  patient  records,  books and  files,
Certificates  of Need,  Medicare and Medicaid  provider  agreements and numbers,
provider  agreements with third party payors,  investments in affiliate offices,
telephone numbers, and to the extent permitted by law, all permits, licenses and
other governmental approvals. The Assets of Arcadia as of the Closing Date shall
also include cash, accounts receivable, and prepaid expenses.

     2.6  LIABILITIES.  As of the  Closing  Date,  Arcadia  shall only have such
liabilities which (i) are reflected as a liability on the Estimated Closing Date
Balance  Sheet in  accordance  with GAAP,  and (ii) arise  under  those  certain
contracts (the  "Retained  Contracts")  set forth on Schedule 2.6,  specifically
assumed by Buyer and assigned by the  Principal  Sellers to Buyer,  with respect
to, and only with respect to, services to be rendered or goods to be supplied to
or  benefits  to  be  conferred   upon  Buyer  solely  after  the  Closing  Date
(collectively,  the "Assumed  Liabilities").  Liabilities and obligations  under
such Retained  Contracts that have accrued,  or the performance of which is due,
on or prior to the Closing,  all  liabilities  and  obligations  under all other
Contracts (as defined  below) or which are in payment or  consideration  for any
excluded assets, and any other claim, lawsuit, liability,  obligation or debt of
any kind or  nature  whatsoever,  whether  absolute,  accrued,  due,  direct  or
indirect,  contingent or  liquidated,  matured or  unmatured,  joint or several,
whether or not for a sum  certain,  whether  for the payment of money or for the
performance or observance of any obligation or condition,  and whether or not of
a type which would be reflected as a liability on a balance  sheet in accordance
with GAAP,  including,  without  limitation,  (i) malpractice claims asserted by
patients or any other tort claims  asserted,  claims for breach of contract,  or
any claims of any kind asserted by patients,  former patients,  employees or any
other  party  that are based on acts or  omissions  occurring  on or before  the
Closing  Date to the extent not covered by  insurance;  (ii) amounts due or that
may become due to Medicare or Medicaid or any other health care reimbursement or
payment  intermediary  on account of Medicare cost report  adjustments  or other
payment adjustments  attributable to any period on or prior to the Closing Date,
or any other form of Medicare  or other  health  care  reimbursement  recapture,
adjustment  or  overpayment  whatsoever,  including  fines and  penalties,  with
respect to any period on or prior to the  Closing  Date  ("Excess  Reimbursement
Liabilities"); (iii) any accounts payable or employment or other taxes; and (iv)
accrued but unpaid compensation or other benefits to any


                                        7

<PAGE>



of Arcadia's or its subsidiaries'  employees,  agents,  consultants or advisers,
including  accrued  vacation,  shall  remain  the  sole  responsibility  of  the
Principal  Sellers  and shall be paid or  performed  on or prior to the  Closing
Date,  unless  such  liabilities  shall have been  properly  accrued  for on the
Estimated Closing Date Balance Sheet.


                             ARTICLE III: IHS STOCK

     3.1 IHS STOCK.  The entire Merger  Consideration  equal to EIGHTEEN MILLION
SEVEN HUNDRED THOUSAND ($18,700,000.00) DOLLARS shall be payable by means of the
delivery to the  Shareholders  of newly issued shares of the Common  Stock,  par
value $.001, of Buyer (the "IHS Stock") in accordance with the following:

       (A) SHARE  VALUE.  The number of shares of IHS Stock  issuable at Closing
(the "Closing Date Share Count")  pursuant to Section 2.1(b) shall be calculated
based upon a price per share of such stock  equal to the  average  closing  NYSE
price of such stock for the thirty (30) trading day period immediately preceding
the date which is two (2) trading days before the Closing Date.

       (B) REGISTRATION  RIGHTS.  Buyer will use its best efforts to cause to be
prepared, filed and declared effective by the Securities and Exchange Commission
(the  "Commission")  within  ninety  (90) days  following  the Closing  Date,  a
registration  statement for the  registration  under the  Securities Act of 1933
(the "Securities Act") of the IHS Stock issued to Shareholders  pursuant to this
Agreement,  including the shares issuable under Section 3.1(c) in respect of any
re-calculation  of the Closing  Date Share Count,  and Buyer shall  maintain the
effectiveness  of such  registration  statement  for a  period  of one (1)  year
following the date on which it becomes effective (the  "Registration  Date"), or
until no  Shareholder  shall own any of the IHS Stock  issued  pursuant  to this
Agreement,  whichever  shall occur first, in each case except to the extent that
an exemption from registration may be available.

       (C) SHARE  ADJUSTMENT.  Upon  registration  of the IHS Stock as  provided
above,  the number of shares  deliverable  as part of the  Merger  Consideration
under  Section  2.1(a)  hereof  shall be  re-calculated  based upon the  average
closing  NYSE  price of IHS Stock for the 30-  trading  day  period  immediately
preceding the Registration  Date. If the number of shares as recalculated  under
this  subsection  (the  "Adjusted  Share Count")  exceeds the Closing Date Share
Count,  the Buyer promptly shall deliver over to the  Shareholders an additional
number of shares  of IHS Stock as shall be equal to the  amount of such  excess,
and such additional shares shall be included in the aforementioned  registration
statement by means of a post-effective  amendment  thereto.  If the Closing Date
Share Count exceeds the Adjusted  Share Count,  the  Shareholders  promptly will
return to the Buyer that number of shares of IHS Stock as shall be equal to such
excess.



                                        8

<PAGE>



       (D) REGISTRATION EXPENSES. Shareholders shall not be responsible for, and
Buyer  shall  bear,  all of the  reasonable  expenses  of Buyer  related to such
registration including, without limitation, the fees and expenses of its counsel
and  accountants,  all of its other  costs,  fees and  expenses  incident to the
preparation,  printing,  registration and filing under the Securities Act of the
registration  statement and all amendments and supplements  thereto, the cost of
furnishing copies of each preliminary prospectus, each final prospectus and each
amendment or supplement thereto to underwriters, dealers and other purchasers of
IHS Stock and the costs and expenses  (including fees and  disbursements  of its
counsel)  incurred in connection with the  qualification  of IHS Stock under the
Blue Sky laws of various jurisdictions. Buyer, however, shall not be required to
pay underwriter's or brokerage discounts, commissions or expenses, or to pay any
costs or expenses arising out of  Shareholder's  or any transferee's  failure to
comply with its obligations under this Article III.

       (E) RESALE LIMITATIONS.  All resales of IHS Stock issued pursuant to this
Agreement  shall be effected  solely  through Smith Barney Inc., as broker,  and
sales by the Shareholders and, if any, their  transferees of such shares,  shall
not at any time, in the aggregate,  exceed One Hundred Thousand (100,000) shares
during any thirty (30) trading day period.

       (F)  REGISTRATION  PROCEDURES,  ETC. In connection with the  registration
rights granted to the Shareholders  with respect to the IHS Stock as provided in
this Section 3.1, Buyer covenants and agrees as follows:

          (I)  At  Buyer's  expense,   Buyer  will  keep  the  registration  and
qualification  under this  Section 3.1  effective  (and in  compliance  with the
Securities Act) by such action as may be necessary or appropriate for so long as
the Shareholders own any of the IHS Stock except to the extent that an exemption
from  registration  may  be  available.   Buyer  will  immediately   notify  the
Shareholders, at any time when a prospectus relating to a registration statement
under this Section 3.1 is required to be delivered  under the Securities Act, of
the  happening  of any event known to Buyer as a result of which the  prospectus
included in such registration  statement,  as then in effect, includes an untrue
statement of a material  fact or omits to state any material fact required to be
stated  therein or necessary to make the  statements  therein not  misleading in
light of the circumstances then existing.

          (II)  Buyer  shall  furnish  the  Shareholders  with  such  number  of
prospectuses as shall reasonably be requested.

          (III) Buyer shall take all  necessary  action which may be required in
qualifying or registering  IHS Stock  included in a  registration  statement for
offering  and sale  under  the  securities  or Blue Sky laws of such  states  as
reasonably are requested by the  Shareholders,  provided that Buyer shall not be
obligated to qualify as a foreign corporation or dealer to do business under the
laws of any such jurisdiction.



                                        9

<PAGE>



          (IV) The  information  included or  incorporated  by  reference in the
registration  statement filed pursuant to this Section 3.1 will not, at the time
any such registration statement becomes effective,  contain any untrue statement
of a material  fact,  or omit to state any material  fact  required to be stated
therein as necessary in order to make the  statements  therein,  in light of the
circumstances under which they were made, not misleading or necessary to correct
any  statement  in any  earlier  filing of such  registration  statement  or any
amendments  thereto.  The  registration  statement  will comply in all  material
respects with the provisions of the Securities Act and the rules and regulations
thereunder.  Buyer  shall  indemnify  the  Shareholders  of IHS Stock to be sold
pursuant to the registration  statement,  their successors and assigns, and each
person,  if any, who controls such  Shareholders  within the meaning of ss.15 of
the Securities Act or ss.20(a) of the Securities Exchange Act of 1934 ("Exchange
Act"),  against all loss,  claim,  damage  expense or liability  (including  all
expenses  reasonably  incurred in investigating,  preparing or defending against
any  claim  whatsoever)  to  which  any of them may  become  subject  under  the
Securities Act, the Exchange Act or any other statute,  common law or otherwise,
arising out of or based upon any untrue statement or alleged untrue statement of
a material fact contained in such  registration  statement  executed by Buyer or
based upon written  information  furnished by Buyer filed in any jurisdiction in
order to qualify IHS Stock under the  securities  laws thereof or filed with the
Commission,  any state securities  commission or agency,  NYSE or any securities
exchange;  or the  omission or alleged  omission  therefrom  of a material  fact
required to be stated  therein or  necessary  to make the  statements  contained
therein not  misleading,  unless such statement or omission was made in reliance
upon and in conformity with written information furnished to Buyer by any of the
Shareholders expressly for use in such registration statement,  any amendment or
supplement  thereto  or any  application,  as the case may be. If any  action is
brought against the  Shareholders or any controlling  person of the Shareholders
in respect of which  indemnity  may be sought  against  Buyer  pursuant  to this
subsection 3.1(f)(iv),  the Shareholders or such controlling person shall within
thirty (30) days after the  receipt  thereby of a summons or  complaint,  notify
Buyer in writing of the  institution  of such action and Buyer shall  assume the
defense  of such  actions,  including  the  employment  and  payment of fees and
expenses  of  counsel  (reasonably  satisfactory  to the  Shareholders  or  such
controlling  person). The Shareholders or such controlling person shall have the
right to employ  its or their own  counsel  in any such  case,  but the fees and
expenses of such  counsel  shall be at the expense of the  Shareholders  or such
controlling  person  unless (A) the  employment  of such counsel shall have been
authorized in writing by Buyer in connection with the defense of such action, or
(B) Buyer shall not have employed  counsel to have charge of the defense of such
action, or (C) such indemnified party or parties shall have reasonably concluded
that there may be defenses  available to it or them which are different  from or
additional to those available to Buyer (in which case,  Buyer shall not have the
right to direct the defense of such action on behalf of the indemnified party or
parties),  in any of which  events  the fees and  expenses  of not more than one
additional firm of attorneys for the Shareholders and/or such controlling person
shall be borne by Buyer.  Except as expressly provided in the previous sentence,
in the event that Buyer shall not  previously  have  assumed the defenses of any
such action or claim,  Buyer shall not thereafter be liable to the  Shareholders
or such  controlling  person in  investigating,  preparing or defending any such
action  or claim.  Buyer  agrees  promptly  to notify  the  Shareholders  of the
commencement  or any  litigation  or  proceedings  against  Buyer  or any of its
officers,  directors or controlling persons in connection with the resale of IHS
Stock or in connection with such registration statement.


                                       10

<PAGE>



          (V)  The   Shareholders  of  IHS  Stock  to  be  sold  pursuant  to  a
registration statement,  and their successors and assigns, shall severally,  and
not jointly,  indemnify  Buyer,  its officers and directors and each person,  if
any, who controls  Buyer  within the meaning of ss.15 of the  Securities  Act or
ss.20(a) of the  Exchange  Act against all loss,  claim,  damage,  or expense or
liability   (including  all  expenses   reasonably  incurred  in  investigating,
preparing or defending  against any claim  whatsoever)  to which they may become
subject under the Securities Act, the Exchange Act or any other statute,  common
law or  otherwise,  arising from  information  furnished by or on behalf of such
Shareholders,  or their successors or assigns in writing for specific  inclusion
in such registration statement.

       (G) NOTICE OF SALE.  If the  Shareholders  desire to transfer  all or any
portion of IHS Stock,  the  Shareholders  will deliver  written notice to Buyer,
describing in reasonable  detail their  intention to effect the transfer and the
manner  of the  proposed  transfer.  If the  transfer  is to be  pursuant  to an
effective  registration statement as provided herein, the Shareholders will sell
the IHS Stock in compliance  with the  disclosure  therein and  discontinue  any
offers  and sales  thereunder  upon  notice  from  Buyer  that the  registration
statement  relating to the IHS Stock being  transferred  is not "current"  until
Buyer gives  further  notice that  offers and sales may be  recommenced.  In the
event of any such notice from Buyer,  Buyer  agrees to file  expeditiously  such
amendments to the registration statement as may be necessary to bring it current
during the period  specified in Section  3.1(b) and to give prompt notice to the
Shareholders  when the registration  statement has again become current.  If the
Shareholders  deliver to Buyer an opinion of counsel  reasonably  acceptable  to
Buyer and its counsel and to the effect that the proposed  transfer of IHS Stock
may be made without  registration  under the Securities  Act, the  Shareholders,
will be  entitled  to  transfer  IHS Stock in  accordance  with the terms of the
notice and opinion of their counsel.

       (H)  FURNISH  INFORMATION.  It  shall  be a  condition  precedent  to the
obligations  of the Buyer to take any action  pursuant to this  Article III that
the  Shareholders  shall  furnish  to  the  Buyer  such  information   regarding
themselves,  the IHS Stock held by them, and the intended  method of disposition
of such securities as shall be required to effect the  registration of their IHS
Stock. In that connection,  each transferee of any Shareholder shall be required
to  represent  to the  Buyer  that all such  information  which is given is both
complete and accurate in all material respects.  Such Shareholders shall deliver
to the  Buyer  a  statement  in  writing  from  the  beneficial  owners  of such
securities that they bona fide intend to sell,  transfer or otherwise dispose of
such  securities.  Each transferee will,  severally,  promptly notify IHS at any
time when a  prospectus  relating  to a  registration  statement  covering  such
transferee's shares under this Section 3.1 is required to be delivered under the
Securities  Act, of the  happening  of any event known to such  transferee  as a
result of which the prospectus included in such registration  statement, as then
in effect, includes an untrue statement of a material fact or omits to state any
material fact required to be stated  therein or necessary to make the statements
therein not misleading in light of the statements as then existing.



                                       11

<PAGE>



       (I)  INVESTMENT  REPRESENTATIONS.  All  shares  of IHS Stock to be issued
hereunder will be newly issued shares of Buyer. The  Shareholders  represent and
warrant to Buyer that the IHS Stock being issued  hereunder  is being  acquired,
and will be acquired,  by the Shareholders for investment for their own accounts
and not with a view to or for sale in connection with any  distribution  thereof
within the meaning of the Securities Act or the applicable state securities law;
the  Shareholders   acknowledge  that  the  IHS  Stock  constitutes   restricted
securities  under  Rule  144  promulgated  by  the  Commission  pursuant  to the
Securities Act, and may have to be held indefinitely, and the Shareholders agree
that no  shares  of IHS Stock may be sold,  transferred,  assigned,  pledged  or
otherwise disposed of except pursuant to an effective  registration statement or
an  exemption  from  registration  under  the  Securities  Act,  the  rules  and
regulations  thereunder,  and under all applicable  state  securities  laws. The
Shareholders  have the  knowledge  and  experience  in  financial  and  business
matters,  are capable of evaluating the merits and risks of the investment,  and
are able to bear the economic risk of such investment. The Shareholders have had
the  opportunity  to make  inquiries  of and  obtain  from  representatives  and
employees of Buyer such other  information  about Buyer as it deems necessary in
connection with such investment.

       (J) LEGEND.  It is  understood  that,  prior to sale of any shares of IHS
Stock  pursuant to an effective  registration  pursuant to subsection (b) above,
the  certificates  evidencing  such shares of IHS Stock shall bear the following
(or a similar)  legend (in addition to any legends  which may be required in the
opinion of IHS's counsel by the applicable  securities  laws of any state),  and
upon  sale of such  shares  pursuant  to such  an  effective  registration,  new
certificates  shall be issued for the shares sold without such legends except as
otherwise required by law:

       THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER
       THE  SECURITIES ACT OF 1933. THE SHARES HAVE BEEN ACQUIRED FOR INVESTMENT
       AND MAY  NOT BE  SOLD,  TRANSFERRED  OR  ASSIGNED  IN THE  ABSENCE  OF AN
       EFFECTIVE  REGISTRATION  STATEMENT FOR THESE SHARES UNDER THE  SECURITIES
       ACT OF 1933 OR AN OPINION OF THE COMPANY'S  COUNSEL THAT  REGISTRATION IS
       NOT REQUIRED UNDER SAID ACT.

       (K) CERTAIN  TRANSFEREES.  Prior to the effective date of registration of
the IHS  Stock,  no  transferee  shall  transfer  any shares of IHS Stock to any
person or entity unless such transferee shall have agreed in writing to be bound
by the provisions applicable to the Shareholders under this Article III.



                                       12

<PAGE>



                             ARTICLE IV: THE CLOSING

     4.1 TIME AND PLACE OF  CLOSING.  The  Closing  under  this  Agreement  (the
"Closing") shall be held as promptly as practicable, but not more than seven (7)
business days following the satisfaction of all conditions  precedent  specified
in this  Agreement,  including  receipt of all necessary  regulatory  approvals,
unless duly waived by the party entitled to  satisfaction  thereof.  The Closing
shall  take place at the  offices of the Buyer,  or at such other time and place
upon  which the  parties  may  agree.  The date on which the  Closing is held is
hereinafter  called the  "Closing  Date."  Subject to the  conditions  set forth
herein,  at the Closing (a) the Shareholders  shall deliver for cancellation one
or more  stock  certificates  representing  the  shares of  Arcadia  Stock  duly
endorsed,  or  accompanied  by one or more stock powers duly  endorsed,  and (b)
Buyer, as agent for Arcadia,  shall, subject to Sections 2.3 and 2.4, deliver to
the Shareholders the Merger Consideration pursuant to Section 2.1(a) hereof.

     4.2 FILINGS AT CLOSING.  At the Closing Date, Buyer and Arcadia shall cause
the  Plan of  Merger  or such  other  certificate  as  required  to be  filed in
accordance  with the Michigan  Business  Corporation  Act and  Delaware  General
Corporation Law, and each of the Shareholders,  Buyer and Arcadia shall take any
and all lawful actions to cause the Merger to become effective.

     4.3 EFFECTIVE  TIME.  Subject to the terms and conditions set forth herein,
including receipt of all required regulatory approvals,  the Merger shall become
effective at the time the Plan of Merger or such other  certificate  as required
by the Michigan  Secretary of State and the Delaware  Secretary of State is made
effective (the "Effective Time of Merger").


           ARTICLE V: REPRESENTATIONS AND WARRANTIES OF THE PRINCIPAL
                               SELLERS AND ARCADIA

     Arcadia and the Principal  Sellers hereby  jointly and severally  represent
and warrant to Buyer and Newco as follows  (it being  understood  that,  for the
purposes of this Article V, "Arcadia"  shall be deemed to refer  collectively to
Arcadia and any subsidiaries listed on Schedule 5.23):

     5.1  ORGANIZATION  AND STANDING OF ARCADIA.  Arcadia is a corporation  duly
organized,  validly existing and in good standing under the laws of the State of
Michigan.  Copies of Arcadia's  Articles of Incorporation  and By-Laws,  and all
amendments  thereof to date,  have been  delivered to Buyer and are complete and
correct.  Arcadia has the power and authority to own the  properties  and assets
now owned by it and to conduct the businesses  presently  being conducted by it.
Arcadia is qualified to do business as a foreign corporation in each state where
the  ownership  of  its  assets  or the  conduct  of its  businesses  make  such
qualification necessary.



                                       13

<PAGE>



     5.2 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement  including all Schedules and Exhibits hereto, or any of the other
instruments  and  documents   required  or   contemplated   hereby  and  thereby
("Transaction  Documents") by Principal Sellers and Arcadia, nor the performance
by Principal  Sellers and Arcadia of the  transactions  contemplated  hereby and
thereby,  conflicts  with, or constitutes a breach of or a default under (i) the
Articles of  Incorporation  or By-Laws of Arcadia;  or (ii) any applicable  law,
rule, judgment,  order, writ,  injunction,  or decree of any court, currently in
effect,  provided that the consents set forth in Schedule 5.3 are obtained prior
to the Closing; or (iii) any applicable rule or regulation of any administrative
agency  or  other  governmental  authority  currently  in  effect;  or (iv)  any
agreement,  indenture, contract or instrument to which Arcadia is now a party or
by which any of the assets of Arcadia is bound.

     5.3  CONSENTS.  Except  as set forth in  Schedule  5.3,  no  authorization,
consent, approval,  license, exemption by, filing or registration with any court
or   governmental   department,    commission,    board,   bureau,   agency   or
instrumentality, domestic or foreign, is or will be necessary in connection with
the  execution,  delivery  and  performance  of  this  Agreement  or  any of the
Transaction Documents by any of the Principal Sellers or Arcadia.

     5.4 ARCADIA STOCK.  Schedule 5.4 sets forth a complete list and description
of the  authorized  capital  stock of Arcadia,  the number of shares  issued and
outstanding of each class or series of such capital  stock,  and the identity of
each  Shareholder  of Arcadia,  in each case  indicating the class and number of
shares held. No shares of Arcadia Stock are held in the treasury of Arcadia. The
Shareholders are the record owners of all of Arcadia Stock and all of such stock
is duly authorized,  validly issued, and fully paid and non-assessable.  Arcadia
will,  as of the Closing  Date,  be the sole  shareholder  of  Grayrose.  On the
Closing Date, there will be no preemptive or first refusal rights to purchase or
otherwise  acquire shares of capital stock of Arcadia  pursuant to any provision
of law or the Articles of Incorporation or By-Laws of Arcadia or by agreement or
otherwise.  On the Closing  Date there shall not be  outstanding  any  warrants,
options, or other rights to subscribe for or purchase from Arcadia any shares of
capital  stock of  Arcadia,  nor  shall  there  be  outstanding  any  securities
convertible into or exchangeable for such shares.

     5.5 ASSETS.  As of the  Closing,  the  consolidated  Assets of Arcadia will
include all of the  tangible  and  intangible  assets  necessary  to operate the
businesses of Arcadia as presently constituted,  including,  without limitation,
cash and accounts receivable;  provided,  however, that Assets shall not include
inventory,  supplies  and other  assets  disposed of in the  ordinary  course of
business,  consistent  with the prior  practice  of  Arcadia's  businesses.  The
quantities of inventory  items included in the Assets are reasonable in light of
the present and anticipated volume of Arcadia's  businesses and the inventory is
good,  usable,  merchantable,  and salable in the  ordinary  course of Arcadia's
businesses,  in each case, as determined by Arcadia in good faith and consistent
with past practice. The accounts receivable of Arcadia are reflected properly on
their  books and  records  in  accordance  with  GAAP,  and have been  billed or
invoiced in the ordinary course of business  consistent with past practice.  The
Assets  are not  subject  to any liens or  encumbrances,  except as set forth on
Schedule 5.5.



                                       14

<PAGE>



     5.6 TRADEMARKS. Schedule 5.6 sets forth a complete and accurate list of all
trademarks,  service marks, or applications for any of the same, copyrights, and
other  items of  intellectual  property  that are  owned,  possessed  or used by
Arcadia.  There are no claims or  proceedings  pending or, to the  knowledge  of
Arcadia, overtly threatened against Arcadia asserting that the use of any of the
aforementioned  properties  or rights  infringes the rights of any other person,
and, to the  knowledge of any of the Principal  Sellers and Arcadia,  Arcadia is
not infringing on the intellectual property rights of any other person.

     5.7  CONTRACTS.  Schedule 5.7 sets forth a complete and correct list of all
agreements,  contracts and commitments of the following type to which Arcadia is
a party or by which Arcadia or any of Arcadia's  assets is bound and as to which
Arcadia  has any  outstanding  material  obligations  as of the date hereof (the
"Contracts"):

       (A) each  contract or agreement  for the  employment  or retention of, or
collective  bargaining,  severance or termination  agreement with, any director,
officer, employee, consultant, agent or group of employees of Arcadia;

       (B) each profit sharing, thrift, bonus, incentive, deferred compensation,
stock   option,   stock   purchase,    severance   pay,   pension,   retirement,
hospitalization, insurance or other similar plan, agreement or arrangement;

       (C) each  agreement  or  arrangement  for the sale of  Arcadia's  assets,
properties or rights outside the ordinary course of business (by sale of assets,
sale of stock, merger or otherwise) which is currently in effect;

       (D) each  contract  currently  in effect which  contains  any  provisions
requiring  Arcadia to indemnify or act for, or guarantee the  obligation of, any
other person or entity;

       (E) each agreement  restricting Arcadia from conducting business anywhere
in the world;

       (F) each partnership or joint venture contract or similar  arrangement or
agreement  which is likely to involve a sharing  of  profits or future  payments
with respect to Arcadia's businesses or any portion thereof;

       (G)   each   licensing,   distributor,   dealer,   affiliate,   sales  or
manufacturer's representative,  agency or other similar contract, arrangement or
commitment;

       (H) each contract under which Arcadia performs home health care services,
medical staffing or clerical staffing  services which involves  consideration of
at least $15,000;



                                       15

<PAGE>



       (I) each  contract  under  which  Grayrose  performs  clerical  and light
industrial  staffing services which involves  consideration of at least $15,000;
or

       (J) any other  agreement  not made in the ordinary  and normal  course of
business which involves consideration of more than $50,000.

     Except as indicated on Schedule 5.7, each of the Contracts was entered into
and requires performance in the ordinary course of business and is in full force
and effect.  Arcadia is not in material default under any Contract and there has
not been asserted,  either by or against Arcadia under any Contract, any written
notice of default, set-off or claim of default. To the knowledge of Arcadia, the
parties to the Contracts  other than Arcadia are not in material  default of any
of their respective obligations under the Contracts,  and there has not occurred
any event which with the passage of time or the giving of notice (or both) would
constitute a material default or material breach under any Contract. All amounts
payable  under the  Contracts  are, or will at the Closing Date, be on a current
basis or properly  accrued for on the  Estimated  Closing Date Balance  Sheet in
accordance with GAAP.

     Notwithstanding the foregoing, Buyer acknowledges that it has been informed
by Arcadia  that  Arcadia  has  agreements  with  certain of its  affiliates  in
geographic areas in which Buyer already is conducting business.  Buyer agrees to
assume any and all liability and be responsible  for any claim or loss which may
occur as a result of the  violation  after the Closing Date by Buyer or Arcadia,
or any of their respective  subsidiaries,  of any exclusive  territorial  rights
contained  in any such  affiliate  agreements,  and that  Arcadia  shall have no
obligation to Buyer nor be deemed in breach or violation of any  representation,
warranty or covenant  hereunder  or otherwise  under this  Agreement as a direct
result of such marketplace overlap.

     5.8 FINANCIAL STATEMENTS.

       (A) The audited  consolidated balance sheet of Arcadia and Grayrose as of
June 30, 1995 and the draft  audited  consolidated  balance sheet of Arcadia and
Grayrose as of June 30, 1996,  and the related  statements of operations for the
years then ended,  annexed  hereto as Schedule  5.8(a) (the  "Audited  Financial
Statements"),  present fairly in all material  respects the financial  condition
and results of operations of Arcadia and Grayrose at and for the period  therein
specified and were prepared in accordance with GAAP.

       (B) The  unaudited  consolidated  monthly  balance  sheets of Arcadia and
Grayrose for each calendar month since June 30, 1996 and the related  statements
of operations  for the periods then ended,  annexed  hereto as Schedule  5.8(b),
present fairly in all material  respects the financial  condition and results of
operations of Arcadia and Grayrose at and for the periods therein  specified and
were prepared in accordance with GAAP.

       (C) The unaudited  consolidated balance sheets of Arcadia and Grayrose as
of March 31, 1997 (the "March 31 Balance Sheets"), and the related statements of
operations  for the  nine-month  period then ended,  annexed  hereto as Schedule
5.8(c),  present  fairly in all material  respects the  financial  condition and
results of  operations  of Arcadia and  Grayrose at and for the periods  therein
specified and were prepared in accordance with GAAP.


                                       16

<PAGE>



       (D) Except as set forth on Schedule  5.8(d) or as expressly  set forth on
the March 31 Balance Sheets, Arcadia and Grayrose have no material non-recurring
or extraordinary  income or expense reduction not identified therein or material
liabilities or obligations (whether absolute,  accrued,  contingent or otherwise
and whether due or to become due, including,  without limitation, any guarantees
of any  obligations of any other person or entity) of any kind or nature whether
or not required by GAAP to be reflected in a corporate  balance sheet and/or the
notes thereto.

     5.9 MATERIAL CHANGES.  Except as noted on Schedule 5.9, between the date of
the March 31 Balance Sheets and the date of this  Agreement,  there has not been
any material  adverse  change in the  condition  (financial or otherwise) of the
assets,  properties or operations of Arcadia or any damage or destruction of any
of  Arcadia's  Assets or their  places of  business  by fire or other  casualty,
whether or not covered by insurance,  and during such period of time Arcadia has
conducted  its  businesses  only in the  ordinary and normal  course.  Principal
Sellers have identified and communicated to Buyer all material  information with
respect to any fact or condition that is reasonably  likely to adversely  affect
the future prospects (financial or otherwise) of Arcadia.

     5.10 LICENSES;  PERMITS;  CERTIFICATES OF NEED.  Schedule 5.10 sets forth a
description  of (a) all  licenses  and other  governmental  or other  regulatory
permits,  authorizations  or approvals  required for the  operation of Arcadia's
businesses  that are now in effect,  including  all  certificates  of  occupancy
issued with respect to Arcadia's businesses; (b) all Certificates of Need issued
with respect to Arcadia's and its subsidiaries  that are now in effect;  and (c)
each other license,  permit,  or other  authorization  that is necessary for the
operation  of  Arcadia's   businesses   (a  "License"  and   collectively,   the
"Licenses"). The Licenses constitute all of the governmental, quasi-governmental
and regulatory licenses,  permits and authorizations  necessary to the operation
of the  businesses of Arcadia and its  subsidiaries  as they are operated on the
date  hereof.  Arcadia has  delivered  to Buyer  copies of all of the  Licenses.
Arcadia and its subsidiaries  own, possess or otherwise have the exclusive legal
right to use the Licenses, free and clear of all liens, pledges, claims or other
encumbrances of any nature whatsoever.  Arcadia is not in material default under
any such License,  and Arcadia and its subsidiaries have not received any notice
of any material  default or any other material  claim or proceeding  relating to
any such License.  Each License is in full force and effect, and neither Arcadia
nor any of its  subsidiaries  has received  written  notice of any proceeding to
terminate or suspend any License or of any condition or event (other than survey
deficiencies  which singly or in the aggregate would not be material to any home
health  agency  that  Arcadia or any of its  subsidiaries  operates)  which,  if
uncured,  would result in the termination or suspension of any License.  None of
the Licenses are: (a) provisional, probationary, or restricted in any way except
to  the  extent   qualified  by  any  outstanding   deficiencies  or  citations,
particulars of which have been set forth on Schedule 5.10; or (b) subject to any
investigation,   cancellation,   impairment,   limitation,   order,   complaint,
proceeding,  or suspension nor is such threatened or pending.  No conditions not
generally  applicable to home health agencies requiring changes in the operation
of Arcadia or any of its subsidiaries have been imposed, formally or informally,
by any License issuer during the past twenty-four (24) months.


                                       17

<PAGE>



No  Principal  Seller,  director  or  officer,  employee  or former  employee of
Arcadia,  or any person,  firm or corporation other than Arcadia owns or has any
proprietary,  financial or other  interest,  direct or indirect,  in whole or in
part in any of the Licenses.

     5.11 TITLE, CONDITION OF PERSONAL PROPERTY.

       (A) Except for the security  interests  listed and  described on Schedule
5.11(a),  Arcadia  has good and  marketable  title to,  or valid and  subsisting
leasehold  interests in, all of the personal property located at their places of
business or used in connection with the operation of their  businesses,  subject
to no mortgage,  security interest,  pledge, lien, claim, encumbrance or charge,
or  restraint  on transfer  whatsoever  other than  Permitted  Liens (as defined
below).  No other person has any right to the use or  possession  of any of such
property  which is owned  and,  except  as set  forth on  Schedule  5.11(a),  no
currently  effective  financing statement with respect to such personal property
has been  filed  under the  Uniform  Commercial  Code in any  jurisdiction,  and
Arcadia has not signed any such  financing  statement or any security  agreement
authorizing any secured party  thereunder to file any such financing  statement.
All of such personal property comprising equipment, improvements,  furniture and
other tangible personal property in use by Arcadia,  whether owned or leased, is
in good operating condition and repair,  subject to normal wear and tear, and is
sufficient to enable  Arcadia to operate its  businesses in a manner  consistent
with their operation during the immediately preceding twelve (12) months.

       (B)  Except  as set  forth on  Schedule  5.11(b),  no  tangible  personal
property used by Arcadia in connection  with the operation of its  businesses is
subject to a lease,  conditional sale, security interest or similar arrangement.
Arcadia has delivered to Buyer a complete and correct copy of each of the leases
and other agreements listed on Schedule  5.11(b).  All of said personal property
leases are valid,  binding and enforceable in accordance  with their  respective
terms and are in full force and effect. Arcadia is not in material default under
such leases and there has not been asserted,  either by or against Arcadia under
any of such leases, any written notice of default, set-off, or claim of default.
To the best  knowledge  of Principal  Sellers and  Arcadia,  the parties to such
leases  other than  Arcadia are not in default of their  respective  obligations
under any of such  leases,  and there has not  occurred any event which with the
passage of time or giving of notice (or both) would constitute such a default or
breach under any of such leases.

       (C) "Permitted Liens" shall mean:

          (I) carriers', warehouseman's,  mechanics, materialmen's,  repairmen's
or other like liens arising in the ordinary course of business which are (i) not
overdue for a period of more than 30 days or (ii) which are being  contested  in
good faith and by appropriate  proceedings,  provided that if such contest shall
continue for more than 30 days,  the amount  thereof shall be bonded or properly
reserved against at the end of such 30-day period;


                                       18

<PAGE>



          (II)  deposits  to secure the  performance  of bids,  trade  contracts
(other than for  borrowed  money),  leases,  statutory  obligations,  surety and
appeal bonds, performance bonds and other obligations of like nature incurred in
the ordinary course of business;

          (III) rights of lessors under leases set forth on Schedule 5.11(b);

          (IV) pledges or deposits in  connection  with  worker's  compensation,
unemployment insurance, and other social security legislation; and

          (V) rights of creditors pursuant to Schedule 5.5.

     5.12 LEGAL PROCEEDINGS. Other than as set forth on Schedule 5.12, there are
no claims, actions, suits or proceedings or arbitrations,  either administrative
or  judicial,  pending,  or, to the  knowledge  of Arcadia,  overtly  threatened
against  or  affecting   Arcadia,   or  Arcadia's   ability  to  consummate  the
transactions contemplated herein, at law or in equity or otherwise, before or by
any court or  governmental  agency or body,  domestic or  foreign,  or before an
arbitrator of any kind.

     5.13  EMPLOYEES.  Arcadia  has  previously  furnished  Buyer with a payroll
listing dated May 31, 1997 indicating the names, positions,  and compensation of
each of their  employees.  All of such  information is materially  correct as of
such date and there  has been no  material  change  since May 31,  1997.  To the
knowledge of Principal Sellers and Arcadia, none of the employees,  while in the
employ of Arcadia, has ever had his or her professional license or certification
denied, suspended, revoked, terminated, or voluntarily relinquished under threat
of disciplinary  action,  or has ever been restricted in any way from performing
the  duties he or she is to  provide  for  Arcadia,  and there is no  proceeding
pending, or threatened, pursuant to which any of the foregoing may occur.

     5.14 COLLECTIVE  BARGAINING,  LABOR CONTRACTS,  EMPLOYMENT PRACTICES,  ETC.
During  the two years  prior to the  Closing  Date,  there has been no  material
adverse  change  in the  relationship  between  Arcadia  and  its  employees  or
affiliates  nor any  strike or  material  labor  disturbance  by such  employees
affecting  Arcadia's  businesses  and, to the knowledge of Arcadia,  there is no
indication that such a change, strike or labor disturbance is likely.  Arcadia's
employees  or  affiliates  are not  represented  by any labor  union or  similar
organization  and  Arcadia  has no reason to believe  that there are  pending or
threatened   any   activities,   the  purpose  of  which  is  to  achieve   such
representation,  of all or some of Arcadia's employees or affiliates.  Except as
set  forth on  Schedule  5.7 or  Schedule  5.15(b),  Arcadia  has no  collective
bargaining   or  other   labor   contracts,   employment   contracts,   pension,
profit-sharing,  retirement,  insurance,  bonus,  deferred compensation or other
employee  benefit  plans,  agreements  or  arrangements  with  respect  to their
employees. Arcadia is in material compliance with the requirements prescribed by
all  Federal,  state and  local  statutes,  orders  and  governmental  rules and
regulations  ("Government  Requirements")  applicable  to any  of  the  employee
benefit  plans,  agreements  and  arrangements  identified  on Schedule  5.7 and
Schedule 5.15(b), including, without limitation, the Employee


                                       19

<PAGE>



Retirement  Income Security Act of 1974, as amended  ("ERISA"),  the Immigration
Reform and Control Act, the Worker Adjustment and Retraining Notification Act of
1988, any such  Government  Requirements  respecting  employment  determination,
equal opportunity,  affirmative action,  employee privacy,  wrongful or unlawful
termination, workers' compensation, occupational safety and health requirements,
labor management  relations and unemployment  insurance,  or related matters and
there are no threatened or pending claims relating thereto, in each case. Except
as set forth on Schedule 5.7(a), in the event of termination of employment of an
employee  of  Arcadia,  Arcadia  will not,  after the  Closing,  pursuant to any
agreement  with any  Shareholder  or Arcadia or by reason of any  representation
made or plan adopted by any  Shareholder  or Arcadia  prior to the  Closing,  be
liable to any  employee  of Arcadia for  so-called  "severance  pay",  parachute
payments  or  any  other  similar  payments  or  benefits,   including,  without
limitation, post- employment healthcare (other than pursuant to the continuation
health care provisions of Section 4980B of the Internal Revenue Code of 1986, as
amended or Section 601 through 608 of ERISA  ("COBRA"))  or insurance  benefits,
and  accrued  vacation  and sick days or properly  accrued for on the  Estimated
Closing Date Balance Sheet in accordance with GAAP.

     5.15 ERISA.

       (A) Arcadia  does not maintain or make  contributions  to and have not at
any time in the past maintained or made  contributions  to, any employee benefit
plan which is subject to the minimum  funding  standards of ERISA.  Arcadia does
not now maintain or make  contributions  to, and has not at any time in the past
maintained  or made  contributions  to, any  multi-employer  plan subject to the
terms  of  the   Multi-employer   Pension  Plan   Amendment  Act  of  1980  (the
"Multi-employer Act").

       (B) Schedule 5.15(b) sets forth each severance agreement,  and each plan,
agreement,  arrangement or plan, bonus plan,  deferred  compensation  agreement,
employee  pension,  profit  sharing,  savings or  retirement  plan,  group life,
health,  or  accident  insurance  or other  employee  benefit  plan,  agreement,
arrangement or commitment, including, without limitation, any commitment arising
under severance,  holiday, vacation,  Christmas or other bonus plans (including,
but not limited to,  "employee  benefit  plans",  as defined in Section  3(3) of
ERISA  maintained  by Arcadia for any  employees of Arcadia,  or with respect to
which Arcadia has liability with respect to any employees of Arcadia, or make or
have an  obligation  to make  contributions  on behalf of  employees  of Arcadia
("Plans").

       (C)  Schedule  5.15(c)  identifies  all  employees of Arcadia on leave of
absence eligible to receive health benefits, as required by COBRA. Notice of the
availability  of COBRA coverage has been provided to all employees of Arcadia on
leave of absence  entitled  thereto,  and all persons electing such coverage are
being (or have been, if applicable) provided such coverage.


                                       20

<PAGE>



     5.16  INSURANCE  AND SURETY  AGREEMENTS.  Schedule 5.16 contains a true and
correct  list  of:  (a) all  policies  of fire,  liability  and  other  forms of
insurance  held or  owned by  Arcadia  (including  but not  limited  to  medical
malpractice  insurance,  and any state  sponsored  plan or program for  worker's
compensation);  and (b) all bonds,  indemnity agreements and other agreements of
suretyship  made for or held by Arcadia,  including a brief  description  of the
character  of the bond or agreement  and the name of the surety or  indemnifying
party.  Schedule 5.16 sets forth for each such insurance  policy the name of the
insurer, the amount of coverage,  the type of insurance,  the policy number, the
annual premium and a brief description of the nature of insurance included under
each such  policy and of any claims made  thereunder  during the past two years.
Such policies are owned by and payable  solely to Arcadia,  and said policies or
renewals or  replacements  thereof will be outstanding  and duly in force at the
Closing Date. All insurance  policies  listed on Schedule 5.16 are in full force
and effect,  all premiums due on or before the Closing Date have been or will be
paid,  financed or accrued on or before the Closing  Date,  Arcadia has not been
advised by any of their  insurance  carriers of an  intention  to  terminate  or
modify any such  policies  other  than under  circumstances  where  Arcadia  has
received a commitment for a replacement policy, nor has Arcadia failed to comply
with any of the material conditions contained in any such policies.

     5.17  RELATIONSHIPS.  Except as  disclosed  on  Schedule  5.17  hereto,  no
Shareholder and no controlling Principal Seller, partner or any affiliate of any
Shareholder  has,  or at any  time  within  the last two (2)  years  has had,  a
material ownership interest in any business,  corporate or otherwise,  that is a
party to, or in any property that is the subject of, business  relationships  or
arrangements of any kind relating to the operation of Arcadia or its businesses.

     5.18 ABSENCE OF CERTAIN EVENTS. Except as set forth on Schedule 5.18, since
the date of the March 31 Balance  Sheets,  Arcadia has not, and from the date of
this Agreement through the Closing Date Arcadia will not have:

       (A) except for the sale of its joint venture interest in C.R.K.  Computer
Services  ("C.R.K.")  (provided,  in such  event,  the  proceeds of such sale of
C.R.K.  will be included in the working capital of Arcadia),  sold,  assigned or
transferred  any of its assets or properties,  other than in the ordinary course
of business;

       (B)  mortgaged,  pledged  or  subjected  to any lien,  pledge,  mortgage,
security interest, conditional sales contract or other encumbrance of any nature
whatsoever, other than a Permitted Lien, any of Arcadia's assets;

       (C) made or suffered  any  termination  of any home health care  services
contract  or any  medical,  clerical  and  light  industrial  staffing  services
contract;

       (D) made or suffered any amendment or termination of any other  contract,
commitment,  instrument  or agreement  involving  consideration  or liability in
excess of $25,000;


                                       21

<PAGE>



       (E)  except in the  ordinary  course  of  business  consistent  with past
practices,  or otherwise as necessary to comply with any applicable minimum wage
law, increased the salaries or other compensation of any of their employees,  or
made any increase in, or any additions  to, other  benefits to which any of such
employees may be entitled;

       (F) failed to pay or discharge when due any  liabilities,  the failure to
pay or discharge  which has caused or will cause any actual  damage or give rise
to the risk of a loss to Arcadia;

       (G) changed any of the accounting  principles  followed by Arcadia or the
methods of applying such principles;

       (H) except for the  acquisition of two agencies  located in Grand Rapids,
Michigan and Lansing,  Michigan,  entered into any transaction other than in the
ordinary course of business involving consideration in excess of $50,000;

       (I)  dissolved,  merged or entered into a share exchange with or into any
other entity;

       (J) entered into any contract or agreement with union or other collective
bargaining  representative  representing any employees or affiliates without the
prior  written  consent  of  Buyer,  which  consent  shall  not be  unreasonably
withheld;

       (K) made any change to its by-laws or articles of incorporation;

       (L) failed to maintain its businesses in substantially  the same state of
repair,  order and condition as on the date hereof,  reasonable wear and tear or
loss by casualty excepted;

       (M) failed to maintain in full force and effect all Licenses currently in
effect with respect to its businesses unless such License is no longer necessary
for the operation of Arcadia;

       (N) failed to  maintain in full force and effect the  insurance  policies
and binders currently in effect, or the replacements thereof,  including without
limitation those listed on Schedule 5.16;

       (O) failed to  preserve  intact the  present  business  organizations  of
Arcadia;  failed to keep available the services of Arcadia's present  employees,
affiliates and agents  necessary to the proper  functioning of the businesses of
Arcadia; and failed to maintain Arcadia's relations and goodwill with suppliers,
employees,  affiliates,  affiliated  medical  personnel  and any  others  having
business  relating to Arcadia and where such  relationships are necessary to the
proper functioning of the businesses of Arcadia;


                                       22

<PAGE>



       (P) failed to maintain  all of the books and records in  accordance  with
their past practices;

       (Q) failed to comply in all respects with all provisions of the Contracts
listed in Schedule 5.7 and with any other material  agreements  that Arcadia has
entered  into in the  ordinary  course of  business  since the March 31  Balance
Sheets, and failed to comply in all respects with the provisions of all material
laws, rules and regulations applicable to Arcadia's businesses;

       (R) failed to pay when due, all taxes,  assessments and charges or levies
imposed  upon  them or on any of their  properties  for  which  they  have  been
required to be withheld or paid over;

       (S)  failed  to  promptly  advise  Buyer  in  writing  of the  threat  or
commencement   against  Arcadia  of  any  claim,  action,  suit  or  proceeding,
arbitration or investigation or any other event that would materially  adversely
affect the operations, properties, assets or prospects of Arcadia; and

       (T) failed to notify the Buyer in writing of any event involving  Arcadia
which has had or may be reasonably expected to have a material adverse effect on
the  business  or  financial  condition  of Arcadia or may  involve  the loss of
contracts with any of Arcadia's customers.

     5.19 COMPLIANCE WITH LAWS.  Arcadia is in compliance with all  Governmental
Requirements (as defined  herein).  Except for notices of  non-compliance  as to
which  Arcadia  has  taken  corrective   action  acceptable  to  the  applicable
governmental  agency, and as set forth in Schedule 5.19, Arcadia has not, within
the period of twenty-four months preceding the date of this Agreement,  received
any  written  notice that  Arcadia or the Assets fail to comply in any  material
respect with any applicable Federal,  state, local or other governmental laws or
ordinances,  or any applicable order, rule or regulation of any Federal,  state,
local or other  governmental  agency having  jurisdiction  over their businesses
("Governmental  Requirements").  Arcadia shall report to Buyer,  within five (5)
business days after receipt thereof,  any written notices that Arcadia is not in
compliance in any material respect with any of the foregoing.

     5.20 FINDERS. No broker or finder has acted for the Shareholders or Arcadia
in connection with the transactions contemplated by this Agreement, and no other
broker or finder is entitled to any broker's or finder's fee or other commission
in  respect  thereof  based  in  any  way  on  agreements,   understandings   or
arrangements with the Shareholders or Arcadia.


                                       23

<PAGE>



     5.21 TAX RETURNS.

       (A) Except as set forth in Schedule  5.21, (i) all Tax (as defined below)
returns,  statements,  reports  and forms or  extensions  with  respect  thereto
required  to be  filed  with any  Federal,  state,  local or other  governmental
department   or  court  or  other   authority   having   jurisdiction   over  it
("Governmental  Authority")  on or before  the  Closing  Date by or on behalf of
Arcadia (collectively,  the "Tax Returns"), have been or will be timely filed on
or before the Closing Date in  accordance  in all  materials  respects  with all
applicable Governmental Requirements; and (ii) Arcadia has timely paid all Taxes
payable by them.

       (B) For  purposes of this  Agreement,  "Tax" means any net income,  gross
income, sales, use, franchise, personal, employment, or real property tax.

     5.22 ENCUMBRANCES CREATED BY THIS AGREEMENT.  The execution and delivery of
this Agreement,  or any of Arcadia's  Transaction  Documents,  does not, and the
consummation of the transactions contemplated hereby or thereby will not, create
any liens or other  encumbrances  on any of  Arcadia's  assets in favor of third
parties.

     5.23  SUBSIDIARIES AND JOINT VENTURES.  Schedule 5.23 sets forth a complete
list of all subsidiaries,  joint ventures and partnerships in which Arcadia is a
record or beneficial  owner. All of the issued and outstanding  capital stock of
the  subsidiaries  listed  on  Schedule  5.23  hereto  is  owned  of  record  or
beneficially by Arcadia or by one of the listed subsidiaries on Schedule 5.23.

     5.24 NO UNTRUE STATEMENT.  None of the  representations and warranties made
pursuant to this  Agreement  contains any untrue  statement of material  fact or
omits to state a material fact  necessary,  in light of the  circumstance  under
which it was made, in order to make any such  representation  not  misleading in
any material respect.

     5.25 MEDICARE AND MEDICAID PROGRAMS. Arcadia is qualified for participation
in the Medicare and Medicaid programs. Except as reflected on Schedule 5.25, (a)
no  Principal  Seller nor Arcadia has  received  any notice of  recoupment  with
respect to Arcadia's  operations from the Medicare or Medicaid programs,  or any
other third party reimbursement  source, (b) there is no basis for the assertion
after the Closing Date of any such  recoupment  claim  against Buyer which arose
out of any  transactions  on the part of Arcadia prior to the Closing or against
any Principal Seller for which Buyer will be liable, and (c) to the knowledge of
Principal Sellers and Arcadia, no Medicare and Medicaid investigation, survey or
audit is  pending,  threatened  or imminent  with  respect to the  operation  of
Arcadia prior to the Closing.

     5.26  LEASEHOLD  INTERESTS.  Schedule 5.26 hereto sets forth a complete and
correct list of all leases pursuant to which Arcadia or any of its  subsidiaries
leases real property.  Each of Arcadia and its  subsidiaries has valid leasehold
interests in all such real property free and clear of all liens, claims, charges
and encumbrances of any kind whatsoever, except for Permitted Liens. Arcadia has
provided  access to the  Buyer to  complete  and  correct  copies of the  leases
identified in Schedule 5.26.


                                       24

<PAGE>



     5.27 POWER AND AUTHORITY.  Arcadia and Principal Sellers have all requisite
power and authority to execute,  deliver and perform this  Agreement,  and as of
the Closing,  Arcadia and Principal  Sellers will have all  requisite  power and
authority  to execute  and  deliver  the  Transaction  Documents  required to be
delivered by each party to the Buyer at the Closing.

     5.28 BINDING EFFECT. This Agreement and all Transaction  Documents executed
by  Arcadia  and  Principal  Sellers  constitute  the legal,  valid and  binding
obligations  of such party,  enforceable  against such party in accordance  with
their respective terms.

     5.29 QUESTIONNAIRES. The health care law questionnaire heretofore delivered
to Arcadia by Buyer (the  "Questionnaire")  will be  attached  hereto as Exhibit
5.29 and will as of the Closing  Date have been fully and  accurately  completed
and will not contain any material misstatement of any fact and will not omit any
fact that would have to be stated in order not to render  any  response  to such
questionnaire materially misleading.

     5.30 QUESTIONABLE PAYMENTS. Arcadia nor any shareholder, director, officer,
controlling person or employee of Arcadia,  and no affiliate of Arcadia, (a) has
used any corporate  funds of Arcadia to make any illegal or unlawful  payment to
any  officer,  employee,  representative,  agent  of any  government,  or to any
political party or official thereof, including,  without limitation, any of same
that would violate the Foreign Corrupt Practices Act of 1977, as amended; or (b)
has  made  or  received  any  illegal  payment,   bribe,   kickback,   political
contribution  or  other  similar  questionable  payment  for  any  referrals  or
recommendations  or  otherwise  in  connection  with the  operation of Arcadia's
businesses.


         ARTICLE VI: REPRESENTATIONS AND WARRANTIES OF PRINCIPAL SELLERS

     Each  of the  Principal  Sellers,  each  as to  himself,  hereby  severally
represents and warrants to Buyer and Newco as follows:

     6.1 AUTHORITY. Such Principal Seller has the full legal power and authority
to make,  execute,  deliver  and  perform  this  Agreement  and the  Transaction
Documents. Such execution,  delivery, performance and consummation has been duly
authorized by all necessary action,  corporate or otherwise, on the part of such
Principal Sellers, and any necessary consents of holders of indebtedness of such
Principal Seller have been obtained.

     6.2 BINDING EFFECT.  This Agreement and all Transaction  Documents executed
by such Principal Seller constitute the legal, valid and binding  obligations of
such party,  enforceable  against such Principal Seller in accordance with their
respective terms.

     6.3 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this Agreement or any of the Transaction  Documents by such Principal Seller nor
the performance by such Principal Seller of the transactions contemplated hereby
and thereby conflicts with, or


                                       25

<PAGE>



constitutes a breach of or a default under (i) any law, rule,  judgment,  order,
writ, injunction,  or decree of any court currently in effect applicable to such
Principal Seller, or (ii) any rule or regulation of any administrative agency or
other  governmental  authority  currently in effect applicable to such Principal
Seller, or (iii) any agreement,  indenture, contract or instrument to which such
party is now a party or by which any of the assets of such  Principal  Seller is
bound.

     6.4 CONSENTS. No authorization,  consent, approval,  license, exemption by,
filing or registration  with any court or governmental  department,  commission,
board,  bureau,  agency or  instrumentality,  domestic or foreign, is or will be
necessary in connection  with the  execution,  delivery and  performance of this
Agreement or any of the Transaction Documents by such Principal Seller.

     6.5  OWNERSHIP OF ARCADIA  STOCK.  Shareholders  are the lawful  record and
beneficial  owners of all of Arcadia  Stock  shown as owned by  Shareholders  in
Schedule  5.4, with good and  marketable  title  thereto,  free and clear of all
liens and  encumbrances,  claims and other  charges  thereon  of any kind.  Such
Shareholders  have the full legal power to transfer  and  deliver  such  Arcadia
Stock in accordance with this  Agreement,  and delivery of such Arcadia Stock to
Buyer pursuant  hereto will convey good and marketable  title thereto,  free and
clear of all liens and  encumbrances,  claims and other  charges  thereon or any
kind.  The shares of Arcadia  Stock  indicated on Schedule 5.4 as being owned by
the  Shareholders  constitute  all of the issued and  outstanding  shares of the
capital stock of Arcadia. On the Closing Date there shall not be outstanding any
warrants, options, or other rights to subscribe for or purchase from Arcadia any
shares  of  capital  stock  of  Arcadia,  nor  shall  there be  outstanding  any
securities convertible into or exchangeable for such shares.


         ARTICLE VII: REPRESENTATIONS AND WARRANTIES OF BUYER AND NEWCO

     Buyer and Newco jointly and severally  represent and warrant to Arcadia and
the Principal Sellers as follows:

     7.1  ORGANIZATION  AND  STANDING.  Buyer is a corporation  duly  organized,
validly  existing and in good standing  under the laws of the State of Delaware.
Newco is a corporation  duly  organized,  validly  existing and in good standing
under the laws of the State of Delaware.

     7.2 POWER AND AUTHORITY.  Buyer and Newco each have the corporate power and
authority to execute, deliver and perform this Agreement, and as of the Closing,
Buyer and Newco will have the  corporate  power and  authority  to  execute  and
deliver  the  Transaction  Documents  required  to be  delivered  by them to the
Principal Sellers at the Closing.

     7.3 BINDING AGREEMENT.  This Agreement has been duly executed and delivered
by Buyer and Newco.  This Agreement is, and when executed and delivered by Buyer
and Newco at the Closing each of the Transaction Documents executed by Buyer and
Newco will be,  the legal,  valid and  binding  obligations  of Buyer and Newco,
enforceable against Buyer and Newco in accordance with their respective terms.


                                       26

<PAGE>



     7.4 ABSENCE OF CONFLICTING AGREEMENTS. Neither the execution or delivery of
this  Agreement or any of the  Transaction  Documents by Buyer and Newco nor the
performance by the Buyer and Newco of the transactions  contemplated  hereby and
thereby  conflicts  with, or  constitutes a breach of or a default under (i) the
formation  documents of the Buyer and Newco,  or (ii) any law,  rule,  judgment,
order, writ,  injunction,  or decree of any court currently in effect applicable
to Buyer and Newco,  provided  that the  consents  set forth in Schedule 7.5 are
obtained  prior  to  the  Closing,  or  (iii)  any  rule  or  regulation  of any
administrative  agency  or other  governmental  authority  currently  in  effect
applicable to Buyer and Newco,  or (iv) any  agreement,  indenture,  contract or
instrument  to which  the  Buyer or Newco is now a party or by which  any of the
assets of the Buyer or Newco is bound.

     7.5  CONSENTS.  Except  as set forth on  Schedule  7.5,  no  authorization,
consent, approval,  license, exemption by, filing or registration with any court
or   governmental   department,    commission,    board,   bureau,   agency   or
instrumentality, domestic or foreign, is or will be necessary in connection with
the  execution,  delivery  and  performance  of  this  Agreement  or  any of the
Transaction Documents by Buyer and Newco.

     7.6 SECURITIES AND EXCHANGE COMMISSION FILINGS. Buyer has made available to
the  Principal  Sellers a correct and complete  copy of each  report,  schedule,
registration  statement and definitive  proxy  statement filed by Buyer with the
Commission on or after January 1, 1996 (the "SEC Documents"),  which are all the
documents (other than preliminary material) that Buyer was required to file with
the SEC on or after January 1, 1996. As of their respective  dates,  none of the
SEC  Documents  (including  all exhibits  and  schedules  thereto and  documents
incorporated by reference  therein) contained any untrue statements or omissions
of a  material  fact  necessary  so as  not to  render  the  statements  therein
misleading,  in light of the  circumstances  under which they were made, and the
SEC  Documents  complied  when  filed  in all  material  respects  with the then
applicable  requirements  of the Securities Act or the Exchange Act, as the case
may be. The  financial  statements  of the Buyer  included in the SEC  Documents
complied  in  all  material   respects  with  the  then  applicable   accounting
requirements  and the published  rules and  regulations of the  Commission  with
respect  thereto,  were  prepared  in  accordance  with GAAP  during the periods
involved (except as may have been indicated in the notes thereto or, in the case
of the unaudited  statements,  as permitted by Form 10-Q promulgated by the SEC)
and fairly present (subject, in the case of the unaudited statements, to normal,
recurring audit  adjustments) the consolidated  financial  position of the Buyer
and its  consolidated  subsidiaries as at the dates thereof and the consolidated
results of their operations and cash flows for the periods then ended.

     7.7 CAPITAL STOCK. Buyer's Form 10-Q filed with the Commission with respect
to the fiscal quarter ended March 31, 1997 (the "Form 10-Q"),  sets forth a true
and complete  description of the authorized  and  outstanding  shares of capital
stock of Buyer as of such date. All outstanding  shares of IHS Stock are validly
issued,  fully paid and  non-assessable  and not subject to  preemptive  rights.
Buyer has duly  authorized  and reserved for issuance the IHS Stock,  and,  when
issued  in  accordance  with the terms of  Article  III,  the IHS Stock  will be
validly issued,  fully paid and  nonassessable  and free and clear of preemptive
rights, liens, encumbrances, claims and other charges thereon.


                                       27

<PAGE>



          ARTICLE VIII: INFORMATION AND RECORDS CONCERNING ARCADIA AND
                                ITS SUBSIDIARIES

     8.1 ACCESS TO INFORMATION AND RECORDS BEFORE CLOSING.  Prior to the Closing
Date,  Buyer may make, or cause to be made, such  investigation of Arcadia's (it
being understood that, for the purpose of this Article VIII,  "Arcadia" shall be
deemed to refer collectively to Arcadia and its subsidiaries  listed on Schedule
5.23)  financial  and legal  condition as Buyer deems  necessary or advisable to
familiarize  itself  with  Arcadia  and/or  matters  relating  to its history or
operations.  Arcadia  shall  permit  Buyer  and its  authorized  representatives
(including  legal  counsel and  accountants),  to have full access to  Arcadia's
books and records upon reasonable  notice and during normal business hours,  and
Arcadia will  furnish,  or cause to be  furnished,  to Buyer such  financial and
operating  data and other  information  and copies of documents  with respect to
Arcadia's products, services,  operations and assets as Buyer shall from time to
time  reasonably  request.  The documents to which Buyer shall have access shall
include,  but not be limited to,  Arcadia's  tax returns and related work papers
since their  inception;  and Arcadia shall make,  or cause to be made,  extracts
thereof  as Buyer or their  representatives  may  request  from  time to time to
enable Buyer and their representatives to investigate the affairs of Arcadia and
the  accuracy of the  representations  and  warranties  made in this  Agreement.
Arcadia shall cause its  accountants to cooperate with Buyer and to disclose the
results of audits relating to Arcadia and to produce the working papers relating
thereto.  Without  limiting any of the  foregoing,  it is agreed that Buyer will
have full access to any and all  agreements  between and among the  previous and
current  shareholders  regarding  their ownership of shares or the management or
operation of Arcadia.


              ARTICLE IX: OBLIGATIONS OF THE PARTIES UNTIL CLOSING

     9.1 CONDUCT OF BUSINESS PENDING CLOSING. Between the date of this Agreement
and the Closing, Arcadia and its subsidiaries shall maintain their existence and
shall conduct their  businesses in the customary and ordinary course of business
consistent with past practice.

     9.2 NEGATIVE  COVENANTS OF ARCADIA AND ITS SUBSIDIARIES.  Without the prior
written approval of Buyer,  neither Arcadia nor any of its  subsidiaries  shall,
between the date hereof and the Closing:

       (A) cause or permit to occur any of the events or  occurrences  described
in Section 5.18 (Absence of Certain Events) of this Agreement;

       (B) dissolve, merge or enter into a share exchange with or into any other
entity;

       (C)  enter  into  any  contract  or  agreement  with  any  union or other
collective  bargaining  representative  representing any employees or affiliates
without  the  prior  written  consent  of  Buyer,  which  consent  shall  not be
unreasonably withheld;


                                       28

<PAGE>



       (D) sell off any Assets other than in the ordinary course of business; or

       (E) make any change to their by-laws or articles of incorporation.

     9.3 AFFIRMATIVE COVENANTS. Between the date hereof and the Closing, Arcadia
and each of its subsidiaries shall:

       (A) maintain their businesses in substantially  the same state of repair,
order and condition as on the date hereof,  reasonable  wear and tear or loss by
casualty excepted;

       (B)  maintain in full force and effect all  Licenses  currently in effect
with respect to their businesses  unless such License is no longer necessary for
the operation of Arcadia and its subsidiaries;

       (C) maintain in full force and effect the insurance  policies and binders
currently in effect, or the replacements  thereof,  including without limitation
those listed on Schedule 5.16;

       (D)  utilize  their  reasonable  efforts to  preserve  intact the present
business  organization  of Arcadia  and its  subsidiaries;  keep  available  the
services of Arcadia's and its subsidiaries'  present  employees,  affiliates and
agents; and maintain Arcadia's and its subsidiaries' relations and goodwill with
suppliers,  employees,  affiliates,  affiliated medical personnel and any others
having business relating to Arcadia and its subsidiaries;

       (E) maintain all of the books and records in  accordance  with their past
practices;

       (F) comply in all respects with all provisions of the Contracts listed in
Schedule  5.7 and  with any  other  material  agreements  that  Arcadia  and its
subsidiaries have entered into in the ordinary course of business since the date
of this  Agreement,  and  comply  in all  respects  with the  provisions  of all
material  laws,   rules  and   regulations   applicable  to  Arcadia's  and  its
subsidiaries' businesses;

       (G) cause to be paid when due,  all  taxes,  assessments  and  charges or
levies  imposed  upon  them or on any of their  properties  for  which  they are
required to withhold and pay over;

       (H)  promptly  advise  Buyer in  writing  of the  threat or  commencement
against Arcadia or its subsidiaries or affiliates of any claim,  action, suit or
proceeding,   arbitration  or  investigation  or  any  other  event  that  would
materially adversely affect the operations,  properties,  assets or prospects of
Arcadia or its subsidiaries or affiliates;


                                       29

<PAGE>



       (I) notify the Buyer in  writing  of any event  involving  Arcadia or its
subsidiaries or affiliates which has had or may be reasonably expected to have a
material adverse effect on the business or financial condition of Arcadia or its
subsidiaries  or affiliates or may involve the loss of contracts  with Arcadia's
or its subsidiaries' customers; and

       (J) provide monthly financial  statements of Arcadia and its subsidiaries
within  twenty (20) days of the month end prepared in  accordance  with GAAP and
consistent with past practices.

     9.4 PURSUIT OF CONSENTS AND  APPROVALS.  Prior to the Closing,  Buyer shall
use its reasonable  efforts to obtain all consents and approvals of governmental
agencies and all other  parties  necessary  for the lawful  consummation  of the
transactions  contemplated hereby and the lawful use, occupancy and enjoyment of
Arcadia's  and its  subsidiaries'  businesses  by Buyer in  accordance  herewith
("Required  Approvals").  Arcadia and its subsidiaries  shall cooperate with and
use their reasonable efforts to assist Buyer in obtaining all such approvals.

     9.5  EXCLUSIVITY.  Until the earlier of Closing or the  termination of this
Agreement pursuant to Section 13.1, neither Arcadia nor any Shareholder, nor any
of their respective  affiliates,  shall enter into any agreement,  commitment or
understanding  with  respect to, or engage in any  discussions  or  negotiations
directly or indirectly with, or encourage or respond to any solicitations  from,
any other  party with  respect to the sale,  lease or  management  of any of the
Assets, or in respect of the sale of any shares of capital stock in Arcadia.


             ARTICLE X: CONDITIONS PRECEDENT TO BUYER'S OBLIGATIONS

     Buyer's and Newco's obligations to consummate the Merger are subject to the
fulfillment,  prior to or at the Closing,  of each of the following  conditions,
any one or more of which  may be  waived  by Buyer  or  Newco in  writing.  Upon
failure of any of the following  conditions,  Buyer and Newco may terminate this
Agreement pursuant to and in accordance with Article XIII herein.

     10.1 REPRESENTATIONS AND WARRANTIES.  The representations and warranties of
Arcadia and Principal  Sellers made pursuant to this Agreement shall be true and
correct in all material  respects at and as of the Closing  Date, as though such
representations  and  warranties  were made at and as of such time except to the
extent affected by the transactions herein contemplated.

     10.2  PERFORMANCE OF COVENANTS.  Each of the Principal  Sellers and Arcadia
shall have performed or complied in all material  respects with their respective
agreements and covenants  required by this Agreement to be performed or complied
with by it prior to or at the Closing.


                                       30

<PAGE>



     10.3 DELIVERY OF CLOSING  CERTIFICATE.  Each of the  Principal  Sellers and
Arcadia  shall  have  executed  and  delivered  to  Buyer a  certificate  of its
president,  dated  the  Closing  Date,  upon  which  Buyer  and  Newco may rely,
certifying that the conditions contemplated by Sections 10.1 and 10.2 applicable
to it have been satisfied.

     10.4  OPINION OF COUNSEL.  Each  Principal  Seller and  Arcadia  shall have
delivered  to Buyer  and Newco an  opinion,  dated the  Closing  Date,  of their
counsel, in substantially the form attached hereto as Exhibit 10.4.

     10.5 LEGAL MATTERS.  No preliminary or permanent  injunction or other order
(including a temporary  restraining  order) of any governmental  authority which
prevents the  consummation  of the  transactions  contemplated by this Agreement
shall have been issued and remain in effect.

     10.6  AUTHORIZATION  DOCUMENTS.  Buyer shall have received a certificate of
the  Secretary or other  officer of Arcadia  certifying as of the Closing Date a
copy of  resolutions  of the  Shareholders  and of Arcadia's  board of directors
authorizing   Arcadia's  execution  and  full  performance  of  the  Transaction
Documents and the incumbency of Arcadia's respective officers.

     10.7 MATERIAL  CHANGE.  Since the date of the March 31 Balance Sheets there
shall not have been any material  adverse change in the condition  (financial or
otherwise)  of  the  assets,   properties  or  operations  of  Arcadia  and  its
subsidiaries.

     10.8 APPROVALS.

       (A) The consent or approval of all persons necessary for the consummation
of the  transactions  contemplated  hereby  shall have been  granted,  including
without limitation, the Required Approvals;

       (B) None of the  foregoing  consents  or  approvals  (i) shall  have been
conditioned upon the  modification,  cancellation or termination of any material
lease,  contract,  commitment,  agreement,  license,  easement,  right  or other
authorization with respect to Arcadia's and its subsidiaries' businesses,  other
than as  disclosed or approved  hereunder,  or (ii) shall impose on the Buyer or
Newco any  material  condition  or  provision  or  requirement  with  respect to
Arcadia's  and its  subsidiaries'  businesses  or their  operation  that is more
restrictive  than or different from the  conditions  imposed upon such operation
prior to Closing.

     10.9 CONSENTS.  Buyer shall have received the written consent to assignment
for each of the Retained Contracts set forth on Schedule 2.6, where such consent
is required  by reason of the change of control of Arcadia and its  subsidiaries
contemplated under this Agreement.

     10.10 ESTIMATED  CLOSING DATE BALANCE SHEET.  Principal Sellers and Arcadia
shall have delivered the Estimated Closing Date Balance Sheet to Buyer.


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<PAGE>



     10.11 REAL PROPERTY CONSENTS.  Arcadia and the Principal Sellers shall have
used their best  efforts to obtain the  written  consent to  assignment  of each
landlord  with  whom  Arcadia  or any of its  subsidiaries  has a lease  of real
property  which,  by its  terms,  requires  consent  in the event of a change of
control of Arcadia,  and the written  consent of such landlords  shall have been
received by the Buyer.  Alternatively,  Arcadia and Principal Sellers shall have
delivered a waiver from each such landlord of any provision  contained in any of
such leases which would  require the  landlord's  consent upon any change of the
voting stock of the tenant.  Buyer shall have received notice from the Principal
Sellers by the Closing  Date,  identifying  any landlord  that has not given any
necessary consent as of such date.

     10.12  ARCADIA'S  SUBSIDIARIES  AND OPTIONS.  Each of the  subsidiaries  of
Arcadia as of the  Closing  Date will be one  hundred  (100%)  percent  owned by
Arcadia and there shall not be  outstanding  as of the Closing Date any options,
warrants  or rights  for the  purchase  of any  capital  stock of Arcadia or its
subsidiaries  or any  obligations  to grant or issue any  options,  warrants  or
rights for the purchase of any capital stock of Arcadia or its subsidiaries.

     10.13 BOARD APPROVALS.  The Buyer will have received all necessary Board of
Director approvals.

     10.14  HART-SCOTT-RODINO.  All applicable  filings ("H-S-R  Filings") shall
have been made and all  applicable  waiting  periods  shall have expired or been
terminated under the  Hart-Scott-Rodino  Antitrust  Improvement Act of 1976 (the
"H-S-R Act").

     10.15  EMPLOYMENT  AGREEMENTS.   Cameron  Hosner,  James  Bellinson,   Gary
Dabkowski,  Herbert  Graebner and Leonard  Bellinson shall have terminated their
existing  employment  agreements and any ongoing obligations  thereunder.  James
Bellinson  shall have executed and delivered to Buyer his  employment  agreement
and Cathy  Sparling  shall have  executed  and  delivered  to Buyer her  amended
employment  agreement,  upon such  terms  and  conditions  as shall be  mutually
acceptable to the parties in the form of Exhibit  10.15 hereto (the  "Employment
Agreements").

     10.16 REQUIRED TRANSACTIONS. Arcadia shall have consummated the acquisition
of two agencies located in Grand Rapids, Michigan and Lansing,  Michigan.  Also,
Arcadia  will have  transferred  to a  liquidating  trust for the benefit of the
Shareholders its joint venture  interest in C.R.K.  and such  liquidating  trust
shall have assumed all of Arcadia's  liabilities  in connection  with  Arcadia's
joint venture interest in C.R.K.

     10.17 TERMINATION OF NON-RETAINED AGREEMENTS. All Contracts, other than the
Retained  Contracts,  shall  have  been  terminated,  as  well  as  any  ongoing
obligations thereunder.

     10.18  ESCROW  AGREEMENTS.   The  Principal  Sellers,   on  behalf  of  the
Shareholders, shall have executed and delivered each of the Escrow Agreements in
the form of Exhibits 2.3 and 2.4.


                                       32

<PAGE>



     10.19  TERMINATION  OF  CERTAIN  CONTRACTS.   All  plans,   agreements  and
arrangements set forth on Schedule  5.7(b),  except the Longevity Award Program,
shall have been terminated.

     10.20 GRAYROSE. Grayrose shall be a wholly-owned subsidiary of Arcadia.

     10.21 STOCK  CERTIFICATES.  Shareholders  shall have delivered to Buyer all
stock certificates representing Arcadia Stock duly endorsed in blank.

     10.22 DISSENTER'S  RIGHTS.  All dissenting shares of Arcadia Stock, if any,
shall not  constitute in the  aggregate  more than one (1%) percent of the total
issued and outstanding shares of Arcadia Stock.

     10.23 CAPTIVE INSURANCE. Shareholders shall have used their best efforts to
sell to an A-rated insurance carrier all liabilities and obligations,  including
but not limited to Incurred  But Not Recorded  liabilities  in  connection  with
worker's  compensation  claims that are processed through the Captive Insurance.
In the event the  Shareholders are unable to sell said liabilities in connection
with the Capture  Insurance to an A-rated insurance carrier by the Closing Date,
Shareholders shall increase the Escrow Deposit referenced in Section 2.3 to such
amount that is mutually satisfactory to Buyer and Principal Sellers.

     10.24  OTHER  DOCUMENTS.  The  Principal  Sellers  and  Arcadia  shall have
furnished  Buyer and  Newco  with all other  documents,  certificates  and other
instruments required to be furnished to Buyer and Newco by the Principal Sellers
and Arcadia pursuant to the terms hereof.


             ARTICLE XI: CONDITIONS PRECEDENT TO PRINCIPAL SELLERS'
                                   OBLIGATIONS

     Principal  Sellers'  obligation to consummate  the Merger is subject to the
fulfillment,  prior to or at the Closing,  of each of the following  conditions,
any one or more of which may be waived by  Principal  Sellers in  writing.  Upon
failure of any of the following conditions, Principal Sellers may terminate this
Agreement pursuant to and in accordance with Article XIII herein:

     11.1 REPRESENTATIONS AND WARRANTIES.  The representations and warranties of
Buyer and Newco in this Agreement shall be true at and as of the Closing Date as
though such  representations  and  warranties  were made at and as of such time,
except to the extent affected by the transactions herein contemplated.

     11.2  PERFORMANCE  OF  COVENANTS.  Buyer and Newco shall have  performed or
complied with each of its agreements  and conditions  required by this Agreement
to be performed or complied with by it prior to or at the Closing.


                                       33

<PAGE>



     11.3 DELIVERY OF CLOSING CERTIFICATE.  Buyer and Newco shall have delivered
to Principal  Sellers a certificate  of an executive or senior vice president of
Buyer and Newco dated the Closing  Date upon which  Principal  Sellers can rely,
certifying that the conditions contemplated by Sections 11.1 and 11.2 applicable
to it have been satisfied.

     11.4 OPINION OF COUNSEL.  Buyer and Newco shall have delivered to Principal
Sellers an opinion,  dated the Closing Date, of Blass & Driggs,  Esqs.,  counsel
for Buyer and Newco, in the form attached as Exhibit 11.4.

     11.5 LEGAL MATTERS.  No preliminary or permanent  injunction or other order
(including a temporary  restraining  order) of any governmental  authority which
prevents the  consummation  of the  transactions  contemplated by this Agreement
shall have been issued and remain in effect.

     11.6  AUTHORIZATION  DOCUMENTS.  Principal  Sellers  shall have  received a
certificate  of the Secretary or other officer of Buyer and Newco  certifying as
of the  Closing  Date a copy  of  resolutions  of  their  respective  boards  of
directors  authorizing  their execution and full  performance of the Transaction
Documents and the incumbency of their officers.

     11.7  H-S-R  FILINGS.  The  H-S-R  Filing  shall  have  been  made  and all
applicable waiting periods shall have expired or been terminated under the H-S-R
Act.

     11.8  EMPLOYMENT  AGREEMENTS.   The  Buyer  shall  have  entered  into  the
Employment Agreements with James Bellinson and Cathy Sparling.

     11.9 ESCROW AGREEMENTS. Buyer shall have executed and delivered each of the
Escrow Agreements in the form of Exhibits 2.3 and 2.4.

     11.10  OTHER  DOCUMENTS.  Buyer and Newco  shall have  furnished  Principal
Sellers with all documents,  certificates and other  instruments  required to be
furnished to Principal Sellers by Buyer and Newco pursuant to the terms hereof.


                    ARTICLE XII: SURVIVAL AND INDEMNIFICATION

     12.1 SURVIVAL OF REPRESENTATIONS  AND WARRANTIES.  All  representations and
warranties  made by  each  party  in this  Agreement  and in each  Schedule  and
Transaction  Document shall survive the Closing Date and for a period of one (1)
year after the Closing, notwithstanding any investigation at any time made by or
on behalf of the other party,  provided that the  representations and warranties
contained in Section 5.25 (Medicare and Medicaid) and Section 5.21 (Tax),  shall
survive until thirty (30) days after the applicable  period of  limitations  for
audits by the applicable  Governmental  Authority shall have expired,  including
extensions for any necessary appeals. All representations and warranties related
to any claim  asserted  in writing  prior to the  expiration  of the  applicable
survival  period shall  survive (but only with respect to such claim) until such
claim shall be resolved and payment in respect thereof,  if any is owing,  shall
be made.


                                       34

<PAGE>



     12.2   INDEMNIFICATION  BY  SHAREHOLDERS  AND/OR  PRINCIPAL  SELLERS.   The
Shareholders  and/or Principal Sellers (as set forth herein) shall indemnify and
defend  Buyer  and hold it  harmless  against  and with  respect  to any and all
damage,  loss,  liability,  deficiency,  cost and  expense  (including,  without
limitation,  reasonable  attorney's  fees and  expenses)  (all of the  foregoing
hereinafter collectively referred to as "Loss") resulting from:

       (A) any inaccuracy in any  representation or certification,  or breach of
any warranty,  made by any of the Principal  Sellers or Arcadia pursuant to this
Agreement; or

       (B) the breach of any  covenant or  undertaking  by any of the  Principal
Sellers or Arcadia contained in this Agreement which survives the Closing and is
not waived by Buyer at or prior to the Closing; or

       (C) the  ownership or operation of Arcadia or its  subsidiaries  or their
business or assets prior to the Closing Date, including, without limitation, (i)
any Excess Reimbursement Liabilities (as defined in Section 2.6); (ii) any Taxes
resulting from the operation of the businesses of Arcadia or ownership of any of
the Assets for any period ending on or before the Closing  Date;  (iii) any Loss
arising out of the noncompliance of Arcadia with COBRA or any like statute; (iv)
any Loss  arising out of the failure to receive the refund claim within nine (9)
months  following  the  Closing  Date  (the  "Nine-Month   Period")  and/or  any
recoupment of any part of the refund claim  associated with the income tax carry
back provision through the period set forth in Section 12.4, below;  provided in
the event  Arcadia  receives any part of the refund  claim after the  Nine-Month
Period, Buyer shall reimburse  Shareholders for such portion of the refund claim
received by Arcadia to the extent  Shareholders  had  indemnified  Buyer for any
Loss pursuant to this Section 12.2(c)(iv);  (v) any Loss arising out of the sale
of Arcadia's  ownership  interest in Arcadia  Hospice,  Inc. to William Beaumont
Hospital;  (vi) any Loss arising out of the transfer of Arcadia's  joint venture
interest in C.R.K. to a liquidating  trust for the benefit of the  Shareholders;
(vii) any Loss  arising  out of the Captive  Insurance;  (viii) any claim of the
type that would be covered by a standard liability insurance policy,  including,
without  limitation,  professional  liability,  malpractice,  general liability,
automobile  liability,  worker's compensation or employer's liability insurance,
arising out of the operation of Arcadia's  businesses prior to the Closing Date,
including payments of any deductibles  applicable to the aforesaid policies,  to
the extent not covered by any existing  insurance  policy;  and (ix) any and all
actions, suits, proceedings,  demands, assessments,  judgments,  settlements (to
the extent approved by Arcadia,  such approval not to be unreasonably  withheld,
delayed  or  conditioned),  costs  and  legal  expenses  incident  to any of the
foregoing;  but excluding current liabilities and long-term liabilities that are
reflected on the  Estimated  Closing Date Balance  Sheet or that  otherwise  are
taken into account in any adjustment to the Merger  Consideration  under Section
2.2; or

       (D) any  prepayment  penalty,  premium,  or other  fees  which may become
payable by Arcadia by reason of the  termination  by Arcadia  after the  Closing
Date of its factoring lines with NPFII-W, Inc.


                                       35

<PAGE>



     Any claim for  indemnification  sought  against the  Shareholders  shall be
expressly  limited to the Escrow  Deposit.  If the amount of Loss is equal to or
less than  $1,500,000,  Buyer  shall  first  offset  such amount from the Escrow
Deposit.  If the Escrow  Deposit is  insufficient  to cover such Loss,  then the
Principal Sellers, jointly and severally, will indemnify and hold harmless Buyer
for the remaining amount of the Loss subject to the indemnity cap referred to in
Section 12.5.

       (E) To the extent not otherwise satisfied by the General  Indemnification
Fund, the Principal Sellers will each personally indemnify Buyer for any Loss in
an amount up to $200,000 (in an aggregate  amount up to $400,000) in  connection
with the McClain,  McWilliams  and Brown  matters  listed on Schedule  5.12 (the
"Litigation  Matters").  Such  indemnification  by Principal Sellers pursuant to
this Section 12.2(e) shall only apply to Loss arising from punitive  damages not
otherwise covered by insurance.  Furthermore,  such indemnification  pursuant to
this  Section  12.2(e)  shall not be  subject  to the  indemnity  basket and cap
referenced   in   Section   12.5,   below.   Additionally,   Buyer's   right  to
indemnification  under this Section 12.2(e) shall survive until thirty (30) days
after the applicable statute of limitations for commencing any legal proceedings
arising out of the  applicable  Litigation  Matter shall have lapsed.  The total
aggregate  obligations  of the  Principal  Sellers  shall  not  exceed  $400,000
pursuant to this Section 12.2(e).

     12.3   INDEMNIFICATION   BY  BUYER.   Buyer  shall   indemnify  and  defend
Shareholders and hold them harmless against and with respect to any and all Loss
resulting from:

       (A) any inaccuracy in any  representation or certification,  or breach of
any warranty, made by Buyer pursuant to this Agreement; or

       (B) the breach of any covenant or undertaking by Buyer which survives the
Closing  and is not  waived by  Principal  Sellers or Arcadia at or prior to the
Closing; or

       (C) the  ownership or operation of Arcadia or its  subsidiaries  or their
business or assets on or after the Closing Date.

     12.4  ASSERTION OF CLAIMS.  Any claims for  indemnification  under Sections
12.2(a)  or 12.3(a)  must be  asserted  by written  notice by a date which is no
later than one (1) year following the Closing Date,  except that any claim based
upon a breach of the  representations  and warranties  contained in Section 5.25
(Medicare and Medicaid) or Section 5.21 (Tax) may be asserted  until thirty (30)
days after the  applicable  period of  limitations  for audits by the applicable
Governmental  Authority  shall  have  expired,   including  extensions  for  any
necessary appeals.

     12.5 INDEMNITY BASKET AND CAP.  Notwithstanding any other provision of this
Article XII, no claim for indemnification made under Sections 12.2(a) or 12.3(a)
shall be made unless and until Buyer or  Shareholders/Principal  Sellers, as the
case may be, have  incurred  Loss in excess of One Hundred  Thousand  ($100,000)
Dollars in the aggregate, in which case, the party seeking indemnification shall
be entitled  to assert  claims  including  such  initial  One  Hundred  Thousand
($100,000)  Dollars.  The maximum aggregate  liability for any Loss arising from
claims for  indemnification  pursuant to Sections 12.2(a) or 12.3(a)  (excluding
any Loss arising from


                                       36

<PAGE>



fraud,  Tax liability,  and Excess  Reimbursement  Liabilities) of the Principal
Sellers or Buyer,  respectively,  for indemnification hereunder shall not exceed
an amount equal to Fourteen  Million Two Hundred  Fifty  Thousand  ($14,250,000)
Dollars.

     12.6  CONTROL  OF  DEFENSE  OF  INDEMNIFIABLE  CLAIMS.  Any  party  seeking
indemnification  under this  Agreement (an  "Indemnitee")  shall give each party
from whom  indemnification is sought (an "Indemnitor")  prompt written notice of
the claim for which it seeks indemnification.  Failure of the Indemnitee to give
such  prompt  notice  shall not  relieve an  Indemnitor  of its  indemnification
obligation,  provided that such  indemnification  obligation shall be reduced by
any damages  suffered by the Indemnitor  resulting from a failure to give prompt
notice  hereunder.  All  Indemnitors  shall be  entitled to  participate  in the
defense of such claim.  If at any time the  Indemnitor  acknowledges  in writing
that the claim is fully  Indemnifiable  under this Agreement,  it shall have the
right to assume total control of the defense of such claim (other than claims in
connection with Excess Reimbursement  Liabilities or Section 5.25 which it shall
not  control  but be  entitled to  participate  in) at its own  expense.  If all
Indemnitors  do not assume total control of the defense of any such claim (or in
the case of  claims in  connection  with  Excess  Reimbursement  Liabilities  or
Section  5.25),  the  Indemnitee  agrees not to settle  such claim  without  the
written  consent of all  Indemnitors  which  consent  shall not be  unreasonably
withheld. Nothing contained in this Section 12.6 shall prevent either party from
assuming total control of the defense  and/or  settling any claim against it for
which indemnification is not sought under this Agreement.

     12.7 RESTRICTIONS.

       (A) From and after the Closing Date, none of the Principal  Sellers shall
disclose,  directly  or  indirectly,  to any person  outside  of Buyer's  employ
without the express  authorization  of the Buyer,  any patient  lists,  customer
lists,  pricing  strategies,  customer  files,  or patient  files and records of
Arcadia and its  subsidiaries,  any  proprietary  data or trade secrets owned by
Arcadia and its subsidiaries or any financial or other information about Arcadia
and its  subsidiaries  not then in the public domain;  provided,  however,  that
Principal Sellers shall be permitted to make such disclosures as may be required
by law or by a court or governmental authority.

       (B) After the Closing Date, none of the Principal Sellers shall engage or
participate  in any  effort or act to induce any of the  customers,  physicians,
suppliers,  associates,  employees,  affiliates,  or independent  contractors of
Arcadia and its  subsidiaries to cease doing business,  or their  association or
employment, with Arcadia and its subsidiaries.

       (C) No Principal  Seller shall,  for a period of five (5) years after the
Closing Date, directly, or indirectly, for or on behalf of himself or herself or
any  other  person,  firm,  entity or other  enterprise,  be  employed  by, be a
director  or manager  of,  act as a  consultant  for,  be a partner  in,  have a
proprietary  interest in, give advice to, loan money to or  otherwise  associate
with, in a business fashion, any person, enterprise,  partnership,  association,
corporation,  joint  venture or other entity which is directly or  indirectly in
the business of owning, operating


                                       37

<PAGE>



or managing any entity of any type, licensed or unlicensed,  which is engaged in
or provides home health care and medical, clerical and light industrial staffing
services or in any way competes with Arcadia or its subsidiaries anywhere within
the counties where Arcadia or its subsidiaries currently operate.

       (D) The Principal Sellers acknowledge that the restrictions  contained in
this  Section  12.7 are  reasonable  and  necessary  to protect  the  legitimate
business  interests of Buyer and that any violation thereof by any of them would
result in irreparable harm to Buyer.  Accordingly,  Principal Sellers agree that
upon the violation by any of them of any of the  restrictions  contained in this
Section  12.7,  Buyer shall be  entitled  to obtain from any court of  competent
jurisdiction a preliminary and permanent  injunction as well as any other relief
provided at law or equity,  under this Agreement or otherwise.  In the event any
of the foregoing restrictions are adjudged unreasonable in any proceeding,  then
the parties agree that the period of time or the scope of such  restrictions (or
both)  shall be  adjusted  in such a manner  or for such a time (or  both) as is
adjudged to be reasonable.

     Notwithstanding  the  foregoing,  for  purposes of this Section  12.7,  any
advertisement  prepared  for and  disseminated  to the public in general,  which
advertises  the services of the Principal  Sellers not otherwise in violation of
this  Section  12.7 or  advertises  the need for  services to be supplied to the
Principal Sellers,  shall not be deemed to be an inducement or solicitation with
respect to any such patients, physicians,  suppliers,  employees,  affiliates or
independent contractors.

     12.8  RECORDS.  On the Closing  Date,  Principal  Sellers and Arcadia shall
deliver,  or cause to be  delivered,  to Buyer all records and files not then in
Buyer's possession relating to the operations of Arcadia and its subsidiaries.

     12.9 BUYER'S AFFIRMATIVE COVENANTS.

       (A) Buyer  agrees to pay an amount up to $100,000  (which  amount will be
accrued for on the Estimated  Closing Date Balance Sheet) for  attorney's  fees,
costs and expenses in connection with the Arizona Litigation.

       (B) Buyer  agrees to retain  Steven  Graebner in its employ for a minimum
period of one (1) year following the Closing Date at his current salary level.

     12.10  DISSENTERS'  RIGHTS.  In the event that any holder of Arcadia  Stock
asserts  dissenter's  rights  with  respect  to the  Merger  under the  Michigan
Business  Corporation  Act,  the  Shareholders,  jointly  and  severally,  shall
indemnify and hold harmless  Buyer from and against (i) any amount which becomes
payable to such holder by Arcadia in satisfaction of such dissenter  rights,  to
the extent that such amount  exceeds  the Merger  Consideration  that would have
been payable to such holder had such holder not exercised his or her dissenter's
rights,  and (ii) any costs or expenses,  including  reasonable  attorneys fees,
incurred by Arcadia in  investigating  or litigating  such  dissenters'  rights;
provided, however, that as a condition to the recovery of


                                       38

<PAGE>



attorneys fees and expenses,  Buyer shall provide prompt notice to the Principal
Sellers of any exercise of  dissenters'  rights and will permit  Shareholders  a
reasonable  opportunity  to select and direct  counsel for Arcadia in respect of
the investigation and litigation of such rights.  The provisions of Section 12.5
shall not apply to any claim for indemnification under this Section 12.10.

     12.11 SPECIAL  PROVISIONS WITH REGARD TO INDEMNIFICATION OF REPRESENTATIONS
AND  WARRANTIES.   Buyer  hereby   acknowledges  that  in  connection  with  the
indemnification  by the  Principal  Sellers of  representations  and  warranties
contained in this Agreement,  that their ability to provide such indemnification
is dependent in part upon the  availability of the books and records  maintained
by Arcadia up and through the Closing  Date.  It is therefore a condition to the
indemnification   obligations   of  the   Principal   Sellers  with  respect  to
representations  and warranties  contained herein,  that Buyer preserve and make
available through the entire  indemnification  period, all records maintained by
Arcadia up to the Closing  Date.  In addition,  it is hereby  acknowledged  that
certain Medicare and Medicaid cost reports for the year ended June 30, 1997, and
for the stub period from June 30, 1997 through the Closing Date will be prepared
and  filed   subsequent   to  the  Closing  Date  (the  "Cost   Reports").   The
indemnification  obligations of the Principal Sellers pursuant to this Agreement
necessarily  include matters set forth in the Cost Reports.  Buyer hereby agrees
that it is necessary and appropriate that the Principal  Sellers be permitted to
examine and provide consultation on the Cost Reports in a timely manner prior to
the time they are submitted to the respective  agencies.  It is therefore agreed
that as a condition to providing indemnification to Buyer for the period covered
by the Cost Reports,  that the Principal  Sellers consent to the contents of the
Cost Reports which consent will not be unreasonably withheld or delayed.


                            ARTICLE XIII: TERMINATION

     13.1 TERMINATION.  This Agreement may be terminated at any time at or prior
to the Closing by:

       (A) Buyer or Newco,  if any  condition  precedent  to  Buyer's or Newco's
obligations  hereunder,  including without limitation those conditions set forth
in Article X hereof,  have not been satisfied by the Closing Date or pursuant to
Section 14.1 if any portion of the Assets is damaged or destroyed as a result of
fire, other casualty or for any reason whatsoever;

       (B) Principal Sellers,  if any condition  precedent to the obligations of
any Principal Seller or Arcadia  hereunder,  including without  limitation those
conditions  set forth in  Article  XI  hereof,  have not been  satisfied  by the
Closing Date; or

       (C) the mutual consent of Buyer, Newco and Principal Sellers.


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<PAGE>



     13.2 EFFECT OF TERMINATION.  If a party  terminates this Agreement  because
one of its conditions precedent has not been fulfilled,  or if this Agreement is
terminated by mutual consent,  or if it is terminated  pursuant to Section 14.1,
this Agreement  shall become null and void without any liability of any party to
the  other;  provided,  however,  that if such  termination  is by reason of the
breach by any party of any of its  representations,  warranties  or  obligations
under this  Agreement,  the other party shall be entitled to be indemnified  for
any Losses  incurred  by it by reason  thereof in  accordance  with  Article XII
hereof (and for such purposes such Article XII shall survive the  termination of
this  Agreement).  Further,  nothing in this Section  13.2 shall affect  Buyer's
right to  specific  performance  of the  obligations  of Arcadia  and  Principal
Sellers at Closing hereunder.

                       ARTICLE XIV: CASUALTY, RISK OF LOSS

     14.1 CASUALTY,  RISK OF LOSS.  Arcadia and Principal Sellers shall bear the
risk of all loss or damage to any of the  Assets  from all  causes  which  occur
prior to the  Closing.  If at any time prior to the  Closing  any portion of the
Assets is damaged or  destroyed as a result of fire,  other  casualty or for any
reason  whatsoever,  Arcadia and Principal Sellers shall immediately give notice
thereof  to  Buyer.  Buyer  shall  have the  right,  in its  sole  and  absolute
discretion,  within ten (10) days of receipt of such notice, to (1) elect not to
proceed with the Closing and terminate this Agreement, or (2) proceed to Closing
and  consummate  the  transactions  contemplated  hereby and receive any and all
insurance  proceeds received or receivable by any Principal Seller or Arcadia on
account of any such casualty. Nothing contained in this Section 14.1 shall limit
or adversely affect the right of Buyer to receive indemnification for any Losses
incurred  by either of them by reason of any breach by any  Principal  Seller or
Arcadia of any  representation,  warranty or obligation  under this Agreement in
accordance  with  Section 12.2 hereof (and for such  purposes  such Section 12.2
shall survive the termination of this Agreement).


                            ARTICLE XV: MISCELLANEOUS

     15.1 COSTS AND  EXPENSES.  Except for Buyer bearing all of the fees for the
H-S-R  Filings and as expressly  otherwise  provided in this  Agreement,  Buyer,
Newco  and  Principal  Sellers  shall  bear  their own  costs  and  expenses  in
connection  with  this  Agreement  and  the  transactions  contemplated  hereby;
provided,  however,  that no such costs and expenses shall be charged to Arcadia
and its subsidiaries.

     15.2 PERFORMANCE.  In the event of a breach by any party of its obligations
hereunder,  the other  party  shall have the  right,  in  addition  to any other
remedies which may be available,  to obtain specific performance of the terms of
this Agreement, and the breaching party hereby waives the defense that there may
be an adequate  remedy at law. Should any party default in its  performance,  or
other  remedy,  the  prevailing  party  shall  be  entitled  to  its  reasonable
attorneys' fees.


                                       40

<PAGE>



     15.3 BENEFIT AND ASSIGNMENT. This Agreement binds and inures to the benefit
of each party hereto and its successors and proper assigns.  Buyer and Newco may
not assign their  interests  under this  Agreement to any other person or entity
without the prior written consent of Principal Sellers; provided,  however, that
Buyer and Newco may assign their rights, duties and obligations hereunder to one
or more  subsidiaries or affiliates of Buyer;  and further  provided that in the
instance of such assignment Buyer shall guaranty the performance of its assignee
hereunder.

     15.4 EFFECT AND  CONSTRUCTION  OF THIS  AGREEMENT.  This  Agreement and the
Exhibits and Schedules hereto embody the entire  agreement and  understanding of
the  parties  and  supersede  any and all  prior  agreements,  arrangements  and
understandings relating to matters provided for herein. The captions used herein
are for  convenience  only and  shall  not  control  or affect  the  meaning  or
construction of the provisions of this Agreement. This Agreement may be executed
in one or more counterparts,  and all such counterparts shall constitute one and
the same instrument.

     15.5  COOPERATION  - FURTHER  ASSISTANCE.  From  time to time,  as and when
reasonably  requested by any party hereto after the Closing,  the other  parties
will (at the expense of the requesting  party) execute and deliver,  or cause to
be executed and delivered, all such documents, instruments and consents and will
use reasonable efforts to take all such action as may be reasonably requested or
necessary to carry out the intent and purposes of this Agreement, and to vest in
Buyer good title to, possession of and control of all of the Assets.

     15.6  NOTICES.  All notices  required or  permitted  hereunder  shall be in
writing  and  shall be  deemed  to be  properly  given or made  when  personally
delivered to the party or parties  entitled to receive the notice or within five
(5) days when sent by certified or registered mail,  postage prepaid,  or on the
next  business  day if sent for next day  delivery  by a  nationally  recognized
overnight  courier,  in either case,  properly addressed to the party or parties
entitled to receive such notice at the address stated below:

If to Arcadia:                   Herbert Graebner
                                 33 Boulder Lane
                                 Bloomfield Hills, MI 48304

                                 Leonard Bellinson
                                 7403 Via De Fortuna
                                 Carlsbad, CA 92009

If to the Principal Sellers
and the Committee:               Herbert Graebner
                                 33 Boulder Lane
                                 Bloomfield Hills, MI 48304



                                     41

<PAGE>



                                 Leonard Bellinson
                                 7403 Via De Fortuna
                                 Carlsbad, CA 92009

with a copy to:                  Lawrence S. Jackier, Esq.
                                 Michael J. Eizelman, Esq.
                                 Jackier, Gould, Bean, Upfal, Eizelman & Goldman
                                 1533 North Woodward Avenue, Suite 250
                                 Bloomfield Hills, MI 48304

If to Newco:                     Integrated AG Acquisition, Inc.
                                 10065 Red Run Boulevard
                                 Owings Mills, MD 21117
                                 Attn:   Brian K. Davidson
                                         Elizabeth B. Kelly
                                 cc:     Marshall A. Elkins, General Counsel

If to the Buyer:                 Integrated Health Services, Inc.
                                 10065 Red Run Boulevard
                                 Owings Mills, MD 21117
                                 Attn:    Brian K. Davidson
                                          Elizabeth B. Kelly
                                 cc:      Marshall A. Elkins, General Counsel

with a copy to:                  Michael S. Blass, Esq.
                                 Blass & Driggs, Esqs.
                                 461 Fifth Avenue, 19th Floor
                                 New York, NY 10017

     15.7  WAIVER,  DISCHARGE,  ETC.  This  Agreement  shall  not  be  released,
discharged,  abandoned,  changed  or  modified  in  any  manner,  except  by  an
instrument in writing  executed by or on behalf of each of the parties hereto by
their duly  authorized  officer or  representative.  The failure of any party to
enforce at any time any of the provisions of this  Agreement  shall in no way be
construed  to be a waiver of any such  provision,  nor in any way to affect  the
validity  of this  Agreement  or any  part  hereof  or the  right  of any  party
thereafter to enforce each and every such provision.  No waiver of any breach of
this Agreement shall be held to be a waiver of any other or subsequent breach.

     15.8 RIGHTS OF PERSONS NOT PARTIES.  Nothing  contained  in this  Agreement
shall be deemed to create rights in persons not parties  hereto,  other than the
successors and proper assigns of the parties hereto.

     15.9 GOVERNING  LAW. This  Agreement  shall be governed by and construed in
accordance  with  the laws of the  State of  Michigan,  disregarding  any  rules
relating to the choice or conflict of laws.


                                       42

<PAGE>



     15.10  AMENDMENTS,  SUPPLEMENTS,  ETC.  At any time  before  or  after  the
execution and delivery of this Agreement by the parties  hereto,  this Agreement
may  be  amended  or   supplemented  by  additional   agreements,   articles  or
certificates,  as may be mutually  determined  by the  parties to be  necessary,
appropriate or desirable to further the purposes of this  Agreement,  to clarify
the intention of the parties, or to add to or to modify the covenants,  terms or
conditions  hereof or thereof.  The  parties  hereto  shall make such  technical
changes to this Agreement,  not inconsistent with the purposes hereof, as may be
required to effect or facilitate any governmental approval or acceptance of this
Agreement or to effect or  facilitate  any filing or recording  required for the
consummation  of any  portion  of the  transactions  contemplated  hereby.  This
Agreement may not be amended  except by an instrument in writing  signed by each
of the parties.

     15.11  SEVERABILITY.  Any  provision,  or  distinguishable  portion  of any
provision,   of  this   Agreement   which  is  determined  in  any  judicial  or
administrative  proceeding to be prohibited or unenforceable in any jurisdiction
shall, as to such jurisdiction, be ineffective to the extent of such prohibition
or unenforceability  without  invalidating the remaining  provisions hereof, and
any  such  prohibition  or   unenforceability  in  any  jurisdiction  shall  not
invalidate or render unenforceable such provision in any other jurisdiction.  It
is the  intention of the parties that if any  provision of Section 12.7 shall be
determined to be overly broad in any respect,  then it should be  enforceable to
the  maximum  extent  permissible  under the law.  To the  extent  permitted  by
applicable law, the parties waive any provision of law which renders a provision
hereof prohibited or unenforceable in any respect.

     15.12 COUNTERPARTS. This Agreement may be executed in several counterparts,
each of which  shall be  deemed an  original,  and all of which  shall  together
constitute one and the same instrument.

     15.13  ARBITRATION.  Any dispute or controversy  between any of the parties
hereto  pertaining to the performance or  interpretation of this Agreement shall
be  settled  by  binding  arbitration  pursuant  to the  rules  of the  American
Arbitration Association.  The cost of such proceeding shall be shared equally by
all parties thereto,  and each such party shall bear its own costs incurred as a
result of its participation in any such arbitration.

     15.14 PUBLIC ANNOUNCEMENTS.  Following the execution of this Agreement, any
general  public  announcements  or similar media  publicity with respect to this
Agreement or the transactions  contemplated  herein shall be at such time and in
such manner as Buyer shall determine; provided that nothing herein shall prevent
either  party,  upon as much  prior  notice  as  shall  be  possible  under  the
circumstances  to the other,  from making  such  written  announcements  as such
party's counsel may consider advisable in order to satisfy the party's legal and
contractual obligations in such regard.


                       [SIGNATURES ON THE FOLLOWING PAGE]


                                       43

<PAGE>


                  IN  WITNESS  WHEREOF,  each of the  parties  hereto and in the
capacity  indicated  below has  executed  this  Agreement as of the day and year
first above written.

                                            ARCADIA:
WITNESS:                                    ARCADIA SERVICES, INC.


By:/s/                                      By:/s/
   ----------------------------                ---------------------------------
                                                     James Bellinson
                                            Its:     President

WITNESS:                                    PRINCIPAL SELLERS:


By:/s/                                         /s/
   -------------------------                ------------------------------------

                                            Herbert Graebner

WITNESS:


By:/s/                                         /s/
   -------------------------                ------------------------------------
                                            Leonard Bellinson

WITNESS:                                    COMMITTEE
                                            (on behalf of Shareholders):


By:/s/                                         /s/
   -------------------------                ------------------------------------
                                            Herbert Graebner

WITNESS:


By:/s/                                         /s/
   -------------------------                ------------------------------------
                                            Leonard Bellinson

                                            BUYER:
                                            INTEGRATED HEALTH SERVICES, INC.


                                            By:/s/
                                               ---------------------------------

                                            Executive Vice President
                                            Corporate Development

                                            NEWCO:
                                            INTEGRATED AG ACQUISITION, INC.

                                            By:/s/
                                               ---------------------------------
                                            Executive Vice President


                                       44



THE SECURITIES ISSUABLE UPON EXERCISE HEREOF (THE "SECURITIES") WILL BE ACQUIRED
FOR INVESTMENT AND HAVE NOT BEEN REGISTERED  UNDER THE SECURITIES ACT OF 1933 OR
ANY OTHER SECURITIES LAWS, AND MAY NOT BE OFFERED, SOLD, PLEDGED OR HYPOTHECATED
UNTIL SUCH  SHARES HAVE BEEN  REGISTERED  UNDER THE  SECURITIES  ACT OF 1933 AND
OTHER APPLICABLE SECURITIES LAWS, OR IN THE OPINION OF COUNSEL TO THE COMPANY IN
FORM AND SUBSTANCE REASONABLY  SATISFACTORY TO THE COMPANY,  SUCH OFFER, SALE OR
TRANSFER, PLEDGE OR HYPOTHECATION IS IN COMPLIANCE THEREWITH.


                                WARRANT AGREEMENT
                                -----------------

     WARRANT  AGREEMENT  dated as of October 21,  1997,  executed by  INTEGRATED
HEALTH SERVICES,  INC., a Delaware corporation (the "Company"),  for the benefit
of Stephen P. Griggs (the "Holder").

     The  Company  and the  Holder  wish to set forth  the terms and  conditions
whereby  the  Holder  will have the option to  purchase  shares of the $.001 par
value common stock of the Company (the "Stock").  Accordingly,  in consideration
of the mutual  covenants  and  agreements  contained  herein and in that certain
Employment  Agreement (the "Employment  Agreement")  dated as of the date hereof
between RoTech Medical Corporation, a subsidiary of the Company, and the Holder,
and  intending to be legally  bound  hereby,  the Company and the Holder  hereby
agree as follows:

     1. Grant of the Warrant.  Subject to the terms and  conditions set forth in
this  Agreement  and any  adjustment  required  by Section 6 below,  the Company
grants to Holder the warrant  (the  "Warrant")  to  purchase  all or any part of
750,000  shares of the Stock (the  "Warrant  Shares") for the purchase  price of
$33.16 per  Warrant  Share.  The Company  shall  cause the Warrant  Shares to be
registered pursuant to an S-3 registration statement.

     2. Term of the Warrant.  The Warrant granted hereunder shall expire at 5:00
p.m., Eastern Standard Time on the date which is on the tenth anniversary of the
date hereof (the "Expiration Time").

     3.  Restrictions  on  Exercisability.   Unless  accelerated,  in  the  sole
discretion of the Company, or except as specifically  provided otherwise herein,
the Warrant will become  exercisable  in accordance  with the following  vesting
schedule:  the Warrant shall become  exercisable  with respect to twenty percent
(20%) of the  Warrant  Shares on October 22 of each  year,  commencing  in 1998,
until the  Warrant  has become  exercisable  with  respect to all of the Warrant
Shares;  provided,  however,  that if Holder  shall die  during  the term of his
employment with the Company, or if a Change of Control (as hereinafter  defined)
shall occur, the Warrant shall become fully exercisable.  For purposes hereof, a
"Change of  Control"  of the  Company  shall mean the  occurrence  of any of the
following  events:  (a) any party or two or more parties acting in concert shall
have acquired beneficial  ownership,  directly or indirectly,  of, or shall have
acquired by  contract or  otherwise,  or shall have  entered  into a contract or
arrangement that, upon consummation, will result in its or their acquisition of,
control  over,  Stock of the Company  representing  25% or more of the  combined
voting power of all Stock of the  Company,  or (b) during any period of up to 24
consecutive  months,  commencing  after the date hereof,  individuals who at the
beginning of such 24-month  period were directors of the Company  (together with
any new director  whose  election by the  Company's  Board of Directors or whose
nomination for election by the Company's  shareholders was approved by a vote of
at least  fifty-one  percent  (51%) of the  directors  then  still in office who
either were directors at the beginning


<PAGE>


of such period or whose  election or nomination  for election was  previously so
approved) cease to constitute a majority of the directors of the Company then in
office. As used herein,  "beneficial  ownership" shall have the meaning provided
in Rule 13d-3  promulgated  pursuant to the Securities  Exchange Act of 1934, as
amended.

     4.  Exercise  of the  Warrant.  Subject  to the  restrictions  set forth in
Section 3 above,  the Holder may exercise the Warrant with respect to all or any
portion  of the  Warrant  Shares at any time or from  time to time  prior to the
Expiration  Time by  tendering  to the Company  payment in full of the  purchase
price for the Warrant Shares then being  purchased  together with written notice
to the Company of such exercise that sets forth the following, as applicable:

          (a) if not yet  registered  as set  forth in  paragraph  1  above,  an
acknowledgment  that the Warrant  Shares are being  purchased for investment and
not for  distribution  or resale (other than a distribution  or resale which, in
the  opinion of counsel  reasonably  satisfactory  to the  Company,  may be made
without  violating the provisions of the Securities Act of 1933, as amended (the
"Act"), or any other applicable federal or state securities laws); and

          (b) if not yet  registered  as at  forth  in  paragraph  1  above,  an
acknowledgment  that Holder  understands that the Warrant Shares are "restricted
securities"  within the meaning of Rule 144  promulgated  by the  Securities and
Exchange Commission,  that the Warrant Shares have not been registered under the
Act or any other  applicable  federal or state  securities laws and must be held
indefinitely  unless  they are  subsequently  registered  under such Act and all
applicable laws or an exemption from  registration is available  therefrom,  and
that the Company is under no obligation to register the Warrant Shares under the
Act or any other  applicable  securities  laws or to take any action which would
make available to the Holder any exemption from such registration.

               The  Company   shall  issue  a  stock   certificate   bearing  an
appropriate  legend,  if applicable,  representing the Warrant Shares then being
purchased  upon the actual receipt by the Company of any such written notice and
payment; provided,  however, that if the listing,  registration or qualification
of the Warrant Shares then being purchased upon any securities exchange or under
any  federal  or state  law or the  consent  and  approval  of any  governmental
regulatory  body shall be required in  connection  with the  purchase of Warrant
Shares then being  purchased by such Holder,  the Company shall not be obligated
to issue or deliver a certificate  representing  such Warrant  Shares unless and
until such listing, registration,  qualification, consent or approval shall have
been effected or obtained.  Holder shall have no rights as a stockholder  of the
Company with respect to his Warrant Shares then being  purchased  until the date
on which a stock certificate representing such Warrant Shares has been issued to
the Holder.  The Warrant  granted  hereunder  shall  expire with  respect to any
Warrant Shares as to which Holder has not exercised the Warrant on or before the
Expiration Time.

     5. Transfer of the Warrant. The Warrant may be exercised only by the Holder
or by the Holder's heirs, personal representatives and executors in the event of
such Holder's  death,  and neither the Warrant nor any interest or right therein
shall be subject to or liable for any debts,  contracts  or  engagements  of the
Holder  or  be  subject  to   disposition  by  transfer,   alienation,   pledge,
encumbrance,  assignment  or  any  other  means,  whether  such  disposition  be
voluntary or involuntary or by operation of law by judgment,  levy,  attachment,
garnishment or any other legal or equitable proceedings (including bankruptcy).

                                      - 2 -

<PAGE>


     6. Adjustment.

          (a) If the number of shares of issued and outstanding Stock changes at
any time on or before the Expiration  Time as a result of any  recapitalization,
stock  split,  stock  dividend or other  change in the capital  structure of the
Company,  the number of Warrant Shares covered by the Warrant shall be increased
or  decreased  in direct  proportion  to such  change in the number of shares of
issued and  outstanding  Stock and the per share  purchase price of such Warrant
Shares shall be adjusted accordingly so that it is the substantial equivalent of
the purchase price prior to such change.

          (b) If the  Company is merged  into,  or  consolidated  with,  another
company, or another company is merged into the Company, or in the case of a sale
or conveyance  to another  company of the property of the Company as an entirety
on or before the Expiration Time, the Company shall provide in the agreement for
such  merger,  consolidation  or sale that the Warrant is fully vested as of the
date that the merger, consolidation or sale is consummated, and the surviving or
new company  shall grant to the Holder  under  substantially  the same terms and
conditions  as are  contained  in this  Agreement  the option to  acquire  for a
purchase  price adjusted as provided in Section 6(a) above that number and class
of shares in the  surviving  or new  company  into which the shares of the Stock
then  subject to this  Warrant  would have been  converted  or  exchanged if the
Warrant  had  been  exercised  prior  to the  effective  date of the  merger  or
consolidation.

     7.  Taxes.  All  amounts  which,  under  federal,  state or local law,  are
required  to be  withheld  from the amount  reportable  as taxable  income  with
respect to the  exercise of this  Warrant  shall be so withheld by the  Company.
Whenever the Company  proposes or is required to issue or transfer shares of the
Stock hereunder,  the Company shall have the right to require Holder to remit to
the  Company  an  amount  sufficient  to  satisfy  any  federal,  state or local
withholding  tax  requirements  prior  to the  delivery  of any  certificate  or
certificates for such shares of the Stock.

     8. Miscellaneous.

          (a) Notices. All notices to the Company provided for in this Agreement
shall be in writing and shall either be  hand-delivered,  sent by  registered or
certified  mail,  or  delivered by a nationally  recognized  overnight  delivery
service to the following  address (or such other address as may be designated by
notice duly given in the manner provided herein):

                  Marc B. Levin
                  Integrated Health Services, Inc.
                  Owings Mills Corporate Campus
                  10065 Red Run Boulevard
                  Owings Mills, Maryland  21117

Any such notice,  including but not limited to notices and tenders under Section
4 hereof,  shall be deemed delivered (i) when hand delivered,  or (ii) three (3)
business days after the date deposited in the U.S. registered or certified mail,
addressed as provided above.


                                      - 3 -

<PAGE>


          (b) Integration;  Modification. This Agreement between the Company and
Holder constitute the entire understanding and agreement between the Company and
the  Holder  regarding  the  subject  matter  hereof  and  supersede  all  prior
negotiations  and agreements,  whether oral or written,  between the Company and
Holder with respect to the subject matter of this Agreement.  This Agreement may
not be modified  except by a written  agreement  signed by the Holder and a duly
authorized officer of the Company.

          (c) Severability.  In the event of the invalidity or  unenforceability
of any part or provision of this Agreement,  such invalidity or unenforceability
shall not affect the validity or  enforceability  of any other part or provision
of this  Agreement,  and the remainder of this Agreement  shall continue in full
force and effect in accordance with its terms.

          (d) GOVERNING  LAW. THIS  AGREEMENT  SHALL BE GOVERNED BY THE INTERNAL
LAWS OF THE STATE OF MARYLAND.

          (e) Arbitration.  Any controversy arising out of, or relating to, this
Agreement,  or any breach hereof, shall be settled by binding arbitration before
a single  arbitrator in accordance with the Commercial  Arbitration Rules of the
American Arbitration  Association In Baltimore,  Maryland, or in any other place
the parties shall  mutually  agree,  and judgment upon the award rendered by the
arbitrator may be entered in any court having jurisdiction thereof.

          (f) Headings.  The headings and paragraphs  have been included  herein
for convenience only and shall not be considered in interpreting this Agreement.

          (g) Binding  Effect.  This Agreement shall be binding upon the Company
and shall inure to the  benefit of the  Company and Holder and their  respective
heirs, legal representatives, successors and permitted assigns.

     IN WITNESS  WHEREOF,  the  Company,  by its duly  authorized  officer,  has
executed this Agreement as of the date first above written.


Attest:                               INTEGRATED HEALTH SERVICES, INC.


                                       By:
- ------------------                         ------------------
                                      Its: Executive Vice President
                                           ------------------------

                                      - 4 -

<PAGE>



                                                              DATE:
                                                                   -------------



Marc B. Levin
Executive Vice President
Integrated Health Services, Inc.
10065 Red Run Boulevard
Owings Mills, MD 21117

         Re: Notice of Exercise

Dear Mr. Levin:

     With respect to the exercise of an option to purchase  _________  shares of
common stock of Integrated  Health  Services,  Inc. (the "Warrant  Shares") at a
purchase price of $33.16 per share,  the notice of which is hereby given and the
payment of which is hereby enclosed, I hereby make the following acknowledgments
and representations:

          (a) the Warrant Shares are being  purchased for investment and not for
distribution  or resale  (other  than a  distribution  or resale  which,  in the
opinion of counsel reasonably  satisfactory to the Company,  may be made without
violating the  provisions of the Securities Act of 1933, as amended (the "Act"),
or any other applicable securities laws); and

          (b)  the   undersigned   understands   that  the  Warrant  Shares  are
"restricted  securities"  within  the  meaning  of Rule 144  promulgated  by the
Securities  and  Exchange  Commission,  that the  Warrant  Shares  have not been
registered  under the Act or any other  applicable  securities  laws and must be
held  indefinitely  unless they are  subsequently  registered under such Act and
applicable  laws or an exemption  from  registration  is available  and that the
Company is under no obligation  to register the Warrant  Shares under the Act or
any other  applicable  securities  laws or to take any action  which  would make
available to the Holder any exemption from such registration.



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

                                                       Stephen P. Griggs
                                                       (Holder)

                                      - 5 -




                                                                    EXHIBIT 23.1


              CONSENT OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS


The Board of Directors and Stockholders
Integrated Health Services, Inc.:

     We consent to the use of our report  dated March 24,  1997  relating to the
consolidated  financial  statements  of  Integrated  Health  Services,  Inc. and
subsidiaries,  incorporated  by reference  herein,  our report dated October 17,
1996 relating to the consolidated  financial statements of First American Health
Care of Georgia,  Inc. and subsidiaries,  incorporated by reference herein,  and
our  report  dated  April  14,  1997  relating  to  the  consolidated  financial
statements of Community Care of America, Inc. and subsidiaries,  incorporated by
reference  herein,  and to the reference to our firm under the heading "Experts"
in the registration statement.

     Our report dated March 24, 1997 refers to changes in accounting methods, in
1995, to adopt Statement of Financial  Accounting  Standards No. 121 relating to
impairment  of long-lived  assets and, in 1996,  from  deferring and  amortizing
pre-opening  costs of medical specialty units to recording them as expenses when
incurred.  Our report dated October 17, 1996 contains an  explanatory  paragraph
regarding the uncertainty with respect to certain contingent  payments which may
be  payable  under  a  settlement  agreement  with  the  Health  Care  Financing
Administration.  Our  report  dated  April  14,  1997  refers  to the  change in
accounting method in 1996 to adopt Statement of Financial  Accounting  Standards
No. 121 relating to impairment of long-lived assets.

                     KPMG Peat Marwick LLP

Baltimore, Maryland
December 8, 1997


                                                                    EXHIBIT 23.2


              CONSENT OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS


     We  consent  to  the  Incorporation  by  references  in  this  registration
statement on Form S-3 of Integrated  Health  Services,  Inc. (IHS) of our report
dated  September  18, 1997  (October  21, 1997 as to Note 1),  appearing  in the
Annual Report on Form 10-K of RoTech Medical Corporation for the year ended July
31,  1997,  which report  appears in the Form 8-K,  dated  October 21, 1997,  as
amended,  of IHS, and to the  reference  to us under the heading  experts in the
registration statement.



Deloitte & Touche LLP
Orlando, Florida
December 8, 1997


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